Transport of Critically Ill Patients —
Training activity: 3

Details

Identify appropriate equipment and resources required for transfer

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Availability of appropriate equipment
• Calculation of requirements for transfer
• Managing risk
• Infection prevention and control measures
• Manual handling training
• Appropriate staffing and skill mix to ensure safe and efficient transfer

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

What does success look like?

• Identify what is expected of you in relation to correctly listing all necessary equipment based on the patient’s condition and the specifics of the transfer.
• Consider how the learning outcomes apply, specifically in relation to developing transfer plans and assessing the necessary technical requirements, such as ventilation, monitoring, and suction equipment.
• Discuss with your training officer to gain clarity of what is expected of you in relation to the local protocol for identifying and documenting equipment needs for different types of transfers (e.g., non-invasive vs. invasive ventilation, short vs. long transfers).

What is your prior experience of this activity?

• Think about what you already know about the equipment used for transferring critically ill patients (e.g., portable ventilators, transport monitors, infusion pumps, emergency bags).
• Consider possible challenges you might face during the activity, such as ensuring equipment compatibility, availability, or power requirements.
• Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if complex equipment needs require input from senior staff, medical teams, or specialist transport teams.
• Acknowledge how you feel about identifying equipment needs – confident, or is this a new area?

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as systematically assessing patient needs to determine equipment requirements or efficiently locating equipment lists/protocols.
• Identify the specific insights you hope to gain into the rationale behind specific equipment choices or common pitfalls in equipment planning.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of equipment planning, specifically regarding any identified gaps in your knowledge about specific equipment.
• Identify important information you need to consider before embarking on the activity, such as specific patient details (e.g., ventilation mode, infusion rates, monitoring requirements) and the destination facility capabilities that are crucial for accurate equipment identification.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst assessing the patient’s needs and compiling the equipment list?
• Are you encountering situations such as:
  • Unusual patient requirements or complexities (e.g., severe obesity requiring specific handling equipment) that challenge the standard planning list?
  • A sudden report of unavailability or malfunction of a critical piece of equipment (e.g., portable ventilator model) that was central to your initial plan?

How are you reacting to the unexpected development?

• How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to equipment selection by immediately seeking an alternative, compatible device?
• Consider the steps you are taking in the moment, such as:
  • Immediately consulting the transfer plan to review contingency measures for the unavailable equipment
  • Halting the planning process to consult the training officer to resolve unexpected equipment issues
• How are you feeling in that moment? For instance, are you finding it difficult to adapt your initial planning strategy dynamically? Is it affecting your confidence in anticipating specific procedural needs for this condition?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully refining the plan to align with relevant protocols despite initial challenges? Or are you needing support because logistical requirements exceed departmental resource norms?
• What are you learning as a result of the unexpected development? For example, are you mastering a more efficient technique for vetting patient condition against equipment needs? Or gaining insight into the critical details required in clinical history for robust planning?

On action

What happened?

• Begin by summarising the key steps you took when identifying the necessary equipment and resources for the specific patient transfer, including consultation of local protocols.
• Consider specific events, actions, or interactions which felt important, such as successfully justifying the selection of specialist ventilation tubing based on patient need or encountering unexpected unavailability of a critical monitoring device.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately adapting your plan when critical equipment was unavailable by identifying and verifying an approved alternative.
• How did you feel during this experience, e.g., stressed by the equipment issue or confident in your ability to consult the contingency plan?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding assessing equipment requirements for critically ill patient transfers. What strengths did you demonstrate, e.g., meticulous adherence to the equipment checklist?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with a specific parameter required for non-standard therapeutic equipment?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in considering contingencies for equipment availability?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding the need for resource acquisition outside routine departmental stock, and how you reacted to this.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the robustness of your equipment identification and resource vetting process.
• What will you do differently next time you approach identifying equipment needs, for instance, by proactively conducting a technical verification call regarding the compatibility of non-standard accessories?
• Do you need to practise any aspect of the activity further, such as developing your knowledge further regarding specific types of equipment or resource availability?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of planning patient transfers with varied equipment needs since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent case required transportation to MRI or required specialist perfusion equipment forced you to re-evaluate the rigidity of your reliance on a standard equipment list during your first attempt at this training activity.
• Considering what you understand about resource assessment, contingency planning and equipment capabilities/limitations now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your systematic process for anticipating equipment requirements based on further learning and experiences? For example, how you proactively reviewed and integrated manufacturer specifications for different transport ventilators based on further learning, to ensure compatibility with patient needs.
• Has discussing equipment planning challenges or best practices or the impact of missing critical consumables on transfer safety with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a delay caused by inadequate resource verification refined your understanding of the critical nature of meticulous resource assessment.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent transfer preparation experiences, contributed to your overall confidence and ability in resource assessment, logistical planning, and anticipating equipment needs, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated skills in identifying and planning for equipment needs now enables you to discuss patient requirements with destination facilities, including equipment considerations, during an OCE assessment.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to anticipating equipment requirements for patient transfers? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer immediately when the required resources or logistical requirements exceed departmental resource norms, recognising this requires senior input for resource management.
• Looking holistically at your training journey, how has this initial equipment identification experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to developing plans, including contingencies for equipment? For example, how this foundational experience has supported your development in improving your awareness of equipment capabilities or limitations.

Relevant learning outcomes

#	Outcome
# 2	Outcome Develop plans for the transfer of critically ill patients, including contingencies for equipment and escalation in patient care.