Discharging ICU ventilator-dependent patients to home healthcare.

Patients who are ventilator dependent have few alternatives to continued hospitalization. Within our institution and community, intensive care unit (ICU) bed occupancy and lack of skilled nursing facilities forced us to look for other ways to meet their healthcare needs. The only placement alternative to continued hospitalization for some patients appeared to be home care, because it was available and cost-effective. The possibility of using home care for the ventilator-dependent patient was a new concept for many of the staff, and generated a moderate degree of anxiety among them. Overcoming the anxiety and developing and implementing the discharge plan became our goals. The goals were achieved when the patient was effectively and safely discharged from the ICU to his home.