Authors (including presenting author) :
Au W (1), Chan PH (2), Chan SY (3), Chu KM (4), Lam KL (5), Wong TF (6)
Affiliation :
Department of Medicine & Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Transfers of critically ill patients (CIP) are inevitable but challenge for healthcare professionals as all transfers are complex and pose significant risks to patients, especially those requiring multiple organ support (1). During the transfer process, various preparations including patient, equipment, drugs and communication. To conceptualize staff’s practice in a systemic and simple way, a new P.A.C.K.E.D. approach (2) (P= Patient stable; A= Assessment; C= Communication; K= Keep it simple; E= Examine Equipment; D= Drug & Disconnect) is introduced in order to minimize the risks from system and staff factors (3). Simulation approach provides a realistic clinical environment for staff to experience the process. Following with debriefing session immediately offers the chance for self-reflection and critical thinking on appropriate decisions makings.
Objectives :
To familiar with the role and responsibilities when handling transportation of CIP
To conceptualize the staff’s practice by P.A.C.K.E.D. approach
To enhance staff’s competence and independence
Methodology :
Before the training, the P.A.C.K.E.D. approach was introduced through online Pre-reading. During the training day, participants were arranged to play different roles including patients, nurses & doctors. They were divided into three groups to experience different scenarios, including transporting intubated patient to ICU; transporting CIP to CT scan; and transporting patient with Non-invasive positive pressure ventilator by lift. PACKED approach was applied to enhance preparation, team collaboration and communication. Debriefing with in-depth case discussions started following the simulation. Satisfaction survey was done in the end of the course. A post quiz with scenario study and MC question was performed to evaluate staff’s knowledge after two weeks.
Result & Outcome :
31 nurses were participated the training. They were engaged and encountered exciting by the scenarios. 100 % of them agreed the training content and style is practical. 100% of them agreed that the in-depth case debriefing session enhanced their learning. Meanwhile, common weakness and difficulties were addressed while improvement and clarification were made. The overall mean score for the post-test is 28 over 30 illustrated the knowledge base was built. Transfers of CIP is a complex and risky procedure, practical workshop with simulated scenarios help to improve participants’ decision making, communication and collaboration skill (4). P.A.C.K.E.D approach helps nurses to conceptualize the complicated procedure in an easy memorable and systematic way. This course allows them to practice with reflection. Through critical thinking, it will enhance their ability to deal with crisis. In turns, it will effectively enhance the quality and safety of patient care during transportation.
