Abstract

Objective: The purpose of this study was to identify the intrahospital transport practices of pediatric intensive care units and the adverse events that occurred during intrahospital transport in Türkiye.

Method: In this descriptive study, a questionnaire with 22 questions was used, which was created by the researchers based on the relevant literature. The questionnaire was filled out electronically.

Results: The study included 26 centers from 13 different provinces. In terms of intrahospital transport practices, 53.8% of the units lacked a written protocol for patient transport, and 92.3% did not utilize a transport preparation checklist. It was determined that in 65.4% of the units, a nurse accompanied a physician during transport. Examining the adverse events during intrahospital transport, findings reveal that 96.2% of the units reported a decrease in oxygen saturation, 80.8% hypotension, 73.1% hypothermia, 61.5% unplanned extubation, and 61.5% cardiac arrest. It was found that 7.7% of the units had an accident with mortality during transportation.

Conclusion: As a result of our study, it has been determined that many of the measures recommended in the literature to ensure the safe transport of intensive care patients are implemented at varying rates, and adverse events occur during intrahospital transport. In pediatric intensive care units, it is crucial to utilize a written in-hospital transport protocol when transporting pediatric patients and to enhance monitoring procedures during transportation.

Keywords: Pediatric intensive care, intrahospital transport, patient safety, nursing

Copyright and license

Copyright © 2023 The author(s). This is an open-access article published by Aydın Pediatric Society under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Arslan G, Köker A, Benligül EM. Intrahospital transport practices of pediatric intensive care units and adverse events experienced during transport process in Türkiye. Trends in Pediatrics. 2023;4(3):186-191. https://doi.org/10.59213/TP.2023.60352

