A before- and after-intervention trial for reducing unexpected events during the intrahospital transport of emergency patients.
BACKGROUND
This study was aimed to explore the effect of intervention in safe intrahospital transport on the incidence of unexpected events (UEs) occurring during the transport of emergency patients.


METHODS
This study was performed in an urban tertiary teaching hospital emergency department (ED) from May 17 to October 30, 2010. Patients older than 15 years who were transported to general wards; intensive care units; and magnetic resonance imaging, intervention, or operation rooms were enrolled. Demographics and data on all UEs related to the devices, clinical situations, and tubes or lines were measured by registered nurses at pre- and postintervention period. The intervention was that acting nurses were required to use a designed transport checklists before the patients were transported. Primary outcomes were the rate of all and serious UEs during the pre- and postintervention periods. Serious UEs were defined as any worsening of a patient's clinical status. Statistical values were measured with 95% confidence intervals (CIs) and compared using Student t tests or χ(2) tests.


RESULTS
In total, there were 680 transports before interventions and 605 transports after interventions. Overall, UEs decreased significantly from a value of 36.8% (95% CI, 33.1-40.5) in the preintervention period to a value of 22.1% (95% CI, 18.9-25.7) in the postintervention period (P = .001). Serious UEs in clinical status also decreased significantly from 9.1% (95% CI, 7.1-11.5) in the preintervention period to a value of 5.2% (95% CI, 3.6-7.4) in the postintervention period (P = .005).


CONCLUSIONS
A significant reduction in the rate of total and serious UEs during intrahospital transport from the ED was found through using transport checklists.
Emergency Medical Center, Seoul National University Hospital, Seoul, Korea. chk5278@hanmail.net
Hee Kang
HK
Choi
Sang Do
SD
Shin
Young Sun
YS
Ro
Do Kyun
DK
Kim
Sun Hwa
SH
Shin
Young Ho
YH
Kwak
D057189:Checklist; D004636:Emergency Service, Hospital; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D014187:Transportation of Patients / Q000379:methods* / Q000592:standards