Inter-hospital and intra-hospital transfer of critically ill patients: results of a questionnaire survey

Abstract

Transfer of critically ill patients is often a forced but necessary measure. The article presents data from a multicenter study of the Russian Federation of anaesthesiologists and reanimatologists (RFAR), on the current state of problems in intra-hospital and inter-hospital transportation of critically ill patients. The aim of this study was to interview physicians in the intensive care and intensive care units about the problems that arise during the transfer of intensive care patients. To identify problematic issues that arose among doctors of specialists in the process of in-hospital transportation and inter-hospital transportation, a survey was conducted in medical centers from four federal districts of the Russian Federation. The data is presented in the form of relative frequencies and graphical visualization (histograms and diagrams). The study involved 538 doctors of specialists of the intensive care unit and intensive care unit. As a result, it was revealed that 88 % of the respondents faced complications during the transportation of patients in their practical work. The most common causes of complications are associated with medical aspects in 38.6 % of cases and technical reasons (equipment failure, etc.) in 35.1 % of cases, to the least extent these are organizational problems (26.3 %). The main problems with in-hospital transportation and inter-hospital transportation: insufficient provision of modern transport equipment, as well as the lack of medical transport boxes. There are cases of discrepancy between preliminary and real information about the patient's condition. The absence of regulatory documents, standardized protocols and algorithms for the transportation of resuscitation patients was stated by 27 % of the surveyed doctors. Most of the surveyed doctors of specialists (61 %) do not use in their practice any assessment of the risks and portability of patients. 90 % of the respondents answered that they do not consider themselves legally protected in the event of adverse events during transportation. Inadequate equipment with transport equipment, lack of regulatory documents, as well as inconsistencies in medical information about the patient's condition create a risk for the safe and efficient transportation of resuscitation patients, and medical personnel cannot consider themselves legally protected. These areas are important targets for investigation and the development of interventions to improve patient safety.