Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Wong SY(1), Li KM(1), Sin MW(1), Choi WK(1), Lo YC(1), Ma LF(1), Lo WC(1), Szeto L(1)
Affiliation :
(1)Department of Anaesthesia & Operating Theatre Services, Tseung Kwan O Hospital
Introduction :
Local anaesthetic systemic toxicity (LAST) is a potentially life-threatening yet largely preventable complication that occurs in perioperative setting. However, the complex and critical clinical situation imposes a challenge for nurses and doctors to manage the crisis. Therefore, a structured training programme for perioperative nurses and cognitive aids have been designed to provide guidance in managing the crisis in Tseung Kwan O Hospital.
Objectives :
(i) To raise perioperative nurses’ awareness and alertness of LAST
(ii) To enhance nurses’ competency and preparedness in managing LAST
(iii) To facilitate safe procedure and enhance patient safety
Methodology :
A 60-minute training session was designed which included a 30-minute theoretical lecture and a 30-minute hands-on session. The lecture content focused on prevention, early detection and management of LAST, and a reference card consisting of the maximum safe dose (MSD) of common LAs used in operating theatres was presented. To facilitate LAST crisis management, a rescue kit, which includes Intralipid 20%, the necessary consumables and quick reference cards, were also introduced.
Result & Outcome :
A total of ninety-nine perioperative nurses participated in the training programme. Pre- and post-test demonstrated statistically significant difference in knowledge score (total score=11; mean difference=3.828; p<0.0001). The mean confidence level of nurses in managing LAST increased from pre-programme 3.424 to post-programme 7.071 out of 10 (mean difference= 3.646; p<0.0001).
An evaluation on the training programme was conducted at the end of the training programme. All participants agreed that the MSD reference card was practical for use in the workplace and the LAST rescue kit was easy to reach. These readily available resources could facilitate them to manage LAST. Overall, 100% of the participants were satisfied with the training programme. They considered the programme was comprehensive and practical, and provided a quick idea on the safe dose recommendation of different LA agents commonly used in daily operations.
To conclude, the training programme successfully enhanced the knowledge, confidence level and proficiency among perioperative nurses in managing LAST, which could ensure a safe produce and improve patient safety.
