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1.
Artículo en Inglés | MEDLINE | ID: mdl-38679521

RESUMEN

INTRODUCTION: Currently, in intensive care units (ICUs), the in-hospital transport (HIT) of patients is carried out without a unified criterion of personnel necessary for it. OBJECTIVE: To evaluate the concordance of the Patient Assessment System for Transport-ICU (PAST-ICU) with the medical criteria (CM) to determine the Human Resources (HR) and identify Adverse Effects (AE). METHODS: Descriptive, cross-sectional and prospective study of the IHT of patients admitted to an area of adult medical-surgical critical patients. The PAST-ICU instrument was created to recommend the HR of HIT. Through the assessment of clinical parameters, the Past-ICU indicates whether the HIT should be performed with (1) a stretcher-bearer (2) Stretcher-bearer/nurse or (3) stretcher-bearer/nurse/doctor. AE were recorded during the hospital transfer. Prior to the IHT, the nurse performed the PAST-ICU and the result was contrasted with the Medical Criteria (MC) responsible for the patient, the latter prevailing. STUDY PERIOD: Phase 1: pilot test 2013-2014. Phase 2: 2015-2021. VARIABLES: Reason and duration HIT, PAST-ICU sheet, checklist, AE. RESULTS: Phase 1: 458 IHT were analyzed. The concordance index between the PAST-ICU and the MC was 84,9% (389 IHT). The Cohen Kappa of 58,5% and p < 0,001. There were a total of 16 AE. Phase 2: 3423 IHT. The Concordance index of 87,2% (2984 TIH). The Cohen Kappa of 63%and the P < 0,001. Registered 49 AE. CONCLUSION: The PAST-ICU could be a useful, safe and reliable tool to adapt the necessary HR. There was good concordance between the PAST-ICU vs the MC to determine the HR in the HIT. The percentage of AE was low.

2.
Rev Esp Anestesiol Reanim (Engl Ed) ; 67(3): 119-129, 2020 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31806153

RESUMEN

OBJECTIVE: The main objective of our study is to determine if the implementation of an HIT protocol modifies the annual rate of incidents related to patient safety. The secondary objectives are, firstly, to classify the identified events, secondly to analyze the factors that are associated with the presence of said adverse events and finally to analyze the degree of monitoring of the protocol. MATERIAL AND METHODS: Retrospective descriptive analysis that included patients admitted to the Intensive Care Unit who required HIT between 2009 and 2018. A multidisciplinary protocol was developed and the incidents were classified according to the severity and type of events. RESULTS: We included 1662 transfers. The total number of transfers with incidents was 153 (9.2%) in which 189 incidents were registered, of which 17 (9%) were described as adverse events (AD), while 172 (91%) were classified as Incidents without Damage (IsD). The clinical incidents were the most frequent (70.37%). In the multivariate analysis we found as associated factors cardiac arrhythmias (OR: 2.88 [IQR 2.01-4.12]), history of stroke (OR 1.72 [IQR 1.06-2.78]) and anemia (OR 1.55 [IQR 1.02-2.37]) The rate of safety-related incidents was less over time as adherence to protocol compliance increased. CONCLUSIONS: The implementation of a critical patient transport protocol and its application through checklists allows to reduce both the incidence of adverse events in these patients and of Incidents without Damage.


Asunto(s)
Enfermedad Crítica , Unidades de Cuidados Intensivos , Seguridad del Paciente/estadística & datos numéricos , Transferencia de Pacientes/estadística & datos numéricos , Gestión de Riesgos/estadística & datos numéricos , APACHE , Lista de Verificación , Protocolos Clínicos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Análisis Multivariante , Transferencia de Pacientes/métodos , Transferencia de Pacientes/organización & administración , Estudios Retrospectivos , Gestión de Riesgos/métodos , Gestión de Riesgos/organización & administración
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