Related Experiment Videos
Mishaps during transport from the intensive care unit
I Smith1, S Fleming, A Cernaianu
1Department of Anesthesia, Cooper Hospital/University Medical Center, Camden, NJ 08103.
Abstract:
We undertook a prospective study of 125 intrahospital patient transports from the ICU in an attempt to identify any factors that could influence the occurrence of mishaps. One third of the transports sustained at least one mishap. Therapeutic intervention scoring system class IV transports had the highest rate of mishaps (35%). We found no relationship of occurrence of mishaps to severity of illness (Acute Physiology and Chronic Health Evaluation, APACHE II), number of lines, monitoring and support modalities, and time out of the ICU. Transports for elective procedures had more mishaps (60%) than occurred for emergencies (40%). Most mishaps occurred either during the procedure, on transports to CT scan, or while waiting at the destination. The numbers and types of escorts as defined by our ICU policy and physician attendance on transport did not clearly reduce mishap risk. Morbidity and mortality were not affected by mishaps. Although certain trends did emerge, no clearly defined predictive factor could be identified. Further study into transport mishaps is warranted.
Insights
Patient transports from the ICU frequently result in mishaps, particularly for high-acuity patients. While elective transports and CT scans showed higher mishap rates, no single predictive factor was identified.
Area of Science:
- Critical Care Medicine
- Patient Safety
- Healthcare Logistics
Background:
- Intrahospital patient transports are common but carry inherent risks.
- Mishaps during transport can potentially impact patient outcomes.
- Identifying risk factors for transport-related incidents is crucial for improving patient safety.
Purpose of the Study:
- To prospectively identify factors influencing mishaps during intrahospital patient transports from the Intensive Care Unit (ICU).
Main Methods:
- A prospective study was conducted on 125 intrahospital patient transports from the ICU.
- Data collected included patient acuity, procedure type, transport destination, and escort details.
- Mishaps were recorded and analyzed in relation to various transport characteristics.
Main Results:
- One-third of all transports experienced at least one mishap.
- Therapeutic Intervention Scoring System (TISS) class IV transports had the highest mishap rate (35%).
- Elective procedure transports had more mishaps (60%) than emergency transports (40%).
- Mishaps were most common during procedures, CT scans, or waiting periods.
- No significant relationship was found between mishaps and illness severity (APACHE II), monitoring, or time out of ICU.
- Escort composition and physician attendance did not significantly reduce mishap risk.
- Morbidity and mortality were not affected by the observed mishaps.
Conclusions:
- A significant proportion of ICU patient transports involve mishaps, with specific procedures and patient groups at higher risk.
- Despite identified trends, no definitive predictive factors for transport mishaps were established.
- Further research is necessary to better understand and mitigate risks associated with intrahospital patient transports.