Authors (including presenting author) :
Yiu SC (1), Pun SD, (2), Yuen WS (3), Lee SW (4)
Affiliation :
(1) Department of M & T, Prince of Wales Hospital, (2) Department of Medicine, North District Hospital, (3) Department of ICU, North District Hospital, (4) Department of Medicine, Alice Ho Miu Ling Nethersole Hospital
Introduction :
The management of invasive devices such as sheaths is paramount to ensuring patient safety and optimal recovery. Sheath care strategies encompass a set of practices that healthcare providers, particularly nurses, must master to minimize complications associated with sheath insertions and removals. The significance of proper sheath care cannot be understated, as it plays a critical role in preventing infection, maintaining hemostasis, and promoting overall patient outcomes. With advancements in medical technology and increasing complexity of patient cases, nurses are at the forefront of implementing evidence-based practices in sheath management. This education program focuses on the techniques for care management, and the critical checklist and protocol that should be followed post-removal.
Objectives :
1.To equip nursing professionals with the necessary knowledge and skills to effectively manage sheath placements and facilitate best practices following sheath removal.
2.To develop and promote the sheath removal checklist and protocol in Critical Care Setting.
Methodology :
To address the diverse training needs of the nursing staff across various acute hospitals within the New Territories East Cluster (NTEC), we developed three distinct training classes tailored to specific topics relevant to acute care settings.
1. Prince of Wales Hospital (PWH): On June 18 and June 21, we conducted four identical training sessions focused on "Nursing Management of Vascular Access Sites in Cardiac Procedures."
2. North District Hospital (NDH): On September 30, we facilitated two identical sessions addressing "Management of Patients with Vascular Sheath."
3. Alice Ho Miu Ling Nethersole Hospital (AHNH): On October 31, we held two identical sessions, again on the topic of "Management of Patients with Vascular Sheath."
Each training session utilized a combination of lectures and hands-on workshops to enhance learning and practical application of the material.
To evaluate the effectiveness of the training, pre-test and post-test were administered to the nurses attending these sessions. This assessment strategy allowed for the measurement of knowledge gain and training impact.
This structured approach ensured that nursing staff received targeted education pertinent to their specific clinical environment.
Result & Outcome :
1. PWH (Cardiac Ward and Day Ward)
- Total Attendance: 22 nursing staff (1 APN, 18 RNs, 1 EN, 1 student)
- Pre-Test Mean Score: 2.95 out of 5
- Post-Test Mean Score:4.5 out of 5
Outcome: There was a significant improvement in knowledge and skills, with the mean score increasing by 1.55 points.
2. NDH (Critical Care Units)
- Total Attendance: 42 nursing staff (2 WMs, 11 APNs, 27 RNs, 2 ENs)
- Pre-Test Mean Score: 5 out of 10
- Post-Test Mean Score:8 out of 10
- Outcome: A notable enhancement in understanding was observed, as the mean score rose by 3 points.
3. AHNH (Critical Care Setting)
- Total Attendance: 29 nursing staff (3 WMs, 7 APNs, 19 RNs)
- Pre-Test Mean Score:6 out of 10
- Post-Test Mean Score: 9 out of 10
-Outcome: A significant advancement in competency was achieved, with a mean score increase of 3 points.
Summary of Outcomes:
All three facilities demonstrated positive outcomes post-training, with all mean scores showing substantial improvement. Each facility's nursing staff benefited from the educational sessions, enhancing their knowledge and skills in their respective care areas.
Next step should be providing the sheath removal checklist and protocol to ensure and maintain the quality of care and optimize the patient outcomes.
