Summary of the National Dutch Intensive Care Guideline 2006 14

Appendix 1

Summary of the National Dutch Intensive Care guideline 2006 [14]

Criteria Intensive care level 3Intensive care level 2Intensive care level 1 Head intensivist intensivist intensivist Medical intensivist intensivist responsibility

Procedural Intensivist coördinates Intensivist coördinates Intensivist coördinates responsibility care and makes formal care and makes formal care and makes formal arrangements on local arrangements on local arrangements on local level so that other level so that other level so that other specialists can take their specialists can take their specialists can take their own responisibility. own responisibility. own responisibility.

Continuity of care, 7d/week 7d/week 5d/week daytime Continuity of care, exclusively on call, exclusively on call, on call, within 2h at nighttime within 20 min. at within 20 min. at bedside. IC house bedside. IC house bedside. IC house officer within 5 min. officer within 5 min. officer within 5 min. at bedside at bedside at bedside

Intensivist staffing 0,45 - 0,55 / bed 0,35 - 0,42 / bed 0,1 - 0,15 / bed (Full Time Equivalents = FTE)

IC house officer 0,6 - 0,9 / bed 0,55 / bed 5-6 / hospital staffing (FTE) IC nurse staffing 4,2 / ventilation bed 3,5 / ventilation bed 2,7 / ventilation bed (FTE) Treatment days / >3000 > 2500 year Ventilation days / >1500 > 1250 year Optimal size ICU 12 beds 12 beds 6 beds

1 Optimal size subunit 6-12 beds 6-12 beds 6-12 beds

Quality Quality system, Quality system, Quality system, annual report annual report annual report Indicators Minimal set quality Minimal set quality Minimal set quality indicators for indicators for indicators for internal use internal use internal use

Evaluation medical Complication- and Complication- and Complication- and treatment necrology necrology necrology conference conference conference

Interdisciplinary daily daily daily counseling multidisciplinary multidisciplinary multidisciplinary patient conference patient conference patient conference

Guidelines & + + + protocols Material following scientific following scientific following scientific societies and societies and societies and European guidelines European guidelines European guidelines

regionalisation participation in participation in participation in regional network, regional network regional network, if supraregional expected ventilation coordinating > 3d: consultation of function higher level IC within 24h

Bed utilisation secondary to regionalsecondary to regional needs needs