Authors (including presenting author) :
Li PY (1)(2)
Affiliation :
(1)Department of Orthopaedics and Traumatology, (2) Kowloon West Cluster Orthopaedic Rehabilitation Centre, Caritas Medical Centre
Introduction :
Effective communication is crucial in healthcare. In COVID-19 pandemic, suspension of visiting arrangements bring challenges to the linkage between patients, families and nurses. Research showed that patients and families are usually under stress after hospitalization. The gap in between them is believed to be widened after the patient-visitor contact was blocked. Under these circumstances, nurses should bear the responsibilities to keep the patients and families in touch and assure them during this traumatic period. Literature showed that a timely, visual and clear communication was found effective in building feelings of confidence and reducing anxiety. In order to adjust to this new normal, CMC O&T department adopts some communication enhancement strategies in connecting the three parties despite the physical barriers.
Objectives :
(1) To connect patients, families and nurses under visiting suspension arrangement
(2) To timely update patient’s condition to family by nurses
(3) To promote interpersonal communication between patients and families by technology
Methodology :
The implementations were mainly focused on the vulnerable group of patients in O&T, who were patients with major operations done, cognitive impairment (i.e. who scored < 2 percentile in HK-MoCA 5 min) and required moderate assistance in bedside care. A timely update call was promoted to nurses to contact patient’s families at four designated moments, which were the moments when patients returned from theatre after major OT, transferred from acute to rehabilitation ward, at the acute episode of conditional change and regular condition update once a week. A monthly random snapshot checking of nursing documentation by retrospective IPD review was organized. Besides, ward staff were trained by nurses in operating video calls for patients and families in order to facilitate the virtual patient visit . Usage record was kept for reference. Extra manpower of TUNS was trained by nurses and allocated in forming a ‘Connect Team’ mainly to assist meal feeding and video call arrangement for patients in order to compensate the loss of companionship of families.
Result & Outcome :
A monthly survey about the snapshot nursing documentation checking was conducted. Total 282 samples were reviewed from Jan to Nov 2020. Apart from the failed contact and patients with no relatives, the overall performance rate increased from 37.75% in Jan to 93.68% in Nov. Team nurses could reach families by phone calls with an average 1.7 hours postoperatively to update patients’ condition. A relatively higher performance rate was observed at the moment of patient arrival, conditional change and regular update respectively. Improvements were all shown over the four designated moments throughout the period. Besides, more than 350 video calls were arranged in O&T with an average duration 10 minutes per call in 2020. With the rise of the ‘Connect Team’, it was noted that the patient's appetite was promoted and appropriate measures could be taken as soon as possible for patients with poor appetite and dysphagia .
Positive feedback was collected from nurses, patients and families by random interview. Patients gain motivations and a sense of togetherness as well as nurses gain satisfaction towards their job. The improvement in the performance of communication enhancement strategies are believed to lessen patient and families worries. To adjust to the ever-changing pandemic, changes are no time to delay. No matter the policy and environment transforms, the principles of people-centered care and family engagement should remain a priority.
