A critical care pandemic staffing framework in Australia

Andrea P Marshall¹, Danielle E Austin², Di Chamberlain³, Lee-Anne S Chapple⁴, Michele Cree⁵, Kate Fetterplace⁶, Michelle Foster⁷, Amy Freeman-Sanderson⁸, Rachel Fyfe⁹, Bernadette A Grealy¹⁰, Alison Hodak¹¹, Anthony Holley¹², Peter Kruger¹³, Geraldine Kucharski¹⁴, Wendy Pollock¹⁵, Emma Ridley¹⁶, Penny Stewart¹⁷, Peter Thomas¹⁸, Kym Torresi¹⁹, Linda Williams²⁰

Affiliations

¹ Intensive Care Unit, Gold Coast University Hospital, E 2.015, 1 Hospital Blvd, Southport, 4212, QLD, Australia; Griffith University, Parklands Drive, Southport, 4212, QLD, Australia. Electronic address: a.marshall@griffith.edu.au.
² Intensive Care Unit, Liverpool Hospital, Elizabeth and Goulburn St., Liverpool, 2170, NSW, Australia; University of NSW, High Street, Kensington, 2052, NSW, Australia. Electronic address: danielle.austin@health.nsw.gov.au.
³ Flinders University, Sturt Rd, Bedford Park, SA, Australia. Electronic address: di.chamberlain@flinders.edu.au.
⁴ Intensive Care Research, Royal Adelaide Hospital, Port Road, Adelaide, 5000, SA, Australia; Discipline of Acute Care Medicine, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, 5000, SA, Australia. Electronic address: lee-anne.chapple@adelaide.edu.au.
⁵ Queensland Children's Hospital and Children's Health Queensland, 501 Stanley Street, South Brisbane, 4101, Queensland, Australi; Society of Hospital Pharmacists Australia, Collingwood, 3066, Victoria, Australia. Electronic address: michele.cree@health.qld.gov.au.
⁶ Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Parkville, 3050, Victoria, Australia; The University of Melbourne, Melbourne Medical School, Victoria, Australia. Electronic address: Kate.fetterplace@mh.org.au.
⁷ Emergency and Assessment Services, Gold Coast Health, 1 Hospital Blvd, Southport, 4215, QLD, Australia. Electronic address: Michelle.foster@health.qld.gov.au.
⁸ University of Technology Sydney, Graduate School of Health, 100 Broadway, Sydney, 2007, NSW, Australia; Speech Pathology Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, 2050, NSW, Australia; The George Institute for Global Health, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, 2050, NSW, Australia. Electronic address: amy.freeman-sanderson@uts.edu.au.
⁹ Society of Hospital Pharmacists Australia, Collingwood, 3066, Victoria, Australia; Pharmacy Department, Barwon Health, Bellerine Street, Geelong, 3220, Victoria, Australia. Electronic address: rachel.fyfe@barwonhealth.org.au.
¹⁰ Critical Care & Perioperative Services Program, Central Adelaide Local Health Network, Port Road, Adelaide, 5000, South Australia, Australia. Electronic address: Bernadette.grealy@sa.gov.au.
¹¹ High Dependency Unit, Flinders Medical Centre, SA Health, Flinders Drive, Bedford Park, 5042, SA, Australia. Electronic address: Alison.hodak@sa.gov.au.
¹² Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield St., Herston, QLD, Australia; Australian and New Zealand Intensive Care Society, 1.01 Level 1, 277 Camberwell Road, Camberwell, VIC, 3124, Australia. Electronic address: anthony.holley@health.qld.gov.au.
¹³ Intensive Care Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, 4072, Australia. Electronic address: p.kruger1@uq.edu.au.
¹⁴ Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield St., Herston, QLD, Australia. Electronic address: Geraldine.Kucharski@health.qld.gov.au.
¹⁵ Nursing, Midwifery & Health, Northumbria University, Newcastle-upon-Tyne, UK. Electronic address: wendy.pollock@northumbria.ac.uk.
¹⁶ Australia and New Zealand Intensive Care Research Centre, Monash University, 553 St Kilda Rd, Melbourne, 3004, VIC, Australia. Electronic address: emma.ridley@monash.edu.
¹⁷ Intensive Care Unit, Alice Springs Hospital, 6 Gap Rd, The Gap, NT, 0870, Australia. Electronic address: Penny.stewart@nt.gov.au.
¹⁸ Department of Physiotherapy, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, Australia. Electronic address: peterj.thomas@health.qld.gov.au.
¹⁹ Speech Pathology Australia, 114 William St, Melbourne, 3000, VIC, Australia. Electronic address: agedcare@speechpathologyaustralia.org.au.
²⁰ Agency for Clinical Innovation, NSW Health, 1 Reserve Rd, St Leonards, NSW, 2065, Australia. Electronic address: Linda.williams3@health.nsw.gov.au.

