Authors (including presenting author) :
Lin SF(1), Lai FY(1), Ho LM(1), Wong HW(1)
Affiliation :
(1) Operation Theatre, A&ICU, Prince of Wales Hospital
Introduction :
Local anaesthesia (LA) is generally considered very safe. It is preferable to general anaesthesia for many reasons. In the past three years, there were about 1000 LA cases annually, which was around 9-10% of total cases in the Operating Theatre of Prince of Wales Hospital. However, some incidents of LA procedures were identified. A project was designed to promote a better care and increase the awareness of critical change of condition in LA patient by some means of measures and devices in our department.
The project named “Enhancing Care, Early Detection and Management of Deterioration for Local Anaesthetic Patient in PWH OT” in 2019. The needs of improvement were focused. We analyzed the data concerning LA patients, developed implementation plan and executed implementation of the new measures and devices, monitored and evaluated the whole project.
Objectives :
The project aims to enhance staff knowledge on LA nursing care with improved quality of care by involving patient. Also it aims to promote early detection of deterioration by strengthen staff knowledge during crisis
Methodology :
This project adopt the FADE model to improve the quality of our service. There are four broad steps in this model which includes Focus, Analyses, Develop, Execute.
Implementations in the enhancement plan were developed which includes the educational talks, information sheet for patient, alert sheet to theatre and cue card on physiological monitor, patient’s call bell and incorporation of National Early Warning Score (NEWS) form in perioperative monitoring.
A short quiz will be done by the attendants to test their knowledge level before the educational talk.
Result & Outcome :
14 sessions of educational talk were held and totally 60 nurses attended. Immediate questionnaires were distributed. All feedbacks were positive, over 90% of them agreed the talk would achieve the targets. During the trial period, post questionnaires were collected, around 90% strongly agreed the information sheet was comprehensive. The call bell was an effective communication tool between patients and staff. The NEWS charting helped to detect early deterioration of patient’s condition, and 100% of staff was willing to continue to use them. 43 patients was provided with the call bell intraoperatively, surgeons were welcomed as it was helpful to alert them to aware patient’s condition intraoperatively.
