优化ICU危重患者院内安全转运流程的实践探索

Optimization the intra-hospital transportation process of critical patients in Intensive Care Units

目的 :优化ICU危重患者院内转运流程,降低转运途中不良事件发生率,提高危重患者院内转运安全性。方法 :优化转运流程前医生和护士主要依据经验进行病情评估和物品准备;优化转运流程后应用"ICU转运决策核查单"进行病情评估和物品准备,第一部分为危重患者风险评估,第二部分为自行设计的转运前核查单,主要包括患者准备、物品准备、人员准备、相关科室确认和转运中病情观察记录单。结果 :优化ICU患者院内转运流程前,院内转运危重患者40例,共发生不良事件6例,发生率为15.0%,其中病情变化发生2例、跌倒1例、仪器设备故障1例、氧气瓶供氧不足1例、微量泵电量不足1例,转运急救物品携带齐全率93.0%;优化ICU危重患者院内转运流程后,院内转运危重患者45例,共发生不良事件3例,发生率为6.7%,其中病情变化发生1例、仪器设备故障1例、氧气瓶供氧不足1例;转运急救物品携带齐全率98.0%。结论 :ICU危重患者院内转运流程的优化可降低不良事件发生率,提高危重患者院内转运安全性。

Objective： To optimize the intra-hospital transportation process of critical patients in ICU, reduce the incidence of adverse events and improve the safety. Methods： Before the optimization of the process, the patients were evaluated and items were prepared according to the experience of doctors and nurses. Application＂ the ICU transferc decision checklist＂, the first part is the risk assessment of critical patients. The second part is the self-designed pre-transfer checklist, which mainly includes patient preparation, goods preparation, personnel preparation, relevant department confirmation and medical observation record sheet. Results： Before the optimization of the process, six adverse events occurred before the transportation decision-making checklists. The incidence was 15.0%, including 2 cases of condition changing events, 1 case of falls, 1 case of instrument and equipment failure, 1 cases of insufficient oxygen supply in the oxygen bottle and 1 cases of insufficient power of the micro pump. The rate of transferring with complete first-aid kits achieved 93.0%. After the optimization, 3 cases of adverse events occurred during intra-hospital transportation of critically ill patients, whose incidence was 6.7%, including 1 cases of condition changing events, 1 cases of instrument failure and 1 cases of insufficient oxygen supply in the oxygen bottle. The rate of transferring with complete first-aid kits achieved 98.0%. Conclusion： Optimization the intra-hospital transportation process of critically ill patients can help reduce the incidence of adverse events and improve safety of critically ill patients.