Authors (including presenting author) :
Lui BKP(1), Lam SS(1), Chan LY(1), Lee KN(1), Chan LW(1), Tong PY(1), Tao YCK(2), Wong YYV(2), Yeung CJ(2), Wong MYA(3), Kong TS(3), Yam CLY(3), Pang HSI(1), Kng PLC(1)
Affiliation :
(1) Department of Medicine & Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals (RTSKH) (2) Physiotherapy Department, Ruttonjee and Tang Shiu Kin Hospitals (3) Occupational Therapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
COVID 19 pandemic affected all kinds of non-essential services in the Hospital Authority such as rehabilitation training in Geriatric Day Hospitals (GDH). The service capacity of the GDH at RTSKH had reduced 30% due to adoption of infection control measures. We observed that the lack of rehabilitation training had impact on the frail elderly patients and the caregivers. These included lack of social activities and interactions; increased sense of loneliness; significant deterioration of functional abilities and increased caregivers’ stress. In order to improve the service quality for the frail elderly patients, a Nurse-led activities program was initiated when GDH service was resumed during the 5th wave epidemic.
Objectives :
• Turn the waiting time of patients into therapeutic time for those who arrive early at Geriatric Day Hospital • Act as a pre- training warm up so as to raise patients’ interest and compliance level during rehabilitation training • Provide individualized care advice with multi-disciplinary input
Methodology :
The patients attending GDH usually arrived 45 minutes earlier as most of them required transportation service or home help service. They were identified to be recruited in this program and were engaged with nurse led activities while waiting to start the regular rehabilitation training. The design of activities was individualized for each patient, tailor made in collaboration with the allied health colleagues. Being the case manager, nurses decided the schedule of training and implemented activities with the help of supporting staff. Data on the number of patients, therapeutic time and patients/ staff satisfaction were collected for program analysis. The nurse led activities included: • Walking exercises, muscle strengthening exercises • Continence training • Hand function training, fine motor training • Cognitive training • Doll therapy • Conduct ad-hoc health education if necessary such as disease management advice, fall prevention advice, drug compliance monitoring, drug safety and administration education
Result & Outcome :
The program was conducted from Oct to Dec, 50 out of 143 patients had joined the program. After a 3-month trial, total 187 hours waiting time were turned into therapeutic time. Average therapeutic time increased per patient was 3.74 hours. Satisfaction survey involved patients and staff were conducted and revealed a high rating of 90% satisfaction in average. 98% patients and staff agreed that the program turned the waiting time into therapeutic time. 98% patients and staff expressed that the program could act as a pre-training warm up so as to raise patients’ interests and compliance level during rehabilitation training. 96% patients felt the program could increase nurses’ understanding of their mobility functions, interests and needs. They agreed appropriate assistance and follow up were provided by nurses. 96% patients were satisfied with the arrangement of the program. Though 77% staff thought the program increased their workload a bit, they all agreed that the program could help our patients and improved the service quality of Geriatric Day Hospital. Limitations and Recommendations: As our frail elderly patients required one to one attention such as assisted a stroke patient in walking exercise; assisted a dementia patient to perform cognitive training or doll therapy, so the variety of activities provided and the scope of service were limited due to manpower constraint. In the future, if the anti-epidemic measures are lifted, we might collaborate with Medical Social Worker department to recruit volunteers to assist. So more activities could be provided and more patients would be benefited.
