Authors (including presenting author) :
Chan PC(1)(2)(3), Chan TF(1)(2)(3), Yeung HM(1)(2)(3), Wong HL(1)(2)(3), Hai MT(2)(3), Pang HS(2)(3), Lai KM(1)(4)
Affiliation :
(1)Palliative Care Unit (PCU), (2)Department of Medicine and Geriatrics (Dept. of M&G), (3)Ruttonjee and Tang Shiu Kin Hospitals, (4)Hong Kong East Cluster
Introduction :
IVAP is a small, disc-shaped reservoir implanted in patient’s central venous system beneath the skin. IVAP has been used for long-term treatments including blood taking and medication administration especially in palliative care (PC) patients who are difficulty in setting intravenous access. With increasing number of PC patients including inpatient and outpatient with IVAPs, nurses in PCU are lack of related knowledge and practical skills, hence, IVAPs are mostly kept in-situ only. Consequently, patients are not received appropriate care or even being delayed treatment. Therefore, it is essential to enhance nurses’ competency to provide immediate care for patients with IVAP.
Objectives :
1. Improve knowledge, skills and nursing care to care IVAP
2. Provide medical treatment to patients via IVAP
3. Enhance staff competency in managing IVAP complications
4. Implement a monitoring plan for potential complications associated with IVAP
Methodology :
The enhancement program included three phases of staff training in different aspects:
1. Train-the-trainer at the Department of Oncology in Pamela Youde Nethersole Eastern Hospital
2. Staff training workshop with education materials, IVAP management video, knowledge quiz and dummy demonstration
3. One-to-one dummy or real case demonstration and return-demonstration
Result & Outcome :
From June to December 2024, total 16 palliative care in-patient and home care nurses had completed the training with 100% pass on 10-question knowledge quiz. For practical skills, all trainees achieved 100% compliance in competency assessment during return-demonstration. Total 14 patients received care without complication. Staff satisfaction survey was collected six months after. 93.8% of the interviewees satisfied with enhancement program. 93.8% and 87.5% nurses satisfied with knowledge gain and practical skills respectively. 75% and 81.3% staff felt increased competency and professionalism in managing IVAP respectively. 81.3 % nurses reflected the program can improve patient safety to prevent complications. 100% nurses would recommend the program to others.
Safe practice of managing IVAP is crucial for frontline nurses. Ongoing assessment of IVAP are critical to reduce risks of complications. Concrete nursing assessment form and education leaflet are established for further reinforcement. The enhancement aims to expand knowledge and skill to other specialties within Dept. of M&G, or even beyond the department.
