Authors (including presenting author) :
Leung MN(1),Chung CM(1),Tsui NH(1);Yeung YF(1)(2)Kwan YH(1); Rachel Yeung (1);Chan LM(1)(2);Yan KP(1);Law KY(1); Lee HY(1)
Affiliation :
(1)Surgical Department, Tuen Mun Hospital, (2)Neuro Surgery Department, Tuen Mun Hospital
Introduction :
In 11th Dec., 2017, our first Surgical Stream Rehabilitation Ward with mixed gender included Specialties of Surgical, Neuro & Surgical Palliative (SPAL) cases was set up at ward R7B, Rehabilitation Block, TMH with the new combination. According to the nature of convalesce, limited manpower of doctors, nurses & supporting staff was deployed. One IOD for MHO of patient bathing was happened. Thus, some seems minor but significant tasks needed to be reorganized. And also enhanced our team work and quality of patient.
Objectives :
(1)To reschedule of supporting staff work allocation in in-patient bathing with maximum manpower at one time slot. (2) To maintain quality and safety of procedure and patient hygiene. (3) To enhance patient QOL during long stayed hospitalization for those days which ceased visiting hour in nCOV19 period. (4) To enhance staff safety according to OSH issue. (5) To enhance staff team work and team spirit.
Methodology :
(1) Work flow and time of Room / Bed / Assisted Bating was rearranged from Am / Pm shift to only one-time slot from 13:05- 14:45 (~100 mins) + BW measuring every day without any increase of manpower. (2) Get the understanding and cooperation with Supporting staff. Two scheduled ward meeting with supporting staff were held within 3 months before the pilot. (3) This can ultimate manpower for duty of A/E/D was assembled together. At least 4 supporting staff were assigned in assisting bathing, lifting & transfer of patient in this time slot. (4) One more shower bathing trolley was requested from NSD after one staff IOD reported for MHO issue. (5) Briefing for ward I/C to assign numbers of patient for bathing every day according to the infection guidelines was introduced.
Result & Outcome :
Results : Zero IOD was reported related to bathing. Survey for staff satisfaction was done in April 2021 with over 63-92.6% of staff agreed that the program can meet the above target. The shortest Bathing days is 3.2 days / person vs the longest bathing days is 42.6 days per person before the program started. Aim to maintain patient can have bathing every 4 days during hospitalization especially in the period of COVID-19 with ward setting for rehabilitation. Conclusion : Expectation management for patients’ need on their hygiene issue versus workload arrangement and safety control for our supporting staffs is a great challenge. Our proposal for re-engineering the workflow can meet this challenge. Meantime escalate patient’s hygiene quality with a better QOL and early discharge. Last but not least, the OSH issue for our supporting staff and patient QOL is enhanced. Average sates for each bathing till Nov 2022 is around 4.
