The impact of an ICU liaison nurse service on patient outcomes

To determine the effect an intensive care unit liaison nurse service had on ICU patient discharges, readmissions and outcomes.

We evaluated the impact of our ICU liaison nurse service in a 36-month before-and-after study on ICU and hospital length of stay (LOS) and mortality, and ICU step-down days (time spent in ICU in a 1 : 2 nurse to patient ratio).

There was a 13% increase in patient throughput after the introduction of the ICU liaison nurse service (835 ICU admissions in the 18 months before v 943 in the 18 months after). Despite trends to an improvement, there was no significant change in median ICU LOS (2.2 days before v 2.1 days after) or median hospital LOS (12.0 days before v 11.5 days after), or in ICU or hospital mortality (ICU, 15% before v 14% after; hospital, 23% before v 22% after). ICU step-down days were significantly decreased by 48% (71 +/- 14.2 days v 37 +/- 15.5 days; P < 0.001). In the patient group readmitted to the ICU (49 patients before v 55 patients after), there was a 25% (1 day) decrease in median ICU LOS (4.0 v 3.0 days), and a trend to decreased mortality in both the ICU (18% before v 16% after) and hospital (35% before v 26% after).

The introduction of our ICU liaison nurse service was associated with a trend towards more efficient ICU discharges (increased throughput, decreased ICU step-down days and ICU readmission LOS) and improved survival for ICU patients requiring readmission, but overall ICU and hospital LOS and mortality, and ICU readmission rates were unchanged.