Incidents relating to the intra-hospital transfer of critically ill patients

Abstract

Intra-hospital transport poses an important risk to ICU patients. The adequate provision of highly qualified staff, specially designed and well maintained equipment, as well as continuous monitoring are essential to avoid/mitigate these incidents. Professional societies and local units should adopt guidelines/protocols for intra-hospital transportation. Monitoring of incidents should aid in the continuous improvement in patient safety.

Transporte intra-hospitalar de pacientes adultos em estado crítico: complicações relacionadas à equipe, equipamentos e fatores fisiológicos

“…The rate adverse events observed during transportation ranged from 30% to 70% of all cases of intrahospital transportation (7,(12)(13) . The most frequently observed events included: patients' physiological alterations, problems in the multidisciplinary team involved in the transport, inter-staff communication, and equipment failure.…”

“…The studies, in general, report a series of physiological alterations patients may experience during intrahospital transport, among them, increased heart rate (4,7,12) , altered blood pressure (4,7,12) , increased intracranial pressure (12) , arrhythmias (4,7,12) , heart attacks (12) , altered respiratory rate (4,12) , decreased oxygen satura-tion (4,7) , increase in airway pressure (7) , airway obstruction by secretion (7) , excessive coughing (7) , agitation (7) , bleeding (7), , hypo/hypercapnia (12) , hypoxemia (7,12) and cardiac arrest (7,14) . Change in blood pressure and cardiac rate are the most frequently found.…”

“…The analysis of professionals involved in the occurrence of events during transport shows that the incidence of events triggered by the nursing staff was smaller when compared to the medical team (22% and 26% respectively) and similar to that found among other health workers (22%). Additionally, the incidents that did occur were primarily detected by nursing professionals (82%) (7) .…”

“…In this sense, the safety of patients during transport has been facilitated by the development of appropriate equipment, trained staff, and the development of specific protocols, since this is a population exposed to potential complications and instability that is inherent to the primary disease (7)(8)(9) .…”

“…Successful intrahospital transportation directly depends on the planning and work organization of the multidisciplinary team, as well as the use of appropriate equipment (6)(7) . In this context, an important aspect in the transportation of patients is the prior communication of information between the staff transporting the patient and the staff receiving the patient so that the safety and continuity of health care is reinforced (10) .…”