Authors (including presenting author) :
Lam N, Lo OT, Chiu SH, Hui YC, Wong LY
Affiliation :
Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong
Introduction :
Emergency Intubation is a risky and stressful procedure requiring efficient and prompt response. Inadequate airway management may have devastating consequences in increasing the morbimortality rate in ICU patient. Therefore, an effective and organized Intubation procedure is crucial. As of July 2021, nurses with less than 3 years ICU experience account for 46% (17 out of 37) of our frontline nursing workforce. Emergency Intubation and re-strapping procedure could be hazardous and unconfident for nurse with minimal related clinical experience. Thus, there is an indispensable need to establish a staff empowerment program to ensure safety and effectiveness in Intubation and re-strapping endotracheal tube (ETT) in our ICU.
Objectives :
1. To enhance effectiveness of Intubation by equipping nursing staff with related knowledge and skills.
2. To promote patients’ safety by enhancing nursing competency and confidence in re-strapping ETT.
Methodology :
The empowerment program comprised of hands-on session and didactic session. Nurses with less than 3 years ICU experience are targeted.
The hands-on session targeted on baseline assessment and reinforcement of participant’s technical skill. To maximize learning and assessment impact, each session is hosted in individual basis. A scenario-based assessment was held to evaluate the competency based on the compliance checklists prepared. Participants were required to prepare equipment for Intubation and perform re-strapping on a full body manikin. Debriefing and return demonstration were given to facilitate conceptualization and reinforcement of the skills.
The didactic session aimed at theoretical consolidation of knowledge in line with updated hospital infection control guidelines. Teaching videos collaborated with anesthetists of Cardiothoracic surgery unit were introduced to drive professional learning in a direct and realistic manners. Survey, competency assessment and return demonstration were implemented to evaluate the effectiveness and receive feedback of the program.
Result & Outcome :
Participants including 17 nursing staffs with ICU experience less than 3 years were recruited. 17 individual hands-on sessions and 7 didactic sessions were hosted from August to December 2021. Participants’ compliance rate in preparing equipment for Intubation were verified to be markedly improved from pre-program assessment 9% to post-program return demonstration 100%. The compliance rate of re-strapping ETT securely also show remarkable results from pre-program 63% to post-program 100%. Moreover, 93% participants gave assent in the significant growth of confidence in preparing patient for Intubation and re-strapping after the program in the survey returned. To conclude, nursing competency and effectiveness in Emergency Intubation and re-strapping ETT could be enhanced in a great extent with the implementation of the Empowerment program, in which the sustainability of such program is highly recommended.
