• Hang Mui So, Wing Wa Yan, and Sek Ying Chair.
• Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China.
• Aust Crit Care. 2019 Nov 1; 32 (6): 494-501.

IntroductionVarious critical care outreach services have been developed and evaluated worldwide; however, the conflicting findings indicate the need to strengthen the outreach service research. This study aimed to evaluate the effects of a nurse-led critical care follow-up program on intensive care unit (ICU) readmission and hospital mortality in patients with respiratory problems discharged from the ICU in Hong Kong.MethodsA quasi-experimental study design, with a historical control and a prospective intervention for 13 months, was used. The intervention group received a nurse-led, multidisciplinary ICU follow-up program in addition to the usual care. The outcome measures included ICU readmission within 72 h after ICU discharge, all ICU readmission (ICU readmission irrespective of the time frame after ICU discharge), hospital mortality, and 90-day mortality rate. Logistic regression analysis was used to determine the predictors for ICU readmission within 72 h.ResultsA total of 369 participants (the intervention group: 185; the control group: 184) were recruited. A significant reduction in ICU readmission within 72 h was observed in the intervention group compared to the control group (p = 0.001), even after controlling for confounders (odds ratio: 0.158, p = 0.007). The intervention group also demonstrated a significant reduction in all ICU readmission (p < 0.001) and hospital mortality (p = 0.042), but not on 90-day mortality (p = 0.081), when compared with the control group. This nurse-led ICU follow-up program was shown to be cost-effective, saving an estimated US$ 145,614 for a period of 13 months.ConclusionThe findings demonstrated that a nurse-led multidisciplinary ICU follow-up program was a beneficial and cost-saving strategy to avert ICU readmission in patients with respiratory problems after ICU discharge. It also highlighted the competent role of ICU nurses in planning and leading the implementation of a multidisciplinary program. The results contributed to the database of an innovative follow-up program to inform the practice worldwide.Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

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