Checklist para o transporte intra-hospitalar seguro do doente crítico: A scoping review

Abstract

Transportar a un paciente crítico conlleva una serie de riesgos que pueden poner en peligro su seguridad. Conocer los riesgos asociados con el transporte intrahospitalario es esencial para mejorar su seguridad. Elegimos estudiar la lista de verificación de transporte intrahospitalario, ya que la literatura los describe como una forma práctica y simple de aumentar la seguridad.Objetivo: Mapear la envidencia científica existente sobre los aspectos del check list o lista de verificación garantizando la seguridad del paciente crítico en el transporte intrahospitalario. Material y método: Se realizó un scoping review através de la metodologia The Joanna Briggs Institute, utilizando los motores de búsqueda EBSCOhost y B-on. La investigación fue realizada en portugués, inglés y español. Fueron seleccionados artículos con texto libre, sin límite de tiempo. Los criterios incluídos: el paciente crítico adulto/anciano, transporte intrahospitalario, la lista de verificación y la seguridad del paciente.Resultados: Se incluyeron 7 artículos. La mayoría de los aspectos de la lista de verificación se enfoca en la preparación del transporte, el aspecto que más se menciona es la monitorización del paciente. La parte después del transporte, aspectos de la lista de verificación solo es mencionada en 3 de los 7 artículos.Conclusión: Todos los estudios constatan aspectos que pueden incluírse en una lista de verificación y que mejoran la seguridad de los pacientes críticos en el transporte intrahospitalario. No hay unanimidad en cuanto a qué aspectos incluir en la lista de verificación. Transporting critically ill patients is has a set of risks that may jeopardize their safety. Knowing the risks associated with intrahospitalar transport of critically ill patients is essential to improving patient safety. For the sake of improving patient safety, was chosen to approach it as an intrahospitalar transport checklist, as the literature describes it as a practical and simple way to increase safety.Objective: Map available scientific evidence regarding aspects of a checklist that ensure the safety of critically ill patients in intrahospitalar transport.Material and Method: A scoping review was performed following the methodology proposed by The Joanna Briggs Institute in databases using the EBSCOhost and B-on search engines. Conducted research in Portuguese, English, and Spanish. Selected free full text articles, with no time limit. Inclusion criteria: adult/elderly critically ill patient, intrahospital transport, a checklist and patient safety.Results: Included 7 articles for analysis. Most verification requests that ensure the safety of critical patients on intrahospitalar transport concern the transport preparation phase, in which patient is monitored was the most mentioned aspect. From the post-transportation phase, checklist aspects are only available in 3 of 7 articles Conclusion: All studies address aspects that improve the safety of critically ill patients in intrahospitalar transport and are likely to be included in the checklist. There is no unanimity as to which aspects to include in the checklist. O transporte do doente crítico acarreta um conjunto de riscos para a sua segurança. Conhecer os riscos associados ao transporte intra-hospitalar do doente crítico é essencial para melhorar a segurança do mesmo. Optou-se por abordar a checklist de transporte intra-hospitalar, uma vez que a literatura a descreve como uma forma prática e simples de aumentar a segurança.Objetivo: Mapear a evidência científica disponível referente aos aspetos de uma checklist que garantem a segurança do doente crítico no transporte intra-hospitalar.Material e Método: Realizou-se uma scoping review recorrendo à metodologia do The Joanna Briggs Institute, nas bases de dados utilizando os motores de busca EBSCOhost e B-on. Realizada pesquisa em Português, Inglês e Espanhol. Selecionados artigos free full text, sem limite temporal. Critérios de inclusão: o doente crítico adulto/idoso, o transporte intra-hospitalar, a checklist e a segurança do doente.Resultados: Foram incluídos 7 artigos. A maioria dos aspetos da checklist que garantem a segurança do doente crítico no transporte intra-hospitalar, dizem respeito à fase da preparação do transporte, na qual o aspeto mais mencionado é a monitorização do doente. Da fase posterior ao transporte, aspetos da checklist apenas são mencionados em 3 dos 7 artigos.Conclusão: Todos os estudos abordam aspetos que são passíveis de incluir em checklist e melhoram a segurança do doente. Não existe unanimidade quanto aos aspetos a incluir na checklist do transporte intra-hospitalar.

Evaluation of the safety status of intrahospital transfer of critically ill patients from the perspective of emergency and ICU nurses: a cross-sectional study in Iran

“…10 19 23 In some cases, even the simple movement of the patient in the corridors and elevators of the hospital may cause patient discomfort. 26 The mean score of 'teamwork' (subscale IV) was lower than the mean score in Bergman et al's study. 23 This dimension covers essential aspects of teamwork, such as team leadership, information transfer, validation of team roles and feedback among team members.…”

“…By training and completing the performance of all members involved in IHT and standardising monitoring equipment and actions, adverse events can be prevented, and the IHT safety of critically ill patients can be guaranteed. 26 In addition, the mean score of 'environments' (subscale III) was lower than the mean score reported for Swedish nurses. 23 This result shows that from the point of view of emergency and ICU nurses, the physical layout and design of the hospital environment, including the ED and ICU settings, the rooms and the destination, especially the obstacles in the corridors (according to the score of the relevant item), are pretty suitable for safe transfer.…”

“…It is essential to be equipped with appropriate monitoring equipment before transfer because performing major interventions during transfer is very difficult. By training and completing the performance of all members involved in IHT and standardising monitoring equipment and actions, adverse events can be prevented, and the IHT safety of critically ill patients can be guaranteed 26…”

“…Even the infrastructure of the physical environment can be considered a factor in accidents during IHT 10 19 23. In some cases, even the simple movement of the patient in the corridors and elevators of the hospital may cause patient discomfort 26…”

Inter-hospital and intra-hospital transfer of critically ill patients: results of a questionnaire survey

“…Конкретные знания о возможных критических инцидентах во время транс портировки могут способствовать повышению безо пасности. Меры по сокращению инцидентов включают более точное планирование перед транспортировкой, введение протоколов транспортировки с оценкой ри сков транспортабельности, повышение уровня под готовки персонала и достаточное материальное ос нащение, в том числе транспортным оборудованием, и внедрение организационных мер по использованию контрольных списков (чеклистов) на этапе подготовки к перевозке [7,[11][12][13].…”