Emergency Department, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Emergency Department, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
BMJ Open Qual. 2024 Sep 30;13(3):e002870. doi: 10.1136/bmjoq-2024-002870.
In any healthcare setting, cardiopulmonary resuscitations (CPRs) stand out as demanding and chaotic resuscitation endeavours. Emergency departments (EDs) witness a significant volume of CPRs. Given the critical nature of CPR, content knowledge and procedural skills alone fall short in delivering optimal care. Effective teamwork, complemented by a well-coordinated response, is imperative for achieving favourable patient outcomes. A survey conducted in our ED highlighted that while the majority of staff acknowledged the significance of teamwork in CPR and were aware of the whiteboard for assigning team roles, only 19% were familiar with their individual roles during CPR.
To address this gap, our project aimed to increasing the role delegation for CPR from 19% to 80% within 2 months. We formed an interprofessional team and implemented strategies through four plan-do-study-act cycles. Interventions encompassed increasing sensitisation, creating a simplified format for assigning team roles and entrusting the nursing team leader of each shift with the responsibility of role assignment for accountability. The sharing of progress charts for acknowledgment served as a motivating factor, leading to sustained adherence to the project goals without necessitating reminders in the final two weeks.
This project proved to be highly successful as our process indicator steadily increased and remained above the target for 4 consecutive weeks.
Our results underscore the importance of patience and teamwork in achieving project objectives. It serves as a good example of the efficiency of simple and cost-effective interventions, one that can be replicated and implemented in other EDs.
在任何医疗保健环境中，心肺复苏术（CPR）都是一项高要求、混乱的复苏努力。急诊科（ED）见证了大量的 CPR。鉴于 CPR 的关键性，仅具备内容知识和程序技能不足以提供最佳护理。有效的团队合作，辅以协调一致的反应，对于实现有利的患者结果至关重要。我们在 ED 进行的一项调查表明，尽管大多数工作人员都认识到 CPR 中团队合作的重要性，并且了解用于分配团队角色的白板，但只有 19%的人在 CPR 期间熟悉自己的个人角色。
为了解决这一差距，我们的项目旨在在 2 个月内将 CPR 的角色委托从 19%提高到 80%。我们组建了一个多专业团队，并通过四个计划-执行-研究-行动循环实施策略。干预措施包括提高敏感度、创建简化的团队角色分配格式，并将每个班次的护理团队负责人负责角色分配以提高问责制。分享进度图表以获得认可作为一种激励因素，导致在最后两周无需提醒的情况下持续遵守项目目标。
该项目非常成功，因为我们的过程指标稳步上升，并连续 4 周保持在目标之上。
我们的结果强调了耐心和团队合作在实现项目目标方面的重要性。这是一个简单且具有成本效益的干预措施的效率的很好例子，可以在其他 ED 中复制和实施。
