A critical care pandemic staffing framework in Australia

Abstract

Background: Pandemics and the large-scale outbreak of infectious disease can significantly impact morbidity and mortality worldwide. The impact on intensive care resources can be significant and often require modification of service delivery, a key element which includes rapid expansion of the critical care workforce. Pandemics are also unpredictable, which necessitates rapid decision-making and action which, in the lack of experience and guidance, may be extremely challenging. Recognising the potential strain on intensive care units (ICUs), particularly on staffing, a working group was formed for the purpose of developing recommendations to support decision-making during rapid service expansion. Methods: The Critical Care Pandemic Staffing Working Party (n ¼ 21), representing nursing, allied health, and medical disciplines, has used a modified consensus approach to provide recommendations to inform multidisciplinary workforce capacity expansion planning in critical care. Results: A total of 60 recommendations have been proposed which reflect general recommendations as well as those specific to maintaining the critical care workforce, expanding the critical care workforce, rostering and allocation of the critical care workforce, nurse-specific recommendations for staffing the ICU, education support and training during ICU surge situations, workforce support, models of care, and de-escalation. Conclusion: These recommendations are provided with the intent that they be used to guide interdisciplinary decision-making, and we suggest that careful consideration is given to the local context to determine which recommendations are most appropriate to implement and how they are prioritised. Ongoing evaluation of recommendation implementation and impact will be necessary, particularly in rapidly changing clinical contexts.

Australian critical care nurses' knowledge, preparedness, and experiences of managing SARS-COV-2 and COVID-19 pandemic

“…Since the start of this pandemic, critical care nurses have been heavily involved in managing and treating COVID-19 cases in all the states and jurisdictions ( 21 , 22 ). Our findings show that more than two thirds of critical nurses in this study were directly involved in caring for patients with suspected or confirmed COVID-19 in the country.…”

2020 the year we wish never was

“…The included articles focus on areas of patient management including nutrition, 1 coagulation, 2 , 3 and communication. 4 Others have focused on the impact on the health workforce including staffing, 5 , 6 personal protection, 7 , 8 psychological wellbeing, 9 , 10 communication, 4 and family visiting 11 Some give a brief insight into the reality of providing critical care during a pandemic, which has seen health systems in some areas of the world incomprehensibly stretched and critical care clinicians tested like never before.…”

Response to “Protecting the role of the intensive care research coordinator during pandemics”

“…When developing the pandemic staffing framework, we were careful to consider roles that support the delivery of clinical care and took this a step further to encourage organisations to consider the value of role expansion in these areas. 5 Recommendation 18 states that ‘Expansion of nonclinical roles, such as those in education, research, and leadership, may be required to support staff development, service delivery, and data acquisition which are fundamental to the delivery of safe and high-quality clinical care’.…”