References

  1. Karaböcüoğlu M, Köroğlu TF. Çocuk yoğun bakım kavramı ve yatış-çıkış endikasyonları. In: Karaböcüoğlu M, Köroğlu TF, editors, Çocuk Yoğun Bakım Esaslar ve Uygulamalar. 1st ed. İstanbul: İstanbul Medikal Yayıncılık; 2008;3-8.
  2. Murata M, Nakagawa N, Kawasaki T, et al. Adverse events during intrahospital transport of critically ill patients: a systematic review and meta-analysis. Am J Emerg Med. 2022;52:13-9. https://doi.org/10.1016/j.ajem.2021.11.021
  3. Haydar B, Baetzel A, Elliott A, MacEachern M, Kamal A, Christensen R. Adverse events during intrahospital transport of critically ill children: a systematic review. Anesth Analg. 2020;131:1135-45. https://doi.org/10.1213/ANE.0000000000004585
  4. Veiga VC, Postalli NF, Alvarisa TK, et al. Adverse events during intrahospital transport of critically ill patients in a large hospital. Rev Bras Ter Intensiva. 2019;31:15-20. https://doi.org/10.5935/0103-507X.20190003
  5. Quenot JP, Milési C, Cravoisy A, et al. Intrahospital transport of critically ill patients (excluding newborns) recommendations of the Société de Réanimation de Langue Française (SRLF), the Société Française d'Anesthésie et de Réanimation (SFAR), and the Société Française de Médecine d'Urgence (SFMU). Ann Intensive Care. 2012;2:1. https://doi.org/10.1186/2110-5820-2-1
  6. Nakayama DK, Lester SS, Rich DR, Weidner BC, Glenn JB, Shaker IJ. Quality improvement and patient care checklists in intrahospital transfers involving pediatric surgery patients. J Pediatr Surg. 2012;47:112-8. https://doi.org/10.1016/j.jpedsurg.2011.10.030
  7. Kue R, Brown P, Ness C, Scheulen J. Adverse clinical events during intrahospital transport by a specialized team: a preliminary report. Am J Crit Care. 2011;20:153-61; quiz 162. https://doi.org/10.4037/ajcc2011478
  8. Esmail R, Banack D, Cummings C, et al; Patient safety and adverse events team. Is your patient ready for transport? Developing an ICU patient transport decision scorecard. Healthc Q. 2006;9 Spec No:80-6. https://doi.org/10.12927/hcq.2013.18376
  9. Horoz ÖÖ, Yıldızdaş Y, Menemencioğlu A. Çocuk yoğun bakım ünitesinde yatan ve hastane içi transport gerektiren hastalarımızın değerlendirilmesi. Çocuk Acil ve Yoğun Bakım Dergisi. 2014;1:25-30.
  10. Brunsveld-Reinders AH, Arbous MS, Kuiper SG, de Jonge E. A comprehensive method to develop a checklist to increase safety of intra-hospital transport of critically ill patients. Crit Care. 2015;19:214. https://doi.org/10.1186/s13054-015-0938-1
  11. Fanara B, Manzon C, Barbot O, Desmettre T, Capellier G. Recommendations for the intra-hospital transport of critically ill patients. Crit Care. 2010;14:R87. https://doi.org/10.1186/cc9018
  12. Day D. Keeping patients safe during intrahospital transport. Crit Care Nurse. 2010;30:18-32; quiz 33. https://doi.org/10.4037/ccn2010446
  13. Papson JP, Russell KL, Taylor DM. Unexpected events during the intrahospital transport of critically ill patients. Acad Emerg Med. 2007;14:574-7. https://doi.org/10.1197/j.aem.2007.02.034
  14. Beckmann U, Gillies DM, Berenholtz SM, Wu AW, Pronovost P. Incidents relating to the intra-hospital transfer of critically ill patients. An analysis of the reports submitted to the Australian incident monitoring study in intensive care. Intensive Care Med. 2004;30:1579-85. https://doi.org/10.1007/s00134-004-2177-9
  15. Lovell MA, Mudaliar MY, Klineberg PL. Intrahospital transport of critically ill patients: complications and difficulties. Anaesth Intensive Care. 2001;29:400-5. https://doi.org/10.1177/0310057X0102900412
  16. Wallen E, Venkataraman ST, Grosso MJ, Kiene K, Orr RA. Intrahospital transport of critically ill pediatric patients. Crit Care Med. 1995;23:1588-95. https://doi.org/10.1097/00003246-199509000-00020
  17. Williams P, Karuppiah S, Greentree K, Darvall J. A checklist for intrahospital transport of critically ill patients improves compliance with transportation safety guidelines. Aust Crit Care. 2020;33:20-4. https://doi.org/10.1016/j.aucc.2019.02.004
  18. Jarden RJ, Quirke S. Improving safety and documentation in intrahospital transport: development of an intrahospital transport tool for critically ill patients. Intensive Crit Care Nurs. 2010;26:101-7. https://doi.org/10.1016/j.iccn.2009.12.007
  19. Choi HK, Shin SD, Ro YS, Kim DK, Shin SH, Kwak YH. A before- and after-intervention trial for reducing unexpected events during the intrahospital transport of emergency patients. Am J Emerg Med. 2012;30:1433-40. https://doi.org/10.1016/j.ajem.2011.10.027
  20. Alizadeh Sharafi R, Ghahramanian A, Sheikhalipour Z, Ghafourifard M, Ghasempour M. Improving the safety and quality of the intra-hospital transport of critically ill patients. Nurs Crit Care. 2021;26:244-52. https://doi.org/10.1111/nicc.12527
  21. Harish MM, Siddiqui SS, Prabu NR, Chaudhari HK, Divatia JV, Kulkarni AP. Benefits of and untoward events during intrahospital transport of pediatric intensive care unit patients. Indian J Crit Care Med. 2017;21:46-8. https://doi.org/10.4103/0972-5229.198326
  22. Nonami S, Kawakami D, Ito J, et al. Incidence of adverse events associated with the in-hospital transport of critically ill patients. Crit Care Explor. 2022;4:e0657. https://doi.org/10.1097/CCE.0000000000000657
  23. Bergman L, Pettersson M, Chaboyer W, Carlström E, Ringdal M. Improving quality and safety during intrahospital transport of critically ill patients: A critical incident study. Aust Crit Care. 2020;33:12-9. https://doi.org/10.1016/j.aucc.2018.12.003
  24. Bodur HA. Kritik hastanın transportu. Yoğun Bakım Dergisi. 2005;5:36-41.
  25. Wells JL, Murphy PS. Clearing the runway: an innovative approach to preparing an intensive care unit patient for a magnetic resonance imaging scan. Journal of Radiology Nursing. 2014;33:147-51. https://doi.org/10.1016/j.jradnu.2014.01.001
  26. Ringdal M, Chaboyer W, Warrén Stomberg M. Intrahospital transports of critically ill patients: critical care nurses' perceptions. Nurs Crit Care. 2016;21:178-84. https://doi.org/10.1111/nicc.12229
  27. Delacrétaz R, Fischer Fumeaux CJ, Stadelmann C, Rodriguez Trejo A, Destaillats A, Giannoni E. Adverse events and associated factors during intrahospital transport of newborn infants. J Pediatr. 2022;240:44-50. https://doi.org/10.1016/j.jpeds.2021.08.074
  28. Jia L, Wang H, Gao Y, Liu H, Yu K. High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China. Crit Care. 2016;20:12. https://doi.org/10.1186/s13054-016-1183-y