Intermediate respirtory care unit patient flow analysis during the covid-19 pandemic

ABSTRACT

The IRCU of our hospital has increased its activity in the COVID-19 pandemic. The respiratory isolation condition has been an organizational challenge and has had a huge impact in the patient flow. Our IRCU has 3 subunits nonCOVID (8 beds), COVID (up to 24 beds in open stay) and non-tested (8 beds). We have analysed the hospital activity register from November 2020 to April 2021, analysing the patient flow. For COVID IRCU admission criteria, a positive PCR with FiO2 > 0.50 with SatO2 <95%, RR > 25 and PaO2/FiO2 <250. We had 685 admissions 52% in the COVID IRCU (average stay 6.82 days), 27.6% in the non-tested IRCU (AS 3.94 d) and 26.4% in the non-COVID IRCU (AS 6.32 d). A total of 43% admissions of the COVID-IRCU came from the Infectious Diseases Unit (IDU), 43.5% from the ED/other hospitals, and 1.12% from the ICU. Of the overall of COVID-IRCU, 29% required admission to the ICU and the mortality rate (MR) was 15.16%. A total of 40.7% admissions of non-COVID IRCU, ED 45.7%, and 13.6% the ICU. Of 6.4% patients required admission to the ICU (MR 6.4%). A total of 61.4% admissions of the non-tested IRCU, ED and 22.2% required admission to the ICU, with a 13.2% MR. The pandemic has highlighted the importance of the IRCU, reducing admissions and ICU stay. Our IRCU, maintains optimal respiratory isolation conditions in the non-tested IRCU, maintaining the normal activity in the non-COVID IRCU.