Assessment of current practices of intrahospital transportation in critically ill patients at an academic hospital in South Africa

Abstract

Purpose: There is a paucity of guidelines for safe intrahospital transportation(IHT) in a resource-limited setting. The aim of this study was to describe the practices of IHT of critically ill patients perioperatively by anaesthetists. Methods: We conducted a prospective, cross-sectional study including 101 IHTs between theatre and Intensive care unit (ICU) . The most senior anaesthetist completed an adapted questionnaire. Frequency distributions were described, and Chi- square/Fisher's exact tests were performed to identify associations between IHT practices and categorical variables with anaesthetist seniority and first and subsequent IHTs. Results: The majority(72.97%) of the variables investigated were below the expected compliance rate(75%). Only 22.80% of anaesthetists were aware of IHT guidelines. Statistically significant differences were observed in IHT practices between senior and junior anaesthetists for: airway equipment taken(OR 0.25 95% CI 0.08-0.84), emergency drugs taken(inotropes(OR 1.49 95%CI 1.29-1.73), muscle relaxants(OR 5.81 95% CI 1.70-19.83), induction agents(OR 7.23 95% CI 1.86-28.13)) and awareness of IHT guidelines(OR 1.35 95% CI 1.20-1.53); and between first and subsequent transfers for: notification of the current condition(OR 0.23 95% CI 0.08- 0.71), use of manual resuscitation bag(OR 3.64 95% CI 1.21-11.00), and awareness of IHT guidelines(OR 0.14 95% CI 0.04-0.49). Conclusion: The majority of IHT practices interrogated during this study were below the expected compliance level irrespective of the seniority of the anaesthetist or the number of IHTs. Resource limitations and education seem to be the major contributors.