Workload and main activities of consultative ICU nurses: long-term experience in a large teaching hospital in the Netherlands.

BACKGROUND

Early recognition and prompt treatment of deteriorating patients outside the intensive care unit (ICU) improves hospital survival. Over the past decade, consultative services have been implemented in many institutions. This service is frequently performed by ICU nurses, while little information is available on the workload and type of activities these ICU nurses actually perform.

METHODS

In 1995, a consultative ICU nurse-driven service was introduced in a large teaching hospital in the Netherlands. In this descriptive study, we determined types of consultation, time consumed per visit, and main interventions during these activities.

RESULTS

During the study period, 9144 consultations in 4365 patients were performed. While the number of 'scheduled' visits (visits of patients after discharge from the ICU) was reasonably variable during the study period, the number of 'on demand' visits (visits demanded by non-ICU personnel) increased gradually, especially during the first years. At the end of the observation period, approximately half of the visits were 'on demand' in the non-ICU wards. The mean number of consultations per patient dropped gradually over the whole period, from 4.02 in 1996 to 1.54 in 2004. The total workload was approximately half an hour per day; visits were combined with regular activities of the ICU team. Tracheal suctioning was among the most frequent activities during consultation (approximately 90% of all visits).

CONCLUSION

Consultative ICU nurses play a growing role in bridging the gap between the ICU and non-ICU departments in our hospital. Workload is acceptable.