Authors (including presenting author) :
Lau PP(1), Ling SO(1), Ng PK(1), Lai LT(1), Tsang CC(1), Mok YF(1), Lee A(1),Kam YF(1)
Affiliation :
(1)Department of Respiratory Medicine, Kowloon Hospital
Introduction :
Negative feedbacks on patient service always relate to substandard care. Patient Care Assistants (PCAs) have close contact with clients. From March 2016 to April 2018, eighteen negative feedbacks were received in two Orthopaedic and Spinal Rehabilitation wards, over fifty percent related to dissatisfaction of PCA care.
Objectives :
Enhancement Program was developed for nurses to strengthen PCAs about basic concept of specific care, effective communication and appropriate manner; to enhance patient satisfaction, quality of service and job satisfaction.
Methodology :
From May to July 2018, senior nurses were trained for skills in service improvement. From August 2018 to November 2020, trained nurses delivered the Program to PCAs working in two Rehabilitation wards. The Program included basic concept on handling of orthopaedic and spinal rehabilitation patients, roles of PCAs, therapeutic communication, legal and ethical concerns, stringent patient privacy, proper patient identification, occupational safety and health issue, strict infection control precautions, pressure injury prevention with orthosis or medical devices, specific skin care, tips on fall prevention, smart dental care, handling and self-protection for violent patients; and general pain control. Evaluation included pre and post knowledge and staff satisfaction survey. Related negative feedbacks, appreciations and incident rate were reviewed. All information was recorded in Log Book for ongoing monitoring.
Result & Outcome :
From August 2018 to November 2020, no negative feedback related to PCA care was received. All PCAs showed improvement on knowledge and satisfaction. They felt frustration and considered resignation when complained by patients. After the Program, they expressed when concept about specific care became clearer; they would have better understanding on patient needs. Formal appreciations for PCAs increased from nil to nine. PCAs who received appreciations stated that they had more sense of belonging to job and withdrew idea of resignation. As the turnover reduced, the need to train new PCAs decreased. More experienced PCAs were retained. The incidents related to PCA care reduced. We observed negative feedbacks for nurses also decreased by forty-four percent. It reflected the Program also enhanced nurse awareness on provision of quality care. The Program is continuing with on-going evaluation and update. Minimal resource is required; it is cost effective to provide similar Program in various units to enhance service provision. The Program will be promulgated in other wards of our department.
