Poster Abstracts from the 2014 Conference of the Canadian Society of Respiratory Therapists

Can J Respir Ther Vol 50 No 2 Summer 2014 52 5. Ramos K, Schafer S, Tracz S. Validation of the Fresno test of competence in evidence based medicine. BMJ 2003;326:319-321. 6. Broomfield D, Humphries GM. Using the Delphi technique to identify the cancer education requirements of general practitioners. Medical Education 2001;35:928-937. rtP02 Pediatric high acuity suPPort team (Phast): initiaL Phases and imPLementation Within a smaLL urban Pediatric heaLth centre e bales bhsc rrt, k Joudrie bscn rn, J gallant bsc bscn rn, c donnelly rn iWk health centre, halifax, ns [email protected] InTRODUCTIOn: Rapid response teams (RRTs) are comprised of specialized healthcare professionals who deliver high acuity care to the bedside of inpatients experiencing a significant deterioration in clinical status (Massey, Aitken, & Chaboyer, 2010; Wolf, 2007). The structure of the RRT varies between hospitals, but the common competencies include the ability to provide critical care outside of the ICU via: 1) obtaining central venous access, 2) providing advanced airway management, and 3) the prescription and delivery of medications and diagnostic therapies (VanVoorhis & Willis, 2009). The ultimate goal of the RRT is to improve quality of care and health outcomes through the reduction of morbidity and mortality (Massey, Aitken & Chaboyer, 2010; Safer Healthcare Now! The Quebec Campaign, 2009). OBJECTIVE: At the present time the IWK Health Centre in Halifax, Nova Scotia has not yet implemented a RRT, despite active care delivery to critically ill children. The IWK is restructuring their pediatric critical care program to achieve excellence and improve their healthcare delivery. At the heart of this redevelopment is the formation of a Pediatric High Acuity Support Team (PHAST) Committee to work toward the implementation of a RRT. PLan: Through the use of “Getting Started Kit: Rapid Response Teams How-to Guide” (Safer Healthcare Now! The Quebec Campaign, 2009) and additional literary resources, eight steps have been developed to implement PHAST: 1) Identification of a gap in current clinical care provided 2) Formation of an interdisciplinary, collaborative research group 3) Literature review; Family and staff survey; Benchmarking; Obtain staff support 4) Compile data 5) Identify need for PHAST 6) Presentations to key stakeholders 7) Staff the team; Development of policies; Education; Allocation of resources 8) Roll out: activating and evaluating PHAST fUTURE GOaLS: Recently a six-month pilot has been approved by upper level management at the IWK, which will be funded by Pediatric Critical Care. The pilot project will provide an opportunity to collect data, assess and evaluate the function of PHAST at the IWK Health Centre. This is an evidenced-based project with the end goal of providing the best possible care to patients and families. REfEREnCES: Massey D, Aitken L & Chaboyer W. (2010). Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient? Journal of Clinical Nursing 19: 3260-3273. doi: 10.1111/j.1365-2702.2010.03394.x Safer Healthcare Now! The Quebec Campaign. (2009). Getting started kit: Rapid response teams how to guide. Retrieved from http://www. safehealthcarenow.ca/EN/Interventions/RRT/Documents/RRT%20 Getting%20Started%20Kit.pdf Van Voorhis K & Willis T. (2009). Implementing a pediatric rapid response system to improve quality and patient safety. Pediatric Clinics of North America 56: 919-933. doi: 10.1016/j.pcl.2009.05.017 Winberg H, Nilsson K, & Aneman A. (2008). Paediatric rapid response systems: A literature review. ActaAnaesthesiologicaScandinavica 52: 890-896. doi: 10.1111/j.1399-6576.2008.01672.x Wolf Z. (2007). Rapid response team in a pediatric hospital: One nurse’s focus on outcomes, quality, and safety. Pennsylvania Nurse 62(3): 22-23. Retrieved from http://www.ncbi.nln.nih.gov/pubmed/18019312 rtP03 comPLications increase With greater than one endotracheaL intubation attemPt: exPerience in a canadian aduLt tertiary care teaching centre Lv duggan md frcPc, ks minhas bsc rrt, tL miller bsc rrt, J Zurba bsc rrt, b deady md, r noseworthy md, Lv carter ba rn, de griesdale md mPh frcPc, sc reynolds md frcPc royal columbian hospital, university of british columbia, vancouver, bc [email protected] This prospective review/poster was undertaken to better understand outof-operating room endotracheal tube intubations (ETI) at our hospital. A multi-disciplinary designed collection card was used to record complication of intubations over a 13-month period. Respiratory therapists recorded, collected and analyzed these data cards. From this review, greater than 1 attempt at ETI was associated with a 4.5-fold increase in severe complications, and a 4-fold increase in total complications. This information is mapping a change in practice and a multidisciplinary team initiative to improve patient care and safety.