Brandy Pitts is an RN and Midge Vaughan is ECMO program coordinator at Providence Covenant Children's Hospital, Lubbock, TX. Jamie Kay Roney was Texas regional research coordinator at Providence Covenant Health, Lubbock, TX, during implementation of the adult ECMO program and is currently director of nursing professional development at the Texas Nurses Association, Austin. Contact author: Jamie Kay Roney,
Am J Nurs. 2023 Dec 1;123(12):46-53. doi: 10.1097/01.NAJ.0000997232.94091.ba.
In response to the needs of patients infected with COVID-19, an interdisciplinary team was assembled to implement an adult extracorporeal membrane oxygenation (ECMO) program in the surgical ICU of a West Texas tertiary care hospital. Use of Extracorporeal Life Support Organization (ELSO) guidelines was essential to the development of this effort.
The aim of this project was to develop, implement, and evaluate an adult ECMO program.
A logic model was used in designing and evaluating the adult ECMO program. A 35-hour ECMO specialist training course was developed, and training began in August 2020, a month before implementation of the project began. Patient outcomes were measured between September 2020 and December 2021. Descriptive statistics were used to measure the clinical outcomes of interest.
Seventeen newly trained ECMO specialists included experienced critical care nurses and respiratory therapists. Protocols were developed for the initiation of ECMO, and tracked patient outcomes included survival off ECMO, survival to discharge, major and minor complications, and length of stay. Nine patients had COVID-19 and demonstrated an 11.11% mortality rate after adult ECMO program implementation.
Use of the ELSO professional guidelines to design and develop this project led to the achievement of a sustainable ECMO program. Hospital leaders can now implement adult ECMO programs amid other demands for resources that may be created by future pandemics.
为满足 COVID-19 感染患者的需求，一个跨学科团队成立，在德克萨斯州西部一家三级护理医院的外科重症监护病房（SICU）实施成人体外膜肺氧合（ECMO）项目。使用体外生命支持组织（ELSO）指南对该项目的开展至关重要。
本项目旨在开发、实施和评估成人 ECMO 项目。
采用逻辑模型设计和评估成人 ECMO 项目。开发了一个 35 小时的 ECMO 专家培训课程，并于 2020 年 8 月开始培训，即在项目开始实施前一个月。患者结果在 2020 年 9 月至 2021 年 12 月间进行测量。使用描述性统计来测量感兴趣的临床结果。
17 名新培训的 ECMO 专家包括经验丰富的重症监护护士和呼吸治疗师。制定了 ECMO 启动的方案，并跟踪患者的结果，包括 ECMO 脱机存活率、出院存活率、主要和次要并发症以及住院时间。9 名患者患有 COVID-19，在实施成人 ECMO 项目后死亡率为 11.11%。
使用 ELSO 专业指南来设计和开展该项目，实现了一个可持续的 ECMO 项目。医院领导现在可以在可能因未来大流行而对资源产生其他需求的情况下实施成人 ECMO 项目。
