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, T.; O'Brien, Keith; Stuart, Michael; Watt, Michelle

doi:10.4037/ajcc2010965

Cited by 27 publications

(35 citation statements)

References 21 publications

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“…50,56 Most critical care outreach models use patient mortality, critical care readmission rates from the general care area, length of stay, and patient/caregiver satisfaction as measurements of effectiveness. 1,[48][49][50][51][52][53]56,57 Collectively, studies have demonstrated that patients experienced improved outcomes after implementation of a critical care outreach program; following implementation, patients experienced decreased risk of readmission to the critical care unit 49 and/or shorter stays after readmission. 49,50,52,54,56 In contrast, several studies 51,53,56,58 did not show statistically significant alterations in readmission rates, hospital length of stay, patient anxiety, or hospital survival after implementation of outreach services.…”

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

“…[49][50][51][52][53] Most nurse-led models incorporate educational initiatives for nurses in medical-surgical care areas, 48,[51][52][53] and some focus on the psychosocial adjustment of patients and caregivers following transition from the critical care unit. Some models involve primarily critical care nurses called "lead or liaison" nurses, 49,52,54,55 whereas some models of delivery involve interdisciplinary models that incorporate intensivist physicians and critical care nurses. 50,56 Most critical care outreach models use patient mortality, critical care readmission rates from the general care area, length of stay, and patient/caregiver satisfaction as measurements of effectiveness.…”

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

“…1,48,49 The scope of care support provided by critical care outreach models and activities that use outreach teams is diverse. Some models provide direct bedside clinical care after discharge from the critical care unit, [49][50][51][52][53] and some models are responsible for identifying early warning triggers so as to attempt to divert a critical care readmission. [49][50][51][52][53] Most nurse-led models incorporate educational initiatives for nurses in medical-surgical care areas, 48,[51][52][53] and some focus on the psychosocial adjustment of patients and caregivers following transition from the critical care unit.…”

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

“…Some models provide direct bedside clinical care after discharge from the critical care unit, [49][50][51][52][53] and some models are responsible for identifying early warning triggers so as to attempt to divert a critical care readmission. [49][50][51][52][53] Most nurse-led models incorporate educational initiatives for nurses in medical-surgical care areas, 48,[51][52][53] and some focus on the psychosocial adjustment of patients and caregivers following transition from the critical care unit. Some models involve primarily critical care nurses called "lead or liaison" nurses, 49,52,54,55 whereas some models of delivery involve interdisciplinary models that incorporate intensivist physicians and critical care nurses.…”

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

“…4,8,16 Furthermore, the relatively recent implementation of critical care outreach programs has not allowed evaluation of the long-term effectiveness of implementing these services. Three of the studies reviewed 49,52,55 evaluated the effectiveness of critical care outreach on patients' outcomes for a year or more. Most of the studies 50,51,56 evaluated the effectiveness of interventions by Several opportunities were identified to improve patient safety and quality of care because of identified gaps in the process that affect patient care transition.…”

Section: Medication Reconciliation Practicesmentioning

confidence: 99%

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Role of Transitional Care Measures in the Prevention of Readmission After Critical Illness

Peters

2017

Critical Care Nurse

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Transitioning from the critical care unit to the medical-surgical care area is vital to patients’ recovery and resolution of critical illness. Such transitions are necessary to optimize use of available hospital resources to meet patient care needs. One in 10 patients discharged from the intensive care unit are readmitted to the unit during their hospitalization. Critical care readmission is associated with significant increases in illness acuity, overall length of stay, and health care costs as well as a potential 4-fold increased risk of mortality. Patients with complex illness, multiple comorbid conditions, and a prolonged initial stay in the critical care unit are at an increased risk of being readmitted to the critical care unit and experiencing poor outcomes. Implementing nurse-driven measures that support continuity of care and consistent communication practices such as critical care outreach services, transitional communication tools, discharge planning, and transitional care units improves transitions of patients from the critical care environment and reduces readmission rates.

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Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

Section: Care Delivery Practices Supporting Care Continuitymentioning

confidence: 99%

Section: Medication Reconciliation Practicesmentioning

confidence: 99%

See 3 more Smart Citations

Role of Transitional Care Measures in the Prevention of Readmission After Critical Illness

Peters

2017

Critical Care Nurse

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Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge

Sluisveld¹,

Hesselink²,

Hoeven

et al. 2015

Intensive Care Med

102

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PurposeTo systematically review and evaluate the effectiveness of interventions in order to improve the safety and efficiency of patient handover between intensive care unit (ICU) and general ward healthcare professionals at ICU discharge.MethodsPubMed, CINAHL, PsycINFO, EMBASE, Web of Science, and the Cochrane Library were searched for intervention studies with the aim to improve clinical handover between ICU and general ward healthcare professionals that had been published up to and including June 2013. The methods for article inclusion and data analysis were pre-specified and aligned with recommendations outlined in the PRISMA guideline. Two reviewers independently extracted data (study purpose, setting, population, method of sampling, sample size, intervention characteristics, outcome, and implementation activities) and assessed the quality of the included studies.ResultsFrom the 6,591 citations initially extracted from the six databases, we included 11 studies in this review. Of these, six (55 %) reported statistically significant effects. Effective interventions included liaison nurses to improve communication and coordination of care and forms to facilitate timely, complete and accurate handover information. Effective interventions resulted in improved continuity of care (e.g., reduced discharge delay) and in reduced adverse events. Inconsistent effects were observed for use of care, namely, reduction of length of stay versus increase of readmissions to higher care. No statistically significant effects were found in the reduction of mortality. The overall methodological quality of the 11 studies reviewed was relatively low, with an average score of 4.5 out of 11 points.ConclusionsThis review shows that liaison nurses and handover forms are promising interventions to improve the quality of patient handover between the ICU and general ward. More robust evidence is needed on the effectiveness of interventions aiming to improve ICU handover and supportive implementation strategies.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-015-3666-8) contains supplementary material, which is available to authorized users.

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Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

et al. 2021

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Clinical Effectiveness of a Critical Care Nursing Outreach Service in Facilitating Discharge From the Intensive Care Unit

Cited by 27 publications

References 21 publications

Role of Transitional Care Measures in the Prevention of Readmission After Critical Illness

Role of Transitional Care Measures in the Prevention of Readmission After Critical Illness

Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

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