The effect of an intensive care unit liaison nursing service on intensive care unit readmission and mortality; a before/after study.

Ligtenberg, B.A.B. (Bram) (2014) The effect of an intensive care unit liaison nursing service on intensive care unit readmission and mortality; a before/after study. thesis, Medicine.

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Abstract

Introduction: Readmission to the intensive care unit (ICU) is associated with increased mortality, morbidity and length of hospital stay. Predicting and preventing readmission could be an instrument to lower the mortality and morbidity of ICU patients. The use of a critical care outreach team (CCOT) or ICU liaison nursing service may have a positive effect on the occurrence of readmission and mortality after ICU discharge. This pilot-study evaluates the effect of an ICU liaison nursing service on number of readmissions, mortality and overall outcome of the patients. Methods: The design of the study is a before-after study. Primary outcome is the occurrence of a severe adverse event: mortality or readmission. Patient data from the period before the intervention is compared with patient data from the period after the start of the intervention, both for a period of six months. Results: Patients readmitted and consulted by the ICU liaison nurse (n=59) had a significant lower mortality rate and are significantly more often early readmitted (<72hr) than readmitted patients without involvement of an ICU liaison nurse. There were no differences in overall mortality, readmission or severe adverse event rate between the two cohorts. 198 patients were consulted by the ICU liaison nurse. Those consulted by the ICU liaison nurse had significant higher TISS scores and they had more often a respiratory diagnose on initial admission and were more often readmitted with a respiratory diagnosis. The ICU liaison nurse activity consisted mostly of advising the ward nurses on respiratory problems (or consulting the intensivist about readmission). Conclusion: This study shows that readmitted patients with involvement of an ICU liaison nurse had a lower mortality rate and were more often readmitted within 72 hours after ICU discharge. Future research should focus on early recognition of deteriorating patients discharged from the ICU. This could be realized by following up all patients discharged from the ICU by the ICU liaison nurse within 24 hours and instructing and training the general ward nurses how to recognize early deterioration.

Item Type:	Thesis (Thesis)
Supervisor name:	Zijlstra, Prof. dr. Jan G.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:06
Last Modified:	25 Jun 2020 11:06
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2578

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