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Keywords

Adverse effects, Critical care, Intensive care units, Intrahospital, Patient transfer, Transportation of patients

 

Authors

  1. Jones, Honey M. DNP, ACNP-BC
  2. Zychowicz, Michael E. DNP, ANP, ONP, FAANP
  3. Champagne, Mary PhD, RN, FAAN
  4. Thornlow, Deirdre K. PhD, RN, CPHQ

Abstract

Background: Intrahospital transport of the critically ill adult carries inherent risks that can be manifested as unexpected events.

 

Objective: The aim of this study is to evaluate the implementation of a standardized evaluation plan for intrahospital transports to/from adult intensive care units.

 

Methods: Nurses at a level I trauma/academic center captured clinical data throughout transport. Outcome measures included compliance with the organization's transport policy and unexpected events.

 

Results: There were 502 transports audited. Most nurses were compliant with the policy, except for the stabilization process (n = 174, 34.7%). Forty-one transports (8.2%) had an unexpected event, and 11 of these transports (26.8%) were aborted. Most of the events were hemodynamic (12), sedation (11), respiratory (10), and gastrointestinal (5). Fewer events occurred with the transport team (P = .036) and among nurses with a bachelor of science in nursing or higher degree (P = .002). Events were higher among transporting nurses with only 0 to 2 years of intensive care unit experience (P = .002), "stabilized" transports (P = .022), and patients with higher Acute Physiology and Chronic Health Evaluation scores (P = .009).

 

Conclusions: Health care organizations should have a policy that includes both transport and evaluation plans for intrahospital transport. Guidelines should be revised with specific criteria for the stabilization process and unexpected events. Revision should also have a standardized evaluation plan that includes an audit tool to measure incidence of unexpected events and a rapid change quality improvement method.