PubMed · 5796229
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J London. 1969. Open-end ordering.. https://pubmed.ncbi.nlm.nih.gov/5796229/
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An exploratory descriptive survey was conducted to determine the size and character of high dependency units (HDUs) in the UK. A telephone survey and subsequent postal questionnaire was sent to the 39 general HDUs in the UK determined by a recent survey from the Royal College of Anaesthetists; replies were received from 28. Most HDUs (82%, n = 23) were geographically distinct from the intensive care unit and varied in size from three to 13 beds, although only 64% (n = 18) reported that all beds were currently open. Nurse: patient ratios were at least 1:3. Fifty per cent of units had one or more designated consultants in charge, although only 11% (n = 3) had specifically designated consultant sessions. Junior medical cover was provided mainly by the on-call speciality term. Twenty units acted as a step-down facility for discharged intensive care unit patients and 21 offered a step-up facility for patients from general wards. Provision of facilities and levels of monitoring varied between these units. Few HDUs exist in the UK and they are variable in size and in the facilities and monitoring procedures which they provide. Future studies are urgently required to determine cost-effectiveness and outcome benefit of this intermediate care facility.
The present research examined the moderating effects of three structural characteristics of wards: ward type (surgical vs medical), size, and hospital size on the relationship between professional management and quality of nursing care (QNC) on the ward. The sample consisted of 119 wards situated in general hospitals in Israel. The results of the three regression analyses show that only hospital size, had a moderating effect. Further analysis of the interaction showed that the effect of professional ward management on QNC was greater in large than in small or medium-sized hospitals. In addition, ward size was found to have a great effect, i.e. larger wards had lower QNC. Finally, in all three analyses professional management achieved significance, that is, better management is associated with higher QNC.
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