Characteristics and outcomes of patients requiring unplanned transfer from subacute to acute care

Considine, Julie, Mohr, Marie, Lourenco, Rosemary, Cooke, Robynne and Aitken, Mark 2013, Characteristics and outcomes of patients requiring unplanned transfer from subacute to acute care, International journal of nursing practice, vol. 19, no. 2, pp. 186-196.

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Title Characteristics and outcomes of patients requiring unplanned transfer from subacute to acute care
Author(s) Considine, Julie
Mohr, Marie
Lourenco, Rosemary
Cooke, Robynne
Aitken, Mark
Journal name International journal of nursing practice
Volume number 19
Issue number 2
Start page 186
End page 196
Total pages 11
Publisher Wiley - Blackwell Publishing Asia
Place of publication Richmond, Vic.
Publication date 2013-04
ISSN 1322-7114
1440-172X
Keyword(s) clinical deterioration
emergency
geriatrics
risk management
subacute care
Summary The study aims to identify the reasons for, and outcomes from, unplanned transfers from subacute care to acute care. A retrospective patient record review of patients requiring unplanned transfer from subacute to an acute care emergency department (ED) from 1 July 2008 to 30 June 2009 was undertaken. Data collected included patient demographics, clinical characteristics in preceding transfer, and on ED arrival and outcome data. There were 136 patients included in the study with a median age of 81 years. The most common reasons for transfer were respiratory problems and altered conscious state. In the 24 h preceding transfer, 92.6% of patients had ≥ 1 physiological abnormality and 10.3% of patients had no physiological parameters documented. On ED arrival, 75% of patients had physiological abnormalities. Hospital admission occurred in 75% of patients and the inpatient mortality rate was 14.7%. Factors associated with inpatient mortality were tachypnoea and severe hypoxaemia in 24 h preceding transfer and tachypnoea, hypoxaemia, hypoxaemia, severe hypoxaemia and hypothermia on ED arrival. Patients requiring unplanned transfer had higher inpatient mortality than older hospital users. Reasons for unplanned transfer reflect known predictors of in-hospital adverse events so predictive use of physiological data and patient characteristics might optimize patient safety.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30052782

Document type: Journal Article
Collection: School of Nursing and Midwifery
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