Use of an assessment system for the allocation of human resources in the intrahospital transport of the patient admitted to an intensive care unit

Abstract

Introduction

Currently, in intensive care units (ICUs), the in-hospital transport (HIT) of patients is carried out without a unified criterion of personnel necessary for it.

Objective

To evaluate the concordance of the Patient Assessment System for Transport-ICU (PAST-ICU) with the medical criteria (CM) to determine the Human Resources (HR) and identify Adverse Effects (AE).

Methods

Descriptive, cross-sectional and prospective study of the IHT of patients admitted to an area of adult medical-surgical critical patients. The PAST-ICU instrument was created to recommend the HR of HIT. Through the assessment of clinical parameters, the Past-ICU indicates whether the HIT should be performed with (1) a stretcher-bearer (2) Stretcher-bearer/nurse or (3) stretcher-bearer/nurse/doctor. AE were recorded during the hospital transfer. Prior to the IHT, the nurse performed the PAST-ICU and the result was contrasted with the Medical Criteria (MC) responsible for the patient, the latter prevailing.

Study period

Phase 1: pilot test 2013–2014. Phase 2: 2015–2021.

Variables

Reason and duration HIT, PAST-ICU sheet, checklist, AE.

Results

Phase 1: 458 IHT were analyzed. The concordance index between the PAST-ICU and the MC was 84,9% (389 IHT). The Cohen Kappa of 58,5% and p < 0,001. There were a total of 16 AE. Phase 2: 3423 IHT. The Concordance index of 87,2% (2984 TIH). The Cohen Kappa of 63%and the P < 0,001. Registered 49 AE.

Conclusion

The PAST-ICU could be a useful, safe and reliable tool to adapt the necessary HR. There was good concordance between the PAST-ICU vs the MC to determine the HR in the HIT. The percentage of AE was low.