Reducing readmissions to the intensive care unit.
OBJECTIVE
To determine factors that contributed to readmissions to the intensive care unit (ICU) from the general wards.


METHODS
Prospective, descriptive, qualitative, and quantitative.


METHODS
The Royal Melbourne Hospital, which is a large, metropolitan, university-affiliated tertiary hospital with specialist and general wards. The ICU is a 14-bed medical and surgical adult unit.


METHODS
572 patients admitted to ICU between July 1 and December 31, 1993.


RESULTS
There were 639 admissions, with 67 (10.5%) being readmissions. This study showed that 63% of all readmissions came from the general wards. The study identified three main factors that contributed to readmissions from the ward: progression of the patient's illness, postoperative care requirements, and inadequate follow-up care on the general wards. Identifying inadequate continuity of care on the general wards as a cause of readmissions to the ICU led to the appointment of an ICU follow-up nurse to facilitate the transition from the ICU to the general ward.


CONCLUSIONS
Preliminary results indicate that the appointment of the follow-up nurse has not only reduced the rate of readmissions to the ICU but also decreased the acuity levels of those readmitted.
Russell
S
S
School of Nursing at La Trobe University, Bundoora, Victoria, Australia.
D003266:Continuity of Patient Care; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data*; D008297:Male; D009741:Nursing Staff, Hospital; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014739:Victoria; D000078329:Workforce