The Handover from Intensive Care Unit to General Ward: Baseline Performance and Participatory Design of an Electronic...

Area of Science:

• Healthcare Management
• Patient Safety
• Nursing Informatics

Background:

• Patient transfers from intensive care units (ICUs) to general wards pose significant health risks.
• Current follow-up plans for ICU to general ward handovers are inadequately utilized.
• A high mortality rate (25%) exists for patients with existing follow-up plans post-transfer.

Purpose of the Study:

• To investigate the current use of follow-up plans during ICU to general ward patient transfers.
• To propose and design a novel electronic follow-up plan to improve patient care continuity.
• To enhance the handover process by leveraging general ward nurses' expertise.

Main Methods:

• A retrospective record audit of existing follow-up plans for ICU to general ward transfers.
• Participatory-design workshops involving ICU and general ward nurses.
• Development of an electronic "attend-to list" format for follow-up plans.

Main Results:

• Follow-up plans were present in only 16% of audited patient transfers.
• Existing follow-up plans demonstrated infrequent usage.
• 25% of patients with a follow-up plan died within 24 hours of transfer.

Conclusions:

• The study highlights a critical gap in patient follow-up post-ICU transfer.
• The novel electronic "attend-to list" design respects and integrates general ward nurse expertise.
• This new approach aims to mitigate risks and improve outcomes during critical patient care transitions.