Follow-up services and the development of a clinical nurse specialist in intensive care

Use of a personal diary written on the ICU during critical illness

“…Providing patients and relatives with a booklet outlining possible problems during recovery has proved unsuccessful [2]. Dedicated staff focussing on liaison between the ICU, hospital departments and the community have been employed, but the usefulness of this awaits confirmation [9]. A clinic appointment during the recovery period after critical illness has been described as a useful platform for follow-up [9].…”

An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective

“…These patients ongoing care is provided in the ward environment and ultimately impacts on ward nurses, an area that is under-researched. Difficulties faced by ward nursing staff can be related to stress/emotions; patient-nurse relationships; knowledge and skills; communication; interventions; families; and general problems (Griffiths & Jones, 2002;Haines, 2001;Hall-Smith et al, 1997;Whittaker & Ball, 2000). Stress and emotional difficulties often relate to concerns about the state of the patient upon transfer, nurses are unsure about what to expect in terms of level of the acuity or stability of the patient.…”

“…This frequently occurs within the context of the study setting ICU, particularly as it is often the only way to hear of a patient's progress. Follow-up services are mentioned throughout the literature in relation to intensive care, provided in various contexts such as follow-up outpatient clinics, ICU Clinical Nurse Specialists, ICU Liaison Nurse or Critical Care Outreach Teams, all of which are designed to support acutely ill patients beyond the boundaries of ICU (Chaboyer et al, 2005;Department of Health, 2000;Haines, 2001;Hall-Smith et al, 1997;Russell, 1999). Follow-up services, moreover, have been shown to complement the work of intensive care and improve the speed and quality of recovery (Department of Health, 2000).…”

“…Hall-Smith, Ball and Coakley (1997) ICU clinical practice group developed a similar form: an ICU summary sheet relevant to staff in wards and an assessment sheet outlining the ability of each patient and the care required in order to promote continuity of patient care by providing brief and relevant information.…”

“…This is particularly in relation to a lack of understanding of what ward staff can manage regarding knowledge/skill level and experience, where assumptions can be made and ICU does not always appreciate the ward situation. Poor communication between departments, along with a busy ward, a lack of knowledge/skills, and a lack of resources (experienced staff) can potentially lead to inadequate care on the wards (Russell, 1999 (Chaboyer et al, 2005;Hall-Smith et al, 1997;Russell, 1999).…”