Abstract
Spiralling health care costs and limited critical care bed capacity has seen the widespread introduction of progressive care units (PCUs) for patients who require more intensive observation, monitoring and treatment than can be provided on the general wards. Previously these patients would have been transferred to the intensive care unit (ICU), which blocked valuable critical care beds and prevented acutely unstable patients from gaining access to the ICU (McCabe & Kaplin,
2005).
An integrative review was conducted focussing on the role of PCUs, the patient profile, admission and discharge criteria, nursing ratios, patient acuity and dependency tools, levels of monitoring and staff education.
This dissertation found that PCUs are a safe and appropriate environment for the 'stable' critically ill patient at risk of deterioration. PCUs remove unnecessary admissions to ICU, improve ICU patient throughput, and reduce overall hospital expenditure. Nevertheless, inconsistent nomenclature and significant differences in health systems between the United States of America (USA) and the United Kingdom (UK) were found to hinder direct comparison of data. In addition, this dissertation identified a lack of local, New Zealand/ Australasian literature on PCUs. Consequently, this dissertation explores and discusses the PCU level of care from the USA and UK perspectives.