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To systematically review and analyze the literature on intrahospital neonatal transport and synthesize the available evidence to inform the development of standardized transport procedures. Following the \"6S\" evidence model, a systematic search was conducted across multiple databases from inception to August 31, 2025. Eligible documents were appraised for methodological quality, and relevant recommendations and evidence statements were extracted and synthesized narratively. The level of evidence and strength of recommendations were graded according to the 2014 JBI evidence pre-grading system. A total of 10 documents were included, comprising 7 guidelines, 2 evidence summaries, and 1 systematic review. A total of 35 evidence statements were synthesized and grouped into 7 themes: transport team; pre-transport assessment and decision-making; preparation of healthcare providers and neonates; preparation of supplies and medications; transport equipment; monitoring and care during transport; and handover and quality management. The evidence base was primarily derived from guideline recommendations, evidence summaries, and expert consensus. This review provides a structured synthesis and critical appraisal of the available evidence and recommendations for intrahospital neonatal transport. The synthesized recommendations may help inform standardized transport procedures; however, they should be interpreted with caution because a substantial proportion of the evidence base is derived from guidelines or expert consensus. Further high-quality prospective, multicenter studies are warranted to evaluate the effectiveness, feasibility, and generalizability of these recommendations across diverse clinical settings.

Background Intra-hospital transport of critically ill, mechanically ventilated patients is associated with significant physiological risks. Adaptive Minute Ventilation (AMV) is a closed-loop ventilation mode that automatically maintains target minute ventilation. While AMV has shown promise in intensive care unit settings, its performance during intrahospital transport has not yet been evaluated. This trial aims to assess the safety and efficacy of AMV compared with conventional ventilation strategies during patient transport. Methods This is a single-centre, open-label, randomized controlled non-inferiority trial conducted at Peking Union Medical College Hospital. Fifty adult patients receiving invasive mechanical ventilation and requiring transport will be randomly assigned (1:1) to either AMV or their pre-transport ventilation mode. The primary endpoint is the change in arterial carbon dioxide pressure (PaCO₂) from 30 min before to 10 min after transport. Secondary outcomes include changes in oxygenation index (PaO₂/FiO₂), peak airway pressure, dynamic compliance, and rapid shallow breathing index. Randomization will be performed using permuted block randomization. Both intention-to-treat and per-protocol analyses will be conducted. Missing data will be handled using multiple imputation. The study protocol has been reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781). It was registered in the Chinese Clinical Trial Registry (ChiCTR2500109659) on 23 September 2025 as a retrospective registration. Discussion This trial will be the first randomized study to evaluate AMV during intrahospital transport of critically ill patients. The findings will address an important evidence gap in transport ventilation strategies, potentially informing clinical practice on whether AMV provides a safe and effective alternative to conventional modes. By employing a non-inferiority design and standardized transport protocols, the study seeks to generate robust and clinically relevant evidence despite its single-centre setting and relatively small sample size. Trial registration Approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781). Trial registration: ChiCTR, ChiCTR2500109659. Registered 23 September 2025, https://www.chictr.org.cn/hvshowproject.html?id=284847 .

Background Intrahospital transport of critically ill patients is a common practice in intensive care units (ICUs), where patients’ safety is constantly challenged in high-intensity and dynamic environments. While Intrahospital Transport Safety Scale (IHTSS) is widely used internationally to evaluate the intrahospital transport safety, it has not been introduced in China. Objectives This study aimed to assess the reliability and validity of the Chinese version of the IHTSS scale among critical care nurses in China. Methods A cross-sectional study was conducted using a cluster sampling method. A total of 544 critical care nurses from 25 ICUs in 10 tertiary hospitals were recruited. We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the questionnaire’s underlying factor structure, ensuring construct validity. Additionally, internal consistency was assessed using Cronbach’s alpha coefficient, test-retest reliability, and corrected item-total correlation. Results The Chinese version of the scale displayed robust psychometric properties, with a Cronbach’s α coefficient of 0.976, a split-half reliability of 0.906, and a test-retest reliability of 0.856. EFA revealed a robust four-factor model that accounted for 75.970% of the variance, with the factor loadings of the items ranging from 0.433 to 0.951. CFA indicated a strong model fit, with a chi-square to degrees of freedom ratio (CMIN/DF) of 2.765, comparative fit index (CFI) of 0.943, incremental fit index (IFI) of 0.943, and goodness-of-fit index (GFI) of 0.845, supporting the efficacy of the four-factor model in assessing intrahospital transport safety for critically ill patients. Conclusion The Chinese version of the IHTSS demonstrated favourable reliability and validity among critical care nurses in China, making it a suitable tool for measuring the level of intrahospital transport safety for critically ill patients.

