Authors (including presenting author) :
Chau YF(1), Wong KY(1), Ngan HT(1), Lau CC(1), Fung CK(1), Ngai YY(1), Cheng HK(1), Szeto L(1)
Affiliation :
(1)Department of Anaesthesia & Operating Theatre Services, Tseung Kwan O Hospital
Introduction :
There are varieties of specialties in the operating theatre of TKOH, for example, surgery, orthopedics, gynecology, ophthalmology, and ENT. Each specialty has different types of surgeries. Hence, OT nurses need to handle at least hundred kinds of surgeries in their work. In fact, not all of our OT staffs have trained with all specialties, most of them are skilled in one to two major specialties.
In addition, about one-third of our OT staff are new staff in which have less than 2 years’ experience in OT, and underwent a period of training in different specialties. However, in view of limited experience, they may feel stressed to cope with emergency, rare or difficult operations.
As a result, an integrated E-reference of surgeries can provide a quick reference with different specialties for all OT staffs.
Objectives :
Until 2018, our surgical references were in paper-form, only one staff could hold the reference book, when the others also had the need to access the reference book, they needed to find the reference book, or even made a copy. It is very inconvenient and time-consuming. Moreover, it limits the way in providing information about a surgery because it could be only printed in text.
On the other way, it will be more informative when surgical references become electronic, as the references are not be confined to text, they can be displayed in multi-media ways. And it will be more accessible, our OT staffs can get the reference by means of iPad at the same time in every theatre. Furthermore, all references are stored in the cloud server which provides real time updates, and they can be only edited by qualified staff. As a result, when there are any changes in practice or instruments in any operation, the qualified staff can easily update the references through the cloud server and publish the latest information to all OT staff immediately.
Methodology :
In order to improve the accuracy and the completeness of E-references, a designated workgroup including specialty-in-charge APN and experienced RN was established. Meanwhile, following a 3 month-based review on the references, to ensure the most updated information can be provided to our staff.
Moreover, surgeons are invited to input information so that the E-reference can be enriched. At the same time, our staff can learn more about surgeries and different surgical procedures, rather than only in nursing’s aspect.
E-reference system is firstly implementing on the specialty of general surgery and urology, the surgical references are including as follows: a text reference with graphic or photo of patient and theatre preparation, lecture notes from surgeons, supplementary information about special equipment and consumables, and videos about some new operations provided by related surgeons. Moreover, some self-made video is included to better illustrate specific practice. The information can be accessed through iPad within OT.
Result & Outcome :
The preparation time for an operation can be shortened between OT staffs especially those new staffs, because they can have better understanding and knowledge about specific surgeries, by retrieving the information from E-reference easily.
On the basis of the accessibility and informativeness, E-reference can become a self-learning platform for OT staff. Consequently, the coaching time of new staff can be shortened, and they can be more confident in handling new or difficult surgeries.
In addition, daily practice can be standardized, and hence the surgeries can be performed smoothly. When OT nurses have more understanding about the surgery and procedures they are going to handle, OT nurses can truly give assistance to surgeons during surgery, thus representing the teamwork of OT.
