Preventing ICU Readmissions: The Implementation of a Risk Stratification Tool in the Assessment of Readiness for ICU Transfers to Medical Units

ABSTRACT Heidi McNeill: Preventing ICU Readmissions: The Implementation of a Risk Stratification Tool in the Assessment of Readiness for ICU Transfers to Medical Units (Under the direction of Saif Khairat) Background: Intensive care unit (ICU) readmissions have been shown to increase a patient’s in hospital mortality and length of stay. Despite this no methods, to the best of our knowledge, have been set in place to prevent readmissions from occurring. Objective: The purpose of this quality improvement (QI) project is to decrease the readmission rate of adult patients to the Surgical Trauma ICU through identification of high-risk patients. Methods: A retrospective chart review was performed to evaluate ICU readmissions over a three-month period prior to implementation. The NEWS screening tool was then implemented for three-months to evaluate patient’s readiness for transfer. Following completion of implementation the data was analyzed to evaluate the effectiveness of the NEWS screening tool in identifying high risk patients and decreasing the ICU readmission rate. Results: The retrospective chart review revealed a readmission rate of 4.8% with a calculated NEWS of 4.7. The QI project screened 108 patients’ with the NEWS, whose mean score was 1.99. The overall readmission rate was 2.58%, and the mean NEWS for these patients was 4.8. The majority of patient’s screened were male and 36% of the patients were 65 years or older. Discussion: Though the readmission rate to the Surgical Trauma ICU was decreased after the NEWS was implemented, it is unlikely that this tool contributed to this given low participation.Doctor of Nursing Practic