Authors (including presenting author) :
Lai KM(1), Ho CW(2), Chan TF(2), Wong WT(2), Chan PC(2), Lam SM(2), Wong KW(2), Chan OK(2), Mak PS(2), Liu CY(2), Fan HC(2), Hai MT(3), Pang WS(3)
Affiliation :
(1)Palliative Care, Hong Kong East Cluster
(2)Palliative Care Unit, Department of Medical and Geriatrics, Tang Shiu Kin and Ruttonjee Hospitals
(3)Department of Medical and Geriatrics, Tang Shiu Kin and Ruttonjee Hospitals
Introduction :
In RTSKH PC team, the ultrasound performs at bedside in hospital, means that patients who presented symptoms may need to admit in ward. Some of them were not urgency to admit for abdominal / pleural tapping, and unnecessary admission may be arranged. Otherwise, most of PC patients prefer to stay at home or institution. Hence Home Care Nurse (HCN) is the ideal health professional to utilize handheld ultrasound devices in home-base setting for assist early diagnosis and further clinical intervention. Nevertheless, perform ultrasound in nursing care is not included in tradition nursing training in Hong Kong. The project’s design would initiate the ultrasound application by nurse and empower nursing role in patient’s care.
Objectives :
Decreased unnecessary admission
Assist early diagnosis with clinical decision-making
Enhance home care nurse and supporting role in patient care.
Methodology :
PC AC advised and prepared 2 video demonstration clips pre-reading for all HCNs;
PC AC offered training lecture, demonstration, skill transfer and hand on practice for HCNs. Quiz and re-demonstration in real patients.
Perform ultrasound for home PC patients who have symptoms of dyspnea or abdominal distension with history of pleural effusion / ascites. Verbal consent obtained from patient or carer before examination. Screen captured the ultrasound image and preliminary diagnosis made by HCN.
The follow up action will implement after discuss and confirmed by PC Doctor via the image.
Result & Outcome :
Total of 19 patients with mean of age 77.8 years were included. 1 patient presented pleural effusion and others were abdominal distension. High accuracy (84%) of HCNs on diagnosis made via ultrasound performed. As a result, 58 % patient who presented symptoms, nonetheless, no urgent need to admit hospital for symptom management.
Patients and their carers showed appreciation on to HCNs and PC team with advance investigation in home setting.
HCNs showed job satisfaction and agreed that the handheld ultrasound helped to plan and decision making on nursing interventions.
