Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Tang WY(1), Kam WP(1), Shiu YH(1), Leung KNS(1), Wan HY(1), Wong LY(1)
Affiliation :
(1) Department of Cardiothoracic Surgery, Queen Mary Hospital
Introduction :
In Department of Cardiothoracic Surgery (CTSD), critically-ill patients with Left Ventricular Assist Device (LVAD), tracheostomy, on transvenous or epicardial pacing, or those on high alert medications often require transfer within hospital or between hospitals for investigations and procedures. The need for transport with escorts by nurses and/or doctors in general wards is increasing. Meanwhile, a gap has been observed in the preparation and engagement of newly graduated nurses in patient transport, posing risks and safety concerns.
Objectives :
An education package consisting of lectures and low-fidelity transport simulation was delivered to address this issue. The training was conducted in-situ and materials were prepared based on Hospital Authority HA guidelines on Inter-/Intra-hospital transport of critically-ill patients. 1. Minimise the clinical gap in managing transport of critically-ill patients among junior nurses. 2. Ensure patient safety. 3. Consolidate transport theory into clinical practice. 4. Provide standardised training on Inter-/Intra-hospital transport. 5. Improve competency and confidence in preparing and engaging in transport among junior nurses.
Methodology :
All nurses working in CTSD under the preceptorship program were recruited. They received the following training components: 1) Lecture on Inter-/Intra-hospital transport 2) 15-minute low-fidelity scenario-based transport simulation 3) Updates on HA guidelines on Inter-/Intra-hospital transport of critically-ill patients 4) Reference guide on preparing a patient for Inter-/Intra-hospital transport 5) Debriefing. The training was conducted in groups of 4-5 nurses for better role distribution. A pretest-posttest design was adopted for data collection.
Result & Outcome :
A total of 11 young nurses were recruited in this program (n=11). Three transport simulation sessions were organised from October 2023 to December 2023. A significant improvement in knowledge, competency and confidence among nurses was observed. The mean score of knowledge and competency increased from 6.68 (SD:1.62) to 8.06 (SD:1.06) (total score: 9), with p-value < 0.03. While the mean score of self-confidence increased from 14.62 (SD: 1.02) to 22.75 (SD: 1.44) (total score: 25), with p-value < 0.0001. All sub-questions showed positive improvement. The low-fidelity simulation program showed a significant improvement in knowledge, competency and confidence among junior nurses in managing transport of critically-ill patients. It is recommended to incorporate the transport simulation program into nurse orientation program in our department for better nurturing and development of young nurses. Regular simulation training on transport can be organised to all nursing staff, to refresh and update their knowledge. Furthermore, Patient Care Assistants (PCAs) can be involved in the training for facilitating the transport logistics.
