Experience in the Cohort Intermediate Care Unit Arrangement and Nursing management of patients with COVID-19 at Bangkok Hospital Headquarters

Abstract

OBJECTIVES: To share experiences for the Cohort Intermediate Care Unit (IMCU) setup description. It also involves the focusing on integrated nursing care in collaboration with Multi-professional team to improve patient outcomes. MATERIALS AND METHODS: We collected and searched many articles from the published medical literature that reported standard protocols for the IMCU and nursing management of SARS-CoV-2 (COVID-19). This study was a collection of data from COVID-19 patients who were confirmed cases with positive real time-PCR test results. They were receiving treatment and admitted at Bangkok Hospital Headquarters (BHQ) from May 1 st - June 30 th , 2021. Descriptive statistics were used to describe the results in frequency, percentage and mean. We compared the average number of days for COVID-19 patients stay between two groups. A confidence interval (CI) was used to explain a different sample proportion and a different interval of hospital mortality rate. RESULT: Among 122 COVID-19 patients, 41 (33.6%) patients were admitted to the Cohort IMCU. The average length of stay (LoS) was 5.1 days, with minimum 1 day and maximum 15 days. Three quarter of them (31/41, 75.6%) had clinical improvement and were transferred to Cohort ward, while a quarter (10/41, 24.4%) had experienced clinical deterioration and were transferred to intensive care unit (ICU). Mortality rate of this group was 4.9% (95%CI -1.7, 11.5). During the same time period, 81 COVID-19 patients were directly transferred to ICU. The average LoS in ICU of 6.2 days. Among them, 8 of 81 patients did not survive. As a result, mortality rate among this group was 9.9% (95%CI 3.4, 16.4). CONCLUSION: In our experience, the Cohort IMCU can reduce mortality rate of the COVID-19 patients and proper management also decrease crowding of ICU.