Transporte intra-hospitalar de pacientes adultos em estado crítico: complicações relacionadas à equipe, equipamentos e fatores fisiológicos

Abstract

Objective: To identify in the literature the complications related to physiological changes of the patient, the multidisciplinary team and the use of equipment during the intrahospital transport of critically ill patients. Methods: Integrative review of literature, through a search in the databases of PubMED, MEDLINE, and LILACS. Results: We encountered 20 articles, all written in the English language. Studies have shown that changes in arterial pressure and heart rate are most common during transport. Of the adverse events related to problems with the team, the lack of knowledge of the professional and failure of communication stood out, apart from those derived from equipment used. Conclusion: Transporting the critically ill patient safely requires improving communication between teams, standardizing the actions and equipment used by means of protocols, and identifying opportunities to obtain excellence in service during transport. RESUMOObjetivo: Identificar na literatura as complicações relacionadas às alterações fisiológicas do paciente, à equipe multidisciplinar e ao uso de equipamentos durante o transporte intra-hospitalar de pacientes críticos. Métodos: Revisão integrativa da literatura, com busca nas bases de dados PUBMED, MEDLINE, e LILACS. Resultados: Foram encontrados 20 artigos, todos escritos na língua inglesa. Os estudos mostraram que as alterações na pressão arterial e na frequência cardíaca são as mais comuns durante o transporte. Dos eventos adversos relacionados a problemas com a equipe, destacaram-se, a falta de conhecimento do profissional e a falha de comunicação, além dos provenientes dos equipamentos utilizados. Conclusão: Transportar o paciente crítico de maneira segura significa melhorar a comunicação entre as equipes, padronizar as ações e equipamentos utilizados por meio de protocolos e identificar intercorrências para obter excelência no atendimento durante o transporte. Descritores: Transporte de pacientes; Transferência de pacientes; Cuidados críticos; Pacientes internados; Sintomas clínicos RESUMEN Objetivo: Identificar en la literatura las complicaciones relacionadas a las alteraciones fisiológicas del paciente, al equipo multidisciplinario y al uso de equipamientos durante el transporte intrahospitalario de pacientes críticos. Métodos: Revisión integrativa de la literatura, con búsqueda en las bases de datos PUBMED, MEDLINE, y LILACS. Resultados: Fueron encontrados 20 artículos, todos escritos en el idioma inglés. Los estudios mostraron que las alteraciones en la presión arterial y en la frecuencia cardíaca son las más comunes durante el transporte. De los eventos adversos relacionados a problemas con el equipo, se destacaron, la falta de conocimiento del profesional y la falla en la comunicación, además de los provenientes de los equipamientos utilizados. Conclusión: Transportar al paciente crítico de manera segura significa mejorar la comunicación entre los equipos, patronizar las acciones y equipamientos utilizados por medio de protocolos e identificar complicaciones...

Práticas assistenciais para segurança do paciente em unidade de terapia intensiva

“…(6) Professionals who work beyond the time period mentioned are more exposed to the risk of error, and the longer the shift the greater the number of accidents. (7) In the intensive care unit, where patients' clinical conditions range between narrow limits of normality/abnormality, where small organic changes can lead to severe impairment of body functions, the risk is greater. (2,8) The occurrence of errors is not only undesirable, but also harmful, thereby the issue of care safety and the context in which care is delivered is inevitably related to the assessment of health services.…”

Filosofia e marco conceitual: estruturando coletivamente a sistematização da assistência de enfermagem

“…In the literature pertaining to this field, holistic care is seen philosophically, because care is a holistic term, originating from the condition and philosophical and humanistic assumptions, belonging to the idea that the human system functions as a whole and is more than the sum the parts (11) . Participants also highlighted the excellence in service, aiming at quality, safe care for the user and their family.…”

“…Participants also highlighted the excellence in service, aiming at quality, safe care for the user and their family. Literature in the field addresses service with excellence, where it is possible to observe that the meaning applied is related to quality of care, humanization, communication between teams, activity and equipment standardization, use of protocols and identification of complications (11) . The nurse's role as team leader was emphasized by the participants, being one of the aspects highlighted in philosophy as well.…”

Checklist for the intrahospital transport of patients admitted to the Intensive Care Unit

“…The problems with the patients involved hypotension, arrhythmias, hypoxia, and increase in intracranial pressure. 15,[23][24] One of the studies recommends that IHT should be undertaken by a specialized team. This team requires scientific knowledge and administrative and financial support.…”

“…This team requires scientific knowledge and administrative and financial support. 23 The studies also emphasized that the evaluation of the patient, the use of protocols and guidelines for IHT, and evaluation of equipment and communication among transport team members are fundamental.…”