Development of a Model for Transportation Critical Accident and Surgical Patient at the Emergency Department of a Tertiary Hospital in Ubon Ratchathani Province
Keywords:
critical patient; critical patient transportation; model for transportationAbstract
The transfer technique for critical accident and surgical patients is crucial for patient safety. This study aimed to develop and evaluate the effectiveness of a model for transporting critical accident and surgical patients at the emergency department. The study framework integrated the Clinical Practice Guideline Development Framework of the National Health and Medical Research Council (NHMRC), Australia, with the 7 Aspects Model of Care. The research was conducted in two phases: Phase I, the model development phase, consisting of 5 participants (1 physician and 4 nurses); and Phase II, the implementation and evaluation phase, involving 43 personnel (13 nurses and 30 porter staff) and 50 critically ill patients (25 in the pre-implementation group and 25 in the post-implementation group). Data were analyzed using descriptive statistics, relative risk (RR), Fisher’s exact test, and the Wilcoxon signed-rank test. The results revealed that the developed model comprised three phases: pre-transportation, during-transportation, and post-transportation. These phases integrated the dimensions of the 7 Aspects Model of Care to identify and prevent 30 common adverse events in the Emergency Department. Post-test results revealed that undesirable incidents among critically ill patients were significantly reduced from 44.00% to 8.00% [RR = .18; 95% CI (.05, 0.74); p < .05]. The experimental results indicate that the developed model reduced the risk of adverse events by 82.00% compared to the pre-implementation period. Furthermore, nursing competencies, as well as the satisfaction levels of nurses and stretcher-bearer staff, showed significant improvement. Therefore, it can be concluded that this model is clinically feasible and effective in enhancing nursing safety during the transfer of critically ill patients in the emergency department.
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