Skip to main content
SpringerLink
Log in

Optimization of Limited Resources and Patient Safety

  • Chapter
Book cover Intensive and Critical Care Medicine

  • 1823 Accesses

Abstract

A rational resource allocation is today an imperative for intensive care medicine; resource allocation, in the intensive care unit (ICU) context, is more related to human resources availability and organization, mainly the number of trained nurses, than technology and supplies. For optimizing resources we must focus on redesigning and improving work processes. Adverse events and medical errors have arisen as a formidable problem since November, 1999, when the US Institute of Medicine released a report on medical error, “To Err is Human;” this publication was followed by several studies [1–4]. Technology complexity has improved patient prognosis but also has increased exponentially the possibility of errors and adverse events.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kohn LT, Corrigan JM, Donaldson MS (eds) (1999) To err is human. Building a safer health system. National Academy Press, Washington, DC

    Google Scholar 

  2. Wu A (2000) Medical error: the second victim. BMJ 320:726–727

    Article  CAS  PubMed  Google Scholar 

  3. Leape LL, Berwick DM (2000) Safe health care: are we up to it? BMJ 320:725–726

    Article  CAS  PubMed  Google Scholar 

  4. Smith R, Hiatt H, Berwick D (1999) Shared ethical principles for everybody in health care: a working draft from the Tavistock Group. BMJ 318:248–251

    CAS  PubMed  Google Scholar 

  5. ATS Bioethics Task Force (1997) Fair allocation of intensive care unit resources. Am J Respir Crit Care Med 156:1282–1301

    Google Scholar 

  6. Martin W, Dünser MD, Inipavudu B et al (2006) A review and analysis of intensive care medicine in the least developed countries. Crit Care Med 34:1234–1242

    Article  Google Scholar 

  7. Hanson CW, Deustshman CS, Anderson HL et al (1999) Effects of organized critical care services on outcomes and resources utilization: a cohort study. Crit Care Med 27:270–274

    Article  PubMed  Google Scholar 

  8. Overview of the Nursing Workforce in Latin America. Fijar numero:http://www.paho.org/English/DD/PIN/ptoday18_sep05.htmAcceded 13/04/2009

    Google Scholar 

  9. What is Behind Hrsa’s Projected Supply, Demand, and Shortage of Registered Nurses? ftp://ftp.hrsa.gov/bhpr/workforce/behindshortage.pdf Acceded 8/04/2009

    Google Scholar 

  10. Williams G, Schmollgruber S, Alberto L (2006) Consensus Forum: worldwide guidelines on the critical care nursing workforce and education standards. Crit Care Clin 22:393–406

    Article  PubMed  Google Scholar 

  11. Williams GF (1997) Labour force planning and policy development: issues for nursing. Aust Crit Care 10:43–46

    Article  CAS  PubMed  Google Scholar 

  12. Stechmiller JK (2002) The nursing shortage in acute and critical care settings. AACN Clinical Issues. Adv Pract Acute Crit Care 13:577–584

    Article  Google Scholar 

  13. Scribante J, Schmollgruber S, Nel E (2004) Perspectives on critical care nursing: South Africa. Connect. World Crit Care Nurs 3:111–115

    Google Scholar 

  14. Albarran J, Scholes J (2005) Blurred, blended or disappearing: the image of critical care nursing. Nurs Crit Care 10:1–3

    Article  PubMed  Google Scholar 

  15. Williams G, Chaboyer W, Thornsteindottir R et al (2001) World wide overview of critical care nursing organizations and their activities. Int Nurs Rev 48:208–217

    Article  CAS  PubMed  Google Scholar 

  16. Cullen DJ, Civetta JM, Briggs BA et al (1974) Therapeutic Intervention Scoring System: a method of quantitative comparision of patient care. Crit Care Med 2:57–60

    CAS  PubMed  Google Scholar 

  17. Miranda DR et al (1996) Simplified Therapeutic Intervention Scoring System: The TISS-28 items. Results from a multicenter study. Crit Care Med 24:64–73

    Article  CAS  PubMed  Google Scholar 

  18. Moreno R, Morais P (1997) Validation of the simplified therapeutic intervention scoring system on an independent database. Intensive Care Med 23:640–644

