Authors (including presenting author) :
Li YS(1), Fong YL(2), Annie Yeung(1), Lau MH(2), Lam MS(2), Chris Chong(3)
Affiliation :
(1)Wound Care Team, Pok Oi Hospital (2)Nursing Services Division, Pok Oi Hospital (3)Department of Surgery, Tuen Mun Hospital
Introduction :
Hospital-acquired pressure injury (HAPI) rates serve as a key quality and safety indicator for nursing care. While Pok Oi Hospital maintained a total pressure injury rate of 0.20 in 2022-2023 (compared to the overall rate of 0.46 in NQ&S Annual Report, NSD, and HAHO), a concerning spike to 25% (n=8) was observed in August 2024, prompting immediate action.
Objectives :
• Improve pressure injury prevention and management
• Enhance nurse competency in Norton scale calculations and preventive interventions
• Strengthen staff understanding of cluster PI prevention and management guidelines
Methodology :
The NSD and wound team conducted:
1. Pre-intervention screening (October-November 2024):
• Utilized the Clinical Command Center to assessed 100 high-risk PI patients within 24 hours of admission
• Identified compliance gaps in NTWC PI prevention protocols
2. Interventions:
• Developed and distributed ward-specific PI prevention quick guides to wards and updated link nurses (December 5, 2024)
• Conducted purposive sampling (December 10-12, 2024)
• Screened 69 high-risk PI patients for outcome comparison
Result & Outcome :
Results
Post-intervention improvements:
• Norton scale calculation accuracy: improvement from 43.5% to 81.2%
• PI intervention documentation and implementation: enhancement from 52.5% to 84.1%
• New PI cases reduced significantly: from 25% to 3% (one case each in November and December)
Conclusion
The results reflected the quick guide of PI prevention and onsite supervision & coaching during ward round was effective in enhancing the quality of care in relation to PI prevention and management. The implementation of Clinical Command Center enhance nurses communication in caring at risk PI patients. Regular updates on best practices with ward link nurses through HA Chat can reinforce the compliance levels. Based on these positive outcomes, such good practices are suggested to share across other hospitals in cluster .
