Safety incidents during intrahospital transport of hemodialysis patients in China: a multicenter cross-sectional study.

OBJECTIVE: To characterize safety incidents during intrahospital transport of hemodialysis patients in Chinese tertiary hospitals to guide evidence-based safety standards. METHODS: A multicenter cross-sectional study (STROBE-guided) included 4,253 registered nurses consisting of 418 head nurses and 3,835 clinical nurses. While the WHO's International Classification for Patient Safety served as the basis for the classification of safety incidents, the structured questionnaires were created based on clinical observation and a review of the literature. Binary logistic regression identified organizational and operational risk factors. RESULTS: Over 12 months, 268 safety incidents were reported from 135,459 intrahospital transports. Hemodialysis facilities accounted for 81.72% reports. Survey report from 3,232 clinical nurses showed that the predominant incident categories were medical device/equipment malfunctions (61.14%), patient accidents (45.24%), blood/blood product-related events (43.94%), oxygen/gas/vapor issues (42.39%), and clinical administration errors (41.83%). Key independent risk factor was a monthly hemodialysis caseload exceeding 3,000 procedures (OR = 2.580; 95% CI: 1.198-5.556; p = 0.015). Additionally, enhanced incident detection rates, facilitated by proactive reporting initiatives, showed a robust positive association with the efficacy of quality control measures (OR = 3.540; 95% CI: 1.604-7.814; p = 0.002). CONCLUSION: High-volume dialysis units are at significantly elevated risk for transport safety incidents. Units implementing quality control measures reported more safety incidents, which likely reflects the role of a proactive reporting culture in enhancing the detection of hidden incidents. These findings support targeted resource allocation and policy standardization for safer intrahospital transport in hemodialysis settings.