Proposal for the transition and continuity of care from the Intensive Care Unit to the nursing
DOI:
https://doi.org/10.33448/rsd-v10i15.22974Keywords:
Transitional care; Continuity of patient care; Discharge of the patient; Intensive Care Unit.Abstract
Objective: to propose elements for a model of transition and continuity of care for patients from the Intensive Care Unit (ICU) to the trauma ward. Method: qualitative, exploratory research, carried out with nurses from a trauma hospital in southern Brazil, from May to June 2017, totaling 22 participants. Data were collected through semi-structured interviews, with a vignette, and analyzed by Categorical Thematic Content Analysis, using the MAXQDA® software for data organization. Results: four categories emerged: elements indicative of the exit and entry of the patient in transition from the Intensive Care Unit (ICU) to the infirmary; planning the process of transition and continuity of patient care from the ICU to the ward; implementation of the transition process and continuity of care for the patient from the ICU to the ward; and facilitating elements in the process of continuity of care for patients in transition from the ICU to the ward. The result was a patient-centered model, with the elements for a patient-centered plan for the transition and continuity of care for patients from the intensive care unit to the trauma ward. Conclusion: The creation of professional practices that foster an understanding of transition are crucial strategies for the continuity of care.
References
Abraham J, Burton S & Gordon HS. (2020). Moving patients from Emergency Department to Medical Intensive Care Unit: tracing barriers and root contributors. Int J Med Inform (133) 104012. https://doi.org/10.1016/j.ijmedinf.2019.104012
Arora, S., Sevdalis, N., Nestel, D., Woloshynowych, M., Darzi, A & Kneebone, R. (2010). The impact of stress on surgical performance: A systematic review of the literature. Surgery [Internet], 147(3), 318–330.e6. Recuperado em: https://www.sciencedirect.com/science/article/pii/S0039606009006175?via%3Dihub
Alves, M. & Melo C. L. (2019). Handoff of care in the perspective of the nursing professionals of an emergency unit. Rev Min Enferm, 23:e-1194. doi: http:// www.dx.doi.org/10.5935/1415-2762.20190042
Balshi, A. N et al. (2020). Modified Early Warning Score como preditor de readmissão à unidade de terapia intensiva dentro de 48 horas: um estudo observacional retrospectivo. Revista Brasileira de Terapia Intensiva [online]. (32)2 301-307. Disponível em: https://doi.org/10.5935/0103-507X.20200047. Epub 13 Jul 2020. ISSN 1982-4335. https://doi.org/10.5935/0103-507X.20200047.
Bench, S., Day, T & Griffiths, P. (2013). Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness. Crit Care Nurse [Internet], 33(3), 41–52. Recuperado em: http://www.ncbi.nlm.nih.gov/pubmed/23727851
Blay, N., Roche, M. A., Duffield, C & Gallagher, R. (2017). Intrahospital transfers and the impact on nursing workload. J Clin Nurs, 26(23- 24):4822–9. https://doi.org/10.1111/jocn.13838
BRASIL. Conselho Nacional de Saúde. Resolução n. 466, de 12 de dezembro de 2012. (2013). Diretrizes e normas regulamentadoras de pesquisa envolvendo seres humanos. Diário Oficial [da] República Federativa do Brasil. Brasília, D.F., Seção 1, p. 59.
Brown, K. N., Leigh, J. P., Kamran, H., Bagshaw, S. M., Fowler, R. A., Dodek, P. M, et al. (2018). Transfers from intensive care unit to hospital ward: a multicentre textual analysis of physician progress notes. Crit Care 22(19) 1-8. doi: 10.1186/s13054-018-1941-0
Coleman, E. A., Smith, J. D., Frank, J. C., Eilertsen, T. B., Thiare, J. N & Kramer, A. M. (2002). Development and testing of a measure designed to assess the quality-of-care transitions. Int J Integr Care [Internet], 2, e02. Recuperado em: http://www.ncbi.nlm.nih.gov/pubmed/16896392
Comín-Colet, J., Enjuanes, C., Lupó, N. D. J., Cainzos-Achirica, M., Badosa, N & Verdú, J. M. (2016). Transiciones de cuidados entre insuficiencia cardiaca aguda y cró nica: pasos críticos en el diseñ o de un modelo de atención multidisciplinaria para la prevención de la hospitalizació n recurrente. Rev Esp Cardiol, 69(10), 951–61.
Cognet, S & Coyer, F. (2014). Discharge practices for the intensive care patient: A qualitative exploration in the general ward setting. Intensive Crit Care Nurs [Internet], 30(5), 292–300. Recuperado em: http://www.ncbi.nlm.nih.gov/pubmed/24907890
Enger, R & Andershed, B. (2018). Nurses’ experience of the transfer of ICU patients to general wards: a great responsibility and a huge challenge. J Clin Nurs. (27) 1-2:e186-94. doi 10.1111/jocn.13911
Germack, H. D., Fekieta, R., Britton, M. C., Feder, S. L., Rosenberg A & Chaudhry, S. I. (2020). Cooperation and conflict in intra-hospital transfers: a qualitative analysis. Nurs Open 7(2) 634–41. https://doi.org/10.1002/nop2.434
Gotur, D. B., Masud, F., Paranilam, J & Zimmerman, J. L. (2018). Analysis of Rothman Index Data to Predict Postdischarge Adverse Events in a Medical Intensive Care Unit. J Intensive Care Med. (2) 1-5. doi: 10.1177/0885066618770128.