To develop and evaluate a risk prediction model for intrahospital transport adverse events in critically ill gynecological patients, providing a scientific basis for early identification of high-risk individuals and optimization of transport decision-making. A retrospective observational cohort study was conducted, including 650 patients who underwent intrahospital interdepartmental transport. Patients were randomly assigned in a 7:3 ratio to a model training set (455 patients) and an internal validation set (195 patients). Data collected included patient demographics, pre-transport condition assessment indicators, transport process parameters, and adverse event occurrences. Potential predictive variables were identified through univariate analysis and least absolute shrinkage and selection operator (LASSO) regression, followed by multivariate Logistic regression to construct the risk prediction model. Model discrimination was evaluated using the receiver operating characteristic (ROC) curve, calibration was assessed by the Hosmer-Lemeshow test, and clinical utility was evaluated via decision curve analysis (DCA). Baseline characteristics were comparable between the training and validation sets (all P>0.05). Multivariate analysis identified mechanical ventilation, Sequential Organ Failure Assessment (SOFA) score, Modified Early Warning Score (MEWS), and transport duration (minutes) as independent predictors of intrahospital transport adverse events in critically ill gynecological patients. Calibration curves demonstrated high consistency between predicted probabilities and observed outcomes, and the Hosmer-Lemeshow test indicated good calibration. The developed risk prediction model for intrahospital transport adverse events in critically ill gynecological patients demonstrates good discrimination and calibration. This study may provide a quantitative tool to support safe intrahospital transport management.

Patient safety during intra-hospital transport (IHT) of critically ill patients is a major global concern, as transfers expose patients to risks including physiological deterioration, equipment malfunction, and adverse events. Despite its importance, Iran lacks a standardized, culturally adapted tool to evaluate IHT safety from nurses' perspectives. This study aimed to translate, culturally adapt, and psychometrically validate the Persian version of the Intra-hospital Transport Safety Scale (IHTSS) for use among Iranian intensive care unit (ICU) nurses. A methodological cross-sectional design was employed in three phases from April to June 2025. Phase 1 involved forward-backward translation and cultural adaptation of the IHTSS. Phase 2 assessed face and content validity through ICU nurses and expert panels using Content Validity Ratio (CVR) and Content Validity Index (CVI). Phase 3 comprised psychometric evaluation among 315 ICU nurses recruited from hospitals in western Iran. Exploratory and confirmatory factor analyses were conducted to examine construct validity. Reliability was assessed through Cronbach's α, McDonald's ω, and test-retest analysis. The Persian IHTSS demonstrated strong content validity (CVR = 0.93; S-CVI = 0.91). Exploratory factor analysis identified a four-factor structure Organization, Teamwork & Transport-related Tasks, Tools and Technologies, and Environment, explaining 63.1% of the total variance. Confirmatory factor analysis supported model adequacy (CFI = 0.96, RMSEA = 0.067, SRMR = 0.048). Internal consistency was high (Cronbach's α = 0.891; ω = 0.877), and test-retest reliability confirmed temporal stability (  = 0.881). The Persian version of the IHTSS is a valid, reliable, and culturally adapted instrument for assessing IHT safety in Iranian ICUs. Its application can help identify system-level strengths and weaknesses, guide targeted interventions, and enhance patient safety during critical care transfers.

