Implementation of the Checklist for Intra-Hospital ICU Patient Transfer Enhanced ICU nurse’s confidence and Satisfaction on critically-ill patient transport

By CHAN Tsz Ho, Ronald, RN, BSN, Intensive Care Unit

Background

Intra-hospital critically-ill patient transport occur frequently in ICU, but risk and some adverse event may occur during transport, that may result from serious patient injury or death. Nurses may feel stressful and lack of confidence to transfer the critically-ill patient. Literature review revealed there are total eight essential elements should be considered when transferring critically-ill patient, and transport checklist for ICU is proved beneficial for patient transport with several advantages.

Purpose and Problem Statement

Preparation of intra-hospital critically-ill patient transport in ICU is complicated, because coordination between departments, patient assessment and stabilization, and equipment preparation must be done in a very short time period, right before the transport commenced. In order to facilitate effective pre-transport planning and coordination, there is a need for an intra-hospital transfer checklist for critically-ill patient in the ICU.

Implementation Plan

A supplementary checklist for intra-hospital critically-ill patient transport was implemented in the ICU in HKSH, in order to facilitate transport preparation. Pre- and post-intervention study was done to evaluate the impact of utilization of transport checklist on nurse’s confidence and satisfaction on critically-ill patient transport.

Results

Total response rate in the post intervention survey was 66.7% (n=30). Significant increase in number of nurses felt more confidence (14%) on escorting patient and transport preparation (33%), and nurses hand better understanding on equipment preparation (32%). Almost 80% of nurses agreed that the critically-ill patient transport checklist was helpful to coordinate the transfer (76.7%), prepare the equipment (83.3%), promote safe patient transport (80%) and encourage comprehensive documentation (80%).

Recommendations and Next Steps

Implementation of the Checklist for Intra-hospital ICU Patient Transfer enhanced ICU nurse’s confidence and satisfaction on critically-ill patient transport. Critically-ill patient transport training and promotion of transport checklist In ICU and ventilation ward were suggested to maintain safe patient transport. Finally, further study on the occurrence rate of adverse event in critically-ill patient transport should be done in order to evaluate the effectiveness of the transport checklist.