Intensive care not confined to the bedspace: successfully implemented ventilation and monitoring solution for ICU intrahospital transport that is offering improvements in patient care

Introduction

The redevelopment of the ICU at Westmead Hospital in 2006 required each of the 39 new bedspaces to have a transportable system that utilised bedside mechanical ventilation and patient monitoring equipment. Clinicians at Westmead ICU felt that there were certain limitations in patient care with the use of transport ventilators and monitors. When patients were transferred out of the ICU to other departments (for example, for CT scan, etc.), it was proposed that enhancements to care could be achieved using more sophisticated bedside equipment in place of basic transport ventilators and monitors.

Methods

A specialised multidisciplinary team was assembled for the planned project. It was envisaged that the new system would be on a detachable trolley, connected to an articulating ceiling-mounted service pendant. It would be mobile, with the equipment mounted in such a way that it would also be capable of docking to the ICU bed. This concept would therefore allow uninterrupted monitoring and mechanical ventilation of the patient by the unit's bedside equipment, thereby allowing seamless transfer out of the ICU for radiological investigations.

Results

The decision on the final configuration for the mounting of the selected equipment for the trolleys required comprehensive strategic planning. This was to ensure that the bulky equipment be manageable during patient transfers. Following installation and implementation, 826 patients have been transferred to CT/radiology, with some patients transferred multiple times. There have been improvements in patient care experienced with the use of the system during these transfers, which include greater patient respiratory and haemodynamic stability, maintenance of lung-protective strategies, advances in infection control and reduced preparation times.

Conclusion

The staff have become extremely competent in the use of the equipment and confident in the system. The patient-centred benefits observed have justified the expense and time invested. After experience in the use of this model, new ideas that could be implemented to enhance patient management with use of the system have also been gained.