ICU Overnight Discharge Risk
Researchers from Monash University (Melbourne, Australia) observed that despite efforts to reduce the number of overnight discharges, one in seven (i.e., 20,000 ICU patients) are transferred to general wards after hours each year.
Data from previous research have indicated that patients moved from ICUs outside of regular working hours have a greater chance of dying than patients discharged in-hours. Still, the rate of overnight discharges has stayed unchanged for the past eight years, said lead author Dashiell Gantner of Monash University's faculty of medicine, nursing and health science.
“We don’t know exactly why things haven’t changed,” stressed Gantner. "Resources are one piece of the puzzle; it would be ideal if going into the night we had an extra bed to admit the unexpected patient without having to discharge another.”
Having a bed available, Gantner explained, was a joint responsibility of clinicians managing the ICU, hospital administrators coordinating ward beds, and policy-makers managing the resources.
Previous studies have suggested a relationship between timing of ICU discharge and hospital outcomes.
Gantner offered several possible explanations for the ICU overnight discharge problem. First, patients moved out of the ICU after-hours may be more sick than those discharged in-hours, he said. "Our study showed that this may account for some of this increased risk, but not all of it."
Another possible reason was that the degree of nursing and medical monitoring available in the ICU could not be provided in normal hospital wards overnight. Thus, if a patient becomes unstable after ICU discharge this might not be picked up until it is too late, Gantner said.
A third possible explanation was that patients who were expected to die despite ICU-level care may be discharged after-hours to receive palliative care on the ward, added Gantner, also an intensive care fellow at The Alfred Hospital in Melbourne.
Further research was necessary to explore these possibilities, the lead author emphasised. The Monash University study was done in collaboration with the Australian and New Zealand Intensive Care Society and involved data from 700,000 patient admissions between 2005 and 2012.
Image Credit: Flickr.com
Published on : Sat, 13 Sep 2014
Print as PDF
Medos hemofilters pro are used for efficient and gentle hemofiltration during extracorporal circulation.Medos hemofilters pro do not need to be pre-flushed and can be used immediately. This guarantees a safe and quick hemofiltration.
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
Get an complete overview of your POCT setup - from one dashboard Your point-of-care-testing setup probably involves many different types of devices from various manufacturers. Radiometer's AQURE point-of-care management system can give you an overview...
FeaturesSV 300 is a state-of-the-art ventilator that’s simple to configure, easy to operate and versatile in use. It equips with extensive ventilation modes that can treats pediatric and adult patients with all acuity levels at ICUs and Intermediate Care.With...
The HAMILTON-T1 combines for the first time the functionality of a fully featured intensive care unit ventilator with the compactness and ruggedness required for transport. This is why the HAMILTON-T1 enables you to provide optimal ventilation therapy...