Patient discharge from neurocritical care may be to one of the wards at NHNN (before being either discharged home or back to their referring hospital if an extended period of care is required) or directly to the critical care unit at their referring hospital if appropriate care can be provided there.
Moving from neurocritical care to a ward can be an anxious time for patients and their families, and there may be concerns about the differences they find in the level of care. (In the intensive care unit there is usually one trained nurse per patient, in the high dependency unit one trained nurse per two patients, and on the ward one trained nurse for six to eight patients.)
Patients in intensive care may ‘step down’ to the high dependency unit prior to their planned discharge to the ward, but some patients may be receiving high-dependency care in the intensive care area in the days prior to discharge, and go directly from intensive care to the ward. Patients are only discharged to the ward once they have been assessed by the multidisciplinary team as no longer requiring the higher level of care provided on the high dependency or intensive care unit.
Critical care outreach
To provide continuity of care and support for patients and their families, the Critical Care Outreach Team will follow up all patients discharged from critical care to the ward.
The critical care outreach team (CCOT) includes a senior nurse, an anaesthetic registrar and a critical care consultant. The team cover the hospital day and night. All patients who are discharged from critical care to the ward are viewed by CCOT and kept under their review until they are satisfied the patient has safely settled on the ward. The ward will also refer any patients they have concerns about to CCOT, who will review and support the ward teams.