Date of Graduation

Fall 12-11-2020

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Nancy Taquino

Second Advisor

Cathy Coleman


A Systems Approach to Increase the ICU Nursing Workforce During a Pandemic


In early March 2020 an intensive care unit (ICU) patient died of COVID-19 in an integrated healthcare system hospital in Northern California. Data from China and the CDC indicated that more healthcare members would require intensive care and could overwhelm the 21 acute care hospital macrosystem. A microsystem pilot program to upskill peri-anesthesia care unit (PACU) RNs to care for ICU patients was initiated. Concurrently the upskill pilot program was reviewed by macrosystem nursing leadership. Over a three-week period, the program was standardized, disseminated and implemented across 21 microsystems.

Three interventions were introduced. Existing communities of practice with education expertise reviewed and approved the learning needs assessment and stratification of PACU RNs with ICU skills into three levels. Level one and two nurses were upskilled to take individual ICU patient care assignments, level three nurses provided functional or team nursing roles. A sense of urgency was built through information sharing, across the organization via multiple communication channels and perioperative communities of practice with ICU support. An accessible online platform database of responsible leaders was created and a daily report out, to leadership, of the number of nurses upskilled implemented. The platform also included a repository for the learning needs assessment, lesson plan, educational materials and ICU resources. This program resulted in an 32% increase in the ICU nursing workforce, with ICU patients cared for in PACUs as well as ICUs across the integrated healthcare system.

Keywords COVID-19 critical care education, upskill, PACU, ICU, team nursing, community of practice.