Implementation of "Creative Joint-Defense Network" to Improve Nursing Quality for Endotracheal Intubation

2.50
Hdl Handle:
http://hdl.handle.net/10755/621521
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Implementation of "Creative Joint-Defense Network" to Improve Nursing Quality for Endotracheal Intubation
Author(s):
Shih, Huang-Jen
Lead Author STTI Affiliation:
Non-member
Author Details:
Huang-Jen Shih, BSN, RN, Professional Experience: 2001 - through the professional ability to advanced N2 level, Chi Mei Medical Center in Taiwan. 2002 - through the professional ability to advanced N3 level, Chi Mei Medical Center in Taiwan. 2004 - through the professional ability to advanced N4 level, Chi Mei Medical Center in Taiwan. 2006 - through the management training group long selection test, promotion team leader, in Taiwan Chi Mei Medical Center. 2007 - through the administration of the Assistant Nursing Assistant Screening Examination, promoted by the Deputy Nursing Director at the Chi Mei Medical Center in Taiwan. 2010 - to participate in quality management center medical quality training classes, in Taiwan Chi Mei Medical Center. Author Summary: The author is working in the sub-acute respiratory care center at Chi Mei Medical Center. She got the outstanding professional achievement award of Great Tainan Nurses Association in 2004, 2011 and 2015. She is studying a master's degree program of nursing in Chang Jung Christian University.
Abstract:

Abstract Introduction

According to 2014 statistics from the Ministry of Health and Welfare’s Taiwan Patient Safety Reporting System (TPR), among various tubing incidents reported by hospitals, endotracheal tubing incidents are of highest percentage (representing 97.8%) that are “harmful” to patients. Therefore, to implement the management of patient safety incidents, to prevent unplanned endotracheal tube removal, and to improve nursing quality for endotracheal intubation are issues of significant importance.

AIMS

According to the statistics unit, unplanned endotracheal tube removal rate increased abruptly from 0‰ to 4.24‰ from 2014 April to June, which is 1.2‰ higher than the unplanned extubation rate of Taiwan Clinical Performance Indicator (TCPI) in 2014. Not only does unplanned extubation cause further harm to patients, but also leads to self-blame and low morale among nurses. Ensuring patient safety and successful ventilator weaning are the unit’s foremost priorities, thus the motivation to conduct an improvement project with the purpose of applying its results to improve nursing quality for endotracheal intubation, prevent unplanned extubation incidents and to ensure the safety of patients.

METHODS

The project is divided into three stages – the planning stage, implementation stage and evaluation stage. First Stage: Establish project team, through interviews, literature review, cause and effect diagrams etc., reasons for unplanned extubation confirmed: 1. Neglect of corner beds and cross-sector nursing care 2. Inexperience in intubation healthcare 3. Lack of auditing system 4. Low compliance from family members 5. Misunderstanding of high-risk self-extubation patients. Second Stage: After discussion and using decision matrix to take feasibility, efficiency, cost and other factors into consideration, solutions are formulated and conducted according to results analysis: 1. Implementation of Creative Joint-Defense Network for corner beds and cross-sector nursing care. 2. Implementation of consensus slogan for the unit team’s joint-defense communication: “Joint-Defense Human Figure Diagram”. 3. Implementation of 3D tape three-dimensional fixing method. 4. Implementation of bed-side empowerment tape (wufendai) fixing tutorial. 5. Implementation of audit system for endotracheal intubation. 6. Health education accompanied by doctors for patients’ family members with low compliance. 7. Organization of health education work-shop for “ping-pong-gloves”. 8. Watch patients’ 30% muscle strength’s “UE Video”. Third Stage: After project implementation, statistics collected from 2015 May to July showed that the unit’s unplanned extubation rate was 0‰, and endotracheal intubation completion was 100%.

 

RESULTS

With the implementation of the project, unplanned extubation rate decreased from 4.24‰ to 0‰, thereby achieving the purpose of the project. Through the results of this project, rigid regulations and technicalities have been integrated with creative approaches, easing rejection against defense regulation implementations, and effectively decreasing unplanned extubation rate.

CONCLUSIONS

During the project’s implementation, there was resistance and rejection from doctors, and project members continued to discuss and negotiate with support and assistance from supervisors to successfully accomplish our goals. After implementing the creative joint-defense network concept, the unit’s unplanned extubation rate dropped from 4.24‰ before improvement to 0‰, demonstrating that medical harm from unplanned extubation can be prevented and avoided. This article hopes to be provided as reference for relative units.

