A Cross-sectional Study on Challenges of Intrahospital Transport of Critically Ill Patients to Kenyatta National Hospital Critical Care Units.

Abstract

Background: Intra-hospital transport of critically ill patients is unavoidable and is associated with an increased risk of adverse events.[1] In 1970, intra-hospital transport (IHT) was first documented and published as potentially dangerous when 84% of transported patients with a high risk of cardiovascular events developed arrhythmias.[2] Objective: To establish the challenges during IHT of critically ill patients to KNH CCUs. Methodology: This was a cross-sectional study of the IHT of critically ill patients into KNH CCUs. The study was carried out in the KNH 4 CCUs over a period of 14 weeks. The study participants were 335 service providers involved in the transfer of critically ill patients already admitted to KNH and required admission into the KNH CCUs. Data was collected using a self-administered questionnaire filled by the transport team leader. It was then entered and analyzed by the use of SPSS version 21 and the findings presented in the form of tables, pie charts, and graphs. Results: The mean age of the patients evaluated was 31.1 years. The majority of the transports to the CCUs come from the operating theatres 125 (37.3%). A dedicated emergency trolley was absent during the transfer of all the critically ill patients though the transport teams carried different equipment and drugs. A total of 231 (69%) transports had patient systemic events involving the cardiovascular, respiratory and the central nervous system. There were no adverse outcomes reported. Equipment failure was recorded in 138 (42.5%) transports. Conclusions: KNH lacks dedicated transport teams and transport equipment for IHT of critically ill patients. Most of the transports were poorly monitored and transport teams were not well equipped with the basic resuscitation drugs and equipment for emergencies. The transports were hindered in most of the time by the crowded busy corridors and the hallways.