Readmission to intensive care: a qualitative analysis of nurses' perceptions and experiences.

OBJECTIVE The purpose of this study was to identify and describe the experiences and perceptions of nurses regarding the factors that contribute to the readmission of patients to intensive care. METHODS Twenty-one nurses participated in the study. Unstructured interviews were conducted to ascertain participants' perceptions and experiences. Interview transcripts were analyzed using a constant comparison method to identify major conceptual categories. RESULTS Five main themes were identified that contributed to the readmission of patients to intensive care: premature discharge from intensive care, delayed medical care at the ward level, heavy nursing workloads, lack of adequately qualified staff, and clinically "challenging" patients who demanded a different skill set from the nurses. CONCLUSION Discharging patients early from the intensive care unit when they are clinically unstable creates issues around workload and significantly challenges ward staff. It also increases the likelihood of patients being readmitted to the intensive care unit. Hospital managers need to look at ways of increasing the knowledge and skills of ward staff or identify more appropriate environments for managing these acutely ill patients.