Authors: (including presenting author): :
Mui CM(1), Cheung CN(1), Lai MN(1), Kwok YC(1), Li CW(1), Chan MY(1), Leung SM(1), Chan K(1)
Affiliation: :
(1)Department of Tuberculosis and Chest, TWGHs Wong Tai Sin Hospital
Keyword 1: :
Simulation training
Keyword 2: :
Administration of medication
Keyword 3: :
staff competence
Keyword 5: :
nursing staff
Introduction: :
Medication incidents, one of the most common adverse effects of medical care, refer to inappropriate or non-compliance in the course of administration of medication. According to the annual report on sentinel and serious untoward events, of the 80 SUE cases, 74 of cases were reported as medication error. The medication error related to anticoagulant, inotrope and known drug allergy, wrong rate of infusion and insulin contributed most significantly to the number of SUE. Although the decline in the rate of medication incidents coincided with the gradual introduction of In-patient Medication Order Entry (IPMOE) system in HA since 2013, the non-compliance in AOM using IPMOE is still the significant root cause of leading medication incidents. Clinical stimulation is a novel teaching method in recent decades and has become a popular tool for medical education. Simulation-based training offers a realistic and interactive learning environment that enhances real-time judgement practice, communication, and psychomotor skills. In DTBC, there is an existing system for assessing and reviewing staff compliance in AOM, including directly observation and audit. However, for the improvement, the use of simulation training with scenario-based approach can be used to facilitate staff competence and compliance in AOM using IPMOE.
Objectives: :
1. To assess and monitor staff compliance in AOM
2. To promote practical tips on AOM
3. To disseminate the hot topic notes related to AOM to staff
Methodology: :
10 questions of Pre and Post test are extracted from e-LC on "Patient identification on AOM for KCC nurses and "Enhancement training on Corporate Standard Dilution Table for Nurses". Participants will be randomly assigned for several roles, Nurse A, Nurse B and observer. Nurse A will be the supervisor, nurse B will be the zone nurse and the other will be the observer. The first scenario is about Dangerous Drugs administration.
Observer will be observed the performance of Nurse A and Nurse B, then score their compliance rate using the audit form of KCC AOM in dangerous drug. And share their comments during debriefing session.
1. Checking the prescription of IMR
2. Nurse should access and retrieve the IPMOE and recognize OxyContin 10mg is on “due time” and Oxynorm last given is at 4am
3. Prepare and collect guideline to give DDA
4. Countercheck with colleague under protocol
5. Complete the DDA registry The second scenario related to dopamine drip infusion Scenario flow
Observer will be observed the performance of Nurse A and nurse B and score their compliance rate using the audit form of KCC AOM in infusion medication. And share their comments during debriefing session.
1. Check the prescription in IMR
2. Check patient’s condition and vital.
3. Prepare the equipment and select the correct medication
4. Countercheck the medication and pump rate with colleague under protocol
5. Observe patient’s condition and document in IMR Debriefing
Each observer will be invited to share their point-of -view and score the compliance rate of Nurse using HAHO AOM and IV injection audit form. After grouping all of their learning points, project-in-charge will be used to share the focusing point in this training and share the practical tips to staff.
Result & Outcome: :
The average score of Pre test result is 6.4/10 and the post test result is 8.4/10.
And using the HAHO AOM and IV injection audit form to evaluate the participant's performance in the training, the critical compliance rate is 100% in (Oral) and 100% (IV injection). And overall compliance rate is 95% in (oral) and 95% in (IV injection). To sum up after the debriefing session, participants missed hand hygiene before the procedure. Participants also missed to check the last given dose. They also missed to recheck patient's condition before starting IV dopamine infusion. And the missed to swab with alcohol on the opened diluent to maintain aseptic.
