Date of Graduation

5-2015

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor

Sabatini, Lindsey

Reader

Gentry, Jacklyn

Second Reader

Smith-Blair, Nan

Abstract

Abstract Background: Unplanned readmissions to the intensive care unit (ICU) are a significant clinical concern associated with more severe illnesses, longer lengths of stay, higher costs, and higher risk for hospital and overall mortality (Boots, 2013; Brown, Ratcliffe, Kahn, & Halpern, 2012; Elliot, Crookes, Worrall-Carter, & Page, 2011; Kramer, Higgins, & Zimmerman, 2013; Rosenberg, Hofer, Hayward, Strachan, & Watts, 2001; & Schorr, 2012). Objective: This quality improvement project was intended to identify a discernable pattern or characteristic associated with unplanned readmissions to the intensive care unit/coronary care unit. Methods: This retrospective cohort study used all patients discharged and subsequently readmitted to the critical care units in the same hospital stay at a Northwest Arkansas hospital were included in the cohort. Results: The most frequent readmission diagnoses were respiratory (33.3%) and cardiac (31.1%) related. The most common reasons for readmission were respiratory decompensation (28.9%), post-operation complications (20.0%), and post-cardiac catheterization complications (15.6%). The majority of patients readmitted were male (80%), over the age of 65 (73.3%) and originally came from the emergency department (51.1%). Discharge and readmission times were not found to be significant in this particular study. Vitals at readmission to ICU/CCU were more unstable than at discharge from ICU/CCU. Conclusions: Identifying the patient characteristics and risk factors associated with readmission can provide a path to improving patient outcomes and implementing interventions to reduce the number of readmissions into the ICU; in turn reducing costs, mortality, and length of stay. Several patient and admission characteristics were associated with readmission.

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