Clinical effectiveness of a critical care nursing outreach service in facilitating discharge from the intensive care unit

Williams, Teresa A., Leslie, Gavin, Finn, Judith, Brearley, Linda, Asthifa, Mariyam, Hay, Ben, Laurie, Karen, Leen, Tim, O’Brien, Keith, Stuart, Michael and Watt, Michelle (2010) Clinical effectiveness of a critical care nursing outreach service in facilitating discharge from the intensive care unit. American Journal of Critical Care, 19 5: e63-e72. doi:10.4037/ajcc2010965


Author Williams, Teresa A.
Leslie, Gavin
Finn, Judith
Brearley, Linda
Asthifa, Mariyam
Hay, Ben
Laurie, Karen
Leen, Tim
O’Brien, Keith
Stuart, Michael
Watt, Michelle
Title Clinical effectiveness of a critical care nursing outreach service in facilitating discharge from the intensive care unit
Journal name American Journal of Critical Care   Check publisher's open access policy
ISSN 1062-3264
1937-710X
Publication date 2010-09
Sub-type Article (original research)
DOI 10.4037/ajcc2010965
Open Access Status
Volume 19
Issue 5
Start page e63
End page e72
Total pages 10
Place of publication Aliso Viejo, CA, United States
Publisher American Association of Critical Care Nurses
Language eng
Formatted abstract
Background: Improved discharge planning and extension of care to the general care unit for patients transferring from intensive care may prevent readmission to the intensive care unit and prolonged hospital stays. Morbidity, mortality, and costs increase in readmitted intensive care patients.

Objectives: To evaluate the clinical effectiveness of a critical care nursing outreach service in facilitating discharge from the intensive care unit and providing follow-up in general care areas.

Methods: A before-and-after study design (with historical controls and a 6-month prospective intervention) was used to ascertain differences in clinical outcomes, length of stay, and cost/benefit. Patients admitted to intensive care units in 3 adult teaching hospitals were recruited. The service centered on follow-up visits by specialist intensive care nurses who reviewed and assessed patients who were to be or had been discharged to general care areas from the intensive care unit. Those nurses also provided education and clinical support to staff in general care areas.

Results: In total, 1435 patients were discharged during the 6-month prospective period. Length of stay from the time of admission to the intensive care unit to hospital discharge (P = .85), readmissions during the same hospital admission (5.6% vs 5.4%, P = .83), and hospital survival (P = .80) did not differ from before to after the intervention.

Conclusions: Although other studies have shown beneficial outcomes in Australia and the United Kingdom, we found no improvement in length of stay after admission to the intensive care unit, readmission rate, or hospital mortality after a critical care nursing outreach service was implemented.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 18 Jul 2014, 09:03:21 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work