Green, A & Edmonds, L. (2004). Bridging the gap between the intensive care unit and general wards—the ICU Liaison Nurse. Intensive Crit Care Nurs [Internet], 20(3), 133–43. Recuperado em: http://www.ncbi.nlm.nih.gov/pubmed/15157931
Grood, C., Leigh, J. P., Bagshaw, S. M., Dodek, P. M., Fowler, R. A., Forster A. J, et al. (2018). Patient, family and provider experiences with transfers from intensive care unit to hospital ward: a multicentre qualitative study. CMAJ (190)2 E669-76. https://doi.og/10.1503/cmaj.170588
Hervé, M. E. W., Zucatti, P. B & Lima, M. A. D. (2020). Transition of care at discharge from the Intensive Care Unit: a scoping review. Revista Latino-Americana de Enfermagem [online]. (28) e3325. Disponível em: https://doi.org/10.1590/1518-8345.4008.3325. Epub 15 Jul 2020. ISSN 1518-8345. https://doi.org/10.1590/1518-8345.4008.3325.
Häggström, M., Fjellner, C., Öhman, M & Holmström, M. R. (2018). Ward visits- one essential step in intensive care followup. An interview study with critical care nurses’ and ward nurses’. Intensive Crit Care Nurs (49) 21-7. doi: 10.1016/j.iccn.2018.08.011.
Holland, D. E & Harris, M. R. (2007). Discharge Planning, Transitional Care, Coordination of Care, and Continuity of Care: Clarifying Concepts and Terms from the Hospital Perspective. Home Health Care Serv Q [Internet], 26(4), 3–19. Recuperado em: http://www.ncbi.nlm.nih.gov/pubmed/18032197
Meleis, A. I. (2010). Transitions Theory - midle range and situation specific theories in nursing research and practice. Springer Publishing Company. New York: Springer Publishing Company.
Moreira, H. E., Verga, F., Barbato, M & Burghi, G. (2017). Prognostic impact of the time of admission and discharge from the intensive care unit. Rev Bras Ter Intensiva 29(1) 63-9. doi: 10.5935/0103-507x.20170010
Naylor, M. D., Aiken, L. H., Kurtzman, E. T., Olds, D. M & Hirschman, K. B. (2011). The Importance of Transitional Care in Achieving Health Reform. Health Aff [Internet], 30(4), 746–54. Recuperado em: http://www.healthaffairs.org/doi/10.1377/hlthaff.2011.0041
Olino, L., Gonçalves, A. C., Strada, J. K. R., Vieira, L. B., Machado, M. L. P., Molina, K. L, et al. (2019). Effective communication for patient safety: transfer note and Modified Early Warning Score Rev Gaúcha Enferm, (40)esp e20180341. doi: https://doi. org/10.1590/1983-1447.2019.2018034.
Oliveira, D. C de. (2016). Análise de conteúdo temático-categorial: uma técnica maior nas pesquisas qualitativas. In: Lacerda MR, Costenaro RGS, organizadores. Metodologias da Pesquisa para a Enfermagem e Saúde: da teoria à prática. Porto Alegre, RS: Moriá, p. 467–96.
Oliveira, L. S. et al. (2021). Práticas de enfermeiros de um hospital universitário na continuidade do cuidado para a atenção primária. Escola Anna Nery [online], (25)5 e20200530. Epub 09 Jul 2021. ISSN 2177-9465. https://doi.org/10.1590/2177-9465-EAN-2020-0530. Acesso em: 18 ago. 2021.
Petry, L & Diniz, M. B. C. (2020). Communication between teams and the care transfer of critical patients. Rev Rene. (21) e43080. DOI: https://doi. org/10.15253/2175-6783.20202143080.
Polit, D. F & Beck, C. T. (2018). Fundamentos de Pesquisa em Enfermagem: Avaliação de Evidências para a Prática da Enfermagem. Brasil: Editora: Artmed. 9ª ed.
Polit, D. F & Hungler, B. P. (1995). Fundamentos de pesquisa em enfermagem. Porto Alegre: Artes Médicas. 3. Ed.
Rosenberg, A., Britton, M. C., Feder, S., Minges, K., Hodson, B., Chaudhry, S. I, et al. (2018). A taxonomy and cultural analysis of intra-hospital patient transfers. Res Nurs Health (41)4 378–88. https://doi.org/10.1002/nur.21875
Schall, M., Coleman, E., Rutherford, P & Taylor, J. (2013). How-to Guide: Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations [Internet]. Institute for Healthcare Improvement. Cambridge: Institute for Healthcare Improvement. Recuperado em: http://www.ihi.org/resources/Pages/Tools/HowtoGuideImprovingTransitionsHospitaltoOfficePracticeReduceRehospitalizations.aspx
Trovó, S. A., Cucolo, D. F & Perroca, M. G. (2021). Transfer of patients in hospital units: impacts on nursing workload. Revista da Escola de Enfermagem da USP [online]. (55) e0327. Disponível em: https://doi.org/10.1590/S1980-220X2020024903727. Epub 18 Jun 2021. ISSN 1980-220X. https://doi.org/10.1590/S1980-220X2020024903727.
Utzumi, F. C., Catafesta, L. M. R., Bernardino, E., Gomes, I. M., Aued, G. K & Sousa, S. M. de. (2018). Continuidade do cuidado e o interacionismo simbólico: um entendimento possível. Texto & Contexto - Enfermagem, 27(2), e4250016. Epub May 03, 2018.https://dx.doi.org/10.1590/0104-070720180004250016
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Louise Bueno Lelli Tominaga; Elizabeth Bernardino; Maria Ribeiro Lacerda; Maria Manuela Martins; Judith Lapierre; Otilia Beatriz Maciel da Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.