Improving the safety and quality of the intra‐hospital transport of critically ill patients

Abstract

Background: Adverse events during patient transport are common and may threaten critically ill patients' lives.Aim: This study aimed to determine the incidence of adverse events during intrahospital transport and to obtain suggestions from critical care nurses for improving the transportation process.Design: This was a cross-sectional study.Methods: This study was carried out with 160 critical care nurses between September 2018 and January 2019. Data were collected through a semi-structured interview using a 53-item questionnaire developed by Brunsveld-Reinders et al. It assesses nurses' experiences of adverse events during the three phases of intra-hospital transport related to equipment, patient physiology, monitoring, medications, and fluid management. The data were analysed using descriptive statistics in SPSS software, and the responses of open-ended questions were analysed using a conventional qualitative content analysis.Results: On scales from 0 to 10, the mean (and SD) values of fear, confidence, and skill to carry out a safe intra-hospital transport were 2.66 (2.73), 6.45 (3.16), and 7.75(1.55), respectively. The most important causes of feeling afraid or unconfident about the transport among the nurses were unstable patient condition, cardiac arrest, extubation, and oxygen desaturation. In all three phases, oxygen desaturation, haemodynamic instability, and agitation were reported as the most frequent events.The most important suggestions by nurses for improving the transport process were related to paying attention to the patient's clinical condition and connections before, during, and after the transfer.Conclusions: Along with the acquisition and improvement of technical and tactical skills, adequate human resources and appropriate equipment can improve the quality of intra-hospital transport.Relevance to clinical practice: Nurses are key members of the transport team and lead the team. They are responsible for keeping patients safe during transport. By identifying adverse events and trying to modify risk factors, nurses can improve patients' safety.

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

“…It also considered the effective time to learn and modify their practice through training in ICU to improve the sense of identity and develop successful intimate relations. This finding is in the same line with Alizadeh sharafi et al (2021) (17) ,who reported that more than three quarters of the studied nurses had age less than 30 years old and more than half of them were female. Additionally, Xie et al (2020) (18) reported that the majority of studied nurses were less than 30 years old.…”

Intrahospital transport of critically ill patients: A survey of emergency nurses

“…The results of this survey are consistent with an ICU study in Australia, wherein 39% of adverse events were related to equipment failure 20 . Although these adverse events are not directly related to patients, they may pose potential threats to life, and can be averted by employing strategies such as the use of checklists 21,22 and development of training interventions 23,24 and technical solutions 25 . Notably, most of the tools and technologies currently used during transport have not been designed for this purpose; thus, they cannot possibly fulfil all the requirements of the transport process.…”

Proactive risk assessment of intrahospital transport of critically ill patients from emergency department to intensive care unit in a teaching hospital and its implications

“…In September 2020, we passed the re‐evaluation for class III A general hospital with a high score, and the quality of IHT was recognised by experts. We believed that it can be helpful in other similar hospitals facing the same problems with IHT in which nurses are playing an important role (Alizadeh Sharafi et al, 2020).…”