Brunsveld-Reinders Anja H, Arbous M Sesmu, Kuiper Sander G, de Jonge Evert
Department of Intensive Care, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300, RC, Leiden, the Netherlands.
Crit Care. 2015 May 7;19(1):214. doi: 10.1186/s13054-015-0938-1.
Transport of critically ill patients from the Intensive Care Unit (ICU) to other departments for diagnostic or therapeutic procedures is often a necessary part of the critical care process. Transport of critically ill patients is potentially dangerous with up to 70% adverse events occurring. The aim of this study was to develop a checklist to increase safety of intra-hospital transport (IHT) in critically ill patients.
A three-step approach was used to develop an IHT checklist. First, various databases were searched for published IHT guidelines and checklists. Secondly, prospectively collected IHT incidents in the LUMC ICU were analyzed. Thirdly, interviews were held with physicians and nurses over their experiences of IHT incidents. Following this approach a checklist was developed and discussed with experts in the field. Finally, feasibility and usability of the checklist was tested.
Eleven existing guidelines and five checklists were found. Only one checklist covered all three phases: pre-, during- and post-transport. Recommendations and checklist items mostly focused on the pre-transport phase. Documented incidents most frequently related to patient physiology and equipment malfunction and occurred most often during transport. Discussing the incidents with ICU physicians and ICU nurses resulted in important recommendations such as the introduction of a standard checklist and improved communication with the other departments. This approach resulted in a generally applicable checklist, adaptable for local circumstances. Feedback from nurses using the checklist were positive, the fill in time was 4.5 minutes per phase.
A comprehensive way to develop an intra-hospital checklist for safe transport of ICU patients to another department is described. This resulted in a checklist which is a framework to guide physicians and nurses through intra-hospital transports and provides a continuity of care to enhance patient safety. Other hospitals can customize this checklist to their own situation using the methods proposed in this paper.
将重症患者从重症监护病房（ICU）转运至其他科室进行诊断或治疗操作通常是重症监护流程中的必要环节。重症患者的转运存在潜在危险，高达70%的患者会发生不良事件。本研究的目的是制定一份检查表，以提高重症患者院内转运（IHT）的安全性。
采用三步法制定IHT检查表。首先，检索各种数据库，查找已发表的IHT指南和检查表。其次，对吕伐登大学医学中心ICU前瞻性收集的IHT事件进行分析。第三，就IHT事件的经验对医生和护士进行访谈。按照此方法制定了一份检查表，并与该领域的专家进行了讨论。最后，测试了检查表的可行性和实用性。
共找到11份现有指南和5份检查表。只有一份检查表涵盖了所有三个阶段：转运前、转运中和转运后。建议和检查表项目大多集中在转运前阶段。记录的事件最常与患者生理状况和设备故障有关，且大多发生在转运期间。与ICU医生和ICU护士讨论这些事件后得出了一些重要建议，如引入标准检查表以及改善与其他科室的沟通。这种方法产生了一份普遍适用、可因地制宜的检查表。使用该检查表的护士反馈良好，每个阶段的填写时间为4.5分钟。
描述了一种为将ICU患者安全转运至另一科室而制定院内检查表的综合方法。这产生了一份检查表，它是指导医生和护士进行院内转运的框架，并提供了连续的护理以提高患者安全。其他医院可以使用本文提出的方法根据自身情况定制此检查表。
