Authors (including presenting author) :
Chan TS(1), Ho SKS(1), Lam CY(1), Wong KPG(2), Lee YHH(3), Pang HSI(1), Siu YS(1), Hai MT(1), Wan MC (1)
Affiliation :
(1)Department of Medicine and Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals, (2)Speech Therapy Department, Ruttonjee & Tang Shiu Kin Hospitals, (3)Dietetic Department, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Careful hand feeding (CHF) based on HA’s guidelines provides an alternative option if patients or families refuse tube feeding. It also is a patient-centred care with respectful patient’s wish and relative’s choice in advance care plan (ACP). It can be a bridge for patient to recall joyful eating moments during end-of-life stage. However, myths of careful hand feeding can be barriers for non-geriatric frontline staff to provide CHF. Therefore, getting trained on safe feeding skills is crucial for nurses and care-related supporting staff. Online learning activities were provided to respiratory medicine ward nurses and supporting staff by gerontology nurse. As a result, online training materials for CHF were developed targeting frontline staff with satisfied outcomes.
Objectives :
Enhancing the non-geriatric nurse and supporting staff's awareness, confidence and skills on safe careful hand feeding through online training materials; Reviewing the CHF training outcomes through post-training survey and on-site skill assessment on ethical principles and safe practice at non-geriatrics setting ward.
Methodology :
To develop tailor-made careful hand feeding online training for nurses and supporting staff, we summed up the procedures and practical tips in four 15-minute videos. It illustrated the safety practice of CHF by multidisciplinary team (Dietitian, Geriatrician, Nurse and Speech Therapist) perspectives. Common misunderstanding and legal issue related to CHF were also included into the contents. Nurse and care-related supporting staff were required to complete pre-training survey, training evaluation and skill assessments after viewing the online training. Target colleagues could access the online training materials on their own space, anytime and anywhere. Designated nurses conducted skill assessment individually to ensure all nurse and supporting staff are familiar with CHF before assisting oral feeding for patients in non-geriatric ward.
Result & Outcome :
Total 21 staff (17 nurses and 5 supporting staff) in respiratory medicine ward have attended the online training. A Wilcoxon signed-rank test indicated that the online CHF training materials were statistically significant improved awareness and experience in providing CHF after training (Z=-3.464, p<0.001). Around 57.1% (12 out of 21) staff enhanced awareness of CHF after online training; 29.4% (5 out of 17) staff decreased difficulty in performing CHF with enhanced confidence (Z=-2.236, p=0.025). The incident rate related to choking in careful hand feeding case at target ward remained zero. Careful hand feeding online training materials gave nurses and care-related supporting staff a good, comprehensive learning opportunity to enhance their awareness and equip safe technique of careful hand feeding. The training program also improved the confidence of the frontline staff to perform CHF in non-geriatric ward.
