Authors (including presenting author) :
CHAN TWL (1), CHAN KHJ (2), CHIU SWJ (3), TAM WYS (4), KWOK WMM (5), KIANG OL (4), LEE SPP (2), CHAN HYT (5), HUNG YLA (5), WONG LSL (5)
Affiliation :
(1) Department of Paediatrics & Adolescent Medicine, TKOH
(2) Department of Medicine, TKOH
(3) Department of Anaesthesia & Operating Theatre Services, TKOH
(4) Department of Surgery, TKOH
(5) Nursing Service Divisionn, TKOH
Introduction :
Health organization should always implement effective systems for the management of medical emergencies, including the identification and care of deteriorating patients. Basic life support and advanced life support training is required for health professionals and other staff, depending upon their roles and responsibilities within the organization. At many hospitals in Hong Kong, the healthcare worker most likely to be present when a patient suffers a cardiac arrest is a nurse or a doctor. Regular refresher training in resuscitation is advocated and encouraged by various hospital accreditation systems. Tseung Kwan O hospital administration targets at filling up the gap on refresher training, hoping to uphold standard on all resuscitation events which may occur inside hospital compound.
Objectives :
1. To fill up the existing service gap in resuscitation training provision in a regional hospital
2. To strengthen and uphold resuscitation skills for all clinical staff
3. To overlook and streamline resuscitation training for all clinical staff
Methodology :
Under the guidance of hospital’s Guidelines, Training and Audit (GTA) Subcommittee, a MEDICAL EMERGENCY RESPONSE (MER) TASKFORCE working group was set up in 2016, led by experienced clinicians and nurses from various fields and Nursing Services Division, which aimed at designing and launching an in-house resuscitation training program for all medical and nursing staff. After detail deliberation and discussion, a two-level Medical Emergency Response Training scheme was designed and launched. Basic level training is targeting for nurses which covers current AHA guidelines, elements of high quality CPR and the use of Automated external defibrillator (AED). Advanced level training is aiming for medical residents with additional elements about concepts on arrhythmia management, cardioversion and airway management. Training content includes Part I (e-learning utilizing eLC platform) on updated AHA guidelines and brief review on resuscitation drugs and equipment, while Part II comprises different skill stations (CPR, use of AED, airway management, infant resuscitation, use of LUCAS chest compression system) and finally a scenario-based practice platform.
Result & Outcome :
The first Advanced MER training was carried out in June 2017 while Basic MER has started to roll out in October 2018. The plan is to provide refresher resuscitation training at least quarterly to all nursing staff and half yearly for all medical residents respectively. Besides, the workgroup overlooks resuscitation training schedule for all hospital clinical staff and streamlines all existing training courses in a more efficient way. As the MER training is a locally designed one, it carries the advantages of incorporating local practices and familiarization of new equipment. Preliminary feedbacks from MER trainees were positive in terms of duration and usefulness. The next step is to provide regular refresher resuscitation training for all clinical staff. In TKOH, strategies for maximizing the impact of a hospital rapid response system are already implemented whereas leadership and support from hospital management is in place and a locally designed resuscitation training program serves to uphold standards in resuscitation skills is established.
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