A team’s priority for patient safety and recuperation at the National Heart Centre Singapore (NHCS) achieves improved postoperative care for patients with multiple chest drains.
“The humble idea of stabilising a drip stand carrying chest drains for patients to move around better with seems trivial, but when implemented, has far-reaching benefits for patients and the care team involved,” said Advanced Practice Nurse (APN) Xiao Li, NHCS Nursing Specialty Care Unit.
For patients at NHCS, being able to ambulate early after surgery makes all the difference between healing successfully and reverting to their normal lives before the illness happened.
Improved circulation, faster healing, decreased constipation and gas pain are advantages that can help a patient avoid post-surgical complications with early ambulation – the ability to move around with minimal to no assistance.
“A patient’s ability to ambulate independently is key for quicker recovery. Patients can become deconditioned after surgery due to prolonged bedrest,” detailed Ms Xiao.
But the struggle is real for patients when they need to move around with chest drains attached post-surgery.
“Additional manpower is needed to carry the drains and also assist the patient to sit up, stand and walk,” explained team leader of the project, Nurse Clinician Yang Ruiqin.
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Observant care drives innovation
These days, overcoming this challenge is aided by an innovative drip stand developed by a 10-person NHCS healthcare team called the Creative Thinking Squad.The situation: At least one to two nurses are needed to help a patient ambulate.
“There were apparent safety issues when the patients had to move around the ward,” co-leader of the project, Nurse Clinician Liang Ming detailed. “We were thus eager to refine existing ambulation equipment because we see obvious gains for patient’s safety.”
To that end, the team navigated around work schedules and challenges to produce a drip stand based on their unique insights from patient care experiences.
With the new drip stands, patients require less help with walking and simple tasks like going to the toilet. Staff numbers for patient ambulation assistance are reduced, since patients do not require help in holding the chest drains when ambulating.
Additionally, patients were able to regain mobility after surgery. It goes a long way to improve patients’ mood, feelings of independence and self-esteem for their future healing journey. These were priceless returns the team sought to achieve for patients.
The final product is testament to the team’s foresight. With five legs, the drip stand now has greater stability; mobile C-shaped hooks for functional flexibility accommodates multiple chest drains.
The team’s attention to details won them the highest accolade awarded by Singapore Productivity Association for quality improvement.Before and after: The new stand has five legs instead of four for increased stability. The new drip hook design also allows for the chest drains and tubes to be hung neatly.
Significant results from simple idea translated into action
With minimal knowledge of technical design, the team had to get creative when working on the project from December 2019 to January 2021, even roping in family help for the most challenging part of the project: Technical drawing of the ideal drip stands.
“I asked my brother-in-law to help me draw up the first model of the drip hooks because he’s an engineer,” shared Ms Yang. “I later modified the model drawings based on our requirements using Powerpoint.
The new and improved drip hooks to fit the different types of chest drains a patient carries while ambulating.
This project had profound ripple effects.
With improved postoperative early ambulation, patients gained a shot at better recovery. This translates to earlier discharge, cost savings all round, heightened job efficiency for the healthcare team and quicker bed turnaround.
Other definitive benefits of the project outcomes for the team were intangible but deeply felt. Patients were more confident in their recovery journeys, encouraged by their postoperative mobility aided by the newly improved chest drain holders.
The project is enjoying continuous improvements and spin-offs. There is potential in further bedside usage with modification of the drip stands, the Cardiothoracic Department has shown interest to procure the modified drip stands, and there are plans to share the product at various nursing platforms.
The 10 team members of the Creative Thinking Squad, with the exception of APN Xiao Li, are from Ward 56 of NHCS:
Project Facilitator, Senior Nurse Manager Foong Jia YiProject Facilitator, Assistant Manager, Quality Management/ Operations (Management Information & Performance), Jacqueline HuoProject Team Leader, Nurse Clinician, Yang RuiqinProject Co-leader, Nurse Clinician, Liang MingNurse Clinician, Anne TokAssistant Nurse Clinician, Rosnita Binte IsmailAssistant Nurse Clinician, Laurie Saldo NovillaSenior Enrolled Nurse, Siti Nur Eisah Binte ZulkifliPhysiotherapist/Cardiac Physiotherapy Services, Ivan Lee
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