Title : Increase staff comfort with managing emergency response in the ambulatory treatment center
Abstract:
Background: The Ambulatory Treatment Center (ATC) at League City (LC) is in the community away from the hospital setting. As a result, there are limited resources to manage emergencies such as a MERIT Team or a Code Team. We are a 9-1-1 facility and staff are trained to provide Basic Life Support (BLS). In the event of medical emergencies, time is valuable in managing the care of the patient until the arrival of Emergency Medical Services (EMS). The collaboration of nursing staff and advanced practice providers is imperative to manage emergencies in the ATC. Rapid emergency response can be challenging because they happen very infrequently in the ambulatory areas. With the administration of numerous cancer medications, it is imperative that nurses must be prepared to manage hypersensitivity reactions. Several of the hypersensitivity reactions can lead to cardiopulmonary arrest. It is important to provide resources/education and training to increase the comfort level of the nursing team to manage medical emergencies. Literature review revealed that mock drills or practicing emergency scenarios in simulated environment improves staff confidence, communication, teamwork, and enhances patient safety.
Objective: The aim of this project is to improve the comfort level of nursing team in managing patients with emergencies during treatment by 15% in the Ambulatory Treatment Center (ATC) at the League City Houston Area Location (HAL) by January 2023.
Intervention: A pre- and post-implementation survey measured nurses, medical assistants, and covering advanced practice providers (APPs), comfort level with managing emergencies in the ATC. Nursing leadership developed Standard of Practice & an algorithm for Management of Medical Emergencies in the Ambulatory Treatment Center at League City and provided education for staff. We collaborated with the Simulation Training Center to provide mandatory Clinical Medical Emergency Team Training Simulation (CMETTS) for all ATC nursing staff and increased the number of mock codes within a year.
Results: The pre-implementation results showed a mean of 67.26% with staff feeling comfortable with managing emergencies in the ATC. The post-implementation results showed a mean of 82.55% with staff feeling comfortable with managing emergencies in the ATC. The results are well above our target goal of 77%.
Conclusion: Providing the necessary education, training, and tools increased our score by approximately 83% which is above the target goal of 77%. As a result of the intervention mentioned above, there has been an increase in staff participation with managing medical emergencies in the ATC as well as team verbalizing increased comfort with managing infusion related emergencies.
