Authors (including presenting author) :
CHIN LS(1), TANG MK(1), SUEN SM (1), CHOW FY(1), LEONG YY(1), YU CS(1), LAU MH(1), KWOK YT(1), TSE YK(1), Cheung WM(2)
Affiliation :
(1)Central Nursing Department, Princess Margaret Hospital (2)Quality and Safety Department, Princess Margaret Hospital
Introduction :
To prevent the spread of COVID-19 in hospital setting, Temporary Specimen Collection Center (TSCC) was set up as a centralized specimen collection center for early identification and isolation of COVID-infected patients in Princess Margaret Hospital since 5 Oct 2020 from 08:00 to 22:00 daily. Non-IDC patients admitted from Accident and Emergency Department were transported to here for respiratory specimen collection before admission to wards. In January 2021, the service was extended to cover pre-admission testing for patients of day admission category and elective admission category. Rapid antigen COVID-19 test kit will be introduced in March 2021 for testing patients with temperature over 37.5°C. Supervised by Central nursing division, the center was initially operated with fulltime nursing and supporting deployment from various clinical department in PMH and KCH. To reduce the manpower constraint from clinical areas undergoing emergency response level and winter surge, the employment of locum nursing and supporting staff was initiated to replace staff deployment.
Objectives :
To operate using locum nursing and supporting workforce for relieving the fulltime deployment demand To demonstrate a new workforce model using only locum staff
Methodology :
From Aug 2021 onwards, 13 Locum nurses with 1-year contract and 5 locum PCA with 6-month contract were employed to gradually replace the initial workforce consisted of 7 fulltime nurse and 3 fulltime PCA deployed for the operation in TSCC. Each locum staff were assigned 24 - 32 working hour per week, approximately 3 shift per week. During the transition period, fulltime nurse would act as duty I/C overseeing the operation of the center. Once the locum operation was fully developed, locum nurse would perform the role as duty I/C, replacing all fulltime employment in TSCC. To ensure the safety of operation in TSCC, CND APN would as at off-site supervisor, conducting inspection to ensure the proper implementation of workflow and protocols. Orientation and training was provided by CND on a regular basis to ensure the quality of locum nurse performance in conducing high-risk COVID-related early identification procedure.
Result & Outcome :
Prior to the employment of locum staff, 77 PMH staff deployment episodes from PMH clinical departments were enforced for 4 weeks’ duration to cover the manpower demand in TSCC, with 2-3 nurse and 1 PCA per shift. From Jan to Jun 21, 3 KCH full time nurse and 3 PCA were deployed to TSCC for relieving manpower constraint from PMH clinical areas. As a result of Locum Nurse and Locum PCA employment to TSCC, the deployment for fulltime nursing staff and supporting staff were replaced gradually. Fulltime deployment was reduced to 1 nurse per shift as duty I/C. By December 2021, the team was fully functioning with locum staff only. With nursing attrition rate in public hospitals reached alarming rate of 7.7 percent in Nov 2021, minimizing manpower constraint in clinical areas was of the utmost urgency. Meanwhile, COVID-related emergency service including HKICC, LCK CVC and AWE created demand for fulltime manpower deployment from already stressed clinical workforce. Employing Locum nurse and PCA enabled the utilization of additional workforce to support the manpower demand instead of regular fulltime staff deployment from clinical areas, thus alleviating the manpower constraint that would potentially jeopardized the operation of clinical areas. TSCC also presented as a pilot site for an innovative workforce model that employ locum manpower only compared to the common fulltime-locum manpower hybrid as used in majority of clinical area. Operation was conducted with locum staff with fulltime nursing staff as back-office supervision.
