Authors (including presenting author) :
Shum WC(1), Cheung HW(1), Law MC(1), Lee KY(1), Yiu LP (1), Ho B (2)
Affiliation :
(1) Department of Medicine & Therapeutic, (2) Central Nursing Division, Prince of Wales Hospital
Introduction :
There have been studies showing that enhanced patient education on discharge can reduce hospital readmission and improve clinical outcomes. The results were most prominent for patients who were suffering from chronic diseases such as congestive heart failure, diabetes mellitus, strokes and chronic renal failure. The Hospital-based Patient Experience and Satisfaction Survey (2013) reported that patients’ information on medication side effects and self-care issues were needed to be enhanced in the Prince of Wales Hospital (PWH).
Objectives :
This program aims to evaluate the effectiveness of disease specific structured pre-discharge patient educations for medical in-patients in term of knowledge gain and satisfaction.
Methodology :
Patients recruited from medical wards of PWH were randomly divided into 3 groups; usual care group(UC), intervention at discharge group(ID) and intervention at admission group (IA). After written consent were obtained, patients were invited to answer the self-developed 8-questions knowledge questionnaire of the specific disease. For patient in the (UC) group, patient discharge education was carried out as the usual practice of each ward. For patients in the (ID) and (IA) groups, structured patient education and distribution of education pamphlets with specific diseases would be provided. PWH patient volunteers who had received training on conducting telephone survey would telephone patients at day3-7 post patient discharge to fill in the self-developed knowledge questionnaire on specific disease and patient satisfaction survey. Self-developed nurse satisfaction survey questionnaire would be given to ward nurses at the end of the study
Result & Outcome :
From June 2017 to August 2019, patients recruited to UC group, ID group and IA group were 132, 161 and 176 respectively. There were more male patients at each group (UC:73%, ID:71.4% and IA:64.1%) with mean age of 67.6, 65.5 and 65.1 years respectively. Improvement of knowledge of patients at UC, ID and IA groups were observed. The Generalized Linear Model(GLM) was adopted to compare the knowledge gain between UC vs ID and UC vs IA, IA group has significant improvement in knowledge of 10.57 (p=0.01) while ID group was 4.27 (p=0.325). IA group has the lowest readmission rates 1.8%, ID group 3.3% and UC group 4%. Patient satisfaction score was 7.81, 7.85, 7.99 respectively. A total of 252 nurses from medical wards were participated to fill in the self-developed nurse satisfaction survey questionnaire and had good response to this program.
