Challenges of Transporting Critically Ill Patients From General Wards to ICU: A Qualitative Study

Abstract

Background: Intra-hospital transport of critically ill patients may be associated with a significant risk of adverse events. Critically ill patients inadequately responding to therapy on general wards need to be transferred to the intensive care unit for immediate intervention and organ support. However, the focus on the safety of transportation from the general ward to the intensive care unit has seldom been addressed. Aim: To investigate the current challenges of transportation of critically ill patients from general wards to intensive care units from nurses' perspectives. Study Design: A qualitative descriptive design. In-depth and semi-structured interviews were performed. Data were collected at a single tertiary university hospital in Hunan province, China. Sixteen nurses participated in this study. Qualitative data were analysed using content analysis. Findings: Four themes were identified: practical barriers in initiating transport (e.g., gaps in early recognition and management), preparation under strong pressure: challenges of covering everything (e.g., juggling multiple roles in the preparation phase), every minute counts: an unexpected journey (e.g., concerns about patient conditions deteriorating in the blink of an eye during the transfer phase), difficulties in multilateral cooperation (e.g., unsynchronised interdepartmental handover). Conclusions: From the perspective of the participants, nurses underwent a difficult experience in transporting critically ill patients from the general ward to the intensive care unit, and challenges were encountered throughout the entire transport process. Relevance to Clinical Practice: Our findings highlighted that managers should clarify criteria for initiating transfers and team member qualification, establish standardised protocols, improve interdisciplinary teamwork and apply constant training programs. The findings underscored the urgent need for high-fidelity-based interdisciplinary training and joint education programs.