Designing and Assessment of a Checklist for Transfer Status of Patient with COVID-19 Referred to Emergency Departments

When transferring patients admitted to hospitals due to coronavirus disease 2019 (COVID-19), it is necessary to take appropriate measures to maintain the safety of patients and staff. The aim of this study was to design a checklist and evaluate in-hospital transfer status of patients with COVID-19 disease in emergency departments.

In this cross-sectional study, a checklist for evaluation of in-hospital transfer of patients with COVID-19 in the emergency department was designed, and then assessed. The initial in-hospital transfer checklist was prepared based on data from guidelines and published articles regarding patients with COVID-19. Its validity was confirmed using face validity (by 20 emergency nurses). Then, the items were evaluated in terms of content validity in both quantitative and qualitative methods. To evaluate the content validity in a quantitative way, the content validity ratio (CVR) coefficient and the content validity index (CVI) were used. Waltz and Basel methods were used to determine CVR from the panel of experts and for CVI, respectively. Using the final checklist, the transfer status of patients with COVID-19 in three stages (before, during, and after transfer) by three samplers, from May to September 2020, in the emergency departments of selected hospitals in Qazvin City, Iran.

In this study, the modes of transmission of 167 patients during 501 observations were investigated. Errors occurred in 50.9% of transfers, especially during transfer (32.9%), the most important cases of which included reduction of arterial blood oxygen saturation, decrease and increase in blood pressure, and incompliance with transfer protocols including non-disinfection of transmission routes (73.7%), lack of hand hygiene (74.6%), and non-replacement of personal protective equipment (60.5%).

The results of the study showed that the most accidents were reduction of arterial blood oxygen saturation and hypotension, respectively, which occurred in terms of time, mainly during patient transfer.