Working practices and patient outcome in the intensive care unit of the University of Benin Teaching Hospital
The working practices and outcome of patients admitted into the intensive care unit (ICU) of the University of Benin Teaching Hospital (UBTH), a tertiary institution, was examined. The conditions under which these were carried out were reviewed over a 15-year period (January 1985 to December 1999). We found that the admission rate was 53.3% with post-surgical patients in the majority (50.4%). One hundred and thirteen patients needed respiratory support and were ventilated (14.1%). The incidence of tracheostomy was 6.4, while the mean length of stay in the ICU was 7.1 days. Outcome of patients admitted into the unit included a mortality rate of 35.1%, 50% direct transfers to the lying-in wards, 2.8% referrals to other tertiary institutions for more specialised care, and 12.1% discharged home! Patients who were not ill enough to require admission into the ICU were found in the study. In addition, unnecessary long stay of patients in the ICU made their management not to be cost-effective. We conclude that there is a need to streamline and enforce admission criteria in the intensive care unit in order to reduce the rate of unnecessary admissions into the unit. Discharge criteria should also be strictly adhered to, thereby making the ICU services more cost-effective. There is a need for a high dependency unit as a step down from the ICU to take care of post-surgical cases that are not critically ill.
Keywords: Working practices, patient outcome, intensive care unit
Journal of Medicine and Biomedical Research Vol. 3 (1) 2004: pp. 67-72