PMID: 33039301
PMCID: PMC7543889
DOI: 10.1016/j.aucc.2020.08.007

A critical care pandemic staffing framework in Australia

Andrea P Marshall et al. Aust Crit Care. 2021 Mar.

. 2021 Mar;34(2):123-131.

doi: 10.1016/j.aucc.2020.08.007. Epub 2020 Oct 8.

Authors

Affiliations

¹ Intensive Care Unit, Gold Coast University Hospital, E 2.015, 1 Hospital Blvd, Southport, 4212, QLD, Australia; Griffith University, Parklands Drive, Southport, 4212, QLD, Australia. Electronic address: a.marshall@griffith.edu.au.
² Intensive Care Unit, Liverpool Hospital, Elizabeth and Goulburn St., Liverpool, 2170, NSW, Australia; University of NSW, High Street, Kensington, 2052, NSW, Australia. Electronic address: danielle.austin@health.nsw.gov.au.
³ Flinders University, Sturt Rd, Bedford Park, SA, Australia. Electronic address: di.chamberlain@flinders.edu.au.
⁴ Intensive Care Research, Royal Adelaide Hospital, Port Road, Adelaide, 5000, SA, Australia; Discipline of Acute Care Medicine, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, 5000, SA, Australia. Electronic address: lee-anne.chapple@adelaide.edu.au.
⁵ Queensland Children's Hospital and Children's Health Queensland, 501 Stanley Street, South Brisbane, 4101, Queensland, Australi; Society of Hospital Pharmacists Australia, Collingwood, 3066, Victoria, Australia. Electronic address: michele.cree@health.qld.gov.au.
⁶ Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Parkville, 3050, Victoria, Australia; The University of Melbourne, Melbourne Medical School, Victoria, Australia. Electronic address: Kate.fetterplace@mh.org.au.
⁷ Emergency and Assessment Services, Gold Coast Health, 1 Hospital Blvd, Southport, 4215, QLD, Australia. Electronic address: Michelle.foster@health.qld.gov.au.
⁸ University of Technology Sydney, Graduate School of Health, 100 Broadway, Sydney, 2007, NSW, Australia; Speech Pathology Department, Royal Prince Alfred Hospital, Missenden Road, Camperdown, 2050, NSW, Australia; The George Institute for Global Health, Level 10, King George V Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown, 2050, NSW, Australia. Electronic address: amy.freeman-sanderson@uts.edu.au.
⁹ Society of Hospital Pharmacists Australia, Collingwood, 3066, Victoria, Australia; Pharmacy Department, Barwon Health, Bellerine Street, Geelong, 3220, Victoria, Australia. Electronic address: rachel.fyfe@barwonhealth.org.au.
¹⁰ Critical Care & Perioperative Services Program, Central Adelaide Local Health Network, Port Road, Adelaide, 5000, South Australia, Australia. Electronic address: Bernadette.grealy@sa.gov.au.
¹¹ High Dependency Unit, Flinders Medical Centre, SA Health, Flinders Drive, Bedford Park, 5042, SA, Australia. Electronic address: Alison.hodak@sa.gov.au.
¹² Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield St., Herston, QLD, Australia; Australian and New Zealand Intensive Care Society, 1.01 Level 1, 277 Camberwell Road, Camberwell, VIC, 3124, Australia. Electronic address: anthony.holley@health.qld.gov.au.
¹³ Intensive Care Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, 4072, Australia. Electronic address: p.kruger1@uq.edu.au.
¹⁴ Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield St., Herston, QLD, Australia. Electronic address: Geraldine.Kucharski@health.qld.gov.au.
¹⁵ Nursing, Midwifery & Health, Northumbria University, Newcastle-upon-Tyne, UK. Electronic address: wendy.pollock@northumbria.ac.uk.
¹⁶ Australia and New Zealand Intensive Care Research Centre, Monash University, 553 St Kilda Rd, Melbourne, 3004, VIC, Australia. Electronic address: emma.ridley@monash.edu.
¹⁷ Intensive Care Unit, Alice Springs Hospital, 6 Gap Rd, The Gap, NT, 0870, Australia. Electronic address: Penny.stewart@nt.gov.au.
¹⁸ Department of Physiotherapy, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, Australia. Electronic address: peterj.thomas@health.qld.gov.au.
¹⁹ Speech Pathology Australia, 114 William St, Melbourne, 3000, VIC, Australia. Electronic address: agedcare@speechpathologyaustralia.org.au.
²⁰ Agency for Clinical Innovation, NSW Health, 1 Reserve Rd, St Leonards, NSW, 2065, Australia. Electronic address: Linda.williams3@health.nsw.gov.au.

