Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
CHOI KC (1), LEE CK (1), WONG CY (1), YEUNG MK (1), LAM YY (2), MAK KW (2), TSANG CF (2)
Affiliation :
(1) Accident and Emergency Department (AED), Princess Margaret Hospital (PMH); (2) Accident and Emergency Department (AED), North Lantau Hospital (NLTH)
Introduction :
In Kowloon West Cluster (KWC), there are different level of hospitals and some specialty services are not available in PMH. Therefore, the nurses in Accident and Emergency Departments (ED) are always need to provide inter-hospital transfer for critical ill patient to trauma center. Besides, they also need to escort patients to other clusters for burn care, cardiac thoracic surgery, and hyperbaric oxygen therapy.
In view of the increasing demand of inter-hospital transferring and it is high risk process to patient transport serious patients especially patients with ventilator. Caring patient with ventilator requires intensive monitoring and special knowledge for safety transportation. The nurses’ knowledge and training on transport critically ill patients are extremely important. A short video-based online education program on inter-hospital patient transportation was prepared to enhance the nurses’ knowledge so as to improve patient safety.
Objectives :
1. To implement a video-based inter-hospital patient transportation online education program for A&E nurses of NLTH and PMH A&E.
2. To improve A&E nurse’s knowledge towards ventilator care during inter-hospital patient transportation.
3. To improve A&E nurse’s self-efficacy towards ventilator care during inter-hospital patient transportation.
Methodology :
A video-based education program of inter-hospital transfer of an intubated patient was developed by a team of nurses experienced in patient transport. The length of video around 10 minutes which uploaded to YouTube for participant’s easy access. The video was developed based on a real situation and using real equipment.
All frontline nurses working in NLTH and PMH A&E invited to join the program. The pre-education assessment was conducted for 2 weeks before launching of education video and post-education assessment were conducted subsequently.
There were two outcome measurements in the pre-test and post-test. Overall median of results was compared. The primary outcome was the knowledge level of ventilator care during inter-hospital transportation. The second outcome was the self-efficacy of ventilator care during inter-hospital patient transportation.
Result & Outcome :
Total 82 nurses finished the program 39 (48%) nurses from PMH, and 42(52%) from NLTH. The participant included 12 (15%) APN, 69 (85%) RN/EN. 20 (25%) participants more than 10 years The post-registration experience, 23 (28%) had 5 to 10 years 17 (21%) had 3 to 5 years, and 21 (26%) less than 3 years.
In the pre-test there were 24 (39%) nurses self-reported that they were lack of confidence in transporting intubated cases with mechanical ventilation support. Nearly 40% nurses expressed that they were not competent to escort critically ill patient.
The median score of knowledge assessment increased from 7 to 10 after the education program. The self-efficacy of participants was improved after taking the education program. Most of participants performed well in “DOPE” mnemonic (96% correct); ventilator alarm management (>80% correct); Capnography waveform interpretation (91% correct); and FX oxygen cylinder operation time estimation (89% correct). However, there were only 52% of participants answered the correct answer of using EtCO2 to confirm endotracheal tube placement during transportation.
