Predictors of Transport Safety for Critically Ill Patients in Emergency Department: Experience of A Medical Center in Mid-Taiwan

• Main Authors: Shu-Hui Fu, 傅淑惠
• Other Authors: Tong-Yuan,Koo
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/52962681950124324598

碩士 === 雲林科技大學 === 工業工程與管理研究所碩士班 === 98 === Abstract Backround: We will take a great risk while the critically ill patients are transported from emergency department to intensive units, so the transport of the critically ill patients is important issue to emergency department. If there are any exception events during transport, they maybe cause the medical malpractices. According to literature reviews, it is better to develop a standard operating process as a guideline for transport and the crews of transport will string along with the critically ill patients when they are transported to intensive units. By the use of the proper measurement tools and process, we can provide safe and effective transports to these patients. In current conditions, the policy of transporting the critically ill patients is to follow the checklist of patient transport process and there are few issues for predictors of transporting critically ill patients, including underlying diseases, tubes of treatment, severity of diseases, and seniority and experience of nursing members. Method and material: Our study is based on the safety indicators of “Checklist for intrahospital transport of the critically ill patients in emergency department”, which include (1) a drop of oxygen saturation more than 5%; (2) a drop of systolic blood pressure (SBP) more than 10 mmHg; (3) equipment problems during transport; (4) Transport duration more than 20 min. They will not be transported if patients meet the safety indicators. There are 751 checklists enrolled and 4 safety indicators analyzed in our study between 1 May 2009 and 30 November 2009. Analyze the medical chart records retrospectively, including the classification of diseases, numbers of tubes upon the patients, severity of diseases (APACHE II score), the seniority and advanced ability of the medical team members, to understand the related factors that interfere with the indicators of intrahospital transport. Identify “high-risk transported patients” to transport patients to be more secure. Result: Our study revealed that patients, with high APACHE II score, shock, pneumonia, respiratory failure, poisoning, head injury, chronic obstructive pulmoarny disease (COPD), post-resuscitation, foley tube, endotracheal tube and central venous catheter, which impact SBP and oxygen saturation, are the high-risk group during transport. The seniority and advanced ability of nurses are associated with transport indicators, so the senior medical care members should pay much attention to the safety of patients during the process of transporting these patients. Conclusion: We conclude that checklist for intrahospital transport is recommended for the critically ill patients, especially for the high-risk group. Strengthen pre-transport preparation, such as the support of personnel or equipment, to prevent the occurrence of accident during the process of transporting. KEY WORDS: Checklist, Critically ill patient, Emergency department, Intrahospital transport, Patients safety