AST Guideline for Patient Transportation

6 F. The surgery team should use smooth, even movements when transferring the non-mobile patient to avoid injury; the patient should not be dragged onto the OR table from the transportation device. Dragging or bouncing the patient can provoke decompensated perfusion and cause physical injury to the patient. 7 G. The patient should be centered on the OR table and the safety strap placed across the thighs approximately two inches above the knee joints. Two fingers should be able to be placed under the safety strap to ensure it is not too tight. H. The surgery team must confirm bony areas of the patient’s body are well- padded and not resting on any metal portion of the OR table. 2. The following patient care concepts should be fulfilled during the transfer of the patient. A. The dignity of the patient should be maintained throughout the transfer process by keeping him/her covered. The unconscious or heavily sedated patient relies upon the ethics and integrity of the surgical team. B. A surgical team member should explain all actions to the conscious patient as to what is occurring in preparation for the transfer and during the transfer. C. A surgical team member should instruct the patient not to move until given the command to do so by the anesthesia provider. Guideline IV The HDO should have a coordinated patient transport system (CPTS) in place for transferring and transporting critically ill patients from the CCU (CICU), ICU, and NICU to the surgery department. 9 1. Critically ill patients are at an increased risk for morbidity and mortality during intrahospital transfer . 10-17 Risks can be minimized and outcomes improved with careful planning through the cooperation of an interdisciplinary team, and selection and use of equipment needed to provide uninterrupted care of the patient during the transportation process. 10,18 During transfer, the patient should be receiving the equivalent level of monitoring and support that was provided in the ICU. A. The data from a study conducted from 2006-2010 involving 1,557 patient transfers of ICU patients to surgery implementing a CPTS found that there was a fourfold improvement in on-time OR starts while also significantly reducing the idle OR time. 9 The results confirm that a CPTS can considerably improve OR efficiency while ensuring quality, safe care of the patient. B. The HDO should conduct a comprehensive analysis of the following elements to develop a written standardized CPTS for the intrahospital transfer of patients. 1) A multidisciplinary team that includes surgeons, CSTs, RNs, respiratory therapists, and HDO administration should be formed to plan and coordinate the assessment process.