Authors (including presenting author) :
TSOI SH (1), LAM PK (1), MAN WK (2), CHOW WC (2), LEE KFM (2), LAM MW (3), LEUNG PMQ (4), WONG PMB (1), HAU LM (1)
Affiliation :
(1) Quality & Safety Division, NTWC (2) Department of Medicine & Geriatrics, TMH (3) Department of Medicine & Geriatrics, POH (4) Nursing Services Division, NTWC
Introduction :
Patients with restricted extremity such as renal patients with arteriovenous fistula (AVF) could be injured when healthcare staff are unable to recognize patients’ affected limbs and perform blood drawing, intravenous (IV) access setting or blood pressure (BP) taking on the specific extremity during hospitalization.
Objectives :
To assist clinical staff to identify the affected limbs of inpatients with restricted extremity and to avoid performing procedures that might cause injury to the specific extremity.
Methodology :
A customized arm badge (Red in colour) with alert message “Restricted Extremity: No blood pressure measuring and blood taking” was produced. It can be easily secured on patient’s affected limb with loose elastic band. To enhance comfortability and patient experience, arm badges with Velcro type was also produced. The project was supported by the Cluster Nursing Management Committee and piloted in two renal wards in TMH & POH from July to September 2022. Renal patients with AVF were invited to wear the customized arm badge on their affected limb during hospitalization.
Result & Outcome :
An evaluation was conducted in October 2022 to collect feedback from ward staff, phlebotomists and involved patients. Among the 53 returns from staff, 97% of them identified the arm badge before performing procedures concerned and 93% of them believed that the arm badge was effective in preventing them to perform procedures that might harm the patient’s specific extremity. A total of 13 returns were received from inpatients used the customized arm badge. All of them reported that no staff had performed blood drawing, IV access setting or blood pressure measuring on the affected limb. All patients did not feel uncomfortable while wearing the arm badge and agreed they would reuse the arm badge in their next hospital admission. 92% of patients would recommend the arm badge to other patients. Given the positive feedback received, the customized arm badges to enhance patient safety with restricted extremity identification alert will be rolled out to other wards in early 2023.
