Assessment of facilitators and challenges in implementing safety transfer of critically ill patients at selected referral hospitals in Rwanda

Abstract

Background: critically ill patients are often transferred from different hospitals or from scene to tertiary care hospitals for better outcome, However adverse effect may arise during the transportation and worsen the patient health status. Even though mitigation like equipment and drugs necessary for cardiac and respiratory support, personnel skills and better organization in inter-hospital and pre-hospital transfers may increase patient safety and survival rate during pre and inter- hospital transfer and after admission in referral settings Aim of this study was to assess facilitators and challenges in pre and inter -hospital transfer; regarding critically ill patients safety. Method: Quantitative Research approach using descriptive cross sectional research design has been adopted in a period of 2 months involving nurses, non-physician and physicians who accompanied critically ill patients during transfer to tertiary care. Data analysis: Data collected has been analyzed; descriptively: including frequency and percentages have been calculated; chi-square Pearson test has been used to test associations among variables like education level and monitoring vital signs of patients during transfer using the Statistical Package For Socio Science SPSS version 21. The results are presented in the form of tables and graphs. Results: This study reviled that in 120 participants enrolled in study 69.1 % of participants were registered nurses 58.3 % working in district hospitals and 35.8% of them were working in ambulance services and emergency department and 35.0 % didn‟t receive any training regarding BLS, ACLS or another training regarding emergencies and critical care. Monitoring patient vital signs as important facilitator in transfer about 56.3% of health care providers did not be able to monitor Blood pressure during transfer and 51.7 % didn‟t be able to monitor SPO2, and 76.6% did not document vital signs during transfer. Conclusion: Even much have been done to improve pre and interhospital in Rwanda, There is still a gap in facilitators regarding staffing such as lack of training related to emergencies and critical care which may help health care providers to acquire more knowledge and skills in continuation of care during pre and interhospital transfer