Authors (including presenting author) :
Cheng HW (1), Chu W Nora(1), , Lau KC(1), , Leung SK(1), , Leung SY(1), , Poon ST(1), Ho KM (1)
Affiliation :
(1) Department of Anesthesia & Intensive Care Unit, Prince of Wales Hospital & The Chinese University of Hong Kong
Introduction :
The Adult Intensive Care Unit (ICU) at Prince of Wales Hospital provides medical and surgical intensive care for all adult patients. As a referral center, we also admit patients suffering from cancer illness, major burns, trauma and cardiac surgeries. To support our services, there are around 400 types of varies types of consumables and over 80 kinds of standalone devices, like infusion pumps, physiological monitoring devices kept in in an electric mobile racking compartments (total 200 slots) separated in three different store rooms. Nurses and Patient Care Assistants (PCAs), particular the new comers usually expressed that they spent certain time and motion to look for the items required for preparation a common procedure trolley.
Objectives :
In order to reduce the time and staff motion of locating and retrieving the required items aimed to shortening the set-up time for the procedure trolley and enhance clinical efficiency, a quality improvement project was implemented. The project included standardizing the color-coding system of both the equipment and consumable stores with ultimate goal to facilitate easier locating the required items. In order to avoid miscommunication between nursing staffs and PCAs, a photo guide was used to act as a common language when ICU nurse asking PCA to prepare a common procedure trolley or getting items from either the equipment or consumable room.
Methodology :
A pre-intervention survey was conducted, different ranking nurses and PCAs were invited to prepare different ICU procedure trolleys and getting items directly from the storage rooms and the time used were recorded accurately. The record showed that time spent in each preparation was 3-10 mins and the item accuracy was only 30%. Therefore, the following intervention were implemented after this survey:
1/. The color code label of consumable store and equipment room are standardized, specific color label in same sequence in consumable store and equipment room are displayed. A new coding system in English and Chinese was created to facilitate item searching.
2/. A photo guide involved 20 procedures was made hard copy in poster size were display in the board in the consumable stores in ICU and soft copy was uploaded in ICU bedside monitoring system for easy and quick asset at bedside.
4/. Briefing sessions were conducted to introduce the entire project to all nursing staff and PCAs in ICU. The implementation of the project last for 3 months
Result & Outcome :
After 3-month of implementation, a post-intervention survey was conduct, same staff were invited to prepare same procedure in the pre-intervention survey. 1/. All procedure can be set up within 4 minutes, and the efficiency is improved by 54%. 2/. The accuracy of the set up raised from 30% to 100%. The color code is standardized in equipment rooms and consumable stores. 3/. The time of communication and orientation to new staff can be shortened by new photo guide This quality improvement project can shorten the procedure trolley preparation time spent by both the nursing and PCAs due to the reduction of unnecessary motion in item searching, and avoidance of any miscommunication by use of the photo guide. The ultimate outcome is to enhance clinical efficiency on one side and promote patient care and safety on the others as correct items and equipment is collected from the storage rooms.
