Authors (including presenting author) :
Fung YYE (1), Pang HSI (1), Hai MT (1)
Affiliation :
Department of Medicine and Geriatrics, RTSKH (1)
Introduction :
CHF program has been implemented in Geriatric wards in Ruttonjee Hospital for few years. In the busy acute wards, the conventional treatment for patients with aspiration risk or inadequate intake is Artificial Nutrition and Hydration (ANH) e.g. nasogastric tube feeding, intravenous fluid, etc that with known complications. This approach does not align with the preferences of mentally competent patients and patients with an Advanced Directive (AD). Those patients must be kept Nil by Mouth with/without an IV infusion until they can be transferred to Geriatric Wards. It is imagined that how hungry, dehydrated, and unwell those patients and their carer are. To ensure the best interest for these patients, implementing CHF in acute wards allows immediate fulfilment of patients' needs and enhances patient-centred care and their experiences. An acute respiratory ward (A6) was selected for trial.
Objectives :
1. To improve patient experiences for those with aspiration risk and with AD
2. To improve nutritional and hydration status of patients
3. To promote the feasibility of CHF in acute wards.
4. To enhance nurses’ job satisfaction by improving patient experiences.
Methodology :
The program was organized into 3 parts:
1. On-line training sessions and Train-The-Trainer workshops by ANC (Gerontology)
All staff in A6 attended the on-line trainings from July to August 2024 and two designated nurses trained as trainer for conducting individual feeding technique demonstrations to staff
2. Skill assessments by return demonstrations
3. Staff Satisfaction Survey
A 5 questions with 5-point Likert scale questionnaire was used to evaluate nurses’ view on patient experience and nursing perspectives.
Result & Outcome :
From August to December 2024, 8 patients were initiated on CHF by trained staff. NO aspiration incident related to CHF was reported as well as their nutrient and hydration status were maintained.
In December 2024, total 20 nurses returned the questionnaires, showing affirmative responses regarding patient experiences. All participants recognised improvements in patient dignity and autonomy, indicating that CHF enhances overall patient experience.
Regarding nursing perspectives, 65% of participants reported increased job satisfaction due to CHF, while 95% agreed that it enhances nursing continuity. These findings demonstrate the practicality and effectiveness of implementing CHF in acute settings.
Conclusion
The trail of CHF in A6 has proven beneficial for both patients and nursing staff in acute ward settings. It enhances patient experiences by respecting their dignity and autonomy while maintaining adequate hydration safely. Besides, positive feedback from nurses underscores the feasibility of this approach. Therefore, CHF will be implemented to other acute wards in the near future.