PMID: 33039301
PMCID: PMC7543889
DOI: 10.1016/j.aucc.2020.08.007

Abstract

Background: Pandemics and the large-scale outbreak of infectious disease can significantly impact morbidity and mortality worldwide. The impact on intensive care resources can be significant and often require modification of service delivery, a key element which includes rapid expansion of the critical care workforce. Pandemics are also unpredictable, which necessitates rapid decision-making and action which, in the lack of experience and guidance, may be extremely challenging. Recognising the potential strain on intensive care units (ICUs), particularly on staffing, a working group was formed for the purpose of developing recommendations to support decision-making during rapid service expansion.

Methods: The Critical Care Pandemic Staffing Working Party (n = 21), representing nursing, allied health, and medical disciplines, has used a modified consensus approach to provide recommendations to inform multidisciplinary workforce capacity expansion planning in critical care.

Results: A total of 60 recommendations have been proposed which reflect general recommendations as well as those specific to maintaining the critical care workforce, expanding the critical care workforce, rostering and allocation of the critical care workforce, nurse-specific recommendations for staffing the ICU, education support and training during ICU surge situations, workforce support, models of care, and de-escalation.

Conclusion: These recommendations are provided with the intent that they be used to guide interdisciplinary decision-making, and we suggest that careful consideration is given to the local context to determine which recommendations are most appropriate to implement and how they are prioritised. Ongoing evaluation of recommendation implementation and impact will be necessary, particularly in rapidly changing clinical contexts.

Keywords: Allied health; Coronavirus disease; Education; Infection prevention and control; Models of care; Nursing; Pandemic; Surge capacity; Workforce.

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Comment in

Protecting the role of the intensive care research coordinator during pandemics.
Hammond NE, Bates S; ANZICS CTG Intensive Care Research Coordinator Interest Group (IRCIG). Hammond NE, et al. Aust Crit Care. 2021 Mar;34(2):119. doi: 10.1016/j.aucc.2020.11.002. Aust Crit Care. 2021. PMID: 33712179 Free PMC article. No abstract available.
Response to "Protecting the role of the intensive care research coordinator during pandemics".
Marshall AP. Marshall AP. Aust Crit Care. 2021 Mar;34(2):120. doi: 10.1016/j.aucc.2021.02.003. Aust Crit Care. 2021. PMID: 33712180 Free PMC article. No abstract available.
Response to 'A critical care pandemic staffing framework in Australia'.
Ramnarain D, Pouwels S. Ramnarain D, et al. Aust Crit Care. 2021 Mar;34(2):121. doi: 10.1016/j.aucc.2021.02.004. Aust Crit Care. 2021. PMID: 33712181 Free PMC article. No abstract available.
A critical care pandemic staffing framework in Australia - Authors' response.
Marshall AP. Marshall AP. Aust Crit Care. 2021 Mar;34(2):122. doi: 10.1016/j.aucc.2021.02.005. Aust Crit Care. 2021. PMID: 33712182 Free PMC article. No abstract available.

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A critical care pandemic staffing framework in Australia

Affiliations

A critical care pandemic staffing framework in Australia

Authors

Affiliations

Abstract

Comment in

References

MeSH terms

LinkOut - more resources

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Medical