Authors (including presenting author) :
Lee SC(1), On SL(2), Lam CP(3), Cheung PY(4), Chan HT(5), Lui TC(6), Ho KF(7)
Affiliation :
Kowloon Hospital, Community Nursing Service
Introduction :
Pressure injury (PI) is a common problem in all health care settings and use us much effort to care and prevent it. The incidence rate varies from 0.45% to 38.0% in health care settings and home (Lyder, 2003). PI is also the main types of wound care in the community. Currently, clients and care-givers have realized how important the prevention of pressure injury after active publicity and promotion of this concept by health care professionals. In the community, pressure‐relieving devices such as heel protectors, pillows or sitting cushions are used as parts of the accessories to reduce or relieve the pressure on the injury. Evidences supported that these devices can decrease the risk of PI (Heyneman & et al, 2009, Junkin, 2009 & Brienza, 2010). However, community nurses found that some pressure injuries were caused by incorrect use of pressure reduction devices by clients and care-givers. When the devices are used for a long duration, i.e. more than 4 hours. PI may occur as a result of intense and prolonged of them..
A tailor-made enhancement program was thus carried out in January to April 2019 at one aged home and two home cases to the affected clients and their care-givers.
Objectives :
The program was aimed to enhance clients and care-givers’ knowledge on correct use of pressure relieving devices and reduce the incidence of PI caused by incorrect use of the devices.
Methodology :
1. Performed investigation to individual PI and found out the causing factors.
2. Tailor-made the treatment plan and on-site training to clients and care-givers about the precaution of the designated pressure relieving devices.
3. Engaged the clients and care-givers to proper use of pressure relieving devices.
4. Encouraged and engaged the care-givers to share and record the PI progress.
5. Case sharing was conducted in the department meeting to promote awareness of incorrect use of pressure relieving devices and enhanced communication between community nurses.
Result & Outcome :
Results
Six cases (live in the aged home) with stage 3 PI caused by pressure relieving devices healed in two months. Two home cases’ stage 3 PI of were significantly reduced the wound size 50% after the interventions in two months and wound healed in five months without recurrent of PI. The care-givers understood the correct use different pressure reduction device and no more development of PI due to incorrect use of pressure-reduction devices in aged homes and two home cases.
100% of Kowloon Hospital community nurses, clients and care-givers agreed the program can enhance their PI knowledge and agreed they got confidence in caring of the elderly in the community.
Conclusions
CNS provides much workload in caring for PI. The clients and care-givers also put much effort to prevent PI in their daily life. Community nurses act as a detective, an investigator and an educator to improve our clients’ quality of life. After this program, incorrect use of pressure reduction devices could be prevented and the awareness of proper using pressure reduction devices has been enhanced. Faster healing rate on device-induced PI also significantly obtained and the number of home visits was significantly reduced.
