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Reduction in post-ICU, in-hospital mortality following the introduction of an ICU nursing outreach service

Mortality on hospital wards after discharge from intensive care has been reported to range from 6.1% to 16.3% [1]. At the John Radcliffe hospital a nursing outreach service was introduced to assist with the post-ICU management of patients discharged to the wards. Patients received regular outreach nurse review until no longer causing concern. ICU medical staff were alerted at an early point to patients at risk of deterioration.

Following introduction of the service, April-September 2001 post-ICU in-hospital mortality was 7.8% compared with 12.8% for April-September 1999 and April-September 2000 combined, P = 0.068. ICU activity and case mix were unchanged. Patients expected to die on discharge from ICU remain included in the data.

It has been suggested that mortality after discharge from intensive care may be reduced if patients at risk were to stay in intensive care a further 48 hours [2]. Whilst outreach does not replace extended ICU stay, it may have a contribution to mortality reduction following discharge from ICU.

Table 1 Patients discharged from ICU to hospital wards

References

  1. 1.

    Rowan K, et al.: Outcome comparisons of intensive care units after adjustment for case mix by the American APACHE II method. BMJ 1993, 307: 977-981.

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  2. 2.

    Daly K, Beale R, Chang RWS: Reduction in mortality after inappropriate early discharge from intensive care unit: logistic regression triage model. BMJ 2001, 322: 1-6. 10.1136/bmj.322.7277.1

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Young, C., Millo, J. & Salmon, J. Reduction in post-ICU, in-hospital mortality following the introduction of an ICU nursing outreach service. Crit Care 6, P247 (2002). https://doi.org/10.1186/cc1715

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Keywords

  • Public Health
  • Emergency Medicine
  • Medical Staff
  • Mortality Reduction
  • Hospital Ward