| 000 | 04500cam a2200181 4500 | ||
|---|---|---|---|
| 001 | NMDX7489 | ||
| 008 | 120401t2016 xxu||||| |||| 00| 0 eng d | ||
| 100 | _aKhalil, J. | ||
| 240 | _aIntensive Care Medicine Experimental | ||
| 245 | _aInterhospital transfers in a non-tertiary hospital-does it improve with formal training? | ||
| 260 | _c2016 | ||
| 500 | _aNMUH Staff Publications | ||
| 500 | _aEMBASE | ||
| 500 | _a4 | ||
| 520 | _a<p class="Para" id="Par2925"><span style="font-size: 10pt;">The aim of this audit was to demonstrate any significant improvement in our inter-hospital transfer practice following the introduction of a new simulated all day training provided to junior doctors in the view of auditing our transfer data from 2014–2015.</span></p><p class="Para" id="Par2926"><span style="font-size: 10pt;">A single centre retrospective audit in 21 bed mixed ICU of a non-tertiary university hospital. During the audit period (2014–15) 29 critical care transfers were made. We audited data of referring team, location, receiving team, transfer reason, decision-departure time, intubation details, arterial blood gases (ABG), comments of the teams, time of transfer, documentation and transferring doctor grade. Our primary aim was to analyse any effect of our newly introduced complex transfer training program.</span></p><p class="Para" id="Par2927"><span style="font-size: 10pt;">In 2014, transfers were by SHO level doctors 38.5&nbsp;% of cases, staff grade and registrar level doctors were 46.1&nbsp;% each, <strong class="EmphasisTypeBold ">15.3&nbsp;% were not documented</strong>.</span></p><p class="Para" id="Par2928"><span style="font-size: 10pt;">In 2015, transfers were by SHO level doctors 6.25&nbsp;% of cases, staff grade and registrar level doctors were 93.7&nbsp;% each. <strong class="EmphasisTypeBold ">All transfers were documented.</strong></span></p><p class="Para" id="Par2929"><span style="font-size: 10pt;">Non-clinical reasons in 2014 were 24&nbsp;% opposite zero non clinical transfers in 2015. In 2014 (53.8&nbsp;%) of transfers occurred outside normal working hours (8&nbsp;am to 17:00) versus 56.25&nbsp;% in 2015, unlike the past where most of transfers usually happened outside the normal working hours.</span></p><p class="Para" id="Par2930"><span style="font-size: 10pt;">Transfer- decision to departure time varied, with an average time of minutes In 2014 the average time in minutes was 229&nbsp;minutes which was nearly double its peer value in 2015 <strong class="EmphasisTypeBold ">(133&nbsp;minutes).</strong></span></p><p class="Para" id="Par2931"><span style="font-size: 10pt;">Records of the doctor performing the transfer were well kept but those of the receiving team were generally absent but thanks to the new transfer form 24 out of 29 comments from the receiving team were documented (82.7&nbsp;%) and were consistent with the expectations with one comment saying (Excellent handover).</span></p><p class="Para" id="Par2932"><span style="font-size: 10pt;">The transfer of the critically ill patients remains a big challenge to juniors of all grades. A complex and holistic approach needed with a broad spectrum of knowledge regarding the possible complications.</span></p><p class="Para" id="Par2933"><span style="font-size: 10pt;">Our all day transfer course introduced in 2015 gave the opportunity to learn and hands on simulate with a live ambulance what is it like to be on a hot transfer.</span></p><p class="Para" id="Par2934"><span style="font-size: 10pt;">Our data shows significant improvement in the documentation, organization and quality of transfer without adverse events affecting patient´s safety with lack of incident reports.</span></p><p class="Para" id="Par2935"><span style="font-size: 10pt;">The positive feed backs from trainees and the overall improvement of our transfer service proves that simulated training of this difficult and grey area is fruitful and worth carry on.</span></p><span style="font-size: 10pt;">&nbsp;</span> | ||
| 700 | _aKovari, F. | ||
| 856 | _uhttps://link.springer.com/article/10.1186/s40635-016-0099-9/fulltext.html | ||
| 999 |
_c76369 _d76369 |
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