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Hospital bed surge capacity in the event of a mass-casualty incident.

Authors :
Davis DP
Poste JC
Hicks T
Polk D
Rymer TE
Jacoby I
Source :
Prehospital and disaster medicine [Prehosp Disaster Med] 2005 May-Jun; Vol. 20 (3), pp. 169-76.
Publication Year :
2005

Abstract

Introduction: Traditional strategies to determine hospital bed surge capacity have relied on cross-sectional hospital census data, which underestimate the true surge capacity in the event of a mass-casualty incident.<br />Objective: To determine hospital bed surge capacity for the County more accurately using physician and nurse manager assessments for the disposition of all in-patients at multiple facilities.<br />Methods: Overnight- and day-shift nurse managers from each in-patient unit at four different hospitals were approached to make assessments for each patient as to their predicted disposition at 2, 24, and 72 hours post-event in the case of a mass-casualty incident, including transfer to a hypothetical, onsite nursing facility. Physicians at the two academic institutions also were approached for comparison. Age, gender, and admission diagnosis also were recorded for each patient.<br />Results: A total of 1,741 assessments of 788 patients by 82 nurse managers and 25 physicians from the four institutions were included. Nurse managers assessed approximately one-third of all patients as dischargeable at 24 hours and approximately one-half at 72 hours; one-quarter of the patients were assessed as being transferable to a hypothetical, on-site nursing facility at both time points. Physicians were more likely than were nurse managers to send patients to such a facility or discharge them, but less likely to transfer patients out of the intensive care unit (ICU). Inter-facility variability was explained by differences in the distribution of patient diagnoses.<br />Conclusions: A large proportion of in-patients can be discharged within 24 and 72 hours in the event of a mass-casualty incident (MCI). Additional beds can be made available if an on-site nursing facility is made available. Both physicians and nurse managers should be included on the team that makes patient dispositions in the event of a MCI.

Details

Language :
English
ISSN :
1049-023X
Volume :
20
Issue :
3
Database :
MEDLINE
Journal :
Prehospital and disaster medicine
Publication Type :
Academic Journal
Accession number :
16018505
Full Text :
https://doi.org/10.1017/s1049023x00002405