Authors (including presenting author) :
Fung SC(1), Ho SF(1), Chu KF(1), Tong KO(1), LEUNG PY(1), Chu CC(1), Wai NT(1), Chan CY(1), Wong MC(1), Lo SH(1), Wong CS(1)
Affiliation :
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster
Introduction :
Blood tests are nowadays a basic investigation and treatment orders are based on the blood results. The number of blood tests is increasing according to increasing bed occupancy and complications of cancer patients. Blood taking procedure is initiated by Oncologists through Clinical Management System (CMS). However there is a time lag between making test requests and collecting blood sample which lead to sample collection behind schedule. Moreover, missing phlebotomist ward visiting hours increased the waiting time. Nurses were empowered to make requests so as to streamline the blood investigations.
Objectives :
To facilitate blood test process by authorizing nursing staff to make designated blood test in CMS according to doctor’s treatment order.
To shorten the waiting time
To reduce workload of medical staff
Methodology :
In the first phrase, eight most common blood test requests in CMS can be made by nursing staff. Training on making investigation request in CMS was provided to nursing staff. All nursing staff was advised to preset a personal page including the designated blood tests in the investigation request page in CMS for quick and easy access. A pre-printed sticker with the designated blood test was designed for making test order in order to ensure easy recognition. Nurses could enter the designated blood request in CMS based on the visiting schedules of phlebotomist and print out the request form for blood taking after doctor ordered the test in IPD. The statistics of blood request was collected and survey was performed to evaluate the efficiency of the program.
Result & Outcome :
In the first phase of this program, 35% of blood test requests were made by nurses. The waiting time decreased 2 to 6 hours. At the beginning, most of the blood test requests were made by doctors but participation rate of nurses increased over time. The survey showed that both doctors and nurses agreed for further extension of the program in the future. In the next phase, more blood test will be included especially tumor maker which is a frequent test in Oncology settings.
