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Focus on patient safety - « Intrahospital transport of critically ill patients... Transport is critical too »
Context
In 2019, the French national survey of serious care-related adverse events in healthcare facilities revealed that such serious events continued to occur in critical care departments and that, in contrast with other sectors, their incidence density had not decreased in these settings since 2009 [1] [2].
An analysis of serious critical care-related adverse events reported by healthcare professionals revealed that the intrahospital transport of critically ill patients could be implicated in the occurrence of serious adverse events that are very often avoidable. Intrahospital transport is necessary for the management of patients in the critical care setting. The frequency of transport-related adverse events is highly variable depending on the studies, but life-threatening complications are reported in 6.7% to 16.8% of patient transport operations [3] [4]. It therefore seemed important to publish feedback on this subject.
Objectives
By sharing feedback relative to the occurrence of serious adverse events during the intrahospital transport of critically ill patients, this Focus on patient safety aims to:
- alert healthcare professionals and care teams about the occurrence of serious care-related adverse events that could have been avoided by following good clinical practice;
- help reduce the risks related to the intrahospital transport of critically ill patients;
- improve information and training for healthcare personnel on the intrahospital transport of critically ill patients.
So it doesn’t happen again
Based on an analysis of the serious care-related adverse events reported, these events are usually caused by inadequate training of personnel, the absence of a department procedure, poor practice or a failure to monitor the patient.
Main key messages to prevent these events:
- always assess the need for intrahospital transport and the benefit-risk balance;
- always ensure the continuity of monitoring initiated in the critical care department;
- always organise intrahospital transport: trained personnel with access to emergency treatments, procedure, equipment, checklist, emergency call facility.
[1] https://sante.gouv.fr/IMG/pdf/eneis_3_2019_.pdf
[3] Aliaga M. Diagnostic yield and safety of CT scans in ICU Intensive. Care Med, 2015.
[4] Parmentier-Decrucq E. Adverse events during intrahospital transport of critically ill patients. Ann Intensive Care, 2013.
