Communication between pre-hospital and intra-hospital emergency medical services: literature review

Abstract

Objectives: to analyze, according to the scientific literature, communication strategies in the transfer of cases between pre-hospital and in-hospital services and their contributions to patient safety. Methods: this is a literature review study, that is, one that aims to gather and synthesize research results on the subject in a systematic and orderly manner. Results: ten articles were published, published between 2010 and 2018, and two points of discussion emerged: use of mnemonics; and barriers to transferring a case. Conclusions: studies point to the need to standardize the case transfer process, as well as integrative training of professionals, regular assessment of the teams involved in emergency medical services and the need for research on the subject.

Incidents in the context of pre-hospital care by ambulances: contributions to patient safety

“…It is emphasized that pre-hospital care transfer requires the involvement of various organizations, teams, and professionals, creating a complex system that can result in specific challenges for high-quality transfer and, consequently, safe care (14) . The absence of standardized language in care transfer allows for a significant increase in adverse events (15) .…”

“…In this context, some protocols are used in an attempt to organize and expedite the process. Among them, we have: SBAR (Situation, Background, Assessment, and Recommendation); ATMIST (Name, Time of onset, Mechanism or complaint/history, Injury/investigations, Signs and Treatment); IMIST-AMBO (Identification, Mechanism/complaint, Injury/information related to the complaint, Signs and Symptoms, Treatment and Allergies, Medications, Brief History, and other relevant information); and ASCHICE (age, sex, history, injury, condition, estimated time of arrival) (15) . The absence of an implemented and trained protocol in MPHC services may contribute to information loss during patient transfer between pre-hospital and intra-hospital care systems.…”

Effect of Intra-Hospital Safe Transportation Guidelines for Critically Ill Patients on Nurses' Performance and Patients' Clinical Outcomes

“…Intra-Hospital transportation related complications; It was developed by the researcher after reviewing the relevant literature (Putra et al, 2022& Souza et al, 2022 and was used to assess CIPs complications and adverse events that can occur during and post IHT which included; disconnection of endotracheal tube/tracheostomy tube, intravenous lines, disconnection/removal of chest tube, nasogastric tube displacement, disconnection of wound drainage, accidental central line catheter removal or blocked, Spo 2 fall > 5% from baseline for more than 1 min, temperature <35 0 C (hypothermia, increase heart rate, decrease 20 mmHg in systolic and 10 mmHg decrease in diastolic pressure from baseline for more than 5 min (hypotensive event), Increase 20 mmHg in systolic and 10mmhg increase in diastolic pressure from baseline for more than 5 min (hypertensive event), arterial line blocking, accidental dislodging of urinary catheter, altered in mental status, needing advanced 02 support, hypoxia, and cardiac arrest…”

“…Thus, reducing the frequency of adverse events during intra-hospital transportation requires competent nursing knowledge and practice. Additionally, competent nurses play a critical role in improving patient outcomes and their own practice (Souza et al, 2022).…”

Effect of Educational Program about Intra-Hospital Safety Transportation of Critically Ill Patients on Nurses' Performance and Patients' Clinical Outcomes

“…The score had been summed up and converted into total score percent according to the following category: Low level of knowledge was considered less than 60% moderate level of knowledge was considered from 60% to less than 80% high level of knowledge was considered from 80% and more. Tool II: Critical Care Nurses Observational Checklist regarding Intra-Hospital Transportation: This tool was developed by the researcher after reviewing the relevant literature (9)(10)(11)(12)(13) to assess nurses' practice before, during and post IHT through a designed observational checklist. The nurses' practice consisted of 6 domains; checking of necessary equipment (22 items), preparation of necessary medications (5 items), preparation of the patient's connected tubes, devices, intravenous fluids and position (19 items), checking of cardiac monitor and ventilator position (7 items) monitoring of hemodynamic parameters (7 items), nurse' practice during transportation phase (7 items), and nurse' practice immediate post IHT.…”