Authors (including presenting author) :
Tai WS, Chun SW, Li WC, Chan SW, So SW, Chow SY, Cho HY
Affiliation :
Department of Diagnostic and Interventional Radiology Kwong Wah Hospital
Introduction :
Image-guided percutaneous drainage was a common Non-Vascular Interventional Radiology (NVIR) procedure for catheter placement either temporarily for short-term goal of medical treatment or permanently due to disease progress. Patients living with drainage catheter was not easy. Poor management of the catheter resulted in catheter revision, leading to increased workload in radiology, bed occupancy, and patient’s time for hospitalization which are unnecessary and avoidable through the implementation of appropriate strategies in a new program with redesigned workflows and patient empowerment.
Objectives :
Implementation of a program to improve patient's outcomes and service delivery through (1) Enhance patient self-care management on drainage catheter, (2) Develop an enhanced catheter securing method, (3) Reduce unnecessary admission due to drainage catheter dislodgement, (4) Improve patient satisfaction in patient journey, and (5) Utilize IR appointment timeslots effectively
Methodology :
The program was designed in 3 Phases: Pre-operative Phase: Assessment and pre-procedural education with educational materials Intra-operative Phase: Apply enhanced securing method with tailored made spiral shaped latex tubing and catheter securement device with double fixation method and cushioning dressing materials Post-operative Phase: Post procedural patient education with ward visit and phone follow up by radiology nurse Evaluation by a tailor-made questionnaire for knowledge enhancement of patient in self-care of catheter and, satisfaction level for nursing actions provided in this program
Result & Outcome :
Sixty-eight patients were recruited to the program. Positive results were showed after implementation of the program on patient’s self-care management of drainage catheter, with the most prominent effect between 30 to 60 days which achieving ≥ 90% of patients were free from catheter dislodgement incident. Patients also showed an average satisfaction score of 8.5 out of 10 for nursing actions provided in the program. For those who had experience of drainage catheter placement (n=30), 80% of them reported that the program improved their patient experience during hospitalization owing to receiving more care and attention provided by radiology nurses, and acquiring more knowledge and skills in management of drainage catheter, which enhanced disease coping and promoted a higher level of independence in daily activities. The application of the comprehensive perioperative nursing model, which includes pre-intra-post operative care demonstrated a preliminary success in empowering patients in self-management of drainage catheter. It is a promising and delightful outcome resulted from the expanded role of radiology specialty nurse in patient care. Not only the patients will benefit from unnecessary admission due to catheter dislodgement, but also relief workload in healthcare system through effective use of hospital resources and radiology services. Continuous refinement of the sustainable project is expected to bring about favourable outcomes in the long run.
