Authors (including presenting author) :
ON SL(1), Lui N(1), Tang YM(1), Li WH(1), Chung LH(1), Lee SC(1), Li PH(1), Ng CN(1), Hui, F(1)
Affiliation :
(1)Community Nursing Service Department, Kowloon Hospital
Introduction :
Using paper documentation as wound photo record was a usual practice in KH CNS. To complete this documentation, nurses should take the wound photo(s) during home visit by using the working mobile phone. Then, the community nurses needed to label the photos with corresponding patient’s name, identity card number, capture date and the team number before passing the printing job to the clerk. Then, the clerk printed the photos out and distributed the printed documents to the nurses. Finally, the community nurses needed cutting and pasting the photos on the wound photo sheet and filed in the medical records. This complicated procedure had consumed lots of time and manpower to finished one medical record documentation. To simplify these procedures and enhance the work efficiency, the electronic wound photo documentation by using “Clinical Cam” app in iPad mini was introduced in KH CNS.
Objectives :
1. To enhance the work efficiency on wound photo documentation 2. To reduce the risk of misidentification of the patient 3. To save a clerical staff manpower from an complicated documentation procedure 4. To save printing paper 5. To facilitate an instant communication between different specialty disciplines
Methodology :
This project was conducted in 4 phases. In phase 1, stocktaking the ipad mini device in the CNS department to make sure all nursing staff owning their ipad mini. We purchased the sufficient amount of device by the stocktaking result. In Phase 2, we cooperated with the KH Information Technology (IT) Department to install Mobile Device Management (MDM), which allows mobile devices to access Clinical Management System (CMS) outside the hospital. In phase 3, we introduced the project and provided training to the nursing staff on using ipad mini to take and upload the wound photos through a clinical camera app. Then, we chose one team as a pilot to run this project. In Phase 4, we collected the feedback and shared the result of the pilot to all the nursing staff. Then, we fully conducted the project in the final stage.
Result & Outcome :
All nursing staff was able to take the wound photos and upload the photos in CMS by using iPad mini during their home visit. Before the project, it took 10 minutes to successfully print out one wound photo for each patient and spent another 5 minutes for nurse to paste the photo(s) on the wound photo medical record. Moreover, one clerical staff was designated to spent at least 3 hours to perform wound photo printing on the day of wound documentation. After the project, community nurses only take 1-2 minutes to take and upload the wound photos in CMS during home visit. The clerical staff was released to support the other clerical service in the department. All nursing staff welcomed this new smart working procedure. Besides, we discovered benefits after running this project. Firstly, the risk of misidentification of the patient in medical record was greatly reduced. Secondly, it saved printing paper in the department. Supposing It took approximately average 2 papers for one patient of wound photo documentation, it saved at least 1000 papers for wound photo documentation after the project each month in the department. Finally, the e-documentation of wound photo acted as a bridge to facilitate an instant communication between different specialty to explore the best outcome for the patients.
