The establishment of review indicators for intra-hospital transfer of critically ill children and analysis of barrier factors
ZHANG Yan
ZENG Liemei
YANG Shuang
ZHANG Ziyan
TAN Yufei
Abstract：Objective:To conduct evidence-based practice for intra-hospital transport of critically ill children,establish audit criteria based on practice recommendations from the clinical practice guidelines for intra-hospital transport of hospitalized children(2023 edition),comprehensively evaluate current clinical practices,analyze barriers and facilitators,and develop action strategies.Methods:Focusing on the transport process from the emergency department to the intensive care unit,five best practice recommendations from the guidelines were selected and translated into 15 audit criteria across 7 dimensions:pre-transport assessment,risk assessment and classification,pre-transport communication,pre-transport preparation,route planning,and transport handover with documentation.Baseline clinical audits were conducted,followed by barrier and facilitator analysis considering change content,change recipient,organizational environments.Results:Five indicators showed 0 compliance,two<80%adherence,and three demonstrated 80%～<90%compliance.Key barriers included lack of standardized risk classification guidelines,absence of scenario-specific protocols for emergency-to-ICU transport,incomplete handover systems,and insufficient staff knowledge of evidence-based transformation.Main facilitators included management support for clinical changes,thorough preparation for change,team capability for implementing changes,abundant training and educational resources,and advanced information technology,among others.Conclusion:Significant gaps exist between guideline recommendations and clinical practice in intra-hospital transport of critically ill children.Targeted improvements addressing identified barriers and leveraging facilitators should be implemented to enhance evidence translation and standardize transport processes.
Keywords：intra-hospital transportcritically ill childrenaudit criteriabarrier factorsevidence-based nursing
Publication Date：2025-08-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 3059-3064 )