Authors (including presenting author) :
Wong GWH(1), Yeung EMP(2), Cheng YS(2), Lam YF(2), Woo CW(1), Chan BKS(1), Leung KLK(1)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital, Hospital Authority
(2)Department of Rehabilitation, Kowloon Hospital, Hospital Authority
Introduction :
Our healthcare system is facing great challenges from infectious organisms among hospitalized patients. In KCC, a ward in KH was designated to cohort all patients with confirmed Candida auris (CA). Subsequently, admission extend to other clusters on needs basis. Under stringent infection control measures and patient isolation, in-hospital rehabilitation is considerably affected. For CA, a considerable amount of time is spent on patient decolonization. This work explores the collaborative process in this cohort ward with a case example.
Objectives :
To evaluate the collaborative rehabilitation process for CA-patients in an isolation ward.
Methodology :
A one-year retrospective cohort study was performed to review the physiotherapy interventions in designated ward receiving CA-patients in KH.
Result & Outcome :
All patients transferred to designated ward for CA was identified. Total of 581 patient-episodes was admitted in year-2024, age ranged from 21-to-101-year-old, admission source institutions were KH, QEH, KWH, BH, WTSH, UCH, PWH, QMH and PYNEH.
After admission to designated ward, CA-patients required the time-consuming decolonization process in a tight schedule. Physiotherapists collaborated with the nursing team to tailor-made interventions. Physiotherapists assisted CA-patients to optimize physical function while ensuring infection control protocols were strictly followed. CA-patient was only allowed ward-based training to reduce risk of transmission. Different measures were adopted to continue training under isolation policy including exercise equipment and walking aids were provided for the same patient cohort, disposable disinfectant-wipes were used for immediate cleansing afterwards, disposable single-patient-use equipment was used whenever possible. Designated physiotherapists were assigned to provide physiotherapy service to minimize number of staff in contact with CA-patients.
A 21-year-old patient with Guillain-Barre Syndrome and CA transferred from other hospital was selected to demonstrate patient journey. On admission, patient presented with excruciating pain at rest and during body movement. His limb movements were impaired due to motor weakness and pain. He was totally bed-bounded. His mother experienced high emotional carer-stress. Interventions for pain management, limb flexibility maintenance and strengthening, functional mobility training and carer education were delivered. Subsequently, he was able to sit out in recliner wheelchair with 65-degree tilt for 60 minutes and sit out for lunch. Patient and patient’s carer reported positive satisfaction.
In-between the vigorous decolonization process with a tight schedule, through collaborative effort, CA-patients continued physiotherapy training under isolation policy to maximize patients’ potential with reported positive satisfaction.
