Is Your Patient Ready for Transport? Developing an ICU Patient Transport Decision Scorecard

Abstract

Transport of patients from the intensive care unit (ICU) to another area of the hospital can pose serious risks if the patient has not been assessed prior to transport. Recently, the Department of Critical Care Medicine, Calgary Health Region, experienced two adverse events during transport. A subgroup of the Department's Patient Safety and Adverse Events team developed an ICU patient transport decision scorecard. This tool was tested through Plan-Do-Study-Act cycles and further revised using human factors principles. Staff, especially novice nurses, found the tool extremely useful in determining patient preparedness for transport.

Keeping Patients Safe During Intrahospital Transport

“…24 The AHRQ guidelines emphasize training staff about handoffs, troubleshooting equipment, how to get help, and competency. In addition, the AHRQ supports development of a tool, such as a scoring system for patients' acuity, 12,31 for pretransport assessment to evaluate patients' stability for travel.…”

“…Benefit must outweigh risk, with the transport in the best interest of the patient. 3,6,[11][12][13][14]31,33 In a review of transport literature published in 1999, Waydhas et al 2 reported a change in management in 40% to 50% of patients transported for diagnostic procedures, "indicating a good risk/benefit ratio." These older data are not supplemented by more recent studies because little recent research has been conducted.…”

“…Minimally the patient must receive care consistent with ICU standards. 3,8,[10][11][12][13][14]23 However, disorganized clutter from an overabundance of equipment, wires, and tubing can contribute to errors that compromise safety. "More" is not "better" if equipment errors increase and the caregiver is distracted from the patient.…”

“…46 Transport of a nonintubated but critically ill patient may increase the risk of adverse events during transport. 9,12 Again, an example is the head-injured patient with a sudden decrease in consciousness. Will this patient be able to maintain his airway while being transported for emergent head CT?…”

Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients

“…Esmail et al 10 published an ICU patient transport decision scorecard developed for a health system in Calgary, Canada. This tool includes a…”