The role and effectiveness of a nurse practitioner led critical care outreach service

Abstract

Research measuring the effectiveness of critical care outreach (CCOR) has been mixed. The objective of this paper is to describe the role and effectiveness of a nurse practitioner (NP) led critical care outreach service (CCORS). Using a comparative study design, data on the number of intensive care unit (ICU) readmissions <72h were analysed 12 months prior to, and 12 months following implementation of the service. Data was also collected on length of stay and APACHE II scores of ICU readmissions <72h, ICU patient acuity, ICU readmission mortality, and ward medical emergency team (MET) and cardiac arrest calls. Data on NP referrals were collected to identify NP activities. Data analysis was completed using descriptive statistics and run and control charts. There were 133 NP referrals, which resulted in 525 patient visits. The most common interventions completed by the NP during visits included requesting of diagnostic tests and prescribing. Following introduction of the NP CCORS, there was a sustained reduction in ICU readmissions <72h. In conclusion, a NP led CCORS has a positive effect on patient outcomes and supports development of further NP positions.