A PROSPECTIVE 2-MONTH AUDIT OF THE LACK OF PROVISION OF A HIGH-DEPENDENCY UNIT AND ITS IMPACT ON INTENSIVE-CARE

All admissions into a six-bedded intensive care unit were audited pros pectively over a 2-month period. Data were collected daily and classif ied according to criteria for intensive care or high-dependency admiss ion. There were 30 planned admissions (72 bed days) following elective major surgery, seven admissions following semi-elective surgery (41 b ed days) and 47 emergency admissions (185 bed days). Overall bed occup ancy was 89%. Of 366 possible intensive care days, 66 (23%) were occup ied by high-dependency patients. Of the planned admissions all but fiv e were discharged within 2 days. There were 39 major complications dur ing the study period requiring life-saving interventions and 16 lesser but significant complications. In 12% of patients discharge was delay ed because of the absence of a high-dependency unit. Four patients wer e transferred to an intensive care unit in another hospital and four p atients were discharged prematurely because other patients required ur gent admission. Seven patients were refused admission and three patien ts scheduled for elective operations had their surgery deferred. We es timate that over the study period 22 additional patients could have be en cared for if a high-dependency unit existed.