Chapter 4. Manpower. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
OBJECTIVE
To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on manpower.


METHODS
Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including manpower.


RESULTS
Key recommendations include: (1) plan to access, coordinate and increase labor resources for continued and expanded ICU care including increasing critical care specialists and expanded practice for non-critical care personnel; (2) develop an education, awareness, preparation and communication program to ensure a well-protected and prepared workforce with coordinated rapid manpower expansion; (3) maintain a central inventory of all clinical and non-clinical staff with their current roles along with possible emergency re-training possibilities; (4) coordinate all clinical and non-clinical staffing requirements and determine the hospital's daily needs including a sick and no-show list together with ICU requirements; (5) provide clinical care to patients only with clinical staff and not with non-clinical staff; (6) delegate duties not within the scope of workers' practice under crisis conditions with proper supervision and support from experienced clinicians to ensure patient safety; (7) intensivists should supervise nonintensivist physicians to expand the workforce if patient surge exceeds the number of available ICU-trained specialists.


CONCLUSIONS
Judicious planning and adoption of protocols for providing adequate manpower are necessary to optimize outcomes during a pandemic.
Sandrock
Christian
C
Intensive Care Unit, Division of Infectious Diseases, Division of Pulmonary and Critical Care Medicine, UC Davis School of Medicine, Sacramento, CA 95820, USA.
D004189:Disaster Planning / Q000458:organization & administration* / Q000592:standards; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000628:therapy* / Q000821:virology; D007318:Inservice Training / Q000379:methods / Q000592:standards; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards; D054527:Mass Casualty Incidents; D010557:Personnel Administration, Hospital / Q000592:standards; D010564:Personnel, Hospital / Q000193:education / Q000592:standards / Q000600:supply & distribution; D055872:Surge Capacity; D000078329:Workforce