Intrahospital Transport of the Critically Ill Adult: A Standardized Evaluation Plan. Issue 3 (May 2016)

• Record Type: Journal Article
• Authors: Jones, Honey M.; Zychowicz, Michael E.; Champagne, Mary; Thornlow, Deirdre K.
• Is Part Of: Dimensions of critical care nursing. Volume 35:Issue 3(2016:May/Jun.)
• Publication Date: 2016-05
• Subjects: Adverse effects -- Critical care -- Intensive care units -- Intrahospital -- Patient transfer -- Transportation of patients; Intensive care nursing -- Periodicals; 610.736
• DOI: 10.1097/DCC.0000000000000176
• Languages: English
• ISSNs: 0730-4625

Abstract

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.