Outcomes of 'unrecognised situation awareness failures events' in intensive care unit transfer of children in a Japanese children's hospital

Journal of Paediatrics and Child Health
Yoshihiro AokiMuneyuki Takeuchi

Abstract

To demonstrate that unrecognised situation awareness failures events (UNSAFE) transfers are associated with poorer outcomes in the intensive care unit (ICU) at a Japanese children's hospital lacking a rapid response system. This retrospective cohort study was conducted between January 2013 and February 2016. UNSAFE transfers were defined as unplanned in-hospital ward-to-ICU transfers requiring tracheal intubation, vasoactive medications or ≥3 fluid boluses before arrival or in the first 60 min of ICU care. We compared ICU stay duration and mortality between UNSAFE and non-UNSAFE transfers. There were 2126 admissions to the paediatric ICU during the study period, and 244 cases met the definition of an unscheduled in-hospital transfer (11.5%). Of these, the number of patients transferred following cardiopulmonary resuscitation, in the UNSAFE group and in the non-UNSAFE group were 9 (3.7%), 68 (28%) and 167 (68%), respectively. In the UNSAFE group, the number of patients who required tracheal intubation, initiation of vasoactive medications or ≥ 3 fluid boluses in the first 60 min of ICU care or before arrival in the ICU was 61 (90%), 38 (56%) and 9 (13%), respectively. ICU stay duration and mortality were significantly poorer in ...Continue Reading

References

Jan 25, 2003·Journal of General Internal Medicine·Michael P YoungElliott S Fisher
Mar 25, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·James Tibballs, Sharon Kinney
Jun 22, 2011·Pediatrics·Afrothite KotsakisUNKNOWN Ontario Pediatric Critical Care Response Team Collaborative
Nov 13, 2013·JAMA Pediatrics·Christopher P BonafideRon Keren
Feb 23, 2018·Pediatrics International : Official Journal of the Japan Pediatric Society·Yu InataMuneyuki Takeuchi

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Citations

Jun 30, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Farah S HussainPatrick W Brady
Jul 24, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Maya DewanHeather A Wolfe
Jan 27, 2021·Hospital Pediatrics·Justin M LockwoodAmanda F Dempsey
Nov 5, 2020·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Tina SosaPatrick W Brady

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