Inter-hospital transfers of acutely ill adults in Scotland
Inter-hospital transfers of acutely ill adults in Scotland
复制标题
DOI：
10.1111/j.1365-2044.2009.06165.x
复制
发表时间：
2010-02-01
期刊：
影响因子：
10.7
通讯作者：
Smith, G.
中科院分区：
文献类型：
--
作者：
Fried, M. J.;Bruce, J.;Smith, G.
对苏格兰救护车服务机构在医院之间转运的重症成人进行了审计，以确定转运次数并量化不良事件的发生率。16岁以上的患者在转院期间需要干预/生命体征监测或从一开始就需要护理/医疗陪同，被定义为急性成人患者。收到审计表格348份，其中适合纳入审计的表格2396份。转移主要发生在专家管理（1580人，66%）或专家调查（550人，23%）。临床医生陪同825例（34%）患者离开医院的平均时间（IQR[范围]）为2小时（01:24 -3:30[00:05-17:33]）。在84例（4%）转移中需要临床干预。248例（10.3%）需要辅助通气的中位（IQR[范围]）时间为28分钟（00:17-00:50[00:04-02:55]）。在专用运输队（2/ 205,1%）中，无担保医疗设备的发生率（仅在护送转移中）明显低于非专用运输队（113/620,18%;p = 0.004）。医疗设备故障在需要辅助通气的患者转移中较少见（1/ 156,0.6% vs 9/ 97,9%; p = 0.001）。
The transfer of acutely ill adults who were transported between hospitals by the Scottish Ambulance Service was audited in order to determine the number of transfers and to quantify the incidence of adverse events. Patients over 16 years of age requiring intervention/vital signs monitoring during transfer or a nursing/medical escort from the outset were defined as acutely ill adults. Three thousand and forty-eight audit forms were received, of which 2396 were suitable for inclusion in the audit. Transfers primarily occurred for specialist management (1580; 66%) or specialist investigation (550; 23%). Clinicians escorted 825 (34%) patients and were away from their hospital a median (IQR [range]) of 2 h (01: 24-3:30 [00: 05-17:33]) h: min Clinical intervention was required in 84 transfers (4%). The median (IQR [range]) time for 248 transfers (10.3%) requiring assisted ventilation was 28 min (00: 17-00: 50 [00:04-02:55]). The incidence of unsecured medical equipment (in escorted transfers only) was significantly lower in dedicated transport teams (2/205, 1%) vs non-dedicated (113/620, 18%; p = 0.004). Medical equipment failures were less common in the transfer of patients requiring assisted ventilation (1/156, 0.6% vs 9/97, 9%; p = 0.001).