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在转移至新的重症监护病房期间进行多次院内转运。

Multiple intra-hospital transports during relocation to a new critical care unit.

作者信息

O'Leary R-A, Conrick-Martin I, O'Loughlin C, Curran M-R, Marsh B

机构信息

Department of Critical Care Medicine, Mater Misericordiae University Hospital, Dublin 7, Ireland.

出版信息

Ir J Med Sci. 2017 Nov;186(4):815-820. doi: 10.1007/s11845-016-1528-1. Epub 2016 Nov 7.

Abstract

OBJECTIVE

Intra-hospital transport (IHT) of critically ill patients is associated with morbidity and mortality. Mass transfer of patients, as happens with unit relocation, is poorly described. We outline the process and adverse events associated with the relocation of a critical care unit.

DESIGN

Extensive planning of the relocation targeted patient and equipment transfer, reduction in clinical pressure prior to the event and patient care during the relocation phase.

SETTING

The setting was a 30-bed, tertiary referral, combined medical and surgical critical care unit, located in a 570-bed hospital that serves as the national referral centre for cardiothoracic surgery and spinal injuries.

PARTICIPANTS

All stakeholders relevant to the critical care unit relocation were involved, including nursing and medical staff, porters, information technology services, laboratory staff, project development managers, pharmacy staff and building contractors.

MAIN OUTCOME MEASURES

Mortality at discharge from critical care unit and discharge from hospital were the main outcome measures. A wide range of adverse events were prospectively recorded, as were transfer times.

RESULTS

Twenty-one patients underwent IHT, with a median transfer time of 10 min. Two transfers were complicated by equipment failure and three patients experienced an episode of hypotension requiring intervention. There were no cases of central venous or arterial catheter or endotracheal tube dislodgement, and hospital mortality at 30 days was 14%.

CONCLUSION

Although IHT is associated with morbidity and mortality, careful logistical planning allows for efficient transfer with low complication rates.

摘要

目的

重症患者的院内转运(IHT)与发病率和死亡率相关。患者的大规模转移,如科室搬迁时发生的情况,鲜有描述。我们概述了重症监护病房搬迁的过程及相关不良事件。

设计

对搬迁进行了广泛规划,目标是患者和设备转移、在事件发生前减轻临床压力以及在搬迁阶段进行患者护理。

地点

地点为一家拥有570张床位的医院内一个有30张床位的三级转诊综合内科和外科重症监护病房,该医院是心胸外科手术和脊柱损伤的国家转诊中心。

参与者

所有与重症监护病房搬迁相关的利益相关者都参与其中,包括护理和医务人员、搬运工、信息技术服务人员、实验室工作人员、项目开发经理、药房工作人员和建筑承包商。

主要观察指标

重症监护病房出院时和医院出院时的死亡率是主要观察指标。前瞻性记录了一系列不良事件以及转运时间。

结果

21例患者接受了院内转运,转运时间中位数为10分钟。两次转运因设备故障而复杂化,3例患者出现低血压发作需要干预。没有中心静脉或动脉导管或气管内导管移位的病例,30天的医院死亡率为14%。

结论

虽然院内转运与发病率和死亡率相关,但精心的后勤规划可实现高效转运且并发症发生率低。

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