Effects of frequent PATient moves on patient outcomes in a large tertiary Hospital (the PATH study): a prospective cohort study
Joan Webster A D , Karen New B , Mary Fenn C , Mary Batch A , Alyson Eastgate A , Selena Webber A and Anthony Nesbit CA Level 2, Centre for Clinical Nursing, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia. Email: mary.batch@health.qld.gov.au; alyson.eastgate@health.qld.gov.au; sw@grimminc.com
B School of Nursing Midwifery and Social work, Level 3, Chamberlain building, The University of Queensland, St Lucia, Qld 4072, Australia. Email: k.new@uq.edu.au
C Patient Flow Unit, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia. Email: mary.fenn@health.qld.gov.au; anthony.nesbit@health.qld.gov.au
D Corresponding author. Email: joan.webster@health.qld.gov.au
Australian Health Review 40(3) 324-329 https://doi.org/10.1071/AH15095
Submitted: 20 May 2015 Accepted: 17 June 2015 Published: 21 September 2015
Journal Compilation © AHHA 2016
Abstract
Objective The aim of the present study was to investigate the incidence of and patient outcomes associated with frequent patient moves.
Methods In a prospective cohort study, any bed move and the reason for the move were documented. Patients were assessed on admission for anxiety, social support and delirium. Adverse events, length of stay and satisfaction were recorded. Patients moved three or more times were compared with those moved less than three times.
Results In all, 566 patients admitted to a tertiary referral hospital were included in the study. Of these, 156 patients (27.6%) were moved once, 46 (8.1%) were moved twice and 28 (4.9%) were moved at least three times. Those moved three or more times were almost threefold more likely to have an adverse event recorded compared with those moved fewer times (relative risk (RR) 2.75; 95% confidence interval (CI) 1.18, 6.42; P = 0.02) and to have a hospital stay twice as long (RR 7.10; 95% CI 2.60, 11.60; P = 0.002). Levels of satisfaction and anxiety were not affected by frequent moves and there was no effect on delirium.
Conclusion Frequent bed moves affect patient safety and prolong length of stay.
What is known about the topic? Retrospective and qualitative studies suggest that patient safety and costs may be affected by frequent patient moves.
What does this paper add? The present study is the first prospective study to assess the negative effects of frequent patient moves on specific patient outcomes, such as adverse events, length of stay and satisfaction with care.
What are the implications for practitioners? Within- and between-ward moves may affect patient safety. Patients should be moved only when there is a clear and unavoidable reason for doing so.
Additional keywords: healthcare costs, patient safety, patient transfer.
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