Authors (including presenting author) :
Yao PWS, Au Yeung ML, Chan KT, Lau TF, Leung LT
Affiliation :
Department of Medicine, Queen Elizabeth Hospital
Introduction :
Pressure injury (PI) is not solely a concern of Nursing Quality Indicator but also apparently affects the patient’s quality of life, prolongs the days of hospitalization or even increases morbidity and mortality. Apart from patient suffering from PI, the relatives or significant others of the patient would also suffer at different levels. Eventually, both the patient and the family need to be intervened. Due to the aging population of Hong Kong and increasing admissions of bed-bound patients, PI unavoidably becomes a major and problematic issue to the medical department.
Through collaboration with the Medical Department, the PI team in our ward was set up to implement the PI programme.
Objectives :
To enhance PI prevention and management in Ward C5. Six objectives are formulated, including awareness promotion, knowledge enrichment, reshaping the ward routine of patient care and related documentation and strengthening communication between different parties.
Methodology :
The PI programme was designed to enhance PI prevention and management in Ward C5. In general, 5 areas were identified to follow up.
1. To enhance and reinforce knowledge and awareness of PI prevention and
management among our clinical staff. Principle of Check, Protect, Report and Support (CPRS) is adopted.
2. To polish the related ward routine of care and practice.
3. To enhance utilization of available equipment that helps PI prevention.
4. To replenish and enrich the device in stock.
5. To purchase new tools or materials and provide related training on usage.
Monthly PI rate report will be used to evaluate the effectiveness of the PI programme. Ongoing review by the core members of the PI team and sharing of the data among the clinical staff aims to uphold the standard of practice & staff engagement.
Result & Outcome :
The PI rate showed reducing trends in most months after implementation of the PI programme. After promulgation of the PI programme, the PI rate dropped significantly from 1.56% in Feb 2023 to 0 in May 2023. However, an increase in PI rate was observed during Oct to Dec 2023. It might be related to turnover of staff & the winter surge period with increasing admission of bed-bound OAHR and those immunocompromised who are prone to develop PI.
The PI programme could be considered effective in reducing PI formation. However, the increase in PI rate might be related to lenient awareness of staff or abrupt change of the manpower such as loss of well-trained staff and recruitment of newcomers. In addition, the winter surge might increase the admission of patients who are subject to PI formation.
In conclusion, regular reviews of compliance and reinforcement of the reformed practice are crucial to maintaining the performance of the clinical staff in PI prevention and management.
