Enhancement of Staff Competency on Care of Epistaxis

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Authors (including presenting author) :
Pang YL(1, Wong SY(2), Lee SP(3), Au Cindy(4)
Affiliation :
1) Outpatient Department, Yan Chai Hospital 2) ENT surgery, Yan Chai Hospital 3) Ambulatory & OT, Tseung Kwan O Hospital 4) Surg/ENT/PAED, Yan Chai Hospital
Introduction :
There is a great demand on the nursing care services for patients requiring nasal packing due to acute severe epistaxis. The high turnover rate of experienced nursing staff resulting more and more newly graduated and inexperienced nurses working in ENT ward. A clear and standardized guideline for nasal packing procedure could achieve better quality of care. Therefore, this program aiming at improving nursing staff’s knowledge and skill on Acute Epistaxis Management. It consisted of a flow chart on epistaxis management, a nasal packing procedure kit in enhancing doctors for controlling nasal bleeding effectively and efficiently, a guidebook for pre/post-nasal-packing care, and a bedside nasal packing procedure checklist. Moreover, a training workshop concerning the details of the flow chart; guidebook and the bedside procedure checklist as well as the knowledge & skill on epistaxis and nasal packing was delivered to all nursing colleagues to enhancing their understanding and compliance.
Objectives :
-Provide the nurses in ENT ward with updated knowledge & skills in epistaxis management. -Enhance doctors to perform the nasal packing more effectively and efficiently -Reinforce the essential nursing observation for early detection of possible complications.
Methodology :
A questionnaire survey consisting of eight independent questions was conducted before and after the implementation of the epistaxis care enhancement program. The questions mainly relate to our staff’s confidence and opinions on our new epistaxis management, which were rated by the respondents through the 5-point Likert scale. The average of the score of individual question were then calculated and compared. 24 nursing staff with nursing experience ranging from two to fifteen years were recruited in the comparison study. All of them had attended the training workshop with the details of the flow chart; guidebook and the bedside procedure checklist as well as the knowledge & skill on epistaxis and nasal packing were introduced.
Result & Outcome :
24 nursing staff were recruited for the survey with questionnaire return rate 100%. When comparing the data, there were remarkable increase of average score in every single Likert item signifies the effectiveness of the enhancement program. Our staff tend to more agree with their competence and knowledgeability, and more confident in managing nasal bleeding after the enhancement program. However staff compliance might need continue monitoring through intermittent audit activities.

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