Outreach critical care

The impact of an ICU liaison nurse: a case study of ward nurses’ perceptions

AIMS AND OBJECTIVES

To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role.

BACKGROUND

Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit.

DESIGN

Case study of one Australian hospital that utilizes an intensive care unit liaison nurse.

METHODS

Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data.

FINDINGS

Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education.

CONCLUSIONS

This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses.

RELEVANCE TO CLINICAL PRACTICE

Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum.

Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study

OBJECTIVES

To determine the effect of the critical care outreach team on patient survival to discharge from hospital after discharge from critical care and readmission to critical care.

DESIGN

Non-randomised population based study.

SETTING

Tertiary referral teaching hospital with 1200 beds.

PARTICIPANTS

Patients discharged from the critical care unit after their first or only admission for two study periods, 26 February 2000 to 25 February 2001 and 26 February 2001 to 25 February 2002.

MAIN OUTCOME MEASURES

Survival to discharge from hospital after discharge from critical care and readmission to critical care.

RESULTS

The introduction of a critical care outreach team improved survival to discharge from hospital after discharge from critical care by 6.8% (risk ratio 1.08). Readmission to critical care decreased by 6.4% (0.48).

CONCLUSIONS

The activity of the critical care outreach team seems to improve patient survival to discharge from hospital and may reduce the number of readmissions to critical care.