Van Hove, O.; Gillet, A.; Tack, J.; Reychler, G.; Guatteri, M.; Ballarin, A.; Thomas, J.; Espinoza, R.; Bonnier, F.; Norrenberg, M.; Daniel, P.; Toussaint, M.; Leduc, D.; Bonnechère, B.; Taton, O. Development of a Medium Care Unit using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health2022, 19, 7349.
Van Hove, O.; Gillet, A.; Tack, J.; Reychler, G.; Guatteri, M.; Ballarin, A.; Thomas, J.; Espinoza, R.; Bonnier, F.; Norrenberg, M.; Daniel, P.; Toussaint, M.; Leduc, D.; Bonnechère, B.; Taton, O. Development of a Medium Care Unit using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 7349.
Van Hove, O.; Gillet, A.; Tack, J.; Reychler, G.; Guatteri, M.; Ballarin, A.; Thomas, J.; Espinoza, R.; Bonnier, F.; Norrenberg, M.; Daniel, P.; Toussaint, M.; Leduc, D.; Bonnechère, B.; Taton, O. Development of a Medium Care Unit using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health2022, 19, 7349.
Van Hove, O.; Gillet, A.; Tack, J.; Reychler, G.; Guatteri, M.; Ballarin, A.; Thomas, J.; Espinoza, R.; Bonnier, F.; Norrenberg, M.; Daniel, P.; Toussaint, M.; Leduc, D.; Bonnechère, B.; Taton, O. Development of a Medium Care Unit using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 7349.
Abstract
The different waves of the COVID-19 pandemic caused dramatic issues regarding the organiza-tion of care. In this context innovative solutions have to be developed in a timely manner to adapted the organization of the care. The establishment of middle care (MC) units is a bright example of such an adaptation. A multidisciplinary MC team, including expert and non-expert respiratory nurses, physicians, physiotherapists, psychologists, nutritionists and social workers, was built and trained to work in the COVID-19 MC unit. Important educational resources were set up to ensure rapid and effective training of the MC team, limiting the admission or delaying transfers to ICU and ensuring optimal management of palliative care. We conducted a retrospec-tive analysis of patient data in the MC unit during the second COVID-19 wave. Fifty-two COVID-19 ‘step-up’ patients admitted to the MC unit were included in the study. Thirty-four (65%) patients worsened, of which 12 (23%) were not eligible for ICU access. In total, 42% of the ICU-eligible patients were managed in the MC unit to avoid the ICU. Among the 22 patients transferred to the ICU, 15 were intubated. The establishment of an MC unit during a pandemic, mixing expert and non-expert respiratory team members, is feasible and needed. MC units possi-bly relieve the pressure exerted on ICUs. A highly trained multidisciplinary team is key to ensur-ing the success of an MC unit during a pandemic.
Keywords
Intermediate care unit; Middle care; Education; CPAP; Noninvasive ventilation; rehabilitation
Subject
Public Health and Healthcare, Nursing
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.