Authors (including presenting author) :
Tsui KN(1), Lee SY (1), Poon FWN(1), Wong RWY(1), Chan LCN(1).
Affiliation :
(1) Department of Paediatrics, Prince of Wales Hospital
Introduction :
In PICU, it is not uncommon to receive a patient in shock. At this critical moment, provision of important clinical responses including patient’s vital signs, cardiac output and related values, are crucial to shock management. The Ultrasonic Cardiac Output Monitor (USCOM) provides noninvasive haemodynamic assessment and monitoring in critically ill patients. In order to enable a better monitoring to our patients in PICU, nurses start a new trial in the PICU.
Objectives :
(1) To train up nurses in using USCOM in PICU; (2) to provide a close haemodynamic monitoring including cardiac output index and systemic vascular resistance index to the patients in shock; (3) to enhance job satisfaction through an extended role of nurses
Methodology :
After discussion with the PICU team, a training program was started to train up ten PICU nurses with essential knowledge and skill to use USCOM to measure cardiac output index and other data. Repeated return demonstrations were used to enhance competency and accuracy. After the training, nurses extended their monitoring to include the haemodynamic data by USCOM to all patients in shock. The effectiveness of the monitoring was evaluated through retrospective reviews whether clinical judgement had relied on the data and a self-developed survey on satisfactory level on the extended role.
Result & Outcome :
Since Oct 2018, nurses in PICU had included the haemodynamic monitoring by USCOM in all patients presented with shock. From Oct to Dec 2018, they had encountered 15 patients in shock and all of them were monitored with the cardiac output and related values with USCOM. In all of these cases (100%), doctors did refer to the USCOM data to guide in clinical management in choosing and titrating the fluid and drug in shock management.
The trained PICU nurses were invited to participate on the self-developed satisfaction survey. The overall satisfaction level was 89 %. In conclusion, this program enables a better patient monitoring and enhances the knowledge and skill of nurses in using USCOM. Despite adding a new task on the nursing activity, this program enhances the job satisfaction of PICU nurses.
Co-location with:
