title: A qualitative exploration of nurse's perception of Critical Outreach Service: a before and after study.
abstract: BACKGROUND
  Critical Care Outreach Services (CCOS) have been reported to streamline the transfer of patients from the intensive care unit (ICU) to the wards and provide a follow-up service supporting ward staff to provide optimum care for patients discharged from ICU.
  
  
  OBJECTIVE
  The aim of this study was to explore the perceptions of nursing staff before and after the introduction of a CCOS at three adult teaching hospitals in Perth, Western Australia.
  
  
  METHODS
  Exploratory focus groups were conducted with registered nurses (RNs) at each of the participating hospitals prior to and 6 months after the introduction of a CCOS. Framework analysis was used to analyse the transcribed data using a thematic approach with themes developed from the narratives of the participants.
  
  
  RESULTS
  Inexperienced RNs in particular voiced positive comments about the CCOS. The role was seen as a senior nurse who was an additional resource for less experienced staff as they educated them on complex procedures that were not common on the general wards. The RNs reported that apprehensions about the role that they had pre-implementation were not borne out in practice and that they believed that the CCOS had positive effects on patient outcomes.
  
  
  CONCLUSIONS
  The CCOS improved communication processes between members of the multidisciplinary team and units within the hospital, which subsequently enhanced the ward transition process for critically ill patients and ward nursing staff.
authors.affiliation: Centre for Nursing Research Innovation and Quality, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. mariyam.athifa@health.wa.gov.au
authors.forename: Mariyam
authors.initials: M
authors.lastname: Athifa
authors.forename: Judith
authors.initials: J
authors.lastname: Finn
authors.forename: Linda
authors.initials: L
authors.lastname: Brearley
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Williams
authors.forename: Ben
authors.initials: B
authors.lastname: Hay
authors.forename: Karen
authors.initials: K
authors.lastname: Laurie
authors.forename: Tim
authors.initials: T
authors.lastname: Leen
authors.forename: Keith
authors.initials: K
authors.lastname: O'Brien
authors.forename: Michael
authors.initials: M
authors.lastname: Stuart
authors.forename: Michelle
authors.initials: M
authors.lastname: Watt
authors.forename: Gavin
authors.initials: G
authors.lastname: Leslie
mesh_terms: D000328:Adult; D001315:Australia; D003142:Communication; D003422:Critical Care / Q000592:standards*; D004506:Education, Nursing; D005069:Evaluation Studies as Topic; D017144:Focus Groups; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D024802:Nurse's Role / Q000523:psychology*; D010360:Patient Transfer / Q000592:standards*; D010362:Patients' Rooms; D010465:Perception; D013997:Time Factors