Authors (including presenting author) :
Lam YF(1), Ng HY(2), Chan LM(1), Mak KN(1), Wong MS(2), Law HK(2), Pang SW(1)
Affiliation :
(1) Palliative care service, Department of Medicine, Haven of Hope Hospital
(2) Nursing Services Division, United Christian Hospital
Introduction :
Continuous subcutaneous infusion(CSCI) of medications via infusion/syringe pump plays an important role in the symptom control of patients admitted to palliative care(PC) wards, but its implementation has predictable risks that may compromise patient safety. Pointing and calling (P&C) has been proven to be an effective method in occupational safety to avoid human error. A project was implemented in the PC unit of Haven of Hope Hospital(HHH) and United Christian Hospital(UCH) of Kowloon East Cluster(KEC) to ensure patient safety in CSCI using P&C concepts.
Objectives :
(1) To ensure patient safety in CSCI by using "Pointing and Calling" method;
(2) to empower the competency, knowledge and skills of PC nurses in CSCI; and
(3) to align the practice of performing CSCI between PC wards in KEC.
Methodology :
A “pre-test vs. post-test” design was adopted. Subjects were PC nurses of HHH and UCH. A workgroup was formed to develop the training program/kit which includes lecture by PC doctor and demonstration videos on applying P&C concepts in CSCI using infusion/syringe pump. Outcome measures were (1) competency in managing CSCI in PC ward (8-item scale), (2) knowledge quiz on CSCI (13 MCQs), (3) compliance audit on using P&C concepts on medication administration using infusion/syringe pump.
Result & Outcome :
From August to November 2022, all PC nurses of both units received the training program. 33 nurses completed the pre- and post- training tests via electronic questionnaire. 32 nurses were audited on applying P&C concept in CSCI. All perceived themselves being competent in managing CSCI post-training, with 27-42% of them showed improvement in individual competency items. There were 19% (p< .001, paired t-test) increase in the knowledge test, and 100% compliance rate in the audit of using P&C concept in CSCI.
Conclusion:
The project is effective in unifying the practice of adopting P&C concept in CSCI in KEC PC units. PC nurses were empowered on applying P&C concept on medication administration using infusion/syringe pump. The training kit developed can be used for training newly joined PC nurses. Yearly compliance audit is recommended so that patient safety and service quality can be sustained.
