Authors (including presenting author) :
Siu MT(1), Poon CL(1), Chan PF(1), Chan HL(1), Chu CM(1), Ng YB(1)
Affiliation :
(1)Department of Medical and Geriatrics, United Christian Hospital
Introduction :
High Flow Nasal Cannula (HFNC) oxygen therapy becomes an alternative of non-invasive treatment for acute respiratory failure under some conditions such as pre-intubation or post-extubation. HFNC is able to deliver the heated and humidified oxygen at flow rate up to 60L/min. It is proved to reduce anatomical dead space, provide a constant fraction of inspired oxygen (FiO2) and work with positive end-expiratory pressure (PEEP). As a result, improving gases exchange, reducing work of breathing and the chance of escalation of treatment were showed in many journals. Since HFNC is a relatively new treatment in general adult wards apart from respiratory unit, nurses especially in general wards are not familiar with this treatment option with knowledge deficit. A HFNC oxygen therapy program is therefore conducted to enhance nurses’ knowledge.
Objectives :
1.To enhance nurses’ knowledge about the rationale and mechanism of HFNC oxygen therapy. 2.To reinforce nursing role in caring patients with HFNC oxygen therapy.
Methodology :
The HFNC oxygen therapy program was established according to the ‘’HFNC’’ approach as follow: H- HFNC oxygen therapy seminar and workshop The course was conducted on 23rd November, 2018 to introduce the rationale, mechanism of HFNC and nursing role in caring patients with HFNC. The participants’ knowledge enhancement was analyzed by using one group pre and post training assessment quasi-experimental design. F- Facilitate frontline staff The supplementary instruments include bedside signage with prescribed setting, prescription label and cue cards. The bedside signage and prescription labels are designed to facilitate the physicians to order the setting. The nurses are facilitated by the cue cards to guide for device operation and trouble shooting. N-Nursing assessment and care A mechanism has been established in place to promote coordination and continuity of care for the patients using HFNC oxygen therapy from respiratory unit to other specialty unit. Apart from the numeric data documented, patients with HFNC oxygen therapy should be assessed for any adverse effects and complications which were presented in the seminar. C- Continuous observation chart A standardized HFNC oxygen therapy observation chart was designed to document patients’ status. It also helps physicians and nurses to monitor the patient’s progress.
Result & Outcome :
21 nurses, who were represented in different unit in Medical and Geriatric Department, were recruited for temporary program run. The mean score of the nurses’ knowledge level was enhanced by 138% from 4.14 + 1.96 to 9.86 + 1.24 (p<0.001) with significant improvement after the program. Especially, the knowledge about infection control issue of HFNC oxygen therapy was improved by +248% from 1.10 + 0.23 to 3.81 + 0.58 (p<0.001). Nearly all (above 95%) participants satisfied with the empowerment program as evidenced by satisfaction surveys. Overall, they showed understanding and agreed the course content is practical for their daily work. To Conclude, with a significant improvement in knowledge enhancement shown in the results, this new HFNC device can gain the acceptance from the frontline staff, optimizing the HFNC oxygen therapy.
Co-location with:
