Authors (including presenting author) :
CHAN WC (1), CHEUNG KC (1), WONG KL (1), CHAN YY (1), TONG KC (1), HO SM (1), NG YB (2), CHEUNG PS (2), CHENG SL (2), TSUI SN (2)
Affiliation :
(1) Ward 13A, Department of Medicine & Geriatrics, United Christian Hospital
(2) Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Respiratory failure causes significant morbidity and mortality in COVID-19 patients. Most patients required intensive care and ventilator support. During the peak of COVID-19 epidemic, most of the local intensive care units were fully occupied. The medical team of United Christian Hospital (UCH) has implemented a proactive strategy to provide intensive care in the general ward setting. Therefore, the UCH respiratory team co-worked with isolation ward nursing team taking initiative to form a task group called AdVenT (Taskforce for Advanced Ventilator Care) in December 2020 to bridge the service gap.
Objectives :
(1) To enhance respiratory service for COVID-19 patients
(2) To evaluate the effectiveness of AdVenT
Methodology :
The team started with fundamental works including the sourcing of essential equipment and establishing the care protocol and quick references. Respiratory physicians provided training by delivering seminars and hands-on workshop on mechanical ventilator care for COVID-19 patients. Moreover, the nursing team rearranged the duty roster facilitating AdVenT members for onsite support in all shifts. Besides, AdVenT provided round-the-clock offsite physician consultation support. Patients having high risk of respiratory failure were recruited and AdVenT carried out regular assessment to facilitate timely treatment and intensive monitoring. Further, AdVenT also organized educational sessions for all nursing staff on high-risk respiratory procedures in order to strengthen the competency of the nursing team.
Result & Outcome :
Result
The AdVenT service was ready within 2 weeks to kick off the advanced ventilator support. A total of 972 COVID-19 patients were admitted to the isolation ward in UCH. AdVenT actively screened all the admitted cases (181 patients) since December 2020 and 29 cases were identified as high risk of developing respiratory failure. Under our active surveillance, 4 deteriorating patients were promptly treated with high flow oxygen devices as bridging care while waiting for ICU beds.
Also, a total of 42 nurses completed the training from AdVenT. They all expressed high satisfaction levels rating from 89% to 96% in the satisfaction survey. Qualitative comments such as “practical”, “constructive”, and “fruitful” after AdVenT training were received.
Conclusion
AdVenT could effectively enhance advanced respiratory care in COVID-19 patients. A more standardized service protocol, consistent workflow and follow-up were established, with service needs better met and staff satisfaction improved.
