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Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study
BACKGROUND: The worldwide SARS-CoV-2 pandemic represents the most recent global healthcare crisis. While all healthcare systems suffered facing the immense burden of critically-ill COVID-19 patients, the levels of preparedness and adaptability differed highly between countries. Aim: to describe reso...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998281/ https://www.ncbi.nlm.nih.gov/pubmed/36947950 http://dx.doi.org/10.1016/j.jiph.2023.02.022 |
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author | Boussarsar, Mohamed Meddeb, Khaoula Toumi, Radhouane Ennouri, Emna Ayed, Samia Jarraya, Fatma Ben Khelil, Jalila Jaoued, Oussama Nouira, Hajer El Atrous, Souheil Essafi, Fatma Talik, Imen Merhabane, Takoua Trifi, Ahlem Seghir, Eya Abdellatif, Sami Doghri, Hamdi Bahri, Badra Borsali, Nebiha Fathallah, Ines Ksouri, Meriam Kouraichi, Nadia Ben Jazia, Amira Ben Ghezala, Hassan Brahmi, Nozha |
author_facet | Boussarsar, Mohamed Meddeb, Khaoula Toumi, Radhouane Ennouri, Emna Ayed, Samia Jarraya, Fatma Ben Khelil, Jalila Jaoued, Oussama Nouira, Hajer El Atrous, Souheil Essafi, Fatma Talik, Imen Merhabane, Takoua Trifi, Ahlem Seghir, Eya Abdellatif, Sami Doghri, Hamdi Bahri, Badra Borsali, Nebiha Fathallah, Ines Ksouri, Meriam Kouraichi, Nadia Ben Jazia, Amira Ben Ghezala, Hassan Brahmi, Nozha |
author_sort | Boussarsar, Mohamed |
collection | PubMed |
description | BACKGROUND: The worldwide SARS-CoV-2 pandemic represents the most recent global healthcare crisis. While all healthcare systems suffered facing the immense burden of critically-ill COVID-19 patients, the levels of preparedness and adaptability differed highly between countries. Aim: to describe resource mobilization throughout the COVID-19 waves in Tunisian University Medical Intensive Care Units (MICUs) and to identify discrepancies in preparedness between the provided and required resource. METHODS: This is a longitudinal retrospective multicentre observational study conducted between March 2020 and May 2022 analyzing data from eight University MICUs. Data were collected at baseline and at each bed expansion period in relation to the nation’s four COVID-19 waves. Data collected included epidemiological, organizational and management trends and outcomes of COVID-19 and non-COVID-19 admissions. RESULTS: MICU-beds increased from 66 to a maximum of 117 beds. This was possible thanks to equipping pre-existing non-functional MICU beds (n = 20) and creating surge ICU-beds in medical wards (n = 24). MICU nurses increased from 53 to 200 of which 99 non-ICU nurses, by deployment from other departments and temporary recruitment. The nurse-to-MICU-bed ratio increased from 1:1 to around 1·8:1. Only 55% of beds were single rooms, 80% were equipped with ICU ventilators. These MICUs managed to admit a total of 3368 critically-ill patients (15% of hospital admissions). 33·2% of COVID-19-related intra-hospital deaths occurred within the MICUs. CONCLUSION: Despite a substantial increase in resource mobilization during the COVID-19 pandemic, the current study identified significant persisting discrepancies between supplied and required resource, at least partially explaining the poor overall prognosis of critically-ill COVID-19 patients. |
format | Online Article Text |
id | pubmed-9998281 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99982812023-03-10 Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study Boussarsar, Mohamed Meddeb, Khaoula Toumi, Radhouane Ennouri, Emna Ayed, Samia Jarraya, Fatma Ben Khelil, Jalila Jaoued, Oussama Nouira, Hajer El Atrous, Souheil Essafi, Fatma Talik, Imen Merhabane, Takoua Trifi, Ahlem Seghir, Eya Abdellatif, Sami Doghri, Hamdi Bahri, Badra Borsali, Nebiha Fathallah, Ines Ksouri, Meriam Kouraichi, Nadia Ben Jazia, Amira Ben Ghezala, Hassan Brahmi, Nozha J Infect Public Health Original Article BACKGROUND: The worldwide SARS-CoV-2 pandemic represents the most recent global healthcare crisis. While all healthcare systems suffered facing the immense burden of critically-ill COVID-19 patients, the levels of preparedness and adaptability differed highly between countries. Aim: to describe resource mobilization throughout the COVID-19 waves in Tunisian University Medical Intensive Care Units (MICUs) and to identify discrepancies in preparedness between the provided and required resource. METHODS: This is a longitudinal retrospective multicentre observational study conducted between March 2020 and May 2022 analyzing data from eight University MICUs. Data were collected at baseline and at each bed expansion period in relation to the nation’s four COVID-19 waves. Data collected included epidemiological, organizational and management trends and outcomes of COVID-19 and non-COVID-19 admissions. RESULTS: MICU-beds increased from 66 to a maximum of 117 beds. This was possible thanks to equipping pre-existing non-functional MICU beds (n = 20) and creating surge ICU-beds in medical wards (n = 24). MICU nurses increased from 53 to 200 of which 99 non-ICU nurses, by deployment from other departments and temporary recruitment. The nurse-to-MICU-bed ratio increased from 1:1 to around 1·8:1. Only 55% of beds were single rooms, 80% were equipped with ICU ventilators. These MICUs managed to admit a total of 3368 critically-ill patients (15% of hospital admissions). 33·2% of COVID-19-related intra-hospital deaths occurred within the MICUs. CONCLUSION: Despite a substantial increase in resource mobilization during the COVID-19 pandemic, the current study identified significant persisting discrepancies between supplied and required resource, at least partially explaining the poor overall prognosis of critically-ill COVID-19 patients. The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. 2023-05 2023-03-10 /pmc/articles/PMC9998281/ /pubmed/36947950 http://dx.doi.org/10.1016/j.jiph.2023.02.022 Text en © 2023 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Boussarsar, Mohamed Meddeb, Khaoula Toumi, Radhouane Ennouri, Emna Ayed, Samia Jarraya, Fatma Ben Khelil, Jalila Jaoued, Oussama Nouira, Hajer El Atrous, Souheil Essafi, Fatma Talik, Imen Merhabane, Takoua Trifi, Ahlem Seghir, Eya Abdellatif, Sami Doghri, Hamdi Bahri, Badra Borsali, Nebiha Fathallah, Ines Ksouri, Meriam Kouraichi, Nadia Ben Jazia, Amira Ben Ghezala, Hassan Brahmi, Nozha Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title | Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title_full | Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title_fullStr | Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title_full_unstemmed | Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title_short | Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study |
title_sort | resource utilization and preparedness within the covid-19 pandemic in tunisian medical intensive care units: a nationwide retrospective multicentre observational study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998281/ https://www.ncbi.nlm.nih.gov/pubmed/36947950 http://dx.doi.org/10.1016/j.jiph.2023.02.022 |
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