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A before- and after-intervention trial for reducing unexpected events during the intrahospital transport of emergency patients - 28/09/12

Doi : 10.1016/j.ajem.2011.10.027 
Hee Kang Choi, RN a , Sang Do Shin, MD b, , Young Sun Ro, MD c , Do Kyun Kim, MD b , Sun Hwa Shin, RN a , Young Ho Kwak, MD b
a Emergency Medical Center, Seoul National University Hospital, Seoul, Korea 
b Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea 
c Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea 

Corresponding author. Tel.: +82 2 2072 3257; fax: +82 2 741 7855.

Abstract

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 χ2 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).

Conclusion

A significant reduction in the rate of total and serious UEs during intrahospital transport from the ED was found through using transport checklists.

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