Authors (including presenting author) :
Man YL, Lau FCA
Affiliation :
Department of Occupational Therapy, Pok Oi Hospital
Introduction :
Pressure injuries have an adverse impact on patient by causing additional morbidity and escalating healthcare costs. Occupational therapists have an eminent role in provided during inpatient stay to assess and advise suitable pressure redistributing devices to prevent and minimize pressure injuries.
As the generic design of commercially available products may not fit the special need of patients especially when the patients are of small body built or with joint contractures or deformity, Occupational Therapist may prescribe tailor-made positioning aids to meet and fit the individual’s needs. However, the process is often time-consuming and the waiting time for patients to receive the intervention could take 3-8 days. It was also noted that the compliance of positioning devices was fair.
Objectives :
1. To shorten the waiting time, reduce manpower and material costs in prescribing pressure redistributing device
2. To enhance team communication and awareness on using the positioning devices
Methodology :
In 2021, Occupational Therapy Department shared their experience in pressure relieving devices with medical wards. With such collaboration, medical wards have their own stock of positioning wedges which allow early intervention to patients in need. Occupational Therapist will also assess patient’s need and provide appropriate intervention and advices in response to patient’s condition. Besides, new positional devices which are adjustable to different body size and shape with water-proof and sealed cover were designed.
Training workshops had been arranged collaboratively with wound nurse to enhance supporting staff’s knowledge and skills on proper positioning and application of the devices. Instruction sheets were developed by Occupational Therapists and displayed in respective bedhead signboard to improve communication with ward staffs and relatives.
Result & Outcome :
The number of cases received Occupational Therapy Intervention on pressure injury care was increased by 34% from 2020 to 2021. The number of cases received Occupational Therapy treatment was further increased from 264 in the first three quarters of 2022, to 122 in the fourth quarter of 2022.
The development of new devices and inventory improved the efficiency of service by simplifying the workflow from 7 steps to 4 steps. There was a 83% reduction of average time cost in preparing the pressure redistribution device. Occupational therapist can offer timely and appropriate devices to patients after assessment. The new textile and design allows the device to be reused and hence reduce the overall material and manpower costs with compliance of the infection control requirement by infection control nurse.
A training workshop was conducted to supporting staff in November 2022. The average test score on pre-post knowledge test was improved by 26%. The use of instruction sheets has also increased staff awareness and accuracy in using the positioning devices.