Authors (including presenting author) :
Lok WP(1), Chan WY (1), Shani Ip(1), Mable Yip(2), Fung PS(3)
Affiliation :
(1)Medicine Department,Yan Chai Hospital (2)Accident & Emergency Department, Yan Chai Hospital (3)Quality & Safety Department, Yan Chai Hospital
Introduction :
Transport of critically ill patients is a potentially hazardous process. Patient safety depends on accurate assessment; adequate monitoring of the patient before, during and after transport; effective communication between staff; deployment of appropriately trained staff; availability of essential equipment and drugs and proper documentation. The checklist used in Yan Chai Hospital (YCH) for documentation of this process was reviewed in 2017. A documentation audit on the checklist was performed in Feb 2018 with some improvement areas were identified.
Objectives :
(1) to enhance staff skills and knowledge; (2) to ensure complete and accurate documentation; (3) to improve communication between staff and departments; (4) to standardize care on intra-hospital transport of critically ill patients.
Methodology :
Firstly, “Checklist for Inter & Intra-hospital Transport of Critically Ill Adult Patient” was reviewed to facilitate documentation. Secondly, training materials including educational file and simulation training were designed to enhance staff skills and knowledge. Thirdly, pre- and post-training quiz were conducted to assess and reassess staff knowledge. Fourthly, a staff satisfaction survey was performed to obtain staff satisfaction level. Finally, an audit was conducted to evaluate staff compliance on documentation.
Result & Outcome :
The program was started in Sep 2018, checklist contents were reviewed and suggestions were made to facilitate documentation. Total 109 staff from Medicine Department (3 wards) and Accident & Emergency Department were participated by the end of Nov 2018. 54 staff performed the pre- and post-training quiz, the average overall correctness rate was increased from 64.3% to 91.2% after training. Two simulation training sessions were arranged in Oct 2018 with compliance rate 100%. Good practices and recommendations were shared with staff during the debriefing sessions. Staff satisfactory survey showed that all participants were satisfied with the program. 34 samples were collected in the documentation audit, the overall compliance rate was 96.6%, which was 14.6% higher when comparing with the audit result in Feb 2018. The program was effective by enhancing staff skills, knowledge and satisfaction; improving documentation completeness and accuracy; and improving communication between staff and departments. It was expected to extend the program to other wards, departments and cluster level to maintain the standard and safe care on intra-hospital transport of critically ill patients.
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