Authors (including presenting author) :
Lee Peggy(1), Kan KK(1), Leung MY(1), Lam N(1), Tsang WY(1), Lee BK(1), Au KF(1), Tam OY(1), Lee YY(1), Lee SF(1)
Affiliation :
(1) Intensive Care Unit, Kwong Wah Hospital
Introduction :
Prone ventilation has been proven as an effective therapy in oxygenation for patients with severe Acute Respiratory Distress Syndrome. Provider education, guidelines development, equipment readiness and team-based approach are strategies to improve safety for implementing prone ventilation in intensive care unit (ICU).
Objectives :
The objectives of the project were to standardize procedure of prone ventilation, to enhance clinical competency of ICU nurses and doctors, to foster teamwork among ICU nurses and doctors; and to ensure availability and accessibility of prone ventilation materials.
Methodology :
The project included guidelines development; workshops for ICU nurses and doctors; and reorganization of prone ventilation materials. Pre-reading materials including a newly developed guideline and an in-house-made video demonstrating the standardized procedures were provided before the workshop. The simulation-based workshop focused on both hand-on practice and teamwork training among ICU nurses and doctors. Collaboration among ICU nurses and doctors and team communication skills were emphasized. A pre/post-testing was used to measure the difference in knowledge level before and after attending the workshops. Evaluation questionnaires were delivered to collect participants’ feedback. All training materials and guidelines were uploaded to internal website for convenient referencing. All prone ventilation related devices, consumables, prophylactic dressings application illustrated-guide for prevention of prone ventilation induced pressure injury and procedure checklists were stored by complying with the 5-S management system with aims of promoting the efficiency of prone ventilation and standardizing the procedures. Clinical Information System was updated to ensure accurate patient documentation. Project team members would monitor the implementation of procedures in real clinical context.
Result & Outcome :
Total 9 identical workshops were conducted in 2019. 51 ICU nurses and 3 residents attended the workshop and completed the evaluation surveys. The mean confidence level in performing prone position and mean knowledge score greatly increased from 4 to 8 and 5 to 9 (range 1-10) respectively. The mean score in workshop satisfaction was 5.5 (range 1 to 6). 5 patients in 2019 and 2 patients in 2020 underwent prone position ventilation performed in actual clinical context after workshop were evaluated. There were no major adverse events and significant difficulties encountered during the prone procedures. This project not only standardized care and reinforced staffs’ competency in managing prone ventilation, but also enhanced collaboration among ICU nurses and doctors in promoting safe practice.
