Cited by 40Hospital Admissions and OutcomesFamily and Patient Care in Intensive Care UnitsPatient Safety and Medication Errors

Transition of care at discharge from the Intensive Care Unit: a scoping review

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Hervé, Michele Elisa Weschenfelder, Zucatti, Paula Buchs, Lima, Maria Alice Dias Da Silva·2020·Revista Latino-Americana de Enfermagem

Abstract

Objective: to map the available evidence on the components of the transition of care, practices, strategies, and tools used in the discharge from the Intensive Care Unit (ICU) to the Inpatient Unit (IU) and its impact on the outcomes of adult patients. Method: a scoping review using search strategies in six relevant health databases. Results: 37 articles were included, in which 30 practices, strategies or tools were identified for organizing and executing the transfer process, with positive or negative impacts, related to factors intrinsic to the Intensive Care Unit and the Inpatient Unit and cross-sectional factors regarding the staff. The analysis of hospital readmission and mortality outcomes was prevalent in the included studies, in which trends and potential protective actions for a successful care transition are found; however, they still lack more robust evidence and consensus in the literature. Conclusion: transition of care components and practices were identified, in addition to factors intrinsic to the patient, associated with worse outcomes after discharge from the Intensive Care Unit. Discharges at night or on weekends were associated with increased rates of readmission and mortality; however, the association of other practices with the patient’s outcome is still inconclusive.

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  • Residents compensated for suboptimal ICU-ward handoffs by recovering omitted information through chart review, history-taking, duplicating previously completed tasks, or calling the ICU to clarify information; these inefficiencies and documentation burdens compete for trainee time.

    “Residents compensated for suboptimal ICU-ward handoffs by recovering omitted information through the chart review, history-taking, duplicating previously completed tasks, or calling the ICU to clarify information; these inefficiencies and documentation burdens compete for trainee time that could otherwise be spent on patient care and education [2].”

    From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [2]

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  • Complex patient transfers are vulnerable to provider miscommunication, which increases the risk of preventable medical errors and ICU readmissions.

    “These complex patient transfers are vulnerable to provider miscommunication, which increases the risk of preventable medical errors and ICU readmissions [1-3].”

    From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [2]

    The Introduction (page unavailable) identifies miscommunication as a risk in complex ICU transfers, and the Results (page unavailable) identify suboptimal team communication as a possible cause of readmissions. The paper discusses post-discharge adverse events, but does not specifically establish that miscommunication increases preventable medical errors; it also describes the link between transition quality and adverse outcomes as controversial. (LLM, conf=0.86)

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Authors
Hervé, M. E. W., Zucatti, P. B., & Lima, M. A. D. D. S.
Affiliations
  • Universidade Federal do Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Brazil
  • Universidade Federal do Rio Grande do Sul (BR)
Venue
Revista Latino-Americana de Enfermagem
Published
2020
Volume
28
Pages
e3325-e3325
ISSN
  • 0104-1169 (ISSN-L)
  • 1518-8345
OpenAlex
W3043770102
Cited by
40
References
72
Citations by year
2026: 4 · 2025: 7 · 2024: 10 · 2023: 2 · 2022: 15 · 2021: 2
FWCI
1.13
Type
journal article
Language
pt
Open access
Locations
  • Revista Latino-Americana de Enfermagem (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
care transitions, intensive care unit discharge, intensive care unit, hospital wards, hospital readmission, mortality, discharge timing, weekend discharge, discharge planning, patient outcomes, adult patients
MeSH terms
Adult, Cross-Sectional Studies, Humans, Intensive Care Units, Patient Discharge, Patient Readmission, Patient Transfer, Prospective Studies, Retrospective Studies, Hospital Mortality

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