Peter Williams1, Sathappan Karuppiah2, Kate Greentree3, Jai Darvall4. 1. Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia. Electronic address: peter.daniel.williams@gmail.com. 2. Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia. 3. Royal Melbourne Hospital Clinical School, University of Melbourne, Parkville, Victoria, Australia. 4. Department of Anaesthesia and Pain Management and Intensive Care Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre for Integrated Critical Care, University of Melbourne, Parkville, Victoria, Australia.
Abstract
OBJECTIVES: Critically ill patients are often transferred from the intensive care unit (ICU) to other locations around the hospital during which adverse events, some life threatening, are common. An intercollegiate guideline covering the transport of critically ill patients exists in Australasia; however, compliance with this guideline has previously been shown to be poor, and its role in improving safety in transportation of patients in the ICU is unknown. We performed a pre-post interventional study in a tertiary metropolitan ICU, assessing the impact of the introduction of a transport checklist on guideline compliance. METHODS: We performed a prospective, pre-post interventional study, including a total of 76 transfers of critically ill patients between August 2016 and April 2017. RESULTS: After introduction of the checklist, aggregate median (interquartile range) guideline compliance improved from 86.7% (80.0-92.9) to 90% (86.7-100) (p = 0.01). Significant improvements were found in notification of the transport destination (83.7% vs 100%, p = 0.010) and transporting doctors' knowledge of the Cormack-Lehane grade of laryngoscopy (60.5% vs. 84.2%, p = 0.021). There was, however, a reduction in the proportion of full oxygen cylinders taken on transports (100% vs. 76.3%, p = 0.002). CONCLUSIONS: We conclude that a checklist is useful in improving safety in the transport of a critically ill patient population.
OBJECTIVES:Critically illpatients are often transferred from the intensive care unit (ICU) to other locations around the hospital during which adverse events, some life threatening, are common. An intercollegiate guideline covering the transport of critically illpatients exists in Australasia; however, compliance with this guideline has previously been shown to be poor, and its role in improving safety in transportation of patients in the ICU is unknown. We performed a pre-post interventional study in a tertiary metropolitan ICU, assessing the impact of the introduction of a transport checklist on guideline compliance. METHODS: We performed a prospective, pre-post interventional study, including a total of 76 transfers of critically illpatients between August 2016 and April 2017. RESULTS: After introduction of the checklist, aggregate median (interquartile range) guideline compliance improved from 86.7% (80.0-92.9) to 90% (86.7-100) (p = 0.01). Significant improvements were found in notification of the transport destination (83.7% vs 100%, p = 0.010) and transporting doctors' knowledge of the Cormack-Lehane grade of laryngoscopy (60.5% vs. 84.2%, p = 0.021). There was, however, a reduction in the proportion of full oxygen cylinders taken on transports (100% vs. 76.3%, p = 0.002). CONCLUSIONS: We conclude that a checklist is useful in improving safety in the transport of a critically illpatient population.