Authors (including presenting author) :
Leung KW, Chiu SH, Wong KW, Chan YM, Lee KC, Hui YC, Wong LY
Affiliation :
Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong
Introduction :
AOM is one of the core competencies for nurses who are responsible for the medication safety of patient. As neonate and pediatric patients after cardiac surgery will receive immediate post-operative care in Queen Mary Hospital CTSD ICU, nurses need to manage a wide range of medication dosage. These patients are in critical conditions that usually require high alert medications including inotropes, concentrated electrolytes and resuscitation drugs. Moreover, AOM in these patients involve advanced drug calculation and preparation procedures. Therefore, it would be challenging for nurses.
Objectives :
1. To enhance medication safety awareness and competency of nurses in CTSD ICU. 2. To utilize simulation-based training to assess nurses’ competency on AOM procedures and knowledge.
Methodology :
Simulation-based AOM training program was implemented in CTSD ICU from June to September in 2019 with 37 nurses participated. The program consisted of pre-post assessments, scenario-based simulation and lecture. The written pre-test was distributed to assess participants’ baseline medication knowledge. The scenario-based simulation included various complicated clinical situations such as medication dosage was prescribed for pediatric patients exceeding the dosage limit, administering micro dosage of medication for neonate patients which involved multiple dilution technique and drug dosage calculation. A structured debriefing and lecture were conducted to reinforce proper AOM procedures and enhance the medication safety awareness by sharing past medication incidents. Post-test and evaluation forms were employed to evaluate the effectiveness of the program.
Result & Outcome :
A remarkable increase of participants’ AOM knowledge was revealed by pre-assessment mean score of 13.2 ± 1.77 to post-assessment 16.46 ± 0.76. According to program evaluation, 19% of participants found the key components in AOM procedures challenging during simulation, in particular calculating multiple dilution drug dosage. After the debriefing and lecture sessions, all participants accomplished the key components required in the simulation assessment. 94% of our participants agreed that the AOM workshop highlighted the common difficulties of pediatric and neonatal AOM and their competency was enhanced. To conclude, simulation-based AOM training program was effective in promoting staff medication safety awareness and competency, which allowed nurses to identify some challenging clinical situations and chance to practice.
