Knowledge and Utilization of ICU Admission Criteria and Guidelines, Lusaka, Zambia

Abstract

The University Teaching Hospital is the only national tertiary hospital in Zambia. During the period the University Teaching Hospital Main Intensive Care Unit was developed, the yearly admissions had risen from 450 to over 900 between 1984 and 1988. The increase was contained by keeping an average bed- occupancy rate of six patients per day. The ICU team concentrated on prompt diagnosis, treatment and insisted on discharge once patient's condition stabilized and was out of danger. In 2001, the admission criteria and guidelines for ICU were developed. However, since the formulation of the criteria and guidelines in 2001 there has been no formal evaluation.
Purpose: To determine nurses' knowledge and utilization of intensive care unit admission criteria and guidelines.
Design and Measures: A descriptive study was conducted on a randomly selected sample of fifty nurses working in the emergency department, obstetric wards, medical wards, surgical wards and theatres at the University Teaching Hospital. A self administered questionnaire was used to collect data.
Results: Atotal of 50 respondents aged 24 to 59 took part in the study. Eighty six percent were female, 48% were single and 36% had worked as nurses for 8 to 14 years. Two-thirds (60%) of the respondents were registered nurses and only 4% were specialized in critical care nursing. Majority of the respondents had high level of knowledge of ICU admission criteria (94%), and admission guidelines (92%). Almost all respondents (98%) had high level of utilization of ICU admission criteria and all respondents had high level of utilization of ICU admission guidelines.
Conclusion and Implications: The results of the study have shown that although nurses have a high level of both knowledge and utilization of ICU admission criteria and guidelines, almost all of them have not trained in critical care nursing. High knowledge influences utilization of the criteria and guidelines positively. The implication of this study is that, nurses should appreciate the importance of utilizing ICU admission criteria and guidelines so that only the type of patients enshrined in the criteria are admitted to ICU. In this way, admissions for social reasons will be avoided and the scarce resources will be reserved for those patients who really need critical care.