2.50
Hdl Handle:
http://hdl.handle.net/10755/621611
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Therapeutic Hypothermia Improvement Project
Author(s):
Wang, Shiao-Pei
Lead Author STTI Affiliation:
Lambda Beta-at-Large
Author Details:
Shiao-Pei Wang, MSN, RN, Professional Experience: 2014.02~present, RN, Head Nurse, Emergency Intensive Care Unit, National Taiwan University Hospital. 2008.11~2014.01, RN, Head Nurse, Respiratory Care Center, NTUH. 2006~2008.11, RN, Head Nurse, Medical Intensive Care Unit, NTUH. 1996~2005, RN, Cardiac Intensive Care Unit, NTUH. 1992~1996, RN, Nephrology Ward, NTUH. Author and co-author of 15 publications. Four presentations at STTI and ICN national conference. Author Summary: Shiao-Pei Wang, is a head nurse of teaching hospital, and also a doctoral candidate of National Taiwan University, with clinical experience more than 23 years in intensive care field. Join the stti congress is a great experience, not only share research experience also get idea from other researcher.
Abstract:

Background:

Therapeutic hypothermia (TH) is a standard care of post-cardiac arrest (CA), several studies have showed that TH can improve anoxia neurological outcomes. According to the evidence, TH should be initiated as soon as possible after CA. However, TH is a complicated and labor intensive treatment. Therefore, in order to enhance the efficacy of TH, we must shorten the time from return-of-spontaneous circulation (ROSC) after CA to initiation of TH and improve the integrity of nursing care process.

Methodology:

Improvement project:
1. Form a trans-unit TH team
2. Renew and propose TH operational process and nursing care practice standards
3. Put medical treatments into a doctor’s order package
4. Develop a nursing care checklist include all nursing care activities
5. Held in-service education

Project implementation:
1. A trans-unit TH team was formed which included attending physician, residents, clinical nursing staff and administrator of emergency department and
intensive care unit, one pharmacist also involved in this team. Team members met once a month and discussed the difficulties of TH in practice.
2. Renewed and proposed the TH operational process and nursing care practice standard, which approved by
department and became a formal practice guideline. The shared decision making concept was applied into the process
while physician explained TH to patient’s family.
3. Put all medical treatments into a doctor’s order package and made it more convenient when doctor prescribed TH
orders and reduced missing.
4. Developed and integrated all nursing care activities into a nursing care checklist, avoiding incomplete nursing
care.
5. ED and ICU physicians and nurses undergo at least one hour education about TH, and advocated the new TH
protocol and nursing care practice guideline.

Results:

The time from ROSC after CA to initiation of TH was shortened from 151 minutes to 122 minutes. The time from ROSC after CA to target temperature was shortened from 431 minutes to 316 minutes. Care completeness increased from 81.5% to 95%.

Discussion:

Through the trans-unit cooperation, this improvement project shortened the time from ROSC to initiation of TH, time from ROSC to target temperature and improve care completeness successfully. Besides, medical staff had increased knowledge about TH. In the future, we should parallel promote TH protocol and care standard to other ICU.

Keywords:
Out-of-hospital Cardiac Arrest; Target Temperature Management; Therapeutic Hypothermia
Repository Posting Date:
29-Jun-2017
Date of Publication:
29-Jun-2017
Other Identifiers:
INRC17PST
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.titleTherapeutic Hypothermia Improvement Projecten_US
dc.contributor.authorWang, Shiao-Peien
dc.contributor.departmentLambda Beta-at-Largeen
dc.author.detailsShiao-Pei Wang, MSN, RN, Professional Experience: 2014.02~present, RN, Head Nurse, Emergency Intensive Care Unit, National Taiwan University Hospital. 2008.11~2014.01, RN, Head Nurse, Respiratory Care Center, NTUH. 2006~2008.11, RN, Head Nurse, Medical Intensive Care Unit, NTUH. 1996~2005, RN, Cardiac Intensive Care Unit, NTUH. 1992~1996, RN, Nephrology Ward, NTUH. Author and co-author of 15 publications. Four presentations at STTI and ICN national conference. Author Summary: Shiao-Pei Wang, is a head nurse of teaching hospital, and also a doctoral candidate of National Taiwan University, with clinical experience more than 23 years in intensive care field. Join the stti congress is a great experience, not only share research experience also get idea from other researcher.en
dc.identifier.urihttp://hdl.handle.net/10755/621611-
dc.description.abstract<p><strong>Background:</strong></p> <p>Therapeutic hypothermia (TH) is a standard care of post-cardiac arrest (CA), several studies have showed that TH can improve anoxia neurological outcomes. According to the evidence, TH should be initiated as soon as possible after CA. However, TH is a complicated and labor intensive treatment. Therefore, in order to enhance the efficacy of TH, we must shorten the time from return-of-spontaneous circulation (ROSC) after CA to initiation of TH and improve the integrity of nursing care process.<br /><strong></strong></p> <p><strong>Methodology:</strong></p> <p><strong>Improvement project:</strong><br />1. Form a trans-unit TH team<br />2. Renew and propose TH operational process and nursing care practice standards<br />3. Put medical treatments into a doctor’s order package<br />4. Develop a nursing care checklist include all nursing care activities<br />5. Held in-service education<br /><strong></strong></p> <p><strong>Project implementation:</strong><br />1. A trans-unit TH team was formed which included attending physician, residents, clinical nursing staff and administrator of emergency department and<br />intensive care unit, one pharmacist also involved in this team. Team members met once a month and discussed the difficulties of TH in practice.<br />2. Renewed and proposed the TH operational process and nursing care practice standard, which approved by<br />department and became a formal practice guideline. The shared decision making concept was applied into the process<br />while physician explained TH to patient’s family.<br />3. Put all medical treatments into a doctor’s order package and made it more convenient when doctor prescribed TH<br />orders and reduced missing.<br />4. Developed and integrated all nursing care activities into a nursing care checklist, avoiding incomplete nursing<br />care.<br />5. ED and ICU physicians and nurses undergo at least one hour education about TH, and advocated the new TH<br />protocol and nursing care practice guideline.</p> <p><strong>Results:</strong></p> <p>The time from ROSC after CA to initiation of TH was shortened from 151 minutes to 122 minutes. The time from ROSC after CA to target temperature was shortened from 431 minutes to 316 minutes. Care completeness increased from 81.5% to 95%.</p> <p><strong>Discussion:</strong></p> <p>Through the trans-unit cooperation, this improvement project shortened the time from ROSC to initiation of TH, time from ROSC to target temperature and improve care completeness successfully. Besides, medical staff had increased knowledge about TH. In the future, we should parallel promote TH protocol and care standard to other ICU.</p>en
dc.subjectOut-of-hospital Cardiac Arresten
dc.subjectTarget Temperature Managementen
dc.subjectTherapeutic Hypothermiaen
dc.date.available2017-06-29T19:29:51Z-
dc.date.issued2017-06-29-
dc.date.accessioned2017-06-29T19:29:51Z-
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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