Investigating the effectiveness of critical care outreach services: a systematic review

Esmonde, Lisa; McDonnell, Ann; Ball, Caroline; Waskett, Catherine; Morgan, Richard; Rashidian, Arash; Bray, Kate; Adam, Sheila; Harvey, Sheila

doi:10.1007/s00134-006-0380-6

Cited by 86 publications

(65 citation statements)

References 37 publications

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“…This conclusion was supported by the results of an earlier systematic review performed by Esmonde and colleagues. 29 The benefit of the critical care outreach service in facilitating the discharge process was difficult to gauge. We believe that the discharge process was facilitated by the critical care nursing outreach service, as demonstrated by the large number of referrals before patients were discharged from the ICU.…”

Section: Discussionmentioning

confidence: 99%

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

Williams¹,

Leslie²,

Finn³

et al. 2010

American Journal of Critical Care

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Section: Discussionmentioning

confidence: 99%

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

Williams¹,

Leslie²,

Finn³

et al. 2010

American Journal of Critical Care

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“…The experience of participants in this study (for instance, see the section on coping in the broader environments) revealed the importance of careful discharge planning, post-ICU follow-up, and continuity of care in the community in enhancing patients' recovery and in addressing the special needs of their MFCs when they are required to care for their loved ones after discharge (Burr, 2002;Chaboyer et al, 2002;McCallum et al, 1996;Pearson et al, 2004). Although evaluation and searches for substantive evidence of such follow-up care like the critical care outreach service (CCOS) have been conducted by various researchers and their effectiveness is being debated (Ball et al, 2003;Cuthbertson, 2003Cuthbertson, , 2007Esmonde et al, 2006;Gao et al, 2007;Garcea et al, 2004;Priestley et al, 2004;Prinjha et al, 2009), nurses should not underestimate the value of CCOS as indicated by the experiences of patients and their MFCs in this study. According to Deacon (2008) and Whiting and Edbrooke (2006), it is recommended that continuing work or further evaluation be established in hospitals to employ or deploy specialist intensive care nurses to conduct wider ICU follow-up care, e.g.…”

Section: Diagrammentioning

confidence: 99%

Surviving a critical illness through mutually being there with each other: A grounded theory study

Chiang

2011

Intensive and Critical Care Nursing

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Objectives:The objectives of this study were to conduct a theoretical analysis of the critically ill patients' perceptions of the impact of informal support and care from their main family carer (MFC) during the time of their stay in the hospital (ICU) and thereafter (and vice versa). Research design and setting: The grounded theory method was used to investigate the target phenomenon in the ICU of a large general hospital, and three months later in the community after the patients were discharged. Qualitative data were collected through participant observation and interviews for constant comparative analysis until theoretical saturation. Results: A substantive theory emerged and it illustrated and described the dynamic actions and interactions between critically ill patients and their MFC during the process of recovery. Three categories, 1) being there with, 2) coping and 3) self-relying, comprise the essential components of this theory. Conclusion:The theory represents the core process of 'surviving a critical illness through mutually being there with each other' in which both the patients and their MFC are involved. Implications and recommendations were proposed to provide a basis for further research and nursing practice on the phenomenon of informal support and care of critically ill patients and their recovery.

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“…51 However, published studies generally reported a calling rate of 4-5 calls per 1000 admissions, 22,23,37 with only 1 trial reporting a higher calling rate. 34 A recent commentary 20 and a systematic review of critical care outreach teams 21 both addressed the effectiveness of RRSs. We sought to examine the effects of all RRS subtypes and using quantitative analysis and analysis of methodological quality, to determine the overall effect of RRSs.…”

Section: Systematic Review Of Rapid Response Systems / Ranji Et Al 429mentioning

confidence: 99%

“…1,16,17 The considerable enthusiasm generated by these studies 18,19 resulted in the Institute for Healthcare Improvement (IHI) incorporating RRSs into its "100,000 Lives" campaign, 2 and RRSs are now being implemented in the more than 3000 U.S. hospitals that joined the campaign. However, a recent commentary on rapid response teams 20 and a systematic review of critical care outreach teams 21 have raised concerns that this widespread implementation may not be justified by the available evidence. We performed a systematic review of studies of all variations of RRSs in order to determine their effect on patient outcomes and to characterize variations in their organization and implementation.…”

mentioning

confidence: 99%

Effects of rapid response systems on clinical outcomes: Systematic review and meta‐analysis

Ranji

Auerbach

Hurd

et al. 2007

Journal of Hospital Medicine

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BACKGROUNDA rapid response system (RRS) consists of providers who immediately assess and treat unstable hospitalized patients. Examples include medical emergency teams and rapid response teams. Early reports of major improvements in patient outcomes led to widespread utilization of RRSs, despite the negative results of a subsequent cluster‐randomized trial.PURPOSETo evaluate the effects of RRSs on clinical outcomes through a systematic literature review.DATA SOURCESMEDLINE, BIOSIS, and CINAHL searches through August 2006, review of conference proceedings and article bibliographies.STUDY SELECTIONRandomized and nonrandomized controlled trials, interrupted time series, and before‐after studies reporting effects of an RRS on inpatient mortality, cardiopulmonary arrests, or unscheduled ICU admissions.DATA EXTRACTIONTwo authors independently determined study eligibility, abstracted data, and classified study quality.DATA SYNTHESISThirteen studies met inclusion criteria: 1 cluster‐randomized controlled trial (RCT), 1 interrupted time series, and 11 before‐after studies. The RCT showed no effects on any clinical outcome. Before‐after studies showed reductions in inpatient mortality (RR = 0.82, 95% CI: 0.74‐0.91) and cardiac arrest (RR = 0.73, 95% CI: 0.65‐0.83). However, these studies were of poor methodological quality, and control hospitals in the RCT reported reductions in mortality and cardiac arrest rates comparable to those in the before‐after studies.CONCLUSIONSPublished studies of RRSs have not found consistent improvement in clinical outcomes and have been of poor methodological quality. The positive results of before‐after trials likely reflects secular trends and biased outcome ascertainment, as the improved outcomes they reported were of similar magnitude to those of the control group in the RCT. The effectiveness of the RRS concept remains unproven. Journal of Hospital Medicine 2007;2:422–432. © 2007 Society of Hospital Medicine.

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Investigating the effectiveness of critical care outreach services: a systematic review

Cited by 86 publications

References 37 publications

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

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

Surviving a critical illness through mutually being there with each other: A grounded theory study

Effects of rapid response systems on clinical outcomes: Systematic review and meta‐analysis

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