Checklist application for intrahospital safe transfer of patients in ICUs in Alexandria Main University Hospital and its effect on patients’ outcome

Abstract

Introduction Patient safety is a vast field of knowledge aiming to prevent errors and harm to the patients, and it is a key indicator of the health-care quality. Transport of critically ill patients from the ICU to other departments for diagnostic or therapeutic procedures is often a necessary part of the critical care process. Indeed, some guidelines on optimal intrahospital transfer (IHT) are available but they are not easily translated into practical measures to reduce incidents. As an alternative, checklists are practical and can provide tools to improve safety. Objective The aim of this study was to apply a checklist covering the pretransport preparation phase, the actual transport phase, and the ICU reinstallation (posttransport) phase and to assess its effect on patient outcome. This was to improve safety during IHT of adult critically ill patients. Patients and methods The present study was performed over a 12-month period, 6 months retrospectively including 86 patients and 6 months prospectively after application of a checklist including 93 patients. All patients in the study were subjected to history taking including demographic data, past medical history, physical examination including vital signs and acute physiology and chronic health evaluation (APACHE II) score. Results IHT checklist improves the presence of needed equipment for each phase Regarding changes in blood pressure, heart rate and respiratory rate, occurrence of arrhythmias, hypoxemia, and cardiopulmonary arrest, there was a statistically significant difference between pre-checklist and post-checklist implementation favoring the post-checklist phase. There was significant decrease in mortality rates after application of the checklist, as the mortality rate in the retrospective group was 31.6 and 19.3% in the prospective group. Conclusion Adverse events were significantly higher in the pre-checklist phase than the post-checklist phase. IHT checklist enhanced patient safety and decreased mortality significantly.