Introduction:Critically ill children often require transport during diagnosis and treatment procedures during intensive care hospitalization. With this study, it was aimed to evaluate the practice of transport and the problems encountered during transport in pediatric intensive care units in Turkey.Methods:A questionnaire consisting of 18 questions was filled in with internet access by the head nurses of the pediatric intensive care unit, who agreed to participate in the study. Responses to questions about the characteristics of the participating centers, transport practices, problems encountered during transport, interventions and the registration system were evaluated.Results:A total of 29 tertiary pediatric intensive care units from 8 provinces in Turkey were included in the study. The mean number of beds was 14. In most pediatric intensive care units, 5 to 10 patients (51.7%) were transferred within 1 week. It was observed that the most patients were transported to the inpatient service (89.7%), followed by the operating room (69%). There was a protocol for patient transport in 69% of the units. The transport decision was made by the responsible specialist physician at a rate of 96.6%. 65% of the participants stated that the transport was recorded on a form. Transports were accompanied by 93% nurses, 86% allied health personnel, and 79% doctors. In 20 centers (69%), transport was possible with an invasive mechanical ventilator and 11 (37.9%) with a non-invasive mechanical ventilator. The most common problem encountered during transportation was the inadequacy of the physical conditions of the hospital (48.3%). There were 4 (13.8%) participants who encountered problems during patient transport in the last week. It was stated that the oxygen tube was depleted in one of them, and respiratory arrest developed in another patient.Conclusion:In this study, it was shown that; In our country, there are significant differences in intrahospital transport conditions, transport teams, equipment used during transport between centers. Transport standards should be established and these should take into account the conditions of our country. For these, compliance and monitoring mechanisms should be established.

Intrahospital transport of critically ill patients is often necessary for diagnostic procedures, therapeutic procedures, or admission to the intensive care unit. The aim of this study was to investigate and describe safety and adverse events during intrahospital transport of critically ill patients. A systematic search was performed of MEDLINE and the Cochrane Central Register of Controlled Trials for studies published up to June 3, 2020, and of the International Clinical Trials Platform Search Portal and ClinicalTrials.gov for ongoing trials. We selected prospective and retrospective cohort studies published in English on intrahospital transport of critically ill patients, and then performed a meta-analysis. The primary outcome was the incidence of all adverse events that occurred during intrahospital transport. The secondary outcomes were death due to intrahospital transport or life-threatening adverse events, minor events in vital signs, adverse events related to equipment, durations of ICU and hospital stay, and costs. A total of 12,313 intrahospital transports and 1898 patients from 24 studies were included in the meta-analysis. Among 24 studies that evaluated the primary outcome, the pooled frequency of all adverse events was 26.2% (95% CI: 15.0–39.2) and the heterogeneity among these studies was high (I2 = 99.5%). The pooled frequency of death due to intrahospital transport and life-threatening adverse events was 0% and 1.47% each, but heterogeneity was also high. Our findings suggest that adverse events can occur during intrahospital transport of critically ill patients, and that the frequency of critical adverse events is relatively low. The results of this meta-analysis could assist in risk-benefit analysis of diagnostic or therapeutic procedures requiring intrahospital transport of critically ill patients. Trial registration: UMIN000040963.

Aims To explore the knowledge, attitudes and practice status of the intrahospital transport (IHT) of critically ill patients among clinical nurses and their influencing factors. Design Cross‐sectional study. Methods A questionnaire determined the nurses' knowledge, attitudes and practice scores. The questionnaire was used for data collection in a tertiary hospital from 10 January to 17 January 2023. Multivariate regression analysis was also used to evaluate the related factors of IHT of critically ill patients in different dimensions. Results Out of 670 distributed questionnaires, 612 nurses returned the completed questionnaire. The scores of KAP were (9.72 ± 1.61), (42.91 ± 4.58) and (82.84 ± 1.61), respectively. Pearson's correlation analysis showed that knowledge, attitude and behaviour scores were positively correlated. Variables that were associated with the scores of transfer knowledge were the scores of transfer practice, different departments and the scores of transfer attitude. The score of practice, number of IHT and received hospital‐level training had statistical significance on the nurses' attitude scores. Furthermore, the score of the attitude and transport knowledge had statistical significance on the nurses' practice. Conclusion The findings indicate a clear need for clinical nurses' knowledge of IHT of critically ill patients, especially in the emergency department (ED) and ICU. In addition, nurses need to be more active in transporting critically ill patients. Managers should enhance nurses' confidence in the IHT of critically ill patients and promote clinical nurses to establish a correct and positive attitude. Impact The findings of this study benefit nursing managers in understanding the current situation of IHT of critically ill patients. Managers should apply new training methods to nursing education and develop a multi‐level training program that is systematic, comprehensive and demand‐oriented. Patient or Public Contribution The participants of this study were nurses and this contribution has been explained in the Data collection section. There was no patient contribution in this study.

