From the Guidelines
After leaving the surgical ICU, a patient would typically be transferred to a step-down unit or a regular hospital ward, as indicated by the need to move stable ICU patients to step-down units, and step-down and rule-outs to non-monitored beds as appropriate 1. The decision on where to transfer the patient is based on several factors including vital sign stability, pain control, organ function recovery, and the need for specialized care.
- The healthcare team, including the surgeon, intensivist, and nursing staff, collaboratively determines when a patient is ready for transfer and which setting would be most appropriate for their continued recovery.
- A step-down unit provides an intermediate level of care for patients who no longer require intensive monitoring but still need more attention than a regular ward can provide.
- Alternatively, if the patient has stabilized sufficiently, they may go directly to a regular hospital ward where they can continue recovery with less intensive nursing care and monitoring, as part of the process to fill available staffed beds per ‘bed board’ and open unstaffed units/beds 1. The transition from the surgical ICU to another unit represents an important milestone in the patient's recovery journey, indicating significant improvement in their condition while still providing the necessary level of medical supervision.
- The patient's care needs, such as the requirement for ongoing monitoring, medication management, and rehabilitation, are key considerations in determining the most suitable destination.
- The healthcare team's assessment of the patient's condition, in conjunction with hospital protocols and available resources, ultimately guides the decision on where the patient will be transferred after leaving the surgical ICU.
From the Research
Patient Transfer After ICU Discharge
If a patient is well enough to leave the surgical ICU, they may be transferred to various units depending on their specific needs. The possible transfer locations include:
- Step-down unit: A step-down unit provides intermediate care for patients who require close monitoring but do not need the intensive care provided in the ICU 2.
- Ward: Patients who are stable and do not require close monitoring may be transferred to a general ward for further recovery.
- Rehabilitation unit: Patients who require physical, occupational, or speech therapy may be transferred to a rehabilitation unit to receive specialized care 3, 4, 5.
Factors Influencing Patient Transfer
The decision to transfer a patient to a specific unit depends on various factors, including:
- Patient's medical condition and severity of illness
- Availability of beds in the receiving unit
- Hospital policies and protocols
- Patient's insurance coverage and financial status 5
- Geographic location and hospital teaching status 5
Benefits of Step-Down Units
Step-down units can provide effective transitional care for ICU patients, especially those with high-risk conditions. The benefits of step-down units include: