The Factors Affecting the Length of Stay in the Intensive Care Unit

Introduction: length of stay in the intensive care unit (icu) is one of the most important factors that impacts the health care resource utilization. this study aimed to identify the factors associated with prolonging the patients’ stay in nemazi hospitals icus and do interventions to reduce the length of hospital stay to improve the quality of care and decrease hospital costs. methods: during two months, eight sessions were held with the senior physicians, head nurses, and supervisors of eight adult icus working in nemazi hospital, a 850-bed university hospital in shiraz, south of iran. factors contributing to the prolongation of the patients’ stay in the intensive care units were examined. based on a researcher-made questionnaire, 28 important factors were identified and ranked according to the degree of importance. results: the most important factors in terms of the degree of importance were unavailable bed vacancies in the step-down wards, financial problems of the families to pay for the homebased primary nursing care, icu-acquired infections, and admission of patients too sick to benefit from the icu due to unjustified administrative pressure. the most amendable factors were hospital-acquired infections, delay in surgical tracheostomy when indicated, unavailable beds in step-down wards, and poor interdisciplinary collaboration of the staff physicians. conclusion: interventional projects have been designed to reduce icu-acquired infections, facilitating the process of surgical tracheostomy and supporting families who are not able to pay the costs of home-based care.