Authors (including presenting author) :
Chong WS(1), Yung EP(1)
Affiliation :
(1) Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital
Introduction :
Perfusionist is a crucial team member in open heart surgery. Cardiopulmonary bypass is performed by perfusionist and the outcome is critical to the life and death of the patient. Perfusionist is a specialist who requires training in years to ensure their performance is knowledge driven and scientifically based. However, manpower was the main issue for years in all cardiothoracic surgery (CTS) centres due to highly demanding job nature which necessitates critical thinking skill, precise decision making ability and full responsibility impact. Perfusionist provides 24-7 on-call perfusion service to all open heart surgery in Prince of Wales Hospital (PWH). Unpredictable perfusion emergencies, challenges in offering immediate and precise clinical judgement to secure patient safety and ever-changing technological advances are all mentally and physically demanding which impose significant stress and burnout to perfusionist. Non-sustainable manpower with high turnover rate is the key obstacle to the development of the Perfusion Team. A well structured, standardized mentorship training programme launched and logged since 2016 to response to the training needs of the new perfusionist. The programme with pre-set goals by the end of each stage facilitates new perfusionist to adapt challenges and also strength confidence in their new profession – from Registered Nurse (RN) to Perfusionist.
Objectives :
(1) To acquire mastery of competence and knowledge in perfusion by designated mentor. (2) To develop confidence in perfusionist duty by staged performance reviews. (3) To alleviate stress and burnout of new perfusionist by stage-by-stage training and pre-set training goals. (4) To equip critical thinking skills in emergencies by multi-faceted training strategies.
Methodology :
The Perfusion Science and Technology Training Programme launched since 3Q 2016 and currently in progress. The three-year in-service training programme enables RNs to acquire new profession – Perfusionist. RNs with three years’ experience or above could joined either by open recruitment or nomination. Designated mentor assigned to mentee for mentorship throughout the entire training. A comprehensive training guide included all the training content and assessment criteria to facilitate teaching and learning. The programme was designed in three stages. Stage one is a three-month orientation and adaption phase enables newcomers to adapted the environments and operation routine. Stage two is a 36-month progressive training in perfusion in various clinical situations and emergencies. Cases assign to mentee according to operation difficulty progressively and managed together with mentor. Stage three is a competency assessment including routine management and scenario-based simulation. Upon fulfilment of the assessment criteria, staff would be entitled “Qualified Perfusionist”.
Result & Outcome :
In the past five years, the programme recruited 5 RNs with CTS background and clinical experience three years or above. 2 of them were being nominated and 3 of them joined by self application. 4 of them successfully completed the programme and the last member joined the programme in 2021 only. The 4 new perfusionist strongly agreed that in-depth mentor and mentee interview to be holding every six months was an excellent strategy on burnout and stress relief. The post programme evaluation and qualitative interview revealed positive feedback regarding the three key features including stage-by-stage training outlines, designated mentor and regularly review on stress status. The features that were very trailblazing which converted 4 RNs with different clinical background to Perfusionists successfully. The structural design of the programme proposed a concrete trajectory of professionalization of Perfusionist from RN. Perfusionist is essential in clinical interventions. The Programme provides an equilibrium of secured manpower of Perfusionist to meet service demands and further expand of cardiothoracic surgery service in PWH.
