Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.
Centre for Applied Nursing Research (CANR), Western Sydney University, Liverpool, NSW, Australia.
J Clin Nurs. 2017 Dec;26(23-24):4927-4935. doi: 10.1111/jocn.13976. Epub 2017 Oct 10.
To determine whether there was an association between intra-hospital transfers and adverse outcomes.
Transfers between clinical units and between beds on the same unit are routine aspects of an episode of care in acute hospitals. The rate of these transfers per episode has increased in response to high occupancy levels, a decline in bed numbers, and increased demand for hospital services. The impact of the number of transfers between both wards and beds on patient outcomes is not widely explored.
Retrospective cross sectional design using hospital administrative data.
Data were extracted from existing hospital administrative datasets for one large metropolitan hospital for the financial year 2008-09 in Australia (n = 14,133). Descriptive analyses and logistic regression models were developed for each of 3 selected patient outcomes.
Nearly one-tenth of patients (9.2%) experienced a fall with injury, 3.8% of surgical patients a wound infection and 0.1% a complication from medication errors. For each bed or ward transfer, the odds of falls and wound infections increased. Medication errors were not associated with either bed or ward moves.
Hospitals should minimise the number of bed and ward transfers per episode of care in order to reduce the likelihood of adverse patient outcomes. Current bed management policies and practices should be evaluated and further refined to address this need. Additional strategies include improving coordination and communication during and after transfer.
Nurses must consider the potential cost of intrahospital transfers on patients, length of stay and bed availability.
确定院内转科与不良结局之间是否存在关联。
在急性医院中，临床科室之间以及同一科室床位之间的转科是护理过程的常规内容。由于高入住率、床位数量减少以及对医院服务需求的增加，每例转科的数量有所增加。转科的次数（包括科室之间和床位之间）对患者结局的影响尚未广泛探讨。
使用医院管理数据进行回顾性横断面设计。
从澳大利亚一家大型都市医院的 2008-09 财政年度现有医院管理数据集提取数据（n=14133）。针对 3 种选定的患者结局，分别进行描述性分析和逻辑回归模型分析。
近十分之一的患者（9.2%）发生跌倒致伤，3.8%的手术患者发生伤口感染，0.1%的患者发生药物错误相关并发症。每次床位或科室转科，跌倒和伤口感染的几率都会增加。药物错误与床位或科室转移均无关。
为降低不良患者结局的可能性，医院应尽量减少每次护理过程中的床位和科室转科次数。应评估并进一步完善当前的床位管理政策和实践，以满足这一需求。其他策略包括改善转科期间和之后的协调和沟通。
护士必须考虑院内转科对患者、住院时间和床位可用性的潜在成本。
