Authors (including presenting author) :
Ng WF(1), Wong KY(1), Li MC(1), Or KM(2), Chang ST(2), Lam YY(2), Mak WL(2)
Affiliation :
(1) Department of Surgery, United Christian Hospital, (2) Nursing Services Division, United Christian Hospital
Introduction :
August is the month of every year when new graduated nurses start their positions. Various hospitals and departments arrange orientation programs for these new colleagues to help them adapt the new environment, understand their roles, and become aware of high-risk areas. Therefore, surgical department in United Christian Hospital organize an orientation program for surgical preceptee which wound and stoma care are included in the program. I am an Advanced Practice Nurse (APN) currently working in the surgical ward in United Christian Hospital and I am the workgroup leader of the surgical wound and stoma care workgroup in surgical department. A project on organizing the wound and stoma care workshop for surgical preceptee implemented which aim to enhance their knowledge, skills and competence in managing the surgical wound and stoma care in a surgical ward
Objectives :
1. Enhancing clinical competence
- To equip preceptees with essential knowledge and skills in surgical wound and stoma care, ensuring they can provide high quality patient care.
2. Addressing knowledge gaps
- To fill existing gaps in surgical wound and stoma management, patient journey of ostomates, high risk procedures and the guideline of wound management.
3. Building confidence
- To provide hands-on experience that help preceptees feel more confident in their ability to manage complex patient care.
4. Creating a supportive learning environment
- To provide a collaborative environment to preceptees to share experiences, ask questions, and learn from each other
Methodology :
Firstly, the survey- Surgical preceptee stoma and drain care experience survey was conducted which all surgical preceptee involved. The experience
of stoma care and drain removal of the surgical preceptees could be collected to facilitate the analysis and the planning on the training content.
Secondly, the root cause analysis was done by using the Ishikawa chart (Ishikawa, 1976) in the meeting of the project team. The Ishikawa chart (Ishikawa,
1976) is important to find all the reasons that may cause to help on finding the solution to solve the problem completely.
Thirdly, Plan–Do–Study–Act (PDSA) continuous improvement cycle (Deming, 1993) is used. The PDSA (Plan-Do-Study-Act) cycle consists of four key components. First,
in the ‘Plan’ phase, the goal or purpose is identified. Then in the ‘Do’ phase, the change is implemented, while data is collected and the effects of the change are
observed. Following the ‘Study’ phase involves analysing the data gathered during the ‘Do’ phase to assess whether the change resulted in the desired improvement. Finally, in the ‘Act’ phase, decisions are made based on the analysis. This involve adopting the change whether lead to the improvements. If the change is success, it can be implemented in the next cycle to foster the continuous improvement.
Fourthly, pre- and post-workshop quiz and post workshop satisfaction survey were conducted which all surgical preceptee involved for evaluation.
Result & Outcome :
1. Education Talk
The pre and post workshop quiz result (Appendix 9) showed significant improvement as the number of preceptee achieving the correct answer were increased in all
questions.
2. Small group discussion and peer learning and the introduction of product notebook
They showed collaborative learning and willing to share their experience
3. Hands-on practice- Change stoma pouch for a mock stoma
Preceptees expressed positive toward the practice of using mock stoma as less anxiety than helping a real patient. Because they worried
the stool would pass out during the changing process and demonstrating the inexperienced skill before patient. They are more prepared to handle patient with
stoma after gaining the practical experience.
4. Hands-on practice- Skills practice in four surgical wards
The contents from the education talk were transferred to these practices such as the core steps of drain removal and the proper use of advanced wound product.
Finally, the result of the post workshop satisfaction survey with good
feedback from preceptees. Ten preceptee stated strongly agree in all questions while
only one preceptee stated agree in all questions
