Activities undertaken by Intensive Care Unit Liaison Nurses in Argentina.

BACKGROUND: The Intensive Care Unit Liaison Nurse (ICULN), also known as an outreach nurse, is an advanced practice nursing role that emerged in the late 1990s in Australia and the United Kingdom (UK). Little is known about this role in less developed economies. OBJECTIVE: To describe the activities undertaken by ICULNs in Argentina. METHODS: Prospective, descriptive, observational, single site study in an Argentinean metropolitan tertiary referral hospital. Adult patients under ICULN follow up were included in the sample. Data on ICULN activities and patients were collected using an established tool developed by The Australian Intensive Care Unit Liaison Nurse Forum. Descriptive statistics were used to summarise the findings. RESULTS: Two hundred patients were visited by the ICULNs during the study period. The mean age of patients was 52.5 years (SD 17.7). Cardiovascular disease (n=104, 52%), respiratory disease (n=90, 45%) and diabetes (n=40, 20%) were the most common comorbidities. 110 (55%) patients had surgical procedures. The primary reasons for ICULN visit were follow up post ICU discharge (n=138, 69%) and ward referral (n=46, 23%). 136 (68%) patients received up to 3 visits; the remaining 64 (32%) patients received ≥4 visits. In those patients in need of ≥4 visits ICULNs initiated more non-medical treatments (100%), referred to escalate treatment (35%) and to a higher level of care (13.8%) than in those who were visited up to 3 times. CONCLUSIONS: This study is the first to document ICULN activity in Argentina using an international framework and data set. These findings can assist with understanding an advanced practice nursing role in Argentina. It may facilitate future comparisons with other contexts and could help managers implementing the role in similar settings. Further investigation will help develop this practice and document its influence on patient outcomes.

A description of the ICU liaison nurse role in Argentina.

BACKGROUND: Recognising and responding to clinical deterioration in hospital patients has been promoted by many western countries to improve patient safety. In non-western and developing countries it is likely to be even more important to focus on strategies of patient safety. This paper reflects the services provided by Intensive Care Unit Liaison Nurses (ICULN) in the first year of their work, July 2010-June 2011, in an Argentinean hospital. OBJECTIVES: This practice audit aimed to describe the ICULN patient care activities performed for patients discharged from the ICU and ward patients with complex care needs, and to identify education activities carried with ward nursing staff caring for these patients. METHODS: Experienced critical care nurses, with strong communication and education skills were appointed as ICULNs. They were asked to assess ward patients transferred from ICU once per shift and ward patients as requested by staff. They had to provide patient complex care if necessary and education to ward nurses caring for these patients. RESULTS: A total of 387 patients were followed by ICULNs. The median age of patients was 49 (IQR 26) years (range 15-89). A total of 369 (95.3%) of the patients were discharged from ICU and 18 (4.7%) were ward patients who required complex care. The most frequent conditions patients had were surgery, neurologic conditions, trauma and sepsis. Thirty four (9.2%) of 369 patients who were initially in ICU, were readmitted during the same hospitalisation. During the study period ICULNs performed 5973 patient care and 1709 staff education activities. CONCLUSION: ICULNs provide advanced assessment and surveillance of ICU discharged and complex ward patients, and facilitate ICU-ward transition assisting and educating ward staff. Further evaluation is necessary to better describe the role in Argentina and the effect of ICULN service on patient outcomes and on staff.