Authors (including presenting author) :
Choy BPC (1), Ip KWM (1), Li MKL(2), Lau M(1), Yue ASY (1), Lau HMC(3), Chiu GCS(4), Li CYN(5)
Affiliation :
(1) Occupational Therapy Department, Shatin Hospital (2) Occupational Therapy Department, Prince of Wales Hospital (3) Ex-Hospital Chief Executive, Bradbury Hospice, Shatin Cheshire Home & Shatin Hospital (4) Infection Control Team, NTEC (5) Infection Control Team, Shatin Hospital
Introduction :
The process and demand of manual routine wheelchair cleansing in Shatin Hospital Occupational Therapy Department (SHOTD) were reviewed. Two potential clinical risks were identified: (1) Inconsistency in cleansing quality related to high demand & different cleansing workers; (2) Potential risks of cumulative trauma due to repetitive manual cleaning procedures.
Objectives :
(1) To enhance the efficiency, cleansing consistency & quality of manual wheelchair (2) To lower the potential risk of work hazards through reduction of manual labor cleansing tasks and time & enhancement of setup procedures in Wheelchair Washer and Dryer (WWD)
Methodology :
To best minimize the risks, a new WWD was introduced in SHOTD. New cleansing routine related to WWD was set-up. Supporting staff was trained with the new cleansing procedures. The cleansing efficiency, quality and safety procedures of using WWD were evaluated. Set-up procedures using WWD were reviewed and enhanced to lower the potential occupational hazards. (1) A wheelchair lifter was set up for safe transportation of wheelchairs in & out of Wheelchair Washer; (2) Gadgets were added into the Wheelchair Washer for facilitating efficient transport of different models of transit wheelchairs; (3) A water vacuum was setup to dry the floor after transport wheelchairs out of Wheelchair Washer; (4) A regular cleansing schedule of WWD was set up for maintenance; (5) An operation manual was setup for proper usage & highlights of precautions; (6) Supporting staff was trained with coaching for the above-mentioned enhancement;
Result & Outcome :
(1) Infection control tests (Clean-trace Surface Adenosine Triphosphate [ATP] Test, Methicillin-resistant Staphylococcus aureus [MRSA] Screening Test & Carbapenem-resistant Acinetobacter [CRA] Screening Test) were done and showed that WWD was effective in removing contaminants, MRSA & CRA after wheelchair cleansing. _____________________________________________________________________________ Contaminants counts on wheelchair surfaces: Clean-trace Surface ATP Test (wheelchair #1-4) Pre-washing value: 268-1633 Post-washing value: 37-72 (Value < 250: pass) _____________________________________________________________________________ Microbiological sampling on wheelchair surfaces: MRSA (wheelchair #5) Pre-washing: Positive Post-washing: Negative Microbiological sampling on wheelchair surfaces: CRA (wheelchair #6) Pre-washing: Positive Post-washing: Negative _____________________________________________________________________________ (2) The manual labor contact time per wheelchair was reduced from 1234 seconds (Manual cleansing) to 404 seconds (WWD), constituting a 67% reduction in manual labor time. The user had positive feedback on the new mode of wheelchair cleansing including less manual effort needed, better quality of cleansing. Saved manual labor time was restructured to cover other supporting duties so that frontline patient services could be enhanced. Conclusion: The introduction of WWD in SHOTD was effective in enhancing the efficiency, cleansing consistency & quality, and lowering the risks of work hazards in wheelchair cleaning.
