Authors (including presenting author) :
LAM WY (1), CHAN WC (1), HO SM (1), NG YB (2), TSO YK (2)
Affiliation :
(1) Ward 13A, Department of Medicine & Geriatrics, United Christian Hospital
(2) Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
An increased number of patient deaths has been observed in surveillance ward last year. Providing comfort and dignity to dying patients are important. Checklists and guidelines of end-of-life care programme have been established in Kowloon East Cluster but the number of patients recruited in our ward remains low.
In order to narrow the service gap, barriers hindering the delivery of palliative care, such as inadequate knowledge and insufficient attention given to patient, are addressed and managed. Therefore, an enhancement programme was launched between July and October 2021.
Objectives :
(1) To advocate end-of-life nursing care in isolation ward;
(2) To empower staff knowledge and awareness in end-of-life care for patients and their families
Methodology :
A new routine practice was implemented since July 2021 and two different educational sessions were conducted to existing and newly joined staff.
Firstly, duty-in-charge was routinely reminded by a clerk to identify suitable candidates for the end-of-life programme. Moreover, six identical 15-minute refresher seminars for existing nurses were conducted in July 2021. Contents included the possible clinical manifestations and related nursing management to imminently dying patients and their families. Open discussions after each seminar facilitated better understanding and effectiveness was evaluated.
Another one-hour education session was provided for newly joined staff in October 2021. Contents included identifying signs in the dying phase, providing physical and psychological support to patients and their families, common palliative medications, Advance Care Planning, hospitalized and non-hospitalized Do-Not-Attempt Cardiopulmonary Resuscitation forms and compassionate visits. Participants were encouraged to express their concerns and provide feedback. A questionnaire was used to evaluate participants’ satisfaction after the session.
Result & Outcome :
The number of patients recruited into the end-of-life programme increasing from none in the first half of the year to 16 in the latter half of the year after implementing the new routine practice, showing that staff awareness was obviously enhanced.
Six refresher seminars were carried out to 30 existing nursing staff working in isolation ward. They agreed the content was useful and practical, reinforcing the importance in identifying the dying phase and appropriate nursing management.
Besides, seven new staff joined the detailed training session expressing the content was useful, with better understanding in palliative care.
To conclude, the new routine and the two educational sessions targeting nurses with different experiences have improved nursing engagement and awareness in promoting end-of-life care in isolation ward successfully.
