title: Chapter 4. Manpower. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
abstract: 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.
authors.affiliation: Intensive Care Unit, Division of Infectious Diseases, Division of Pulmonary and Critical Care Medicine, UC Davis School of Medicine, Sacramento, CA 95820, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Sandrock
mesh_terms: 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