Authors (including presenting author) :
Tsang MW, Tong MH, Chim CK
Affiliation :
Community Outreach Services Team(COST), New Territories East Cluster(NTEC)
Introduction :
Retained instruments incidents including retained dressing material has been the top 3 of sentinel event reported in Hospital Authority over 10 years. There are 2 major contributing factors identified as (1)no consensus of wound packing method, (2)communication gap among involved parties. Thus, NTEC COST designed a “Conjoined wound packing prototype“ and standardized wound packing practice to enhance safe wound packing management in community starting from September 2020.
Objectives :
1. To establish a standard and safe wound packing practice
2. To enhance safe handover via communication across specialties
3. To empower patient /carer alertness on wound packing
Methodology :
1. Developed a new wound packing dressing prototype with “Removal in whole piece” principle.
2. Designed photo-guide for nurses to familiar with new practice
3. Nurse with specialty wound training joined visit with frontline to ensure nurse’s competency in applying the conjoined wound dressing prototype with wound packing photos uploaded to HA Chat for clinical handover.
4. Designed “Wound Packing Record Form and alert card” to empower patients/carers; and raised their alertness on their wounds with packing.
5. Standardized electronic nursing note template for wound packing included essential wound packing elements. Notes should be entered in CMS to enhance communication between community team and hospitals.
6. Engaged frontline in developing “wound packing prototype”
7. Conducted audits to ensure system in place
8. Evaluated patient’s perspective via survey
Result & Outcome :
From September 2020 to December 2021, there were over 1300 episodes of wound packing (n=122) for tunnel and cavity wounds. After implementation of new practice with application of new packing prototype, ZERO incident of retained dressing in wound was achieved. The result of two-time point audit showed 100% nurses’ compliance in all items in wound packing documentations. 100% patient and carer (n=122) agreed wound packing alert card could enhance their alertness on wound packing. 97% staff agreed “Conjoined Wound Packing Prototype” is easy to use and achieved safe practice. 100% (n=87) staff agreed the prototype arouse alertness in wound packing and would exercise the new practice.
Conclusion
The pilot showed high acceptability and applicability among staff and patients/carers regarding new wound packing practice and wound packing prototype and could achieve patient safety in daily practice.
