Authors (including presenting author) :
Leung MN(1); Chung CM(1); Tsui N H(1); Yeung YF(1);Yeung Rachel(1); Yan K P(1); Kwan YH(1); Law KY(1); Lee HY(1); Tang CW(1)
Affiliation :
Department of Surgery, Tuen Mun Hospital
Introduction :
Introduction : Terminal cancer patient in Ward commonly presented with surgical problems. At the beginning, SPAL Services with 8 beds for mixed gender was set up from 6th Nov. 2017 in A4 acute surgical ward which are located in 2 cubicles among one of the acute surgical ward. However, the occupancy rate of patient in main block’s surgical ward were surging. As a result to release the pressure of high occupancy rate from main block, the SPAL service needed to be relocated to Rehabilitation ward in 1st Dec. 2018 at R7B Rehabilitation Block, TMH.
Objectives :
Objectives : To continue provide the palliative care to the terminally ill patient (including POH) which needed to have care under surgical department in NTWC.
Methodology :
Methods: With support from GMN, DOM, Surgical Doctors & all Surgical WMs for SPAL services relocate to R7B with quota of 8 beds. (2) Invite 2 Experience senior RN with SPAL training to join R7B increased to 6 after training. (3) Gain agreement with them for training of screening SPAL cases for ward I/C with Surgical experience. (4) Discuss with FM to install mixed gender ward signage, 2 different gender toilets were set up (5) Meeting with All ward I/C of R7B, plan for increase the staff number for screening cases since Nov, 2019. All agreed with full team support. (6)CCTV and monitor was installed in the middle of nurse station. SPAL Service in R7B start in Dec., 2018. (7) All ward I/C started training since SEP., 2019 till JAN 2020 with screening case by each I/C 2 times together with the experienced SPAL mentors. (8) Night Roster set up with male and female nurse together by WM afterwards for the nature of ward change to mixed gender (9) 3 APNs from POH for Train-the –trainer of SPAL screening case was finished on 12th Nov., 2019 (10) Refresher training lunch talk of “Surgical Palliative Care” from Team 1 Dr. CC Cheung was updated on 9th Dec., 2019. A 3 years program of staff rotation from NSD with in "Enhance skill of Nurses beyond PC setting" by NC Oncology in 1Q2021 was in progress. Those screened SPAL cases will be the 1st priority for the utilization of bed in R7B among those convalesce bed booking.
Result & Outcome :
Results Patient from NTWC of SPAL can use this service, with better pain control and better environment for R7B will not have emergency admission. Thus, we can meet the target for screening cases within 2 working days. From September 2019 to Sep., 2022, statistics show that the Waiting time for SPAL cases < 2 Working Days Screening was (171 / 173 = 98.8% ) ; Cases > 2 Working Day screening was only (2 / 173 = 1.2%). Thus, enhancement of utilization in acute beds and hospital beds for emergency patient was enhanced.
