Authors (including presenting author) :
Shit KYF(1), Lam MY(1), Tong SY(1), Cheung KWA(1), Mak HN(1), Yu HY(1), Leung YY(1), Wong YK(1), Lo KL(2), Lee SW(2), Hui CN(2), Tam ML(2), Au KW(2), Leung WM(2), Lee LN (2), Ng PCA(3)
Affiliation :
(1) NTEC Wound Services Team, Department of Surgery, Prince of Wales Hospital
(2) Department of Surgery, Prince of Wales Hospital
(3) Department of Occupational Therapy Department, Prince of Wales Hospital
Introduction :
Pressure injuries (PI) are a significant concern in surgical departments due to prolonged pressure on vulnerable body areas. Our data reveals a prevalence of 12 PI and 2 medical device-related PI cases from January to November 2023. To prevent this, we adopted a comprehensive approach to focus on sacral and heel areas. We initiated a Continuous Quality Improvement project for both nurses and supporting staff to prevent PI in these areas.
Objectives :
The project aims to promote consistent adherence to preventive measures and ultimately minimize the occurrence of pressure injuries.
Methodology :
The approach entailed providing educational training to enhance the staff's knowledge and awareness of pressure injuries. Additionally, Occupational Therapists (OT) collaborated to ensure patients receive heel protectors even on weekends and holidays, indicating pressure injury prevention measures.
To establish clear communication among the nursing and supporting staff, a creative "order sheet" was designed. This sheet provided detailed instructions and guidelines for implementing standardized PI prevention. It included different preventive interventions, such as heel protectors, wedge pillows, foam dressings, white paraffin, and zinc cream. The order sheet ensured that staff members consistently adhered to preventive measures.
Result & Outcome :
With the support of the DOM in Surgery, we conducted two identical staff training sessions with 153 participants (53 supporting staff & 100 nurses with CNE:1). The feedback received was overwhelmingly positive. Our study evaluated 32 patients across six surgical wards, revealing an average score of 11/20 on the Norton score, 2.15/5 mobility score, 1.65/5 on the incontinence score, and an average hospitalization period of 12.1 days. Prior to admission, two patients had already presented with PI. However, during the two-month implementation period, only one participant (3.12%) had developed a new Stage 2 PI in the sacral area. Furthermore, the program has received positive feedback from the staff, who have recognized its efficacy in preventing PI and enhancing communication.
