30th World Nurse Practitioners & Healthcare Congress
Brighton and Sussex University Hospitals NHS Trust, United Kingdom
Title: Pre-shift emergency briefing improves nursing efficiency in unexpected medical emergencies
Biography: Svetlana Nela
Introduction & Aim: It has been widely accepted that non-technical or ‘human’ factors play a key role in safety-related outcomes in high-risk industries, for example commercial aviation. Lessons learnt by this industry have been adopted into healthcare in order to improve patient safety and emergency outcomes. There has been a concerted effort to acknowledge and act on the requirement for quality-assured processes and systems to improve leadership, teamwork and communication amongst healthcare professionals e.g. Medical-Emergency Teams, within which there is a skill and grade-mix, with pre-allocated roles for each team member, and protected time for briefing at the start of each shift. Given the significance of every minute’s delay during emergencies, it seems that one key staff group has been overlooked in the application of human factors-based training and procedures in acute/general medical and surgical settings. Nurses are, in the majority of cases, the first healthcare professionals to reach deteriorating patients and it is their job to recognise and escalate this as well as initiate emergency care; however there are no established non-technical processes to ensure good teamwork and communication in the nurse-led phase of emergencies. This project aimed to establish nursing perceptions of non-technical factors during emergencies prior to MET/CA-team arrival and to trial the implementation of a briefing and role allocation system for nurses in order to improve non-technical factors during emergencies.
Method: 1. Selection of a trial ward to study nurses’ perceptions of emergencies and trial a human-factors based intervention – a Neurosurgery/ENT ward was chosen, Initial questionnaire for nursing staff addressing their experience of emergencies, Development of materials for a new briefing and role allocation procedure based on highlighted issues (poster and role badges shown below), Simulation-based resuscitation training for full nursing cohort to refresh BLS and introduce the process of briefing and role allocation Senior nurses provided with briefing guide to facilitate briefings and role allocation, Trial of daily pre-shift briefing and allocation process for 1-year period with unscheduled visits for monitoring compliance and gathering feedback, 2nd questionnaire to assess the effect of the new procedure.
Results & Analysis: Initial questionnaire:
30 responses, including 16 nurses of Band 6 and above, and 14 nurses of Band 5 and below, The results highlighted significant issues with perceptions of non-technical factors in emergencies, There was some dispariy seen between the responses of senior and junior nurses, Additionally, >70% of respondents felt that role allocation would improve their confidence in emergencies
14 responses so far, The preliminary results indicate nurses have found the new procedure to be helpful in improving leadership and teamwork in emergencies