Caring for critically ill patients during interhospital transfers: A qualitative study.

Dabija, Marius; Aine, Matilda; Forsberg, Angelica

BACKGROUND The coronavirus pandemic has resulted in an increased number of interhospital transfers of patients with artificial airways. The transfer of these patients is associated with risks and has been experienced as highly challenging, which needs to be further explored. AIMS AND OBJECTIVES To describe critical care nurses' experiences of caring for critically ill patients with artificial airways during interhospital transfers. DESIGN A cross-sectional study using a qualitative approach was conducted during spring 2020. Participants were critical care nurses (n = 7) from different hospitals (n = 2). METHODS The data were collected through semi-structured interviews based on an interview guide. A qualitative content analysis using an inductive approach was performed. RESULTS The analysis resulted in one main theme, "Preserving the safety in an unknown environment," and three sub-themes, "Being adequately prepared is essential to feel secure," "Feeling abandoned and overwhelmingly responsible," and "Being challenged in an unfamiliar and risky environment." CONCLUSIONS Critical care nurses experienced interhospital transfers of critically ill patients with artificial airways as complex and risky. It is essential to have an overall plan in order to prevent any unpredictable and acute events. Adequate communication and good teamwork are key to the safe transfer of a critically ill patient in that potential complications and dangers to the patient can be prevented. RELEVANCE TO CLINICAL PRACTICE Standardized checklists need to be created to guide the transfers of critically ill patients with different conditions. This would prevent failures based on human or system factors, such as lack of experience and lack of good teamwork.