Authors (including presenting author) :
Wong, YL, Shum HM, Ching SL, Leong WS, Mo TH, Chan CW, Lee YC
Affiliation :
Anaesthesiology and operating theatre, Kwong Wah Hospital
Introduction :
Intraoperative cardiac arrest (ICA) is an emergency condition, it occurs in 7 out of 10000 operations with over 50% mortality rate. During ICA, nurses and anesthetists play an important role. By literature review, lack of practical experience and refresher training is a common problem in operating theatre (OT) resuscitation. In the past 3 years, there were eight ICA cases happened in Kwong Wah Hospital (KWH) OT and half of them were local anesthesia cases without support of anesthetists, thus, addressed the importancy of nurse’s competency in handling ICA situation. In view of current training of cardiac arrest were not designated for OT circumstances and staff’s feedback of lack of competency in handling ICA case, due to lack of experience and confidence. Resulting in contributing an service enhancement program consist of lecture, video, finalization workshop and scenario- based ICA management drill workshop to improve nurses' knowledge, skill and confidence level in handling ICA.
Objectives :
Aim: To enhance perioperative nurses' competency in handling ICA through a comprehensive training program.
objective:
1, To increase the knowledge level of ICA management
2, To enhance self-confidence of nurses in ICA management
3, To evaluate the performance of ICA management among perioperative nurses
4, To explore the effectiveness of enhancement program and its sustainability.
Methodology :
All nurses in the KWH OT are the target participants. Pretest and post-test consist of 25 MCQ were carried out to access nurses’ knowledge of ICA. Self-rating questionnaire of confidence level in handling of resuscitation, communication skill in ICA and nursing role during ICA were evaluated before and after the training program.
Intervention of the training program include:
1. Education on ICA management by lecture video through QR code.
2. Lecture, hands-on practice on resuscitation equipment and Scenario-based ICA management workshop
on 24/12/2022.
Participants are divided into two groups:
Intervention group 1: Receive the ICA management lecture video ONLY
Intervention group 2: Receive the ICA management lecture video & attend the scenario-based ICA management workshop
Result & Outcome :
45 nurses participated in intervention group 1 and 21 nurses participated in intervention group 2. Initial finding reflected nurse’s ICA knowledge and confidence level increased with longer working experience. After intervention, the knowledge level on ICA management increased by 13% and 33% and confidence level increased by 10% and 30% respectively in both intervention group1 and 2. Weakness and limitation of nurses such as, lack of good communication and leadership, knowledge deficit on medication were identified during the scenario base workshop. Related education and skill were redemonstrated during the discussion session with the guidance of anesthetists. The overall result shows that training workshop with lecture video brings better outcome than lecture video alone.
During the evaluation, both nurses and anesthetists show appreciation with the training program and address the importance of regular bases ICA training. It helps to enhance their knowledge, confidence and competency level in handing ICA case, especially for new and junior nurses with less than 3 years of clinical experience. It also arouses the importancy of teamwork and good communication. Anesthetists were willing and showed interest in reviewing and holding the training workshop in a regular base ( e.g. annually ) to sustain the program in the future.
