An audit of state sector intensive care services in Sri Lanka

Abstract

Objective: To survey the facilities, functioning characteristics, bed strength, manpower, operational practices and the distribution of the Intensive Care Units (ICU) of Government Hospitals in Sri Lanka.

Design: A cross-sectional observational study.

Method: Interview of the sister or the nurse in charge of each unit by telephone using a structured questionnaire.

Setting: Department of Anaesthesiology, Faculty of Medicine, University of Peradeniya.

Study population: All intensive care units of the government hospitals in Sri Lanka.

Measurements: Bed strength, facilities, functioning characteristics, manpower and equipment.

Results: Fifty two intensive care units were identified in the island. Two units could not be contacted over the telephone and one refused to participate. Of the 49 ICUs studied 28 (57.1%) were located in teaching hospitals, six (12.2%) in provincial hospitals, 13 (26.5%) in base hospitals and two (4.1%) in special hospitals. Twenty five (51%) of the 49 ICUs were multidisciplinary, three (6.1%) general medical, four (8.2%) general surgical and the remainder were of medical, surgical and paediatric subspecialities. The minimum acceptable standard of a ventilator: bed ratio of 1:1 was seen in 28 (57%) and a nurse : bed ratio of 1:1 was seen in 37 (75.5%) ICUs. A 24-hour resident medical officer was available in 46 (93.9%) of the 49 ICUs. ICUs are mostly located in larger cities. The lowest ICU coverage (one ICU for about 1.2 million people) was seen in the Uva Province.

Conclusions: ICUs in Sri Lanka are mainly located in teaching hospitals. The standards and management strategies vary widely.