Authors (including presenting author) :
TING CT(1), KWOK SY(1), LAM PY(1), CHOI HK(1), SO PS(1), CHUNG KK(1)
Affiliation :
(1)DEPARTMENT OF MEDICINE & GERIATRICS, KWONG WAH HOSPITAL
Introduction :
Despite long term education and multiple hospital interventions, effective fall prevention strategy remains a challenging topic to health care workers. Falls are one of the most disabling conditions, which result in functional decline, fracture and even mortality. (1,2) Apart from health condition, falls contribute to a non-negligible medical burden. (3) According to the Fall Prevention Bundle Pilot Program launched in 2021 in Kwong Wah Hospital E10 medical ward, it is found that some frontline staffs are not familiar with how to operate the BEAS properly which increased the risk of developing some avoidable fall, thus, another pilot enhancement program on improving PCA’s competence on operating BEAS in E10 was started in 2022.
Objectives :
This pilot BEAS enhancement program provides PCAs in E10 an integration of knowledge and skills on how to operate the BEAS properly. It is aimed at maximizing the proper utilization of BEAS to minimize the avoidable fall incidences and the evitable use of physical restraint through staff empowerment.
Methodology :
The pilot program was conducted from Oct 3 2022 to Dec 25 2022. All PCAs in E10 were recruited. Based on the BEAS user guide published by E10 Fall Prevention Workgroup in Aug 2022, an audit form and questionnaire about the operation and disinfection of BEAS were designed. In pre-test assessment, PCAs were asked to answer the questionnaire before any education of the BEAS. Then, PCAs were educated on how to utilize the BEAS with the reference of BEAS user guide. Afterwards, PCAs underwent a competency assessment. The assessment form was used, all critical items should be passed, at least 80% passing rate of the rest items. Otherwise, reassessment is required. Finally, PCAs were asked to fill in a post-test questionnaire. By comparing to the pre-test result, it provided information of the effectiveness and significance of the program.
Result & Outcome :
A total of 17 E10 PCAs were recruited in the program. Overall, when compared to pre-test and post-test questionnaire, the mean score raised from 35.2/70 (50.3%) to 63.5/70 (90.7%). In pre-test questionnaire, more than half of PCAs were not familiar with the correct preliminary setting of BEAS. Besides, they were also unable to manage common alarms, for instance, “lead fault” and low battery alarm. After exhaustive education, over 97% of them were able to manage the above problem correctly. In post-test, almost every question reached over 94.1% passing rate except in the correct preliminary setting of WirelessTM Alarm Transmitter, only 58.8% PCAs answered it right. After investigation, it is found that PCAs found it hard to recognise and remember the meaning of the long English term printed on the Transmitter. As a result, the E10 Fall Prevention Workgroup members labelled a Chinese translation on the transmitters to assist PCAs to choose the correct setting in an easier way. With respect to competency assessment, 16 PCAs passed in their first attempt with the overall performance at 100%. Only one PCA passed at her second attempt with the overall performance at 100% after further re-education. Besides, the support rate on the belief of “proper use of BEAS can prevent fall effectively” raised from 88.2% to 100%. Moreover, 100% E10 PCAs found the program useful in managing daily BEAS operation such as, installation, functional testing, troubleshooting, uninstallation and disinfection of BEAS. Also, they found it practical on how to handle different alarms that may encountered. After this enhancement program, the knowledge and skill of E10 PCAs on how to operate the BEAS was greatly improved. It also strengthens their belief on the effectiveness of BEAS in preventing fall. In future, the target participants of this enhancement program will extended to E10 nurses with more fruitful elements so as to maintain the sustainability of the service quality, including the assessment of Morse Fall Scale scoring skill and the decision-making training on when to initiate a BEAS.
