Authors (including presenting author) :
Lee SC(1),Tang YM(2),Lui TC(3),Chung LH(4),Chan YK(5),Yeo MF(6), Li WH(7), Leung KM(8),Ho KF(9), Kwan SY(10)
Affiliation :
Kowloon Hospital, Community Nursing Service
Introduction :
Community nurses (CNs) face a formidable challenge when providing care to the growing demand for community care services arising from an ageing population. In Kowloon Hospital’s Community Nursing Service(CNS), wound care is increasingly seen as a high demand on limited home-care resources and nursing shortage. Wound debridement in particular is essential for optimal and speedy wound healing. Conservative sharp wound debridement (CSWD) of devitalized tissue is considered the quickest and most cost-effective method of wound care (Ruth, 2009). Effective and safe CSWD associated with wound care knowledge can accelerate wound healing and reduce bed days in turn (Wounds UK, 2013). CSWD is a specialized level of wound care that requires practice based, mentored educational preparation and a regulatory process for ongoing competency assessment. Wound care and CSWD enhancement program was thus carried out in January 2018 at Kowloon Hospital CNS.
Objectives :
The program aimed to evaluate the standard of CSWD among CNs in improving: (i) number of home visits by speedy wound healing; (ii) enhance wound debridement knowledge and wound care.
Methodology :
The program was implemented in two phases – Training & assessment. CNs undertook a series of education sessions, practical training, practice sessions and competency training on CSWD.
Phase 1
A booklet of wound dressing products quick reference and wound care tips was produced. Carried out a lecture and training workshop on CSWD to CNs in order to enhance their knowledge and align the practice. Skill-transfer and assessment of CSWD was directly conducted to colleagues
Phase 2
Assessment on CSWD and wound care were carried among those CNs who achieved the CSWD requirements. Assessment report and recommendation were introduced in the department in order to increase the alertness and alignment of wound care.
Result & Outcome :
Before the program, CNs used to follow the wound care advices from different specialties e.g. orthopaedic, surgical or medical unit. CNs are not confident enough to make clinical judgment on CSWD and wound care. After the program, majority (96.3%) of CSWD procedures’ compliance rate met the standard criteria. CNs expressed their confidence to perform CSWD in the community and 100% of CNs agreed that they got more knowledge to care different type of wounds in the community.
When compares the pre and post program result for 6 months, wound healed cases increased from 2099 cases/6 months to 2199 cases/ 6months. 960 home visits were saved after the program.
CNS care for numerous frailty and advanced age of clients in the community. Advanced wound care is very important. It does not only improve quality of care in speedy recovery. Optimal wound healing allows CNs spare more home visits to care and support other clients. After this program, a number of home visits have been significantly saved. Clients’ wellbeing and cost effectiveness could also be improved.
