Parallel Session 3 - Achieving Nursing Excellence through Contemporary Approach I – Transformation Leadership

There is growing international activity and support for the routine implementation of electronically collected patient-reported outcome measures (ePROMs) in everyday practice to inform patient care. In oncology, evidence shows that ePROMs offer a solution for optimising patient surveillance during and after cancer-related treatments. ePROMs can be used in routine care settings to monitor and manage patient symptoms, quality of life (QoL) and experience, enhancing clinical decisions and patient triage. They provide valuable insight into real-world effectiveness and implications of cancer treatments. When integrated into electronic health records ePROMs can be aggregated with other routinely captured data. This provides a real-world big-data ecosystem with ePROMs at the centre of artificial intelligence (AI) models, that can be used for predicting clinical outcomes and building prognostic models; ultimately building clinical-decision support algorithms. 
In the UK, the Christie NHS Foundation Trust (Christie) pioneered the routine implementation of ePROMs with patient responses being directly linked to the hospital's electronic health records for real-time monitoring of symptoms and QoL. Launched late 2019, over 80,000 ePROMs have been submitted by more than 25,000 patients, from over 40 cancer groups and treatment pathways. 
This talk will provide an overview of the current landscape for the routine implementation of ePROMs in oncology. The Christie experience will be used to demonstrate the facilitators and barriers to the successful implementation of ePROMs at large-scale. Development of the ePROMs service and key impacts on patient outcomes, service efficiencies and experiences of patients and clinicians will be discussed. 

Background
Healthcare providers often struggle to make appropriate decisions regarding the use of physical restraint (PR) without a standard and objective assessment tool. The prevalence rate of PR remains higher, reported as 10.19%, regardless of the hospital group in Hong Kong Hospital Authority. A systematic review revealed that there is a paucity of evidence-based assessment tool to guide nurses in minimizing PR in general adult ward. An effective and validated evidence-based assessment instrument with referencing to a restraint decision wheel in the critical clinical settings was developed to address this gap.


Objectives
To evaluate the effect of the evidence-based assessment instrument to minimize the use of PR, and assess the staff satisfaction in general adult ward settings in Hong Kong.


Methods
A single blinded cluster randomized controlled trial will be reporting using CONSORT guidelines. Eight wards from three departments will be randomly assigned to either the intervention ward, using the evidence-based assessment instrument and the existing record form, or the control ward, using the existing record form only. The Central Institutional Review Board number is CIRB-2024-517-3.


Result
The study will start from April to June 2025, with results expected in August 2025. 


Conclusion
Justifying PR in general acute ward settings is crucial to minimize negative impacts. An evidence-based assessment instrument is expected to help healthcare workers justify PR use and protect them from challenges. 

Heat-related illnesses, exacerbated by global warming, pose a significant threat to public health, with heat stroke having a mortality rate of 10-30% (Bouchama & Knochel, 2002). Rapid cooling is critical for survival, and Cold-Water Immersion (CWI) is recognized as the gold standard for reducing core body temperature (Casa et al., 2015). However, logistical challenges in emergency departments (EDs) limit its widespread adoption. This pilot study, conducted at Pamela Youde Nethersole Eastern Hospital (PYNEH) ED aims to evaluate the effectiveness and feasibility of CWI compared to standard cooling methods, such as evaporative cooling and ice packs, for managing heat-related illnesses.


Using a prospective implementation design, the study will compare two groups of adult patients with heat-related illnesses: one receiving CWI and another treated with standard methods. The primary outcome measure is the time taken to reduce core body temperature to below 39°C. Secondary outcomes include survival rates, neurological outcomes, and feasibility metrics including workflow integration and staff feedback.


This project, inspired by the Hong Kong University Nursing Leadership Development Fellowship (intermediate tier) sponsored by the Hong Kong Jockey Club, aligns with UN Sustainable Development Goals 3, 13, and 4. By addressing climate change health impacts (IPCC, 2021) and implementing evidence-based practices, the study aims to improve patient outcomes while developing a feasible protocol for CWI implementation in ED settings. The anticipated results will contribute to both local healthcare delivery and global efforts in managing climate-related health challenges through innovative, evidence-based, and sustainable practices.

Introduction
In response to the growing challenges of a multi- generational nursing workforce and high attrition among younger nurses, the Hospital Authority Head Office Nursing Services Department (HAHO NSD) has continued to expand the "Nurturing Our Young Generation" (NOYG) campaign since its initiation in 2018. Building on past engagement efforts, the campaign has evolved into a multidimensional initiative that not only supports young nurses through interactive and meaningful events, but also actively shapes cultural transformation across the organisation.


Objectives
To support junior nurses' professional and personal development, foster mutual understanding across generations, and cultivate a supportive, positive and collaborative workplace culture.


Methodologies
The 2023 and 2024 NOYG series of event themed respectively as - "Walk and Grow Together" and "Just Because You're Here" instilled the HA multi- generational workforce with positive attitudes and mindsets such as "Rekindling Meaning and Passion of Being a Nurse", "Appreciation & Recognition in Work", "Communication & Mutual Understanding", "Perseverance & Growth" and "Collaboration & Teamwork" through carefully designed activities including peer-led sharing, recognition awards, interactive games, and impactful performances. Beyond event organisation, the NOYG Team has also strategically expanded its role