175 - Tackling Mock MH Drills in 10 Operating Rooms Simultaneously, at a 32 Operating Room Academic Medical Center
Description: Clinical Issue &
Assessment: The recent completion of our Integrated Procedural Platform (IPP) construction brought forward the need to reinvigorate and update our Malignant Hyperthermia (MH) education. This move has required staff to adjust to new locations for supplies, equipment, and workflow causing staff to be more vulnerable in handling a MH crisis with a code efficiently. Operating Room (OR) leadership wanted an innovative way to provide a full scale mock MH drill leading into a code for OR staff and Anesthesia. Team, Preparation, Planning, Implementation: A multidisciplinary team including OR educators, OR leaders, and Anesthesia providers was created. Planning meetings were held to look at current MH protocol, along with the MH online module. We participated in a national MHAUS presentation, which included lessons learned from other hospitals. MH education was provided in two parts and was mandatory for all staff and Anesthesia providers. First, we had a pediatric anesthesiologist lecturer speak about his expertise in MH procedure and protocol. The second part was the full scale mock drill. We organized our OR staff in 10 of the 32 ORs based on their discipline (RN/ST/Anesthesia provider/Anesthesia techs). Created a MH scenario with specific roles including facilitator, recorder, RN, Anesthesia tech, surgeon, and surgical tech. We created laminated clip art of MH supplies, a written scenario, facilitator instructions, scripts for each role, and a copy of the new OR code record, all contained in a packet for each OR. The facilitators for all MH drills were educators and service coordinators, who were knowledgeable and could lay out expectations for each role including retrieving needed MH supplies (clip art) from the proper locations. Drills lasted an average of 25 minutes. Outcomes: Froedtert Hospital’s new OR became the first procedural area, in the new IPP, to complete a full-scale mock MH drill that included a code situation. After the success of the MH drill in the OR, other areas of the hospital also provided a mock MH drill where there was a potential for an MH emergency. Based on observations and staff feedback, new processes included: cold fluids in closer proximity to ORs, creation of MH bladder irrigation kits, and staff accessibility to MH supplies. Implications for nursing: Staff felt better prepared for MH and code crisis. Walking and getting MH supplies (clip art) from current location, helped reaffirm its proximity, and the ability to achieve Ryanodex administration in under 10 minutes. Completing the OR’s new code record, gave staff more confidence. The drills provided a discussion opportunity with Anesthesia. The MH drill created a more in-depth understanding of what happens with MH patients, especially since our Academic Medical Center has potential for a higher prevalence of MH patients.
Co-Authors: Danielle Ament, Krista Colpaert, Elizabeth Paepke, Mary Haines, Jacqueline Holmbeck