During intrahospital transport, adverse events are inevitable. Real-time monitoring can be helpful for preventing these events during intrahospital transport. We attempted to determine the viability of risk signal detection using wearable devices and mobile apps during intrahospital transport. An alarm was sent to clinicians in the event of oxygen saturation below 90%, heart rate above 140 or below 60 beats per minute (bpm), and network errors. We validated the reliability of the risk signal transmitted over the network. We used two wearable devices to monitor oxygen saturation and heart rate for 23 patients during intrahospital transport for diagnostic workup or rehabilitation. To determine the agreement between the devices, records collected every 4 seconds were matched and imputation was performed if no records were collected at the same time by both devices. We used intraclass correlation coefficients (ICC) to evaluate the relationships between the two devices. Data for 21 patients were delivered to the cloud over LTE, and data for two patients were delivered over Wi-Fi. Monitoring devices were used for 20 patients during intrahospital transport for diagnostic work up and for three patients during rehabilitation. Three patients using supplemental oxygen before the study were included. In our study, the ICC for the heart rate between the two devices was 0.940 (95% CI 0.939-0.942) and that of oxygen saturation was 0.719 (95% CI 0.711-0.727). Systemic error analyzed with Bland-Altman analysis was 0.428 for heart rate and -1.404 for oxygen saturation. During the study, 14 patients had 20 risk signals: nine signals for eight patients with less than 90% oxygen saturation, four for four patients with a heart rate of 60 bpm or less, and seven for five patients due to network error. We developed a system that notifies the health care provider of the risk level of a patient during transportation using a wearable device and a mobile app. Although there were some problems such as missing values and network errors, this paper is meaningful in that the previously mentioned risk detection system was validated with actual patients.

Background: Patients with subarachnoid hemorrhage (SAH) often necessitate intra-hospital transport (IHT) during intensive care treatment. These transfers to facilities outside of the neurointensive care unit (NICU) pose challenges due to the inherent instability of the hemodynamic, respiratory, and neurological parameters that are typical in these patients. Methods: In this retrospective, single-center cohort study, a total of 108 IHTs were analyzed for demographics, transport rationale, clinical outcomes, and pre/post-IHT monitoring parameters. After establishing clinical thresholds, the frequency of complications was calculated, and predictors of thresholds violations were determined. Results: The mean age was 55.7 (+/−15.3) years, with 68.0% showing severe SAH (World Federation of Neurosurgical Societies Scale 5). IHTs with an emergency indication made up 30.8% of all transports. Direct therapeutic consequences from IHT were observed in 38.5%. On average, the first IHT occurred 1.5 (+/−2.0) days post-admission and patients were transported 4.3 (+/−1.8) times during their stay in the NICU. Significant parameter changes from pre- to post-IHT included mean arterial pressure, systolic blood pressure, oxygen saturation, blood glucose levels, temperature, dosages of propofol and ketamine, tidal volume, inspired oxygen concentration, Horovitz index, glucose, pH, intracranial pressure, and cerebral perfusion pressure. Relevant hemodynamic thresholds were violated in 31.5% of cases, while respiratory complications occurred in 63.9%, and neurological complications in 20.4%. For hemodynamic complications, a low heart rate with a threshold of 61/min (OR 0.96, 95% CI 0.93–0.99, p = 0.0165) and low doses of midazolam with a threshold of 17.5 mg/h (OR 0.97, 95% CI 0.95–1.00, p = 0.0232) significantly predicted adverse events. However, the model did not identify significant predictors for respiratory and neurological outcomes. Conclusions: Conclusively, IHTs in SAH patients are associated with relevant changes in hemodynamic, respiratory, and neurological monitoring parameters, with direct therapeutic consequences in 4/10 IHTs. These findings underscore the importance of further studies on the clinical impact of IHTs.