Authors (including presenting author) :
Lok WP(1), Chan SK(1), NG YK(1), Cheung WY(1), Chan LK(1), Lee YK(1),
Sun AK(1), Kwok MK(1), Wong YL(1), Ma KY(1), Lai WK(1)
Affiliation :
Department of Medicine, Yan Chai Hospital
Introduction :
Renal patients with renal problems and those with multiple diseases had higher rate of admission. They always admit in general medical ward caused by those other diseases or the high occupancy rate of renal ward. There is a persistent challenge in healthcare practice to face an increasingly demand of specialty renal nursing care in general medical ward. But, many nurses are incompetent in caring renal patients with needs of related knowledge and skill (Bonner 2006). Most of them lack opportunity to practice their knowledge and skill with limited clinical experience, especially junior or new graduated staffs. Thus, they will face a great stress as not well prepared to practice specialty-nursing care (Missen et al. 2015). Therefore, the introduction of Renal Nurse Ward Rounds was established since 10/12/2018. Through Renal Nurse Ward Rounds, patient safety and renal clinical knowledge will be improved.
Objectives :
Renal Nurse Ward Rounds is one of the renal service expansion programs. The aims are being to achieve 2 objectives in Department of Medicine as below:
1) To enhance renal knowledge and skill of nursing staff in general medical wards
2) To provide professional knowledge and advices to patients in order to improve services quality
Methodology :
The Renal Nurse Ward Rounds Program is started since10/12/2018 which qualified renal nurse is assigned to conduct ward rounds from Monday to Saturday. Each visit would be around 10 minutes. Nurses would discuss special cases with Renal Medical Officers for advanced opinions in need.
For renal patients
Assess patient’s catheters exit site dressing and conditions (including Heamodialysis catheter and Peritoneal Dialysis catheter) to prevent catheter induced complications or infection
Provide advice and education in order to reduce recurrence admissions
Education on diet and fluid control
Provide psychological support to allay fear and anxiety during hospitalization.
For nursing staff
Identify problem and provide solutions to tackle the difficulties when handling renal patients.
Share renal knowledge and skills
Update new renal nursing guidelines and protocols
Educate advanced nursing care in daily operations
Result & Outcome :
Up to 30 July 2019, total 658 visits including 110 renal patients were conducted. Patient and staff satisfaction survey were conducted from 20/7/2019 to 30/7/2019. The result shows that:
Patient satisfaction survey
13 patients were participated
100% of patients agreed that they can understand their reasons of admission, obtain essential information and gain psychological support from renal nurse
The overall satisfaction score was 3.2 out of 4
Staff satisfaction survey
50 nursing staff were randomly invited
100% of staff agreed that the Renal Nurse Ward Rounds would enhance quality of patient care in the clinical workplace.
Over 92% of staff agreed that renal knowledge and skills would be improved.
100% of staff agreed that they could gain the updated renal information in the round
The overall satisfaction score was 3 out of 4.