Authors (including presenting author) :
Sham PK(1), Yeung LH(2), Chao YL(1), Liu YM(1), Law WY(2), Wong YCJ(2), Leung YYC(1)
Affiliation :
(1) Physiotherapy Department, Integrated Neurological Rehabilitation Centre, Princess Margaret Hospital (2) Occupational Therapy Department, Integrated Neurological Rehabilitation Centre, Princess Margaret Hospital
Introduction :
Regular emergency drills are vital to ensure every staff get familiar with the emergency procedures and local protocol such that staff can respond more swiftly and efficiently to a real situation by practicing their actions, potentially saving lives and minimizing damage. Joint simulated scenarios-based emergency drills across different clinical departments were conducted to ensure all staff get familiar and compliant with the local hospital “Guideline on Management of Persons Found Collapsed in Non-ward Areas & in the Vicinity of Hospital”.
Objectives :
To create simulation-based scenarios for (i) practicing joint emergency drill across clinical departments when a patient is found collapsed during exercise training, and (ii) identifying areas for improvement
Methodology :
The drills consisted of 7 essential components on (i) preparation of day-patient and in-patient scenarios by Occupational Therapy (OT) and Physiotherapy (PT) Department respectively at the Integrated Neurological Rehabilitation Centre of the Princess Margaret Hospital, (ii) equipment preparation, (iii) roles and responsibilities assignment for each staff of both clinical departments on drill coordinators, patients, therapists for discovering patient found collapsed/conduct cardiopulmonary resuscitation (CPR), patient care assistants (PCA), clericals, photographers, commanders, recorders, doctors, nurses, and observers, (iv) joint emergency drills execution, (v) feedbacks and comments from observers, (vi) debriefing with recommendation for improvement, and (vii) drill reports writing.
Result & Outcome :
Two simulated emergency scenarios drills were successfully conducted on 16 Oct 2024. Fifty-seven professional staff (37 PTs, 20 OTs), 25 PCAs, 2 clerical staff, and 5 ISS staff joined the drills. The time from the start of incident to completion of CPR, handover cases to doctors/nurses and escort patients to lift lobby was 12.7 minutes and 7.1 minutes in the first and second drills respectively. Immediate learning effect was seen after the first drill. Key recommendations for improvement included (i) timely perform CPR with N95 and face shield being put on if full PPE cannot be ready shortly, (ii) therapists should give direct commands to receivers to facilitate effective communication, (iii) the position of e-trolley should not interrupt the walkway for therapists conducting the CPRs, (iv) regular monitoring of vital signs and oxygen saturation and better on unaffected arm for hemiplegic patients, (v) prophylactic supplemental oxygen should be given at flow rate 15L/min instead of 2L/min and better use wall oxygen whenever feasible, (v) ensure the content level of the oxygen cylinder gauge is adequate for patient transfer journey and should be maintained at the green zone of at least 3/4 full for transferring critically ill patients at prescribed flow rate with the cylinder valve being turned on and with oximeter monitoring. An unexpected medical emergency can happen at any time and a delayed response could result in catastrophic harm or even death. Regular simulated scenario-based emergency drills helped to identify areas for improvement for enhancing efficacy and to assist staff in all ranks in becoming acquainted with emergency procedures/ local guideline, in particular the correct use of supplemental oxygen during transportation which is another crucial part for enhancing patient safety and quality that easily being missed out.
