Authors (including presenting author) :
Chong HI(1), Chow PY(1), Lau CY(1), Lau N(1), Lin YF(1), Chan LH(1), Lam CW(1), Li C(1)
Affiliation :
(1) Orthopaedics and Traumatology, Princess Margaret Hospital.
Introduction :
Halo devices are used to immobilize neck and head, providing traction to cervical spine for patients with cervical spine injury. Patients will be discharged back home with Halo Device in-situ for a period of time. Risks of wearing a Halo device include pressure ulcers, dysphagia, and respiratory difficulties. Risks increase when care providers not trained on proper use which may be life-threatening. As observed in the clinical settings and from the past experience, patients and their caregivers often showed difficulty in coping, and induce discharge problem. And some incidents occurred like pin loosening after discharge and a patient even remove the vest by himself. Some of the patients refused to go home due to anxiety and pain. Thus the length of stay is lengthened and readmission rate is high. Thus, we know that there is a need to enhance patients’ and their caregivers’ competency in care of the halo devices
Objectives :
1. To provide patient education and enhance knowledge so as to promote patients outcome and compliance .
2. To enhance home care when patients are discharged back to community with Halo vest.
3. To provide Halo vest care education to reduce patient anxiety, frustrations, and complications.
4. To improve the compliance of Halo devices, and minimize complications.
5. To enhance nurse empowerment in taking care of this group of patients.
Methodology :
Literature review is performed to study the effective measures to enhance the outcome of patients with Halo devices and their caregivers. The programme is designed under evidence based practice. Literature search key words like Halo vest, Halo traction, Halo jacket or Halo brace Nursing care Education or nurse led and ADL, Fall, Anxiety, Hygiene.
The nurse-led programme is implemented to the patients with halo devices and their caregivers before and after the procedure, during the rehabilitation phrase and phone follow up was conducted for discharged patients. Education modalities include interview, talk and pamphlets given during hospitalization. Also hotline services for patient’s enquiries and phone follow up are provided to patient on discharge.
Result & Outcome :
Feedbacks were collected by phone follow up after patients are discharged. Evaluation of the programme is ongoing for this minority group of patients in which non-compliance and risk may be led due to knowledge deficit. To perform patient survey through Telephone Follow-Up by asking patients on the aspects of Patients’ and their caregivers’ knowledge about Halo vest, anxiety level and compliance of Halo Vest, i.e. Signs of complications Staff satisfaction level was evaluated by survey. All staffs agree that the program is easy to implement, clear instructions were given. They stated that the program could be applicable in clinical settings and it is helpful especially for the junior staffs. Overall, they satisfy with the programme.
