Authors (including presenting author) :
Cheung KW(1), Hwang LM(1), Lee A(1), Wong PL(1), Chan CH(1), Lam CC(2), Kwok LC(2), Yiu WK(2), Chao FW(2), Kwok WY(2), Wong CL(3), Shum CK(3), Lau CC(3), Wong WM(3), Tony Chan(3), Ng MF(3)
Affiliation :
(1) Palliative Home Care Team, Nursing Service Division, Tuen Mun Hospital, New Territories West Cluster (2) Community Care Department, Tuen Mun Hospital, New Territories West Cluster (3) Division of Geriatrics, Department of Medicine and Geriatrics, Tuen Mun Hospital, New Territories West Cluster
Introduction :
Education for staff in Residential Care Homes for the Elderly (RCHE) necessitates strict adherence to established workflows in End-of-Life (EOL) care. A critical requirement including the Non-Hospitalized Do-Not-Attempt-Cardiopulmonary Resuscitation (DNACPR) form and/or Advance Directive (AD) accompany EOL patients during their admission to the Accident and Emergency Department (AED) or hospitalization. Traditionally, training methods for RCHE staff predominantly consisted of lectures, which often insufficient to engage participants effectively. This led to critical lapses, such as the omission of DNACPR forms, resulting in unnecessary resuscitation attempts and causing distress for both patients and their families.
Objectives :
The primary aim of this study is to evaluate the effectiveness of an educational approach that combines lecture-based teaching with simulation training, focusing on improving RCHE staff participation, satisfaction, and adherence to established EOL care workflows.
Methodology :
In October 2024, traditional lecture-based education was replaced with a combined-modality approach. This included simulation training designed to replicate real-life EOL scenarios, providing staff with hands-on training. The intervention emphasized practical application, particularly the importance of compliance with Non-Hospitalized DNACPR and AD forms during patient admissions.
Result & Outcome :
Staff Engagement and Satisfaction: Post-training surveys were conducted to assess staff engagement and satisfaction levels. Adherence to DNACPR Workflow: Compliance was evaluated through audits of patient admissions before and after the implementation of the new training approach. The introduction of combined-modality education significantly enhanced staff engagement and compliance. Key findings include: Satisfaction Scores: Post-training satisfaction surveys yielded a remarkable score of 95 out of 100 for the training format. DNACPR Compliance: Audits revealed a 100% presence of DNACPR forms upon patient admission following the training intervention. Staff Feedback: Participants reported that practical, scenario-based learning effectively reinforced key concepts and protocols. The combination of simulation training with traditional lecture teaching has proven to be a more effective educational modality for RCHE staff. This approach has led to significant improvements in staff satisfaction, engagement, and adherence to EOL care workflows, ultimately enhancing the quality of care provided to patients at the end of life.
