Application of project management in the first aid for acute massive upper gastrointestinal hemorrhage

Abstract

Objective To improve first aid skills in acute massive upper gastrointestinal hemorrhage,and increase the successful rate of rescue.Methods Project management was used from November to December,2008,14 registered nurses were trained regarding fluid infusion for patients with acute massive upper gastrointestinal hemorrhage.9 knowledge points was assessed before and after the training.To evaluate and compare the effectiveness of rescue between control group which included 84 patients rescued before the training from September 2006 to October 2008 and observation group which included 62 patients rescued after the training from January 2009 to July 2011.Results After the application of project management,6 of 9 training contents,including timing of deep vein catheter,selection of venous channel,adjustment of infusion speed,effect and dosage of hetastarch,significance of blood specimen draw before infusion,as well as best time limit for blood volume supplementation,were significantly improved,and the differences were statistically significant (t =4.80,8.79,5.58,7.42,5.16,4.89,respectively;P ＜0.01).In observation group,50 of 62 patients' bleeding stopped,10 patients vital signs were stable and 2 patients were dead,while in control group,42 of 84 patients'bleeding stopped,27 patients' vital signs were stable and 15 patients were dead,and the differences were statistically significant ( x2 =15.48,P ＜ 0.01).Conclusions Project management is an effective method to improve nurses' skills for clinical first aid and the effectiveness of rescue. Key words: Gastrointestinal hemorrhage; First aid; Project management