2.50
Hdl Handle:
http://hdl.handle.net/10755/306584
Category:
Abstract
Type:
Poster
Title:
Medical Video Review: A Multidisciplinary Approach towards Improving Care
Author(s):
Frey, Mary; Oehler, Jennifer; Geis, Gary L.
Lead Author STTI Affiliation:
Non-member
Author Details:
Mary Frey, BSN, RN, CPN, CPEN, mary.frey@cchmc.org; Jennifer Oehler, BSN, RN; Gary L. Geis, MD
Abstract:

Evidence-based Practice Abstract

Purpose: A novel, multidisciplinary Medical Resuscitation Committee (MRC) was developed in a pediatric emergency department (ED) to identify practice gaps, investigate areas of need and educate providers surrounding critically ill children. Since 2008, multidisciplinary education has been provided through the use of monthly medical video review (MVR) conferences. The objectives of this project were to improve care of critically ill children and enhance communication and teamwork among multidisciplinary providers.

Design: The MRC identified high-acuity, low frequency medical emergencies based on safety reports, word-of-mouth, direct involvement, or through an internally derived database. Through the use of video and literature review, collaboration with subspecialists, and evidence-based recommendations, monthly multidisciplinary conferences were developed and delivered by a nurse and physician, both members of the MRC.

Setting: ED at a large, urban, tertiary care pediatric hospital.

Participants/Subjects: Participants voluntarily attended monthly video review conferences. Attendees included ED physicians, nurses, respiratory therapists, paramedics, patient-care assistants, and relevant subspecialists.

Methods: The resuscitation cases were identified as above, but selected based on complexity of case and opportunities for improvement. The nurse-physician team reviewed the video of the medical emergency case, identified performance gaps and determined learning objectives. Written literature was reviewed, and subspecialists were consulted as needed to augment current evidence-based practices. In each one hour video review, the audience watches portions of the resuscitation video, additional details are given, and discussion is facilitated by the nurse and physician from the MRC. To support the discussion, a review of current literature is presented and evidence-based care guidelines are recommended. To evaluate the conference effectiveness and prompt improvement, an online survey-based instrument was distributed to all the disciplines who work in the ED. A 5-point Likert scale was used, with responses ranging from highly disagree, disagree, neutral, agree and highly agree.

Results/Outcomes: Since 2008, the MRC has presented 45 conferences. A sample of the high-acuity, low frequency medical emergency topics include: heat illness, septic shock, hypertensive emergency, non-accidental trauma presented as seizure, adult chest pain, and toxicological emergencies. Attendance showed on average 18 physicians (range 15-25) and 13.1 non-physicians (range 9-17) for conferences. Seventy-four ED clinicians responded to the survey. Sixty-three percent of the survey respondents report conference time as the primary barrier to attendance. Medical video review conference respondents “highly agreed” that the presentations were evidence-based (57.8%), educational (64.1%), multidisciplinary (57.8%), important to ongoing training (60.9%), and impact patient care (60.9%). If you add the percentages of respondents who “agreed” to these numbers, all five categories were supported by at least 83% of ED staff.

Implications: Emergent needs of critically ill pediatric patients can be identified by multidisciplinary team members using video review. Medical video review conferences were developed as a collaborative, unique approach to educate providers and improve the care of critically ill children. These presentations were viewed as important by ED providers, as shown by regular attendance and positive survey feedback. Additionally, conference findings can provide direction for future in situ training sessions and development of best practice algorithms.

Keywords:
Medical video review to improve care of critically ill children
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleMedical Video Review: A Multidisciplinary Approach towards Improving Careen_GB
dc.contributor.authorFrey, Maryen_GB
dc.contributor.authorOehler, Jenniferen_GB
dc.contributor.authorGeis, Gary L.en_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMary Frey, BSN, RN, CPN, CPEN, mary.frey@cchmc.org; Jennifer Oehler, BSN, RN; Gary L. Geis, MDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306584-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: A novel, multidisciplinary Medical Resuscitation Committee (MRC) was developed in a pediatric emergency department (ED) to identify practice gaps, investigate areas of need and educate providers surrounding critically ill children. Since 2008, multidisciplinary education has been provided through the use of monthly medical video review (MVR) conferences. The objectives of this project were to improve care of critically ill children and enhance communication and teamwork among multidisciplinary providers.</p><p>Design: The MRC identified high-acuity, low frequency medical emergencies based on safety reports, word-of-mouth, direct involvement, or through an internally derived database. Through the use of video and literature review, collaboration with subspecialists, and evidence-based recommendations, monthly multidisciplinary conferences were developed and delivered by a nurse and physician, both members of the MRC.</p><p>Setting: ED at a large, urban, tertiary care pediatric hospital.</p><p>Participants/Subjects: Participants voluntarily attended monthly video review conferences. Attendees included ED physicians, nurses, respiratory therapists, paramedics, patient-care assistants, and relevant subspecialists.</p><p>Methods: The resuscitation cases were identified as above, but selected based on complexity of case and opportunities for improvement. The nurse-physician team reviewed the video of the medical emergency case, identified performance gaps and determined learning objectives. Written literature was reviewed, and subspecialists were consulted as needed to augment current evidence-based practices. In each one hour video review, the audience watches portions of the resuscitation video, additional details are given, and discussion is facilitated by the nurse and physician from the MRC. To support the discussion, a review of current literature is presented and evidence-based care guidelines are recommended. To evaluate the conference effectiveness and prompt improvement, an online survey-based instrument was distributed to all the disciplines who work in the ED. A 5-point Likert scale was used, with responses ranging from highly disagree, disagree, neutral, agree and highly agree.</p><p>Results/Outcomes: Since 2008, the MRC has presented 45 conferences. A sample of the high-acuity, low frequency medical emergency topics include: heat illness, septic shock, hypertensive emergency, non-accidental trauma presented as seizure, adult chest pain, and toxicological emergencies. Attendance showed on average 18 physicians (range 15-25) and 13.1 non-physicians (range 9-17) for conferences. Seventy-four ED clinicians responded to the survey. Sixty-three percent of the survey respondents report conference time as the primary barrier to attendance. Medical video review conference respondents “highly agreed” that the presentations were evidence-based (57.8%), educational (64.1%), multidisciplinary (57.8%), important to ongoing training (60.9%), and impact patient care (60.9%). If you add the percentages of respondents who “agreed” to these numbers, all five categories were supported by at least 83% of ED staff. </p><p>Implications: Emergent needs of critically ill pediatric patients can be identified by multidisciplinary team members using video review. Medical video review conferences were developed as a collaborative, unique approach to educate providers and improve the care of critically ill children. These presentations were viewed as important by ED providers, as shown by regular attendance and positive survey feedback. Additionally, conference findings can provide direction for future in situ training sessions and development of best practice algorithms.</p>en_GB
dc.subjectMedical video review to improve care of critically ill childrenen_GB
dc.date.available2013-12-09T17:00:13Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:13Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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