Moving emergency patients to other hospital wards tends to lead to high accident rates

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Moving emergency medical patients to other hospital departments in wheelchairs or carts increases the likelihood of an accident. A study in a major Australian hospital, published online. Emergency Medicine Journal..

Among other things, limb confinement, collisions, catheter or intravenous catheter issues occurred in nearly 4 out of 10 patient transports within 2 months, and the study authors improved transport training. and preparation before transport. I came to ask.

Although a patient’s transit accidents are known in the hospital, it is not clear how common they are and what their predisposition is, as they can interfere with other services.

For the study, the authors observed the transport of adult patients from emergency care in carts or wheelchairs to other departments of a large Australian hospital only on weekdays from January 30 to March 20, 2020. bottom .

The number and nature of incidents were recorded, as well as the predisposition and resulting harm to the patient.

During the monitoring period, the transport of 738 patients was observed. The average age of the patients was 69 years. Half were men.

Incidents were observed with 289 (39%) operations. Only one accident occurred in 169 (23%) transports and several incidents ranging from 2 to 9 in 120 (16%), for a total of 521.

About a quarter (125; 24%) of incidents are patient-related, with acute agitation, coughing and limb displacement being the most common.

More than half (279; 54%) are equipment related, the most common being collisions, infusion pump problems and monitoring. Endotracheal tubes (used to aid breathing), ventilator tubes, and arterial lines were also associated with high accident rates.

About 117 (23%) of all cases were associated with catheters or venous catheters, the most common being line capture or entanglement.

Predisposing factors include the number of devices in a single operation, transport to a general ward and high blood pressure, abnormally high or low temperature, or a low Glasgow coma score used to measure the level of consciousness of a person after a traumatic brain injury.

Thirty-four cases (6.5%) affected patients and caused distress (13 patients). Pain (9); Needlessly wasted material / resources (3); Aggression of staff (2); Unique case of exposure to blood. Missed fall; Delayed treatment; Sedative clothing; Removal of the cannula; Patients’ gowns fall off, exposing the body. Dyspnea (dyspnea).

This was an observational study and only one hospital was involved. The authors also state that the results may not be comparable to the experience of other institutions due to variations in arrangement, transport protocols and distance / duration of transport.

However, they conclude that: [incidents] Demonstrates the need for better transportation training and preparation for shipping prior to training. ”

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For more information:
Risky events during hospital transport of patients from the emergency room: prospective observational studies, Emergency Medicine Journal (2021). DOI: 10.1136 / emerged-2021-211409

Provided by
British medical journal

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Moving emergency patients to other hospital wards tends to lead to high accident rates

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Lillian L. Pena

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