Pediatric intensive care units: results of a national survey

Crit Care Med. 1993 Apr;21(4):607-14. doi: 10.1097/00003246-199304000-00023.

Abstract

Objective: To describe the structure and organization of pediatric intensive care units (ICUs) in the United States.

Survey methods: We directed a mail survey to pediatric ICU medical and nursing directors and hospital quality assurance officers. A total of 201 of 301 hospitals with pediatric ICUs initially responded. Telephone confirmation of the mail survey (n = 193) and telephone data collection for mail survey nonresponders (n = 42) were also undertaken.

Survey results: The largest proportion (40.0%) of pediatric ICUs had four to six beds per unit, while only 6.0% had > 18 beds per unit. The admissions per year averaged 528 +/- 24, and the mortality rates averaged 5.5 +/- 0.2%. Only 79.6% of the pediatric ICUs had full-time medical directors. A pediatric intensivist was available to 73.2% of the units. Physician coverage for 24 hrs/day dedicated only to the pediatric ICU was present in 48.5% of hospitals. As ICU size increased, the estimated mortality rates increased, as did the percentages with full-time directors, pediatric intensivists, and 24 hrs/day dedicated coverage. Medical school affiliation existed for 79.6% of pediatric ICU hospitals, and 81.1% of these hospitals were the primary teaching program sites for pediatrics. Other ICUs caring for children were present in 30.2% of the hospitals.

Survey application: The mail survey respondents were stratified using four factors: size, teaching status, intensivist status, and coordination of care status. A total of 16 respondents were randomly selected for an ongoing outcomes study of the importance of these factors.

Conclusions: Substantial diversity exists in pediatric ICU structure and organization. Determining factors associated with quality of care is important for improving outcomes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Hospital Bed Capacity / statistics & numerical data
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, Teaching / statistics & numerical data
  • Intensive Care Units, Pediatric / organization & administration*
  • Intensive Care Units, Pediatric / statistics & numerical data
  • Intensive Care Units, Pediatric / supply & distribution
  • Models, Organizational
  • Nurse Administrators
  • Patient Admission / statistics & numerical data
  • Patient Care Team / statistics & numerical data
  • Physician Executives
  • Quality Assurance, Health Care
  • Surveys and Questionnaires
  • United States