Authors (including presenting author) :
Chan KHA, Chau MY
Affiliation :
Cardiology Division, Department of Medicine, Queen Mary Hospital
Introduction :
The 24/7 PPCI service in Queen Mary Hospital Cardiology division has been launched since early 2012. Over the 10 years’ period, Cardiac Catheterization Laboratory (CCL) nurses play an important role in sustaining the 24 hours PPCI service. With the department and hospital support on the PPCI service, CCL nurses on-call services and compensation policy were developed in order to ensure 24/7 PPCI service be maintained effectively and efficiently. Each year, around 120-150 patients benefited from the 24/7 PPCI service.
Objectives :
The objective of the review is to provide recommendations on maintaining 24/7 PPCI on call service for nurses.
Methodology :
Progress and timeline on 24/7 PPCI service were reviewed and analysed.
Engaged staff were interviewed to provide valuable comment on improvement.
Result & Outcome :
From 2012, 2 CCL nurses was on call each day from 0700-0659.
Total number of CCL staff: 6. Around 10 calls per month.
From 2013-2019, 2 CCL nurses was on call each day from 0000-2359
Total number of CCL staff: 7-8. Around 7-9 calls per month.
Overtime was reached to maximal level as there were numbers of off-site calls and limited on-call staff. Lack of career path for CCL staff and extensive of urgent and emergent cases which requires long working hours for nurses.
Compensation was set up according departmental and HR policy on overtime and compensation off.
In view of service need and increased of nurse manpower through annual plan, from 2019 onwards, the existing CCL nursing staffs manpower were up to 11. Thus, the arrangement of 24/7 PPCI on call duty for each staff would meet around 5-7 calls per month. On-site support service could be extended from 0900 – 1700 to 0800 – 2000.
Discussion among team members was made to ensure the change was possible and sustainable.
Overtime hours was able to limit to 20 hours and 2 shifts work was implemented to cover 0800-2000 on-site hours.
Conclusion
To develop and maintain a cardiac team for 24/7 PPCI service, particular in limited nursing manpower was not easy at the initial period.
Teamwork and team members’ engagement within the cardiac team were important to make it possible with the support of in-house training and timely review of the pathway.
With the support from HAHO of implementation of 24/7 PPCI services, the set of nursing manpower indicator and compensation mechanism for nursing participated in the on-call service has been stated. Hence, adequate manpower is important to ensure number of calls was limited to acceptable and realistic range.
Besides, minimize the overtime to an ideal range and allow flexible time off to accommodate the service need is considered. Limit the overtime to an ideal range and allow flexible time off to accommodate the service need is one of the key of success.
The job satisfaction for CCL nurses to participate on the 24/7 PPCI service are life saving for patient during acute stage of Myocardial Infarction.
