title: [Nursing approaches to improve extracorporeal membrane oxygenation (ECMO) care in a pediatric intensive care unit].
abstract: BACKGROUND
  Medical technology advances have led to the increasingly frequent use of extracorporeal membrane oxygenation (ECMO) in intensive care unit applications. Four of the 26 patients treated using ECMO in 2009 at our hospital were under 18 years of age. Limited nurse experience with ECMO and resultant nursing staff nervousness / pressure when using this technique encouraged us to establish an ad hoc group to explore ECMO care and related issues.
  
  
  OBJECTIVE
  Improvement measures were implemented to (1) raise the pre- ECMO placement integrity of order sheets to 98%; (2) reduce materials preparation time to below 60 minutes; and (3) enhance nursing care ECMO cognitive accuracy to 99%.
  
  
  METHODS
  We implemented the following intervention measures: (1) A dedicated ECMO vehicle was deployed to enhance clinical work convenience and safety; (2) a ECMO technique preparation checklist was developed to improve tubing placement and reduce preparation time; (3) an ECMO care in-service education program was developed to enhance nurses' ECMO care awareness and skills; (4) an ECMO trainee system was established to increase nurses ECMO care experience and reduce negligence-related errors.
  
  
  RESULTS
  Project results included: material preparation order sheet accuracy rose from 25% to 100%; average materials preparation time fell from 90 to 40 minutes, and nursing staff ECMO cognitive accuracy increased from 51.2% to 99.2%. The program achieved all stated objectives.
  
  
  CONCLUSIONS
  This program enhanced the quality of ECMO care for pediatric patients, reduced materials preparation times, and improved the nursing approach to ECMO care.
authors.affiliation: Pediatric Intensive Care Unit, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC. bean570@adm.cgmh.org.tw
authors.forename: Chin-Ling
authors.initials: CL
authors.lastname: Wu
authors.forename: I-hsiu
authors.initials: IH
authors.lastname: Lin
authors.forename: Hsiao-Ping
authors.initials: HP
authors.lastname: Huang
authors.forename: Ling-Hui
authors.initials: LH
authors.lastname: Shu
authors.forename: Hsu-Hsian
authors.initials: HH
authors.lastname: Shu
mesh_terms: D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000451:nursing*; D006801:Humans; D015278:Intensive Care Units, Pediatric