Impact of an ICU Liaison Nurse Service on major adverse events in patients recently discharged from ICU

Abstract

Aim: To identify the effect of an ICU Liaison Nurse (LN) on major adverse events in patients recently discharged from the ICU.

Methods: Case-control study using a chart audit protocol to assess controls retrospectively and cases prospectively. Controls did not receive ICU-based follow-up care. Cases received at least three visits over 3 days from the ICU LN. The LN service operated 7 days/week 0800-1800. Data on a range of predictors and three major adverse events (unexpected death, surgical procedure needed, and transfer to a higher level of care) were collected using a purpose built audit form.

Results: A total of 388 patients (201 controls and 187 cases) were included in the study. Demographic and clinical characteristics were similar for both groups. A total of 165 major adverse events were identified in 129 patients. After controlling for all other potential predictors, patients who received the LN intervention were 1.82 times more likely to be transferred to a higher level of care (P=0.028) and 2.11 times more likely to require a surgical procedure (P=0.006). Surgical patients were 7.20 times as likely to require a surgical procedure (P<0.001).

Conclusions: Our results support the claim that ICU LN has a role in preventing adverse events. However as the control data was retrospective and the study was conducted at one site, other unknown factors may have influenced the results.