Integrative review of nurse‐led follow‐up after discharge from the ICU

Aim and objectives To analyse and synthesise the structure, content, types of outcome variables and advantages of nurse‐led follow‐up of adult patients after discharge from intensive care units. Background Follow‐up service after discharge from the intensive care unit has been suggested as a way of supporting recovery of patients. Nevertheless, varieties exist in the understanding and content of nurse‐led follow‐up. Design An integrative review of nurse‐led follow‐up inspired by the framework of Whittemore and Knafl. Methods An integrative method merged with the recommendations of the PRISMA statement was used to structure the review and findings. Online databases PubMed, CINAHL, ScienceDirect and Scopus were searched from the years 2003–2014. The retrieved articles were independently assessed by two reviewers. Critical appraisal was conducted using check lists from Johanna Briggs Institute. Emerging patterns were validated by all the authors throughout the entire process of analysis. Results Seventeen papers were included. Three patterns of nurse‐led follow‐up were identified: (1) Ward visits – in the immediate time after discharge from intensive care unit, (2) Ward visits and appointment(s) to an intensive care unit follow‐up clinic and (3) follow‐up visit to an intensive care unit and phone call(s) after discharge. Content of short‐term nurse‐led follow‐up (1) ranged from clinical assessment to supporting patients in articulating their subjective health concerns. Long‐term nurse‐led follow‐up (2, 3) included appointments, phone call(s) or information on where advice could be sought. Types of outcome variables were primarily descriptive. There were strong implications for patients' satisfaction with nurse‐led follow‐up up to six months after discharge. Conclusion Nurse‐led follow‐up might promote patients' health and enable use of adequate resources. Relevance to clinical practice The findings of this review could be used to design, and test, future interventions and their implementation.