Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
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) :
Man YT(1), Cheung MW (1), Wong HL(1), Chow KL (1), Kong LH(1), Kwan KW (1), Yeung MW(1), Yeung KJ (1), Lee CH (1), Lo WP (1), Kwan YF (1), Shum HP(1)
Affiliation :
(1) Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital
Introduction :
Impella, a mechanical circulation support device, is a high-risk, low-volume technology used in the intensive care unit (ICU) to help patients with refractory cardiogenic shock. Case nurses must possess adequate knowledge and skills to provide patient care and to manage troubleshooting with this advanced equipment with other concurrent therapies.
Objectives :
To enhance safe and quality care for patients using mechanical circulatory support devices- Impella
Methodology :
Adopting a Plan-Do-Check-Act (PDCA) model, literature review was conducted for evidence-based Impella practices. We valued every input, inquiry, and feedback. In July 2022, our ICU admitted its first patient; by December 2023, 17 patients had been under our care with Impella. In November 2022, in-house training courses including lectures and hands-on practice for doctors and nurses was begun. In addition, we had created a Impella checklist comprising important information in our Clinical Information System (CIS), to provide guidance for nursing practice. Following the in-house training, we updated the Impella checklist and provided more information, which was easily accessible via department webpages, online data drives, and point-of-care printed copies. Apart from information sharing, our core team members offered beside coaching to support frontlines. Ad hoc briefings and debriefings were held to clarify concepts.
Result & Outcome :
62 nurses participated the In-house Impella training. Pre- and post-training evaluations was reviewed: knowledge enhancement was achieved in 100%, staff confidence in handling troubleshooting and running the machine had improved from 36.5% to 72.2%, and staff confidence in providing patient care had increased from 38.7% to 72.8%. In 17 patients under our care, the checklist successfully alerted staff to change the cassette [4(23.5%)], tighten the tuohy burst [1(5.9%)], entered correct data to the console [1(5.9%)] and took appropriate actions during cardiopulmonary resuscitation [2(11.8%)]. No adverse events were encountered. Conclusions This CQI program focuses on safe and quality practice to optimize specialty services. Regular competence assessment should be continued to ensure sustainability.