Keywords:
Creative Joint-defense Network; Tracheal Tube Care Quality; Unplanned Endotracheal Tube Removal
Repository Posting Date:
19-Jun-2017
Date of Publication:
19-Jun-2017
Other Identifiers:
INRC17PST45
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleImplementation of "Creative Joint-Defense Network" to Improve Nursing Quality for Endotracheal Intubationen_US
dc.contributor.authorShih, Huang-Jenen
dc.contributor.departmentNon-memberen
dc.author.detailsHuang-Jen Shih, BSN, RN, Professional Experience: 2001 - through the professional ability to advanced N2 level, Chi Mei Medical Center in Taiwan. 2002 - through the professional ability to advanced N3 level, Chi Mei Medical Center in Taiwan. 2004 - through the professional ability to advanced N4 level, Chi Mei Medical Center in Taiwan. 2006 - through the management training group long selection test, promotion team leader, in Taiwan Chi Mei Medical Center. 2007 - through the administration of the Assistant Nursing Assistant Screening Examination, promoted by the Deputy Nursing Director at the Chi Mei Medical Center in Taiwan. 2010 - to participate in quality management center medical quality training classes, in Taiwan Chi Mei Medical Center. Author Summary: The author is working in the sub-acute respiratory care center at Chi Mei Medical Center. She got the outstanding professional achievement award of Great Tainan Nurses Association in 2004, 2011 and 2015. She is studying a master's degree program of nursing in Chang Jung Christian University.en
dc.identifier.urihttp://hdl.handle.net/10755/621521-
dc.description.abstract<p><span lang="EN-US"><span lang="EN-US"><strong>Abstract Introduction</strong></span></span></p> <p><span lang="EN-US">According to 2014 statistics from the Ministry of Health and Welfare’s Taiwan Patient Safety Reporting System (TPR), among various tubing incidents reported by hospitals, endotracheal tubing incidents are of highest percentage (representing 97.8%) that are “harmful” to patients. Therefore, to implement the management of patient safety incidents, to prevent unplanned endotracheal tube removal, and to improve nursing quality for endotracheal intubation are issues of significant importance.</span></p> <p><span lang="EN-US"><span lang="EN-US"><strong>AIMS</strong></span></span></p> <p><span lang="EN-US">According to the statistics unit, unplanned endotracheal tube removal rate increased abruptly from 0‰ to 4.24‰ from 2014 April to June, which is 1.2‰ higher than the unplanned extubation rate of Taiwan Clinical Performance Indicator (TCPI) in 2014. Not only does unplanned extubation cause further harm to patients, but also leads to self-blame and low morale among nurses. Ensuring patient safety and successful ventilator weaning are the unit’s foremost priorities, thus the motivation to conduct an improvement project with the purpose of applying its results to improve nursing quality for endotracheal intubation, prevent unplanned extubation incidents and to ensure the safety of patients.</span></p> <p><span lang="EN-US"><span lang="EN-US"><strong>METHODS</strong></span></span></p> <p><span lang="EN-US">The project is divided into three stages – the planning stage, implementation stage and evaluation stage. <strong>First Stage: </strong>Establish project team, through interviews, literature review, cause and effect diagrams etc., reasons for unplanned extubation confirmed: 1. Neglect of corner beds and cross-sector nursing care 2. Inexperience in intubation healthcare 3. Lack of auditing system 4. Low compliance from family members 5. Misunderstanding of high-risk self-extubation patients. <strong>Second Stage: </strong>After discussion and using decision matrix to take feasibility, efficiency, cost and other factors into consideration, solutions are formulated and conducted according to results analysis: 1. Implementation of Creative Joint-Defense Network for corner beds and cross-sector nursing care. 2. Implementation of consensus slogan for the unit team’s joint-defense communication: “Joint-Defense Human Figure Diagram”. 3. Implementation of 3D tape three-dimensional fixing method. 4. Implementation of bed-side empowerment tape (wufendai) fixing tutorial. 5. Implementation of audit system for endotracheal intubation. 6. Health education accompanied by doctors for patients’ family members with low compliance. 7. Organization of health education work-shop for “ping-pong-gloves”. 8. Watch patients’ 30% muscle strength’s “UE Video”. <strong>Third Stage: </strong>After project implementation, statistics collected from 2015 May to July showed that the unit’s unplanned extubation rate was <strong>0</strong>‰, and endotracheal intubation completion was <strong>100</strong>%.</span><span lang="EN-US"><br /></span></p> <p> </p> <p><strong><span lang="EN-US">RESULTS</span></strong></p> <p><strong></strong><span lang="EN-US">With the implementation of the project, unplanned extubation rate decreased from 4.24‰ to 0‰, thereby achieving the purpose of the project. Through the results of this project, rigid regulations and technicalities have been integrated with creative approaches, easing rejection against defense regulation implementations, and effectively decreasing unplanned extubation rate.<br /></span></p> <p><span lang="EN-US"><strong>CONCLUSIONS</strong><br /></span></p> <p><span lang="EN-US">During the project’s implementation, there was resistance and rejection from doctors, and project members continued to discuss and negotiate with support and assistance from supervisors to successfully accomplish our goals. After implementing the creative joint-defense network concept, the unit’s unplanned extubation rate dropped from 4.24‰ before improvement to 0‰, demonstrating that medical harm from unplanned extubation can be prevented and avoided. This article hopes to be provided as reference for relative units.</span></p>en
dc.subjectCreative Joint-defense Networken
dc.subjectTracheal Tube Care Qualityen
dc.subjectUnplanned Endotracheal Tube Removalen
dc.date.available2017-06-19T14:44:15Z-
dc.date.issued2017-06-19-
dc.date.accessioned2017-06-19T14:44:15Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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