Hospitals in the North of the Netherlands have made good joint preparations for a possible flu pandemic.
On a national level, however, there is still insufficient content-related advice and coordination.
This has been revealed by PhD research conducted by Raoul Nap of the University Medical Center Groningen (UMCG).
‘The Ministry of Public Health, Welfare and Sport (VWS) needs to draw up clearer guidelines to be able to deal with a pandemic properly.’
Nap will be awarded a PhD for his research on 19 October 2009 by the University of Groningen.
In the event of a pandemic breaking out, great demands will be made on intensive care bed capacity in hospitals.
At the same time, a pandemic will put the availability of care personnel under pressure.
Raoul Nap investigated whether hospitals in the Northern Netherlands have sufficient capacity available.
He based his research on models and figures from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).
The research revealed that even at the peak of a pandemic, most patients who need ICU care as a result of influenza will be able to be helped.
There will even be capacity over for acute non-influenza patients.
However, this is dependent on strict rules being applied to which patients with which symptoms should be treated when (‘triage’) and strict rules governing decisions on ICU intake and for continuation (or non-continuation) of respiratory support.
‘Policy in this area cannot be determined by individual hospitals; hospitals must attune their capacity to each other.
In the North of the Netherlands, the hospitals have made good joint preparations.’
There are sufficient hospital personnel to cope with a possible pandemic and at the same time continue to provide care in acute non-influenza related instances.
However, hospitals must prepare in good time to ensure that task allocation among the care providers is absolutely clear, and that the management, communication and discipline of all staff is in order.
The research also revealed that Dutch care providers have sufficient knowledge to act correctly in the event of a pandemic.
Dutch care personnel scores highly in international comparisons.
Nevertheless, only 17% of hospital staff consider their knowledge to be adequate.
‘That is a remarkable contradiction.
Although they have had an excellent training, many hospital staff feel insecure.’
In order to counteract that insecurity, in the event of a pandemic hospitals should offer their staff a short training course, according to the researcher.
The UMCG has training programmes ready to improve how large numbers of staff feel about their competence in a short period of time.
In Nap’s opinion, the discussion about a possible flu pandemic is an opportunity to also discuss keeping the costs of an ICU manageable in the long term.
This is because in times of crisis it is clearer than in times of plenty which cuts will not affect, or only slightly affect, the quality of the care.
Nap’s analysis of the EURICUS databases, a pan-European investigation of ICUs in twelve European countries, has revealed that ICUs across Europe do not pay enough attention to cost efficiency.
‘The care that ICUs provide is expensive.
That fact is a given.
There is a lot of personnel and they work with very expensive medication and medical equipment.
However, the spurs at the moment are to provide the best possible care.
The spurs to take care of the pennies are few and far between on ICUs.
And on an ICU a few pennies soon add up to pounds.’
Raoul Nap (Amsterdam, 1968) combined the degree programmes psychology, statistics and medicine at the University of Groningen.
He works at the UMCG in the Medical Affairs, Quality & Safety Department and conducted his research at the departments of Infectious Diseases and Medical Microbiology, and Infection Prevention at the same hospital.
Nap’s supervisors at the Faculty of Medical Sciences were Prof. T.S. van der Werf and Dr N.E.L. Meessen.
His thesis is entitled
‘Preparedness for Pandemic Influenza: Hospital and Intensive Care Resources’.
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050-361 2200, e-mail:
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