Enhancing completion rate of clinical physiology examination report at the acute ward

26^th World Congress on Nursing Care

May 21-23, 2018 Osaka, Japan

Yu-Wen Wang, Shu-Yun Chen, Hsin-Ju Yang and Ru-Ju Su

Taiwan

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Aim: The study aimed to assess the effectiveness of the project launched to promote the completion rate of clinical physiology examination report to help assure the safety and quality of care in the acute ward of our psychiatric hospital. Method: Clinical physiology examination incorporates electrocardiogram, brain wave, pulmonary function and other tests. Failure to complete the examination and to deliver the report in an accurate and prompt manner may prevent medical care professionals from detecting potential physiological problems of patients and providing timely treatment. During the period from April to June in 2017, the average occupancy rate of the 35 beds available at our psychiatric hospital read 94.6%, while the physiology examination reports were completed within one week of hospitalization for only 51.6% of the patients. A special project was accordingly implemented in July to improve the unsatisfactory report completion rate. Based on the fishbone diagram created for cause-effect analysis, four major problems were identified: Nurses were too busy to make prompt arrangement for physiology examination; nurses tended to postpone the examination until they became more familiar with newly hospitalized patients who might flee the hospital during the examination process; new nurses had yet to become proficient in working at the acute ward; there was no effective monitoring mechanism. Solutions responding to the identified problems were then developed: Developing and hosting related training and education courses to enrich competence in clinical physiology; establishing a monitoring mechanism to ensure the timeliness in scheduling clinical physiology examination and to trace the progress and completion of the report; designing a structured checklist to maintain continuity in communication during shift handover and to verify the execution of physiology examination for enhancing the safety and quality of care for hospitalized patients. Result: Execution of the special project helps raise the completion rate of clinical physiology examination report at the acute ward from 51.6% to 100% with the additional benefit of zero patient safety incident as of the end of August. Conclusion: The special project proves to be highly effective in promoting the completion rate of clinical physiology examination report. The structured checklist for use at shift handover helps the nursing staff develop the habits of practicing medical safety management and regular monitoring to facilitate accurate and prompt responses to the physiological changes in patients. 103537@cch.org.tw