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): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Tai YH (1), Ng CF (1)
Affiliation :
(1) Department of Paediatrics & Adolescent Medicine (Paediatrics Intensive Care Unit) Queen Mary Hospital
Introduction :
The Mucosal Atomization Device (MAD) can offer many advantages to patients and health care workers like it is ease of use which only requires simple techniques. Moreover, drugs can be absorbed into systemic circulation via mucous membrane directly and hence the onset time is rapid. It could be easily applied on patients with difficult intravenous access and under situations that are emergency like seizure. Drug deliveries to the highly vascularized nasal mucosa could enhance the effect in achieving the optimal sedation and analgesia during procedures and avoiding the absorption-limiting effects of first pass metabolism.
Although MAD administration is convenient and safe, it requires proper techniques for drug administration to increase the efficiency of drugs. Poor techniques may directly reduce the effectiveness of drug absorption in patients Therefore, a proper and standardized education of the MAD drug administration toward nurses is required for enhancing the knowledge of MAD drug administration.
Objectives :
1. To develop educational programme for nurses to enhance the knowledge of use of MAD
2. To standardize the procedure steps in using MAD by educational programme
3. To improve the competency of nurse to give medications via MAD
Methodology :
The target group of this project was all PICU nurses in QMH. A pretest- and posttest design study was adopted to evaluate the effectiveness of educational programmes on enhancing nurses’ knowledge in use of MAD for drug administration. The project included three parts; 1. Pretest questionnaire 2. Nursing enhancement programme including educational PowerPoint, video demonstration, workshop on teaching the MAD administration, 3. Posttest questionnaire.
Result & Outcome :
Among 28 participants, more than 70% of them had experiences on applying intranasal drugs by using MAD. However, data showed that the average score of the level of competency to give intranasal medications via MAD was 4.4 out of 10.
After the training, they were asked to complete the assessment again. The average level of competency was raised to 8.75 out of 10.
Paired T-test was also carried out to examine the improvement of the competency of nurses in performing MAD drug administration. The average score for nurses’ competency increased from 4.4 to 8.7 after the educational programme. The corresponding T-value calculated was 9.8 with confidence level was set at 0.05. Therefore, it also proved that establishment and introduction of educational programme toward nurses could greatly enhance the competency of MAD drug administration.
