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Related Concept Videos

Discharge Summary Forms01:31

Discharge Summary Forms

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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
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Planning Nursing Care I01:21

Planning Nursing Care I

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The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
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Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

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Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
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Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

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The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
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Related Experiment Video

Updated: Feb 21, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Critical care delayed discharge: Good or bad?

Stephen Gilligan1

  • 1Department of Anaesthesia, Royal Blackburn Teaching Hospital, Blackburn, UK.

Journal of the Intensive Care Society
|October 6, 2017
PubMed
Summary

NHS England aims to reduce delayed critical care discharges. Longer stays for critically ill patients may improve outcomes, but current incentives may hinder this. Further analysis is needed.

Area of Science:

  • Critical care medicine
  • Health services research
  • Quality improvement initiatives

Background:

  • Delayed discharges from adult critical care to ward-level care are a significant issue.
  • Data from the Intensive Care National Audit & Research Centre shows over 64% of patients experienced delayed discharge in the last five years.
  • A substantial proportion (17.9%) faced delays exceeding 24 hours.

Purpose of the Study:

  • To analyze the impact of delayed critical care discharges on patient outcomes.
  • To investigate the potential benefits of extended critical care stays for specific patient cohorts.
  • To evaluate the current Commissioning for Quality and Innovation (CQUIN) framework's influence on discharge practices.

Main Methods:

  • Analysis of the critical care minimum data set from the Intensive Care National Audit & Research Centre over five years.
Keywords:
Critical careDischarge planningHospital mortalityLength of stay

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  • Statistical examination of delayed discharge times (4-24 hours and >24 hours).
  • Comparison of expected versus actual mortality for patients with prolonged critical care stays (>24 hours).

    • Main Results:

    • Over 64.2% of patients experienced delayed discharge (>4 hours).
    • For patients delayed >24 hours, actual mortality was lower than expected (5201 vs. 5892 patients), suggesting potential benefit.
    • The current CQUIN framework may create perverse incentives against extended critical care for some patients.

    Conclusions:

    • Delayed discharges from critical care are prevalent.
    • Critically ill patients experiencing prolonged stays (>24 hours) may have better survival outcomes.
    • Further research is required to identify patient subgroups benefiting from extended critical care and to align CQUIN incentives with optimal patient care.