In:
Journal of Paediatrics and Child Health, Wiley, Vol. 55, No. 2 ( 2019-02), p. 213-215
Abstract:
To demonstrate that unrecognised situation awareness failures events (UNSAFE) transfers are associated with poorer outcomes in the intensive care unit (ICU) at a Japanese children's hospital lacking a rapid response system. Methods This retrospective cohort study was conducted between January 2013 and February 2016. UNSAFE transfers were defined as unplanned in‐hospital ward‐to‐ICU transfers requiring tracheal intubation, vasoactive medications or ≥3 fluid boluses before arrival or in the first 60 min of ICU care. We compared ICU stay duration and mortality between UNSAFE and non‐UNSAFE transfers. Results There were 2126 admissions to the paediatric ICU during the study period, and 244 cases met the definition of an unscheduled in‐hospital transfer (11.5%). Of these, the number of patients transferred following cardiopulmonary resuscitation, in the UNSAFE group and in the non‐UNSAFE group were 9 (3.7%), 68 (28%) and 167 (68%), respectively. In the UNSAFE group, the number of patients who required tracheal intubation, initiation of vasoactive medications or ≥ 3 fluid boluses in the first 60 min of ICU care or before arrival in the ICU was 61 (90%), 38 (56%) and 9 (13%), respectively. ICU stay duration and mortality were significantly poorer in the UNSAFE group than in the non‐UNSAFE group (9 vs. 4 days, P 〈 0.0001; 13 vs. 4.2%, odds ratio = 3.5, 95% confidence interval = 1.2–9.8, P = 0.020, respectively). Conclusions Patients who experienced UNSAFE transfers had longer ICU stays and higher mortality, and it may be used as a metric of evaluation of effects of rapid response system implementation.
Type of Medium:
Online Resource
ISSN:
1034-4810
,
1440-1754
DOI:
10.1111/jpc.2019.55.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2007577-7
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