Objective

To determine the frequency, type, and severity of adverse events (AEs) during intrahospital transport of newborn infants and to identify associated factors.

Study design

We conducted a prospective observational study in a tertiary care academic neonatal unit. All patients hospitalized in the neonatal unit and undergoing intrahospital transport between June 1, 2015, and May 31, 2017 were included. Transports from other hospitals and the delivery room were not included.

Results

Data from 990 intrahospital transports performed in 293 newborn infants were analyzed. The median postnatal age at transport was 13 days (Q1-Q3, 5-44). Adverse events occurred in 25% of transports (248/990) and were mainly related to instability of cardiovascular and respiratory systems, agitation, and temperature control. Adverse events were associated with no harm in 207 transports (207/990, 21%), mild harm in 37 transports (37/990, 4%), and moderate harm in 4 transports (4/990, 0.4%). There was no severe or lethal adverse event. Hemodynamic support with catecholamines, the presence of a central venous catheter, and a longer duration of transport were independent predictors for the occurrence of adverse events during transport.

Conclusions

Intrahospital transports of newborns are associated with a substantial proportion of adverse events of low-to-moderate severity. Our data have implications to inform clinical practice, for benchmarking and quality improvement initiatives, and for the development of specific guidelines.

中文翻译：

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新生儿院内转运过程中的不良事件及相关因素

客观的

确定新生儿院内转运过程中不良事件 (AE) 的频率、类型和严重程度，并确定相关因素。

学习规划

我们在一个三级护理学术新生儿病房进行了一项前瞻性观察研究。纳入 2015 年 6 月 1 日至 2017 年 5 月 31 日期间在新生儿病房住院并接受院内转运的所有患者。不包括来自其他医院和产房的运输。

结果

分析了对 293 名新生儿进行的 990 次院内转运的数据。运输时的中位出生后年龄为 13 天（Q1-Q3，5-44）。不良事件发生在 25% (248/990) 的转运中，主要与心血管和呼吸系统的不稳定、激动和温度控制有关。不良事件与 207 次运输中的无伤害（207/990，21%）、37 次运输中的轻度伤害（37/990，4%）和 4 次运输中的中度伤害（4/990，0.4%）相关。没有严重或致命的不良事件。儿茶酚胺的血流动力学支持、中心静脉导管的存在和较长的转运时间是转运过程中发生不良事件的独立预测因素。

结论

新生儿的院内转运与相当大比例的低至中度不良事件有关。我们的数据对临床实践、基准测试和质量改进计划以及特定指南的制定具有重要意义。