Yi-JiunChou
CMUH, Taiwan
Title: Increase of Completion Rate of Nursing Care during Therapeutic Hypothermia in ICU patients
Biography
Biography: Yi-JiunChou
Abstract
Introduction: In recent years, therapeutic hypothermia (TH) has been used to improve outcomes in patients who have received TH after resuscitation from out-of-hospital cardiac arrest (OHCA). Patients received TH after resuscitation from cardiac arrest are more dependent on continuous and intensive nursing care. It involves many difficult steps, especially achieving target body temperature and maintaining temperature. To our best knowledge, there is no consensus or recommended standard on nursing practice of TH.
Objectives: To increase the completion rate of nursing care at therapeutic hypothermia and achieve consistent care.
Methods: The project members first investigated the cognition of the nursing staffs and then observed the integrity of the nursing care. From the application of Cause-and-Effect analysis (Figure 1), we found the reason of incompletion on nursing care during therapeutic hypothermia. And we took five measurements: (1) Amended nursing standard of therapeutic hypothermia; (2) Amended TH checklist items into nursing records; (3) Established monitor procedure; (4) Designed each TH care reminder cards in each period; (5) Provided in-service training sections of TH for ICU nursing staffs.
Results: The completion rate of nursing care in therapeutic hypothermia increased from 81.3% to 92.3%.
Conclusion: The project team not only increased the completion rate but also improved patient safety, care quality, consistency with doctors, and improved professional level of nursing staffs. We recommend this result to be applied in complex care procedures: providing consistent care standard and checklist, as well as ongoing education and training to improve the feasibility and care quality of clinical care.