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Title: Risk events during intrahospital transport of patients from the emergency department: a prospective observational study.
Austin Authors: Neal-Williams, Tom;Walker, Kimberly;Lines, Travis;Ugoni, Antony;Taylor, David McD 
Affiliation: Emergency
Western Health, Footscray, Victoria, Australia
Alfred Health, Prahran, Victoria, Australia
Department of Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
Nothern Health, Epping, Victoria, Australia
Issue Date: Oct-2021 2021-08-24
Publication information: Emergency Medicine Journal : EMJ 2021; 38(10): 776-779
Abstract: We aimed to determine the incidence, nature of and predisposing factors for risk events (REs) that occur during the intrahospital transport of patients from the ED. We undertook a prospective, observational study of intrahospital patient transports from a single ED between 30 January and 20 March 2020. An investigator attended each transport and recorded any RE on a specifically designed data collection document. An RE was any mishap, even if not foreseen, that had the potential to cause the patient harm. A patient equipment number was assigned based on the number of pieces of equipment required during the transport. Poisson regression generated incidence rate ratios (IRRs) and determined risk factors for REs. Of 738 transports, 289 (39.1%, 95% CI 35.6% to 42.8%) had at least one RE. The total of 521 REs comprised 125 patient-related, 279 device-related and 117 line/catheter-related REs. The most common included trolley collisions (n=142), intravenous fluid line catching/tangling (n=93), agitation/aggression events (n=31) and cardiac monitoring issues (n=31). Thirty-four (6.5%) REs resulted in an undesirable patient outcome, most commonly distress and pain. Predisposing factors for REs included an equipment number ≥3 (IRR 5.68, 95% CI 3.95 to 8.17), transport to a general ward (IRR 2.68, 95% CI 2.12 to 3.39), hypertension (IRR 1.93, 95% CI 1.07 to 3.50), an abnormal temperature and a GCS<14. REs are common in transport of patients from the ED and can result in undesirable patient outcomes. Adequate pre-transfer preparation, especially securing equipment and lines, would result in a reduced risk.
DOI: 10.1136/emermed-2021-211409
ORCID: 0000-0002-8986-9997
Journal: Emergency Medicine Journal : EMJ
PubMed URL: 34429370
Type: Journal Article
Subjects: emergency department
performance improvement
risk management
Appears in Collections:Journal articles

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