step down patient care

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what is a step down?

It is not possible to give every patient the same type of intense care for economical reasons. Doctors need to take the decision of assigning the right type of care to patients. They often have to make a decision on general ward vs home care or step down unit vs telemetry.

Usually, the general medical-surgical wards are not staffed with a lot of nurses since the patients in these wards do not require intensive care. If a doctor thinks that the patient requires a higher level of care than the general medical-surgical ward but providing ICU care would waste the resource, then the patient is referred to step down critical care. Now the question arises: what is a step down care unit?

Step down Units or SDUs provide an intermediate level of care to patients. A step down care unit is often considered by medical experts to lie between Intensive Care Units and the general medical-surgical wards.

types of step down units

Mainly, there are three models or types of step down units. These are:

  • Incorporating step down beds into intensive care units
  • Stand-alone units
  • Incorporating step beds into standard wards

Medical experts choose one of these three models of step down units according to the available medical resources in the hospital. 

facilities available in step down units

As mentioned earlier, the facilities provided in a step down unit lie somewhere between the ICUs and the general wards. You can expect the following facilities in step down care NHS:

  • A highly trained staff that can improve clinical outcome
  • Equipment for continuous monitoring of the ECG
  • Recording of planned doses of drugs

step down in critical care

Thanks to many studies conducted on the results of step down units, it is a well-established fact now that step down units can help in the critical care of patients. Step down critical care Unit is considered a safe postoperative care option for patients who recently had abdominal surgery, cardiothoracic surgery, or similar kind of critical surgeries. 

Step down patient care has also been found to reduce postoperative complications up to a large extent. Other than that, improvements are also noted in patient pain control. To summarize, step down can help a lot in critical care when the doctor thinks that full intensive care is not needed but the patient might require constant screening of ECG or supervision of nurses. 

how step down units helps in recovery after icu

We have already discussed that step down hospital care can prove to be helpful as a postoperative care option. But another area where step down units have provided consistent results is recovery after ICU

Once the patient is recovered, the doctors consider it best to take the patient out of the ICU ward as it is a wastage of resources both for the patient and any other person who might need the ICU bed. However, constant medical supervision is required in order to ensure the constant intake of medicines. Hence, doctors often think that it is best for the best to be admitted in the step down unit instead of moving from ICU to regular room.  

step down unit & covid

During the COVID-19 pandemic, a scarcity of ICU wards was felt almost everywhere. The number of patients who required ICU admissions outnumbered the available ICU beds by several times. In such a condition, COVID 19 step down unit proved to be helpful for both the patient and the hospital. 

Data has shown that the patients who were associated with acute respiratory failure because of COVID-19 showed a major improvement in both clinical and physiological conditions with step down patient care. In fact, many step-down care patients were not even admitted to ICU wards later as they were ready to be discharged home. 

In case of a surge in COVID-19 cases in the future, it is very likely that the medical infrastructure in the country is going to need to step down units. Since the number of ICU wards is not enough even in the metropolitan cities, step down units might prove to be helpful to hospitals in case of the third wave of COVID-19. 

That being said, there are still many active cases of COVID-19. If you or someone you love has been tested positive for COVID-19, a step down unit COVID might prove to be helpful for you. 

how portea can help you

Portea can provide you patient care services at home. We have developed our clinical procedures after consulting with leading medical experts. You can rest assured that you are going to get the highest quality of medical care at the ease of your home. 

Here is a list of the facilities that you can get with our step down care package:


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Mr. Raj Shekhar

Age 32, Chennai

My father had a surgery and required regular healthcare services. Portea has greatly helped him with their in-home healthcare services.

Portea has started home infusion of cerezyme 0.8 (cerezyme replacement therapy) of gaucher disease. From past 5years. I have been undergoing ERT at Delhi hospital. But now with the help of Sanofi Genzyme, Portea done our first home infusion of cerezyme. The team which visited our home (Raghvendra sir and pramod) in this thought condition COVID and rainy weather on time and attended us were highly professional. From the very first step till the and of therapy they did everything very well. They took every percuations, share every details with as regarding home infusion of cerezyme , used every necessary equipment (infusion pump) for therapy, monitored us thoroughly. This new intiative for ERT is very nice and impressive. Thank you Raghvendra sir Thanks to portea and Sanofi for this arrangement.

We would like to put on record that we found the services of Nurse Jeesha and Nurse Sridevi to be excellent. They were competent, dedicated and compassionate Nurses who were able to establish a good rapport with the patient and the family caregivers. Your Nursing Supervisor Anthony Michael responded promptly and effectively to our communications. We would be happy to recommend the services of Portea.