    Article  CAS  PubMed  Google Scholar 

  19. Miranda DR, Nap R, de Rijk A et al (2003) Nursing activities score. Crit Care Med 2003 31:374–382

    Article  PubMed  Google Scholar 

  20. Hanson CW, Deustshman CS, Anderson HL et al (1999) Effects of organized critical care services on outcomes and resources utilization: a cohort study. Crit Care Med 27:270–274

    Article  PubMed  Google Scholar 

  21. Weber RJ, Kane SL, Oriolo VA (2003) Impact of intensive care unit (ICU) drug use on hospital costs: a descriptive analysis, with recomeendations for optimizing ICU pharmacotherapy. Crit Care Med 31 (Suppl):S17–S24

    Article  PubMed  Google Scholar 

  22. Shah ND, Vermeulen LC, Santell JP et al (1993) Projecting future drug expenditure. Am J Hosp Pharm S6–S8

    Google Scholar 

  23. Pierpaoli PG (1993) The rising costs of pharmaceuticals: a director of pharmacy’s perspective. Am J Hosp Pharm 50:S6–S8

    CAS  PubMed  Google Scholar 

  24. Rothschild JM, Landrigan CP, Cronin JWD et al (2005) The Critical Care Safety Study: the incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med 33:1694–1700

    Article  PubMed  Google Scholar 

  25. Valentin A, Capuzzo M, Guidet B et al (2006) Patient safety in intensive care: results from the multinational Sentinel Events Evaluation (SEE) study. Intensive Care Med 32:1591–1598

    Article  PubMed  Google Scholar 

  26. Vincent JL, Moreno R, Takala J et al, on behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine (1996) the SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 22:707–710

    Article  CAS  PubMed  Google Scholar 

  27. Miranda DR, Moreno R, Iapichino G (1997) Nine equivalents of nursing manpower use score (NEMS). Intensive Care Med 23:760–765

    Article  Google Scholar 

  28. Kaushal R, Bates D, Franz C (2007) Costs of adverse events in intensive care units. Crit Care Med 35:2479–2483

    Article  PubMed  Google Scholar 

  29. Gallesio AO (2008) Improving quality and safety in the ICU: a challenge for the next years. Curr Opin Crit Care 14:700–707

    Article  PubMed  Google Scholar 

  30. Smith R, Hiatt H, Berwick D (1999) Shared ethical principles for everybody in health care: A working draft from the Tavistock Group. BMJ 318:248–251

    CAS  PubMed  Google Scholar 

  31. Singer PA (2000) Recent advances: Medical ethics. BMJ 321:282–285

    Article  CAS  PubMed  Google Scholar 

  32. Leape LL, Berwick DM (2000) Safe health care: are we up to it? BMJ 320:725–726

    Article  CAS  PubMed  Google Scholar 

  33. Smith R, Hiatt H, Berwick D (1999) PatShared ethical principles for everybody inhealth care: A working draft from the Tavistock Group. BMJ 318:248–251

    CAS  PubMed  Google Scholar 

  34. Reinertsen JL (2000) Let’s talk about error. BMJ 320:730

    Article  CAS  PubMed  Google Scholar 

  35. Society of Critical Care Medicine (1993) A model for technology assessment applied to pulse oximetry. Crit Care Med 21:615

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Intensive Care, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    A. O. Gallesio

Authors
  1. A. O. Gallesio
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department and School of Anesthesia and Intensive Care, Catania School of Medicine and University-Hospital, Catania, Italy

    Antonino Gullo

  2. Department of Anesthesiology, Keck Medical School, Los Angeles, CA, USA

    Philip D. Lumb

  3. Department of Critical Care Medicine, Hospital Centro Medico de Caracas, Caracas, Venezuela

    José Besso

  4. World Federation of Critical Care Nurses C/-Nursing Administration, Gold Coast Health, Southport, Queensland, Australia

    Ged F. Williams

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Italia

About this chapter

Cite this chapter

Gallesio, A.O. (2009). Optimization of Limited Resources and Patient Safety. In: Gullo, A., Lumb, P.D., Besso, J., Williams, G.F. (eds) Intensive and Critical Care Medicine. Springer, Milano. https://doi.org/10.1007/978-88-470-1436-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1436-7_7

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1435-0

  • Online ISBN: 978-88-470-1436-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation