Ronny Enger1, Birgitta Andershed2. 1. Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. 2. Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjövik, Norway.
Abstract
AIMS AND OBJECTIVES: The aim of the study was to describe nurses' experiences of patients' transition from ICUs to general wards and their suggestions for improvements. BACKGROUND: In the ICU, the most seriously ill patients with life-threatening conditions and multiple organ dysfunction syndromes are cared for and carefully monitored by specially trained professionals using advanced techniques for the prevention of failure of vital functions. The transfer of ICU patients to general wards means a change from a high to a lower level, including the loss of one-to-one nursing and a reduction of visible monitoring equipment and general close attention. DESIGN: A qualitative descriptive design. METHODS: Eight nurses from three different inpatient units in Norway, five from a university hospital and three from a local hospital were selected through a convenience sample. Interviews with open questions were conducted, and qualitative content analysis was used to explore the data. RESULTS: Nurses' experiences were described in one main category: ICU patients' transition-a great responsibility and a huge challenge, and two generic categories: (i) a challenging transition for nurses, patients and relatives and (ii) dialogue and competencies as tools for improvement, with six subcategories. CONCLUSION: A number of factors affected patient care, such as poor cooperation, communication, reporting, expertise and clinical gaze. It was clear that the general wards had major challenges, and a number of improvements were suggested. RELEVANCE TO CLINICAL PRACTICE: This study shows that there is still a gap between the ICU and general wards and that nurses continue to struggle with this. It is therefore important that the managers responsible for the quality of care together with the professionals take seriously the criticism in the present and previous studies and work towards a safe transition for patients.
AIMS AND OBJECTIVES: The aim of the study was to describe nurses' experiences of patients' transition from ICUs to general wards and their suggestions for improvements. BACKGROUND: In the ICU, the most seriously ill patients with life-threatening conditions and multiple organ dysfunction syndromes are cared for and carefully monitored by specially trained professionals using advanced techniques for the prevention of failure of vital functions. The transfer of ICU patients to general wards means a change from a high to a lower level, including the loss of one-to-one nursing and a reduction of visible monitoring equipment and general close attention. DESIGN: A qualitative descriptive design. METHODS: Eight nurses from three different inpatient units in Norway, five from a university hospital and three from a local hospital were selected through a convenience sample. Interviews with open questions were conducted, and qualitative content analysis was used to explore the data. RESULTS: Nurses' experiences were described in one main category: ICU patients' transition-a great responsibility and a huge challenge, and two generic categories: (i) a challenging transition for nurses, patients and relatives and (ii) dialogue and competencies as tools for improvement, with six subcategories. CONCLUSION: A number of factors affected patient care, such as poor cooperation, communication, reporting, expertise and clinical gaze. It was clear that the general wards had major challenges, and a number of improvements were suggested. RELEVANCE TO CLINICAL PRACTICE: This study shows that there is still a gap between the ICU and general wards and that nurses continue to struggle with this. It is therefore important that the managers responsible for the quality of care together with the professionals take seriously the criticism in the present and previous studies and work towards a safe transition for patients.
Authors: Kara M Plotnikoff; Karla D Krewulak; Laura Hernández; Krista Spence; Nadine Foster; Shelly Longmore; Sharon E Straus; Daniel J Niven; Jeanna Parsons Leigh; Henry T Stelfox; Kirsten M Fiest Journal: Crit Care Date: 2021-12-17 Impact factor: 9.097