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1. Swickard, Scott W. Patient Safety Events During Critical Care Transport.

Degree: PhD, Nursing, 2016, Case Western Reserve University School of Graduate Studies

Purpose StatementThe purpose of this retrospective chart review was to investigate the type and frequency of patient safety events (PSE) during critical care transport (CCT) between hospitals and explore the patient characteristics, nursing competencies, and environmental factors impact on PSE. Research QuestionsResearch questions were:1.What are the types and frequencies of patient safety events that occur when registered nurses (RNs) and advanced practice nurses (APNs) are lead clinicians in ground, rotor and fixed-wing vehicles? 2.What is the impact of the patient characteristics of stability, vulnerability, complexity, predictability, and resiliency on frequency of patient safety events?3.Do the nursing competencies of caring practices and clinical judgment, have a mediating or moderating role on the frequency PSE?4.Do modifiable environmental factors (i.e., time outside of the ICU and mode of transport) influence the frequency of PSE?MethodThis was a descriptive, comparative review of 5 months of records at a quaternary academic medical center. Inclusion criteria were all inter-hospital transports via ground, rotor, and fixed wing transport. Cases with PSE reported were compared to randomly selected non-PSE cases (ratio 1 PSE: 8 non-PSE cases). Logistic regression was used to determine relationships among the variables of interest with the occurrence of PSE.ResultsThe rate of PSE was 2.65% among all qualifying cases. A total of 440 cases were reviewed and entered into the database (48 with PSE: 392 without PSE). Adverse events were the most common type of PSE (1.88%), and new or recurrent hypoxia was the most frequent type of adverse event. The patient characteristic of stability was significant (p=0.083, OR 1.059, 95% CI 0.993-1.113). Secondary analyses supported the association of hypoxia, a component of stability, with PSE. The nursing competency of clinical judgment, as measured by experience in years of transport employment of the lead clinician, was identified as a potential moderator of hypoxia-related PSE. Duration of transport demonstrated the most consistent relationship with PSE in secondary analysis.Conclusion Hypoxia, defined as new or recurrent decrements in peripheral oxygenation, emerged as a new consideration for evaluating patients risk for CCT PSE. Advisors/Committee Members: Winkelman, Chris (Committee Chair).

Subjects/Keywords: Nursing; Patient Safety Events; critical care transport; inter-facility transport

…expansion in inter-facility transport in recent years. The majority of CCT is between hospitals… …used during inter-facility transport. They found patient safety event rates decreased from 34… …intra-transport patient safety events during inter-facility transport. Singh and colleagues… …patient in need of inter-facility transport by a defined CCT team in which the initiation or… …defined as the inter-facility transport of a patient using surface transport vehicles (i.e… 

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Swickard, S. W. (2016). Patient Safety Events During Critical Care Transport. (Doctoral Dissertation). Case Western Reserve University School of Graduate Studies. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671

Chicago Manual of Style (16th Edition):

Swickard, Scott W. “Patient Safety Events During Critical Care Transport.” 2016. Doctoral Dissertation, Case Western Reserve University School of Graduate Studies. Accessed October 27, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671.

MLA Handbook (7th Edition):

Swickard, Scott W. “Patient Safety Events During Critical Care Transport.” 2016. Web. 27 Oct 2020.

Vancouver:

Swickard SW. Patient Safety Events During Critical Care Transport. [Internet] [Doctoral dissertation]. Case Western Reserve University School of Graduate Studies; 2016. [cited 2020 Oct 27]. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671.

Council of Science Editors:

Swickard SW. Patient Safety Events During Critical Care Transport. [Doctoral Dissertation]. Case Western Reserve University School of Graduate Studies; 2016. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671

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