The Status of Intra-hospital Transport of Hospitalized Patients in the Intensive Care Units of Sina and Imam Reza Hospitals of Tabriz, 2018

Abstract

Abstract: Background: Quality of care is a key issue in health-centered organizations and health centers. One of the most important pillars of quality care is maintaining patient safety in delivering health care. Providing care during intra-hospital transfers of critically ill patients is a process that can lead to adverse events and threaten patients’ safety. The aim of this study was to determine the status of intra-hospital transport of critically ill patients. designe: A cross-sectional study method: This study was carried out with 160 critical care nurses between September 2018 and January 2019. Also, 50 cases of intra-hospital transfers were observed. To determine the experiences of critical care nurses regarding intrahospital transport and to assess the status of patient transfer questionnaire and checklist designed by Bronsveld-reinders et al. In 2015 were used respectively. Data were collected through semi-structured interview and observation . the data were analysed using descriptive statistics in SPSS software and the responses of open-ended questions were analysed using the conventional qualitative content analysis. results: On a scale of 10 degrees, the mean and standard deviation of fear, confidence, and skill to carry out a safe intra-hospital transport was 2.66 (2.73), 6.45 (3.16), and 7.75 (1.55), respectively. The most important causes of feel of afraid or not confident in the transport from the nurses’ views were: unstable condition of the patient, cardiac arrest, extubation and oxygen desaturation. In all three phases of transport, oxygen desaturation, hemodynamic instability, and agitation were reported the most frequent events by nurses. The most important suggestions of nurses to prevent adverse events and to improve the transport process were paying attention to the patient's clinical condition and connections before, during and after the transfer. The results of observation of 50 cases of intrahospital transport showed that the mean and standard deviation of the patient’ eccompanying team were 3.5 (0.81). Only portable pulse oximetery is used to monitor the patient during transfer. Frequency of hemodynamic changes that required intervention included tachycardia 6(3.75), hypertension 7(4.37), oxygen desaturation 8(5), and tachypnea 3(1.87). In total, 160 cases of adverse events were observed. During interviews with nurses and observation of intra-hospital transport of patients there was no dedicated protocol or checklist for intra-hospital transfers performed for diagnostic or therapeutic purposes. Conclusions: Along with the acquisition and improvement of technical and tactical skills, adequate human resources, and appropriate equipment can improve the quality of the intra-hospital transport. The results of this study can be used to develop a strategic and operational plans in ICUs for improving the performance of nurses toward patients’ safety during the transport.