الفهرس 
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Abstract
Summary
The intensive care unit (ICU) is a hospital unit delivering continuous surveillance and highly specialized care to critically ill patients, either medical or surgical. Patients‘ conditions are life-threatening and require comprehensive care Intensive care faces economic challenges. Therefore, evidence proving both effectiveness and efficiency, i.e., cost-effectiveness, of delivered care is needed. ICUs consume a significant proportion of health care resources, accounting for up to 20% of a hospital‘s cost. Indicators to evaluate the quality of care are progressively being used and focus on patient outcome. Finding a solid technique to determine the performance of single ICUs has been a difficult pursuit for the last 30 years The measurement of quality and patient safety continues to gain increasing importance, as these measures are used for both healthcare improvement and accountability particularly that provided in intensive care units
The aim of this study is to develop a comprehensive set of structure, process, and outcome indicators that measures aspects of all domains of the quality of care at intensive care unit.
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The idea of intensive care stems back to the era when better understanding of the human physiology and the process of death occurred. Understanding the function of oxygenation and that life is an oxidation process led to put emphasis on the respiratory support and oxygen inhalation. Lavoisier (1743-1794) In 1948, muscle relaxants were introduced to anesthesia practice and anesthesiologists used to assist the intubated, partially paralyzed patient who had respiratory depression gained a great experience. Generally speaking, critical care has developed in an ad hoc fashion, largely in response to gaps in service provision, and in response to new medical or surgical developments. This is best illustrated by the polio epidemic in Denmark half a century ago. Prior to 1952, patients suffering respiratory muscle paralysis due to polio were kept alive with negative pressure ventilators, colloquially known as ‗iron lungs‘
Bjorn Ibsen established the first intensive care unit in Copenhagen in 1953. The chronic patients who survived this epidemic were ventilated in negative pressure chamber ―Iron Lungs’ till their natural death
The old concept of identifying ICU as just a separate area with high-tech gadgets no longer holds true. One should take cognizance of the recent developments and the
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various recommendations by bodies like the Society of Critical Care Medicine (SCCM), Indian Society of Critical Care Medicine (ISCCM) and the published literature on the subject. An important dimension is the concerns of the patients and their families, who often complain about overwhelming feelings of insecurity, disorientation, anxiety, fear and anger. The sheer volume of technology, the unfamiliar, sterile surroundings, lack of privacy, constantly revolving medical teams, incessant noise and glaring light, and the lack of natural forms, materials, and sensory experiences all add to this traumatic experience
Telemedicine is medicine practiced from a distance using telecommunication. In 1972 a telemedicine project was set up between the Intensive Care Unit (ICU) of a large university hospital and a small inner-city hospital in the United States, consisting of a two-way audiovisual link and mobile camera the introduction of a tele-ICU in both a surgical and a medical ICU. ICU and hospital mortality decreased significantly in the medical ICU but not in the surgical ICU
Quality of care is an important issue in the health care debate. All countries struggle to optimize quality of care while minimizing costs. Assessment of clinical
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performance is obligatory for the evaluation of both the effectiveness and efficiency of care
Unfortunately, due to a variety of reasons, performance levels are not monitored in Egypt and therefore a national data base does not exist for a meaningful comparison. Dependency on an international data base, even if not logical for Egyptian scenario, becomes inevitable in our strategic design and planning of the service.
An indicator is an instrument of measurement that is used systematically and that its result will be used in managing quality, it is essential to ensure that it reflects reality and is useful
Indicators to evaluate the quality of care are progressively being used and focus on patient outcome. Finding a solid technique to determine the performance of single ICUs has been a difficult pursuit for the last 30 years.
Quality indicators:
A- Patient Safety
B-Process Parameter
C-Outcome Parameter
D-Infection control