Improving the ma na g e me nt of a dult pa tie nts pre se nting - - PowerPoint PPT Presentation

▶
improving the ma na g e me nt of a dult pa tie nts pre se
SMART_READER_LITE
LIVE PREVIEW

Improving the ma na g e me nt of a dult pa tie nts pre se nting - - PowerPoint PPT Presentation

Mar 11, 2023 251 likes •405 views

Improving the ma na g e me nt of a dult pa tie nts pre se nting to the E me rg e nc y De pa rtme nt a t SWH Wa rrna mbool with a tria l fibrilla tion with ra pid ve ntric ula r re sponse , throug h the de ve lopme nt of a n e vide nc e

slide-1
SLIDE 1

Improving the ma na g e me nt of a dult pa tie nts pre se nting to the E me rg e nc y De pa rtme nt a t SWH Wa rrna mbool with a tria l fibrilla tion with ra pid ve ntric ula r re sponse , throug h the de ve lopme nt of a n e vide nc e ba se d c linic a l pa thwa y.

Sue Ande rton (NP/ ANUM) Proje c t L e a d. Proje c t te a m:

F ra nc o Sc hre ve , Christine He na , Me g a n Rie lly, Ca t Ge rvis, Be c She e n, L a ura Co nn, Ma rg Bull, E mily Ba tt a nd Chris Ba rr.

slide-2
SLIDE 2

T he proble m

  • Atria l fib rilla tio n is c o mmo n

in E D

  • De spite pub lishe d

g uide line s va ria tio n in pra c tic e is c o mmo n

  • AF
  • RVR wa s o ne o f the

to pic s a va ila b le to E D in the 2013 E CI I CN e vide nc e - b a se d c a re impro ve me nt pro je c t c yc le

slide-3
SLIDE 3

Me thods

  • Multidisc iplina ry e xpe rt pa ne l de ve lo pe d re c o mme nde d

tre a tme nt pa thwa y, inc luding drug re c o mme nda tio ns

  • L
  • c a l imple me nta tio n
  • Be fo re a nd a fte r e va lua tio n
  • E

va lua tio n e ndpo ints

  • Pro po rtio n o f pa tie nts ma na g e d a c c o rding to a lo c a l pa thwa y
  • Pro po rtio n with do c ume nte d c hro nic ity o f AF
  • Pro po rtio n with do c ume nte d ra te o r rhythm c o ntro l stra te g y
  • Pro po rtio n with do c ume nte d CHADS2 sc o re (o r simila r)
slide-4
SLIDE 4

About Wa rrna mbool E D

slide-5
SLIDE 5

About Wa rrna mbool E D

  • Only E

D in a rura l c ity, le ve l 2 tra uma c e ntre , 15 b e ds inc luding 2 re susc ita tio n b a ys, 24,610 pre se nta tio ns 2013.

  • Po pula tio n a ppro x. 34,000
  • L
  • c a tio n 348km so uthwe st o f Me lb o urne – o n the c o a st
  • Wa rrna mb o o l is ho me to F

e ma le So uthe rn Rig ht Wha le s June –Se pte mb e r (c a lving se a so n).

  • T
  • urism is a ma jo r drive r o f e c o no my with the po pula tio n

e xplo ding o ve r summe r a nd during the Ma y Ra c e c a rniva l.

  • I

npa tie nt c a re fo r pa tie nts with AF

  • RVR pro vide d b y:

Ge ne ra l Physic ia ns.

slide-6
SLIDE 6

T he South We st He a lthc a re Wa rrna mbool E me rg e nc y De pa rtme nt a pproa c h

  • E

xtre me ly e nthusia stic pro je c t le a d a nd pro je c t te a m.

  • K

no wn g a ps in the ma na g e me nt o f this pa tie nt po pula tio n.

  • Pre da ta c o nfirme d wha t we a lre a dy kne w.
  • E

xpe c ta tio n this wo uld so lve the issue s surro unding the a dho c ma na g e me nt o f AF

  • RVR in the E

D.

  • A pro je c t pla n wa s de ve lo pe d.
  • T

he re wa s no inte re st o r e ng a g e me nt o utside o f the E D.

  • T

he e vide nc e wa s e xa mine d a nd a pa thwa y wa s c re a te d.

slide-7
SLIDE 7

De ve loping a nd imple me nting a pa thwa y

  • Cha lle ng ing !
  • F

e e db a c k initia lly minima l

  • Pa thwa y no t b e ing utilise d
  • Co ntinue d e nc o ura g e me nt o f c ha mpio ns
  • E

vide nt initia l e duc a tio n did no t re a c h sta ke ho lde rs

slide-8
SLIDE 8

Pa thwa y - A fe w of the dra fts

slide-9
SLIDE 9

Simula tion to the re sc ue !

  • We use d simula tio n o f the

use o f the AF

  • RVR

pa thwa y in multidisc iplina ry te a m e nviro nme nt.

  • Ma rke d inc re a se in

e ng a g e me nt.

  • F

e e db a c k wa s flo wing a nd wa s use d to furthe r the re fine pa thwa y.

slide-10
SLIDE 10

Re sults

  • Sho we d a mo re c o nsiste nt a ppro a c h to the ma na g e me nt
  • f AF
  • RVR in the E

D.

  • Pa tie nts tre a te d a c c o rding to a pa thwa y improve d from 0% to

41%.

  • Pa tie nts whe re c hro nic ity wa s re c o rde d improve d from 63% to

82%.

  • Do c ume nte d tre a tme nt stra te g y wa s re c o rde d de te riora te d a

little 37% to 32% .

  • Pa tie nts with CHADS sc o re re c o rde d a lso de te riora te d a little 23%

to 17% .

slide-11
SLIDE 11

Suc c e ss fa c tors

  • De dic a te d pro je c t te a m
  • I

nno va tive e duc a tio n thro ug h the use o f re a l time simula te d sc e na rio s to te st a nd re fine the e vide nc e d b a se d c linic a l pa thwa y a nd

  • T

he suppo rt o f the E CI I CN.

Ba rrie rs

  • L

a c k o f b uy-in fro m o utside

  • f the E

D a nd

  • Susta ina b ility.
slide-12
SLIDE 12

Disc ussion a nd Susta ina bility

  • T

he wa ve

  • E

nc o ura g e me nt o f c ha mpio ns

  • A mira c le
  • De ve lo pme nt o f a po lic y b a se d o n e vide nc e d b a se d

pa thwa y.

  • De ve lo pme nt o f Qua lity a nd Sa fe ty c o mmitte e in the E

D.

slide-13
SLIDE 13

Conc lusion

  • De ve lo ping a n e vide nc e b a se d c linic a l pa thwa y fo r the

ma na g e me nt o f a dult pa tie nts pre se nting to the E me rg e nc y De pa rtme nt a t So uth We st He a lthc a re Wa rrna mb o o l with AF

  • RVR impro ve d the ma na g e me nt o f

this po pula tio n. We c o ntinue to wo rk o n e xte rna l sta ke ho lde r a c c e pta nc e a nd susta ina b ility.

slide-14
SLIDE 14

T ha nkyou / Re c ruitme nt

  • I

wo uld like to tha nk the ve ry suppo rtive a nd e nthusia stic pro je c t te a m, no t tha t this is the e nd o f the pro je c t (so rry g uys) its is just in the susta ina b ility pha se .