Caring for Survivors of Critical Illness: Current Practices and the Role of the Nurse in Intensive Care Unit Aftercare

The success of critical care medicine has historically been gauged by short-term mortality outcome. With technological advances, many patients now survive what were previously fatal critical illnesses, generating an expanding population of critical care survivors. Many survivors suffer with new or worsening impairments in physical, cognitive or mental health status arising after a critical illness and persisting beyond acute care hospitalization which has been termed Post Intensive Care Syndrome (PICS). This term can be applied to a survivor or a family member who often experiences significant social & psychiatric burdens caring for a survivor of critical illness. It is estimated that PICS develops in greater than 2.4 million Americans who survive critical illness each year, including approximately two-thirds of Medicare beneficiaries who survive critical illness. As a consequence of both an aging population and the dramatic improvement in mortality rates in those suffering from critical illness, PICS is rapidly becoming a major public health concern. For these survivors, new impairments after critical illness can have dramatic impacts on their quality of life or ability to be employed, and may persist for months or years after hospital discharge. \n \nThis review of the will examine emerging practices in relation to ICU after care for both patients and caregivers, with specific emphasis on the critical role of the nurse.