A clinical nurse specialist intervention to facilitate safe transfer from ICU.

PURPOSE/OBJECTIVES: The purpose of this article was to describe an innovative quality initiative implemented by the clinical nurses specialist in medicine to facilitate the transition process between the intensive care unit and the medical wards.

BACKGROUND/RATIONALE: Safely transferring patients with complex health conditions from an area of high technology and increased monitoring, like the intensive care unit, to an area with lower nurse-to-patient ratio is an intricate process. The care of these patients, once transferred, also requires varying levels of expertise. As indicated in the nursing literature, this type of transition is often associated with high stress levels for the patient and family, as well as for the healthcare providers. To maximize patient safety and ensure optimal care for this patient population, well-defined mechanisms must be put in place.

DESCRIPTION OF THE PROJECT/INNOVATION: The introduction of a formal assessment, consultation, and follow-up process conducted by a clinical nurse specialist (CNS).

OUTCOMES

On average, 150 patients are assessed each year by the CNS. Among these patients, 15% are considered at high risk for complications upon transfer to the unit. INTERPRETATION/CONCLUSION/IMPLICATIONS: A systematic evaluation of patients by the CNS, before their transfer from the ICU to a medical unit, has been proven beneficial in ensuring a comprehensive patient care plan. Patients and families have verbalized that this intervention is helpful. Staff members have indicated that this safety initiative is useful in planning patient transfers. The next step would be to formally measure patient, family, and staff satisfaction with this initiative.