Initiative standardizes evaluation of ICU discharge readiness
A standardized process to evaluate patients for their readiness to be discharged from an intensive care unit (ICU) can help reduce readmissions while providing clarity and supporting collaboration among the interprofessional team, according to a study published in Critical Care Nurse.
A study published in Critical Care Nurse has revealed how a standardized process using the National Early Warning Score (NEWS) can help determine ICU patients' readiness for discharge, potentially reducing readmissions and improving collaboration among the healthcare team. The initiative began at Rush University Medical Center in Chicago, where the medical ICU staff were introduced to the NEWS tool, which uses six vital signs and physiological measurements to generate a score between 0 and 20, with higher scores indicating a greater risk of clinical deterioration.
Within a few months of implementing the protocol, the readmission rate to the unit decreased by 1.5%, and the number of patients discharged with a NEWS score of 7 or higher dropped by 5.2%. The clinical outcomes and positive response from nurses and physicians led to the permanent implementation of the protocol. Abigail Weilbacher, the lead author and a critical care clinical education scholar, emphasized that the score became an integral part of the decision-making process before discharge.
However, while nearly 70% of registered nurses and 50% of physicians experienced delayed or canceled discharges due to the NEWS protocol, 41.2% of physicians supported its continued use, and nearly half were unsure. The retrospective review of electronic medical records found that all readmitted patients had risk factors, primarily respiratory issues and vital sign abnormalities.
Despite differences in the mean ICU length of stay and incidence of rapid response team activations following ICU discharge being largely unchanged, the overall positive response to the NEWS discharge protocol suggests its potential value in improving patient care and reducing readmissions.
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