Critical Care Clinician Reports on Coronavirus Disease 2019: Results From a National Survey of 4,875 ICU Providers.
Critical Care Clinician Reports on Coronavirus Disease 2019: Results From a National Survey of 4,875 ICU Providers.
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DOI：
10.1097/cce.0000000000000125
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发表时间：
2020-05-01
影响因子：
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通讯作者：
Ferraro, David M
中科院分区：
文献类型：
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作者：
Kaplan, Lewis J;Kleinpell, Ruth;Ferraro, David M
重要性：全球2019冠状病毒病感染病例持续增加，大量患者病情危重，给ICU资源带来巨大负担。了解ICU的基线资源需求和激增能力对于满足当前和预计的医疗保健需求至关重要。继续评估个人、区域和国家各级卫生保健系统的准备状况，对于确保我们准备好继续抗击2019年冠状病毒病至关重要。目的：本研究询问了美国ICU临床医生对ICU准备工作的看法以及对2019冠状病毒病患者护理的关注。设计背景和参与者：一项匿名网络调查于2020年3月18日至2020年3月25日进行（电子邮件和通讯），采用调查方法询问美国国家重症监护组织的成员。主要结果和措施：通过一份12项描述性问卷，对ICU临床医生进行了准备、用于增强重症监护能力的技术以及与照顾2019冠状病毒病患者相关的担忧等方面的评估。结果：共有4875名ICU临床医生参与了调查。受访者包括ICU护士（n = 3,470, 71.3%）、内科医生（n = 664, 13.6%）、高级执业医师（执业护士和医师助理；n = 334, 6.9%）、呼吸治疗师（n = 236, 4.9%）和药剂师（n = 79, 1.6%）。超过一半（n = 2552, 52.5%）的人报告曾照顾过一名疑似或确诊的2019年冠状病毒病患者。大多数人（n = 4,010, 82.9%）认为他们所在的医院正在采用技术来增强重症监护能力。然而，64.5% （n = 3125）的人认为他们的ICU设施和团队没有充分准备治疗2019年冠状病毒病患者。大多数人（n = 4,547, 93.9%）根据他们目前的使用情况预计ICU个人防护装备短缺。主要报告的问题包括ICU资源短缺，如用品、药物、床位、ICU人员短缺以及患者激增导致过度拥挤。结论及意义：这项全国ICU临床医生调查显示，医院正在扩大ICU床位容量，以应对2019年冠状病毒病患者激增。重要的是，在准备过程中，ICU临床医生对准备、人员配备和常用资源的关注值得特殊教育以及资源分配和利用计划。
IMPORTANCE: Global cases of coronavirus disease 2019 infection continue to increase, and significant numbers of patients are critically ill, placing an immense burden on ICU resources. Understanding baseline resource needs and surge capacity in the ICU will be essential to meet current and projected healthcare needs. Continued appraisal of the state of readiness for healthcare systems at individual, regional and national levels will be paramount to ensure we are poised to continue the fight against coronavirus disease 2019.OBJECTIVES: This study queried U.S. ICU clinician perspectives on ICU preparedness and concerns regarding delivering coronavirus disease 2019 patient care.DESIGN SETTING AND PARTICIPANTS: An anonymous web-based survey administered from March 18, 2020, to March 25, 2020 (email and newsletter) used survey methodology to query members of U.S. national critical care organizations.MAIN OUTCOMES AND MEASURES: Through a 12-item descriptive questionnaire, ICU clinicians were assessed regarding preparedness, techniques employed to augment critical care capacity, and concerns related to caring for coronavirus disease 2019 patients.RESULTS: A total of 4,875 ICU clinicians responded to the survey. Respondents included ICU nurses (n = 3,470, 71.3%), physicians (n = 664, 13.6%), advanced practice providers (nurse practitioners and physician assistants; n = 334, 6.9%), respiratory therapists (n = 236, 4.9%), and pharmacists (n = 79, 1.6%). Over half (n = 2,552, 52.5%) reported having cared for a presumed or confirmed coronavirus disease 2019 patient. The majority (n = 4,010, 82.9%) identified that their hospital was employing techniques to augment critical care capacity. However, 64.5% (n = 3,125) believed that their ICU facility and team were inadequately prepared to treat coronavirus disease 2019 patients. The majority (n = 4,547, 93.9%) anticipated ICU personal protective equipment shortages based upon their current use profile. The chief reported concerns include ICU resource shortages such as supplies, medications, beds, ICU staffing shortages, and patient surge leading to overcrowding.CONCLUSIONS AND RELEVANCE: This national ICU clinician survey indicates that hospitals are expanding ICU bed capacity to prepare for coronavirus disease 2019 patient surge. Importantly, amid this preparation, ICU clinicians harbor concerns regarding preparedness, staffing, and common use resources that merit specific education as well as resource allocation and utilization planning.