Authors (including presenting author) :
Wong SN(1), Lau KYG(1), Lai YMC(1), Chan SF(1), Li MN(1)
Affiliation :
(1)Community Care Service, Hong Kong West Cluster
Introduction :
Community nurses (CNs) in Hong Kong West Cluster (HKWC) are facing great challenge on high caseload demand of wound care, accounting to 30% of active cases as retrieved from Community Based Nursing System (CBNS). Majority of the wounds are chronic, especially pressure injury, which also cause significant health care burden and high expenditure. Moreover, the impact of the patient with early discharge and comorbidities posted a substantial workload pressure to CNs due to a proportion nursing time spending to provide wound care. Furthermore, the treatment of chronic wounds is complex and it requires the CNs who have an appropriate knowledge and skills. Unfortunately, it is found that 44% of CNs in HKWC whom they are newly joined to the service experienced difficulties in making clinical decision relation to wound management because of knowledge deficits. With CNs often working alone, it is imperative that CNs should be equipped with evidenced-based knowledge and skills in making clinical interventions in wound care.
In view of considering the above situation, a web-based wound education program was launched in view of providing CNs with the competence and confidence needed for managing the wound care in community.
Objectives :
Using evidence-based practice to design and develop wound education program to
1. Enhance CNs’ knowledge and level of confident in wound care management,
2. Ensure the quality and safety of wound care management,
3. Test the effectiveness of web-based learning on wound care knowledge among the CNs in HKWC.
Methodology :
A sample of twenty-three CNs from two community nursing centers in HKWC took part in a period of 4-week wound education program in June 2021. Web-based mode was implemented due to the social gathering restriction amid of the pandemic. Within the educational program, it consisted of 3 parts: (1) a series of lectures including phases of wound healing, wound assessment, concept of TIME framework, and the best practice of wound care management in community; (2) a wound training kit, that was made by the Wound and Stomal Therapy Team in QMH, along with the pressure injury staging and its classification revised by NPIAP; and (3) a surprise check to the compliance of proper wound documentation as well as to the application of wound knowledge in the daily practice by periodical joint visit and patient record review. An experimental pre-test–post-test design using repeat measures was used to test the hypothesis that a structured educational program would positively impact on CNs' wound care knowledge and practice.
Result & Outcome :
The results showed that the CNs’ knowledge of wound care management was significantly improved after the wound education program. It was so encouraging that all participants achieved 100% score on all key areas, such as knowledge on wound assessment, application on the use of TIME framework as clinical decision tool, best practice for wound care management and consultation pathway. Before the training intervention, only 65% and 43% of the CNs were able to identify the concept of staging system and TIME framework respectively. In addition, there was only 35% whom have heard of two-week challenge for wound bed preparation and lack of knowledge on best practice for wound care management. Evaluation in learning objectives, training tools and general satisfaction was also conducted. 100% of participants agreed that the learning objectives were achieved and the information was sufficient. They also greatly satisfied to the delivery mode of the training tools. In addition, the result showed that the level of confident and knowledge on wound management in the daily practice was enhanced and improved among the CNs. In summary, the result of the web-based wound education program was effective, feasible for all staffs and had a positive to empower CN on wound care management.
