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The UK Forum for Multi-Professional Critical Care Outreach, 
   Medical Emergency, Acute and Rapid Response Teams

Critical Care stepdown follow up

  • 26 Nov 2019 10:44
    Message # 8139750

    Dear all.

    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

  • 30 Nov 2019 21:55
    Reply # 8147075 on 8139750

    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.

  • 05 Dec 2019 22:56
    Reply # 8188876 on 8139750

    Hi Linda,

    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. 

    Via.


  • 07 Dec 2019 16:39
    Reply # 8205836 on 8139750

    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.

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