Safe Transfer and Retrieval: The Practical Approach

Driscoll P, Macartney I, Mackway-Jones K, Oakley P. (Eds). 2002: London, United Kingdom: BMJ Books.

The safe transfer of critically ill patients from one place to another is a major concern for critical care nurses. Often, patients may be simply transferred to another unit for care or to a department for a procedure such as surgery. However, this book only covers transfer of critically ill patients to other facilities. The authors do mention that many of the same principles apply for in-hospital transfers. Critical care nurses must do what they can to expedite this process to make it safer for our patients. Careful monitoring of the patient's condition as well as rapid treatment for any life-threatening condition, which may occur during a transfer, is crucial. This book, while written by healthcare providers in the United Kingdom, has much information that would be of use to nurses in all critical care settings.

The book is divided into five sections. Section one deals with the introduction of the material presented in the book as well as a review of safe transfer and retrieval (StaR) principles. A systematic approach to patient transfer is presented in an easy-to-read and follow manner. The authors stress the need for assessment, control, communication, evaluation, preparation and packaging, and transportation and describe each step in detail.

Section two discusses the management of the transfer of the patient. Strategies for the accurate assessment of the patient and methods of controlling the situation are presented. The authors stress the importance of a team leader for overall control of the transfer. Each healthcare provider has his or her own responsibilities during the transfer process. Preparation of the patient for the transfer process is paramount to a successful transfer. The patient must be prepared both medically (ie, all intravenous medications are infusing, a patent airway is present, emergency equipment and medication are readily available) and emotionally. Explain the need for transfer and the measures taken to ensure the patient's safety to the patient and any significant others.

Section three provides detailed information about procedures involved during transfer such as methods of communication and actually moving the patient. All equipment (eg, intravenous lines, chest tubes) must be secured. Monitoring must be continuous. The section also describes various communication methods that can be used from the referring to the receiving facility. The laws and regulation of the United Kingdom concerning patient safety and transfer are discussed and are similar to those present in many other countries.

Section four covers clinical care of the patient and gives examples of specific situations. This section correlates closely with the American Heart Association's recommendation for advanced cardiac life support and reviews several of the same situations, such as the development of a life-threatening arrhythmia or tension pneumothorax.

Section five includes several appendices concerning legal issues, documentation, safety, and helicopter transfers.

This book is a practical source of information for critical care nurses and other personnel who are involved in the transfer of patients from one facility to another. While many of the suggestions made in the book could be readily applied to an in-hospital transfer, clearly the book's intention is to focus on facility transfer. Many guidelines presented in this book could easily be implemented to hospitals located any where in the world.