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Transport of Critically Ill Cardiovascular Patients

Ignatyeva, Yelena, BS, RN, CCRN; Nguyen, Albert Phan, MD; Schmidt, Ulrich, MD, PhD, MBA; Barak, Ron, MD; Agarwal, Ravi; Davidson, Judy E., DNP, RN, FCCM, FAAN

doi: 10.1097/CNQ.0000000000000229
Original Articles

Intra-hospital transport (IHT) of intensive care unit (ICU) patients is associated with a 30% to 60% incidence of adverse events (AEs). This prospective observational study collected data from 200 patient transports from a 24-bed cardiovascular intensive care unit (ICU) between July 2017 and December 2017. Phase 1 of the study focused on identifying and correcting deficiencies in nurses' knowledge regarding IHT. Phase 2 observed the occurrence and type of AEs during the IHT of ICU patients with and without physician accompaniment. The preeducation mean nursing knowledge score was 30.8 ± 10.2 (scale 0-100), and postcurriculum test mean score was 80 ± 20.2 (p < .001). In a series of 200 ICU transports, the incidence of AEs was 21.5% (n = 43). In patients who were unstable prior to transport, there was no difference in complications with or without a physician present (p = 0.40, χ2 = 0.696, odds ratio = 0.643, 95% confidence interval: 0.245-1.96). Patient needs during transport were met with preexisting orders or treatment orders received telephonically. Nurses' knowledge of transport standards improved significantly with education. Physician presence did not affect outcomes. The interventions needed to respond to complications did not require physician presence. In this cohort, there was no statistically significant benefit from physician attendance in transport.

Sulpizio Cardiovascular Intensive Care Unit, University of California San Diego Medical Center (Ms Ignatyeva); and Department of Anesthesiology UC San Diego Medical Center (Drs Nguyen and Barak), Peri-Operative Medicine and Anesthesiology UCSD Medical Center (Dr Schmidt), UCSD-School, volunteer CVC/ICU (Mr Agarwal), and University of California San Diego Health (Dr Davidson), San Diego, California.

Correspondence: Yelena Ignatyeva, BS, RN, CCRN, Sulpizio Cardiovascular Intensive Care Unit, University of California San Diego Medical Center 9475 Maler Road, San Diego, CA 92129 (yignatyeva@ucsd.edu).

We thank doctors and nurses of the intensive care unit who provided care for the patients included in the study.

The authors declare that they have no competing interests.

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