Critical Care and Shock

Compliance of Guidelines for Intensive Care Unit Admissions in San Juan City Hospital in a Three Months Period


Purpose: To measure the degree of compliance of national guidelines for admission to the Intensive Care Unit (ICU) at San Juan City Hospital (SJCH).

Design: This was a prospective observational cohort study at an urban academic hospital. We revised prospectively for three consecutive months all the patients admitted to ICU and then compare the admission criteria used with the national guidelines for ICU admission.

Patients and participants: We included all patients who were admitted to ICU from September 1st to November 30th, 2006, for a total of 125 patients.

Interventions: Data collection from the medical record at the time of admission to ICU.

Measurements and results: A total of 125 patients were admitted to ICU during the three months period of the study. Of these 58% were in compliance with national guidelines. The pulmonary system criteria was the most numerous admission criteria with 41.9% followed by the cardiac system criteria with 25.7% and gastrointestinal system criteria with 13.5%. Regarding the objective parameters model criteria the vital signs and laboratory values was the most frequent with 35.7% followed by electrocardiogram parameters criteria with 21.4% and physical findings criteria with 7.1%.

Conclusions: Our findings revealed that, in general, admissions at SJCH are done accordingly to national guidelines. But a 42% of admissions without criteria is a very high number of admissions which signified a wrong utilization of expensive resources. This finding correlates with the deficiencies in admission criteria knowledge among medical admission officers.