Authors (including presenting author) :
Yip LH (1), Wu SC (1), Kong SM (1), Lai SK (1), Lam FY (1), Wong P (1), Wong YF (1), Yeung FL (1), Wong BC (1), CHU TK (1), Liang J (1)
Affiliation :
(1) Department of Family Medicine and Primary Health Care, New Territories West Cluster
Introduction :
Majority of people who have wounds could receive continuity of wound care in the GOPC. Ineffective wound management would induce negative impact to the patients and the healthcare system. Nurses’ knowledge about the wound management, a structured wound care pathway, integrated and coordinated care planning would be essential in optimizing the effectiveness of the wound management. Hence, the GOPC of the NTWC has launched a Wound Care Enhancement Program in 2018 to cater for the growing needs of the wound care service.
Objectives :
1. Enhance nurses’ knowledge and skill in wound care
2. Establish a structured wound care pathway and Link-nurse system
3. Reduce dressing attendance and default rate through coordinated care
4. Utilize resources effectively
Methodology :
The status of wound care service in the GOPC was reviewed through retrospective retrieval of information from the Clinical Data Analysis and Reporting System (CDARS) and the nursing documentation in 8/2018. A series of wound care enhancement activities were carried out accordingly which included bolstering the appointment booking system, establishment of the Link-nurse system and a structured 3-Tier Wound Care Approach through collaboration with the Wound Nurse Consultant and Advanced Practice Nurses in Nurse Clinics together with on-going training and empowerment to GOPC nurses, and promulgation among all professionals in the GOPC. The program effectiveness was evaluated through second review of the nursing documentation in 7/2020 and on-going data monitoring from the CDARS.
Result & Outcome :
The average number of attendances per dressing service case was significantly reduced from 6.2 (2017-2018) to 3.7 (9-12/2019) and it was lower than the average (4.1) of all GOPCs in the Hospital Authority (HA). The program effectiveness was sustainable and the attendances per service case (4.6) remained lower than HA average (5.2) in 9/2019-3/2020. The default rate also reduced from 13% (1-6/2018) to 4.1% (9-12/2019). In addition, the 3-Tier Wound Care Approach facilitated the nurses to early identification and intervention for advanced wound care in those challenging or prolonged healing wounds. Continuity and quality of wound care had been enhanced by the named-nurse and Link-nurse system. There were 35% of wounds cared with the Link nurses involvement and 27% of non-healing wound of >2 weeks could be cared by a named-nurse as assigned by the trained Link nurse.
