| TITLE |
| Development and Implementation of a Handbook of ‘Crisis Checklists’ for use in Critical Care at …….. |
| BACKGROUND |
| Critical care may be manned out of hours by junior staff with less experience managing critical care emergencies. In an urgent situation it is important that management is prompt and structured. The use of a checklist can facilitate this. Anaesthetists are familiar with the Quick Reference Handbook (QRH)¹ to guide initial management of anaesthetic emergencies, but a national handbook for management of critical care emergencies is not readily available. We aimed to develop a handbook of crisis checklists based on the Association of Anaesthetists QRH, to publicise and implement it, and to provide training for staff on its content and use. |
| METHODS |
| We first identified the lack of a pre-existing, easily-implemented national critical care emergency handbook. We then identified a list of emergencies encountered on critical care and crossover with anaesthetic emergencies that have pre-existing checklists in the Quick Reference Handbook. We extracted and adapted relevant content from the Quick Reference Handbook and then, by drawing upon existing local protocols and collaborating with critical care consultants, developed checklists for the critical care emergencies absent from the QRH. We discussed implementation at the critical care clinical governance meeting and gathered feedback on content, format, assembly, location, roll-out strategy and training. Prior to roll-out, we carried out a survey of nursing staff and junior doctors to ascertain baseline confidence around initial management of critical care emergencies and appetite for additional resources The checklists were publicised using “Focus of the Month” boards in critical care and we provided “tea trolley” teaching for staff to make them aware of the existence of the checklists and how to use them. At the end of the pilot month, we interviewed staff to gather feedback. |
| RESULTS |
| The crisis checklists were successfully piloted during January 2024. Data was collected by pre- and post- implementation surveys and interviews. Responses came from a range of healthcare professionals working on critical care including doctors, nurses and advanced critical care practitioners.All of the staff surveyed felt that access to crisis management checklists would be helpful and that they would feel more confident managing an emergency in critical care with access to a checklist. There was also support for using the checklists for training. We interviewed staff at the end of the pilot month and demonstrated awareness of the checklists’ existence and accessibility, a documented instance of successful emergency management using a checklist, and their utilisation for continuous learning and development. |
| DISCUSSION |
| We identified that staff favoured the availability of emergency checklists to streamline management of critical emergencies. The next steps for the project are to provide further training, and to ensure checklists remain current and are updated based on staff feedback. |
| ACKNOWLEDGEMENTS |
| REFERENCES |
| https://anaesthetists.org/Quick-Reference-Handbook |
