Implementing an Intensive Care Liaison Nursing Service in a Teaching Hospital in Bahrain

Background: The Intensive Care Unit Liaison Nurse (ICU LN) service is a new role developed as a result of challenges in providing follow up to patients transferred from the Intensive Care Unit (ICU) to the general wards.

Objective: To implement and determine the effectiveness of an ICU LN service in reducing patient's readmission rate to ICU and support the ward nurses’ competency in taking care of patients transferred from ICU and critically ill patients in the ward settings.

Method: A mixed methods research approach was used incorporating quantitative and qualitative dimensions. The study sample included patients readmitted to ICU within 72 hours of transfer from ICU to the ward area and ward nurses taking care of patients post transferred from ICU. A one-group pretest-posttest design was also used guided by Kurt Lewin's (1951) Theory change management model to implement ICU LN service in the ICU and ward settings. Statistical Package for Social Science (SPSS) was used to analyze quantitative data, while Krueger’s (1994) framework was applied to analyze the qualitative data.

Findings: The study reported reduction in the ICU readmission rates, patient's length of stay in ICU and an improvement of ward nurses' of competency skill post implementation of ICU LN service. Moreover, the new service redesign of patient transfer process from ICU to the wards resulted in a reduction of the total patients waiting time in ICU awaiting transfer to the wards.

Conclusion: Using a model of change management in implementing the ICU LN service and changing nursing practice in both ICU and the ward setting was very challenging. The study added new insight on the importance of developing the competency and skills in ward nurses to take care of patients post transferred from ICU to the ward settings. Moreover, the LN ICU impacted on the quality of care (continuity of safe patient care) in the ward settings and contributed to patient outcomes.