Authors (including presenting author) :
Leung KK (1), LAM CCK(2)
Affiliation :
(1) Occupational Safety and Health Unit, Quality and Safety Department, Queen Mary Hospital, (2) Division of Haematology, Department of Pathology, Queen mary Hospital
Introduction :
A tourniquet is an essential tool for collecting blood samples from our patients. It can become a hazard if the tourniquet is not released after completion of the procedure. The risk is genuine, particularly in the in-patient setting. Incidents of “retained tourniquet after blood taking” have been reported not infrequently on AIRS, prompting implementation of risk reduction strategies. Various devices and control measures for preventing tourniquet retention were developed in different clusters previously. In Hong Kong West Cluster (HKWC), we aim to design a user-friendly single-unit device which applicable to current disinfectants.
Objectives :
By developing a user-friendly single unit device to improve the patient safety and eliminate the incident of tourniquet retention.
Methodology :
In 1Q2017, HKWC Occupational Safety and Health Team has collaborated with the supplier engineer in the design of tourniquet timer. Previous devices for preventing tourniquet retention and engineering controls from other clusters were reviewed and analyzed. Necessary criteria such as user-friendly, single unit device, adjustable alarm setting and applicable to current disinfectants are identified. In addition, the device should match with both existing reusable tourniquet and disposal tourniquet to minimize unnecessary adaptation period. Technology of pressure type of sensor was selected because of its stability and reliability. In 4Q2017, total 80 numbers of first generation devices were developed with made of 3D printing material – resin which resistant to existing disinfectants. Both audio and visual alarms were equipped with three different alarm settings. This device, which automatically alerts the staff by both audio and visual alarm once the pressure sensor has not been released by the present counting time. In 1Q18, selected departments of Queen Mary Hospital were selected for pilot and numerous user feedbacks were received for further enhancement.
Result & Outcome :
Results Having considered the user feedback, second generation was developed which could be efficiently customized to suit different operational needs by adjustable preset time from one minute to ten minutes, works in lower consumption and performs in superior endurance. Besides advancing the technology, it also providing a vital patient safety features such as the design of sensor was modified to eliminate the risk of discomfort. With the support of top management, this newly pressure sensor tourniquet would be implemented in all cluster hospitals since 1Q19. Conclusion Although the actual cost and benefits are seldom optimally quantified, evidence on the effectiveness of a proactive approach to manage job-related hazards lead to sustain positive outcomes at enterprise level is emerging: job satisfaction, improvements in performance and reduction of incidents, etc. To design an effective strategy for prevention of tourniquet retention, concerted effort from multiple stakeholders is required and a systematic multi-prong approach should be adopted. A scientific basis is essential when new measures are introduced. This tourniquet timer has been extended to other HKWC clusters, other clusters are also keen to adopt this.
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