A large part of our role as Outreach is following up critical care stepdowns. However, there seems to be no formal timeframe/guidance for this and I wondered how other teams their step down reviews? We are looking to review our follow up protocol and would like to get a general idea of how other teams manage this process.
-do you see step downs on day of critical care discharge or the following day?
-do you carry out a full A-E assessment or is it a brief review to ensure prescription chart is updated/obs carried out on arrival/adequate handover paperwork transferred with the patient
- how long/how many reviews are carried out?
- do you see routine post op patients stepped downs ie those in critical care for less than 24 hours
Hi Linda, Our CCO team see all critical care discharges the following day after discharge. We carry out a full advanced physical assessment including looking at bloods, imaging etc. They are discharged from our CCO service once they no longer meet the admission criteria, so they may just require 1 assessment & discharged or we may keep reviewing them for a few days. It is the decision of the ANP assessing them that decides the frequency for further reviews.
Hope you are well.
We see all our ICU discharges. Most get a review on the same day ( depending on time of discharge from ICU). A full A-E is done and a plan is put in place including the standard frequency of NEWS 2 monitoring we use for all ICU discharges. The decision to keep patient on our active list for ongoing review is made by the CCORT nurse - taking into account LOS in ICU, level of care received in ICU (Level 2/ Level 3), ongoing issues/concerns and clinical judgement. Minimum of two reviews per patient depending on above. Let me know how you get on with your protocol.
Thank you both for your replies - essentially it sounds like we are all doing similar things. Will continue to monitor this discussion for any new comments and await the outcome of the Quality & Operational Standards for the Provision of Critical Care Outreach Services Consultation document.
© Copyright NOrF National Outreach Forum 2020 Legal Notices Contact Us