Intrahospital transports of critically ill patients: critical care nurses' perceptions

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Abstract

Background:

Between 30% and 70% of intrahospital transports is associated with some form of adverse event, compromising patient safety.

Aims:

(1) To describe critical care nurses' perceptions of intrahospital transport problems, including the stress associated with transport and their perceived ability to respond appropriately to these problems; (2) to determine if there were associations between problems and responses.

Design and methods:

This survey was conducted in three intensive care units. Descriptive data and correlations between perceived problems and responses and correlations between perceptions of the problems and ability to respond appropriately were calculated. Results from the open-ended item were categorised.

Results:

Eighty-six nurses completed the web survey, a response rate of 57%. Two-thirds said their intensive care Units had written transport guidelines, and two-thirds of the transports were performed by nurses without physicians. Circulatory failure was the most frequently perceived problem (4·2±2·8) followed by decreased levels of consciousness (3·5±2·9). Positive correlations between two perceived patient problems, circulatory failure and neurological deterioration and nurses' perceptions of how to respond appropriately to them, were identified. Failure in pulse oximetry and equipment-related problems were positively correlated to nurses' responses. Nurses described the transports as an unsafe and stressful task: ‘It's like a marathon race’.

Conclusion:

Nurses report that undertaking transports were a stressful activity, but they perceived transport problems to be an infrequent occurrence. They stated that they respond appropriately to the problem.

Relevance to clinical practice:

Nurses reported they were alert to the potential risks patients face during transport. Because fewer staff remained in the intensive care units, these remaining patients are also at risk during intrahospital transport.

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