Swickard Scott, Winkelman Chris, Hustey Fredric M, Kerr Mary, Reimer Andrew P
Director of Clinical Operations, Mercy Health Life Flight Network, 2213 Cherry St, Toledo, OH 43608.
Associate Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106.
Air Med J. 2018 Jul-Aug;37(4):253-258. doi: 10.1016/j.amj.2018.02.009. Epub 2018 Apr 23.
Patient safety events (PSEs) occurring during interfacility transport have not been studied comprehensively in critical care transport (CCT) teams in the United States. The purpose of this research was to investigate the type and frequency of PSEs during CCT between hospitals; to explore the impact of patient stability, vulnerability, complexity, predictability, and resiliency; and to examine if the nurse factors of licensure or experience and transport factors of duration or mode of transport influence the frequency of PSEs. The study was conducted at a large hospital-based quaternary health care system in the Midwestern United States.
This was a retrospective, descriptive correlational study using chart review. The study selected 50 sequential qualifying cases with PSEs and randomly selected control cases reviewed at a single site over a 5-month period.
The rate of PSEs was 27.7 events per 1,000 patient contacts. Of 9 reported adverse event types, new or recurrent hypoxia had the greatest frequency. Hypoxia, when present at the time of initial CCT contact, was associated with the PSE occurrence (P = .046). Duration of transport was a significant predictor of PSEs (P = .025).
Pretransport hypoxia and duration of transport are independent predictors for intratransport PSEs, particularly intratransport hypoxia.
在美国，针对重症监护转运（CCT）团队在医疗机构间转运过程中发生的患者安全事件（PSE）尚未进行全面研究。本研究的目的是调查医院间CCT期间PSE的类型和频率；探讨患者稳定性、脆弱性、复杂性、可预测性和恢复力的影响；并检验护士执照或经验等护士因素以及转运持续时间或转运方式等转运因素是否会影响PSE的发生频率。该研究在美国中西部一家大型的基于医院的四级医疗保健系统中进行。
这是一项使用病历审查的回顾性描述性相关性研究。该研究选取了50例连续的有PSE的合格病例，并在5个月的时间内在单一地点随机选取对照病例进行审查。
PSE的发生率为每1000次患者接触27.7起事件。在报告的9种不良事件类型中，新发或复发性缺氧的发生频率最高。初始CCT接触时出现的缺氧与PSE的发生相关（P = .046）。转运持续时间是PSE的一个重要预测因素（P = .025）。
转运前缺氧和转运持续时间是转运期间PSE的独立预测因素，尤其是转运期间的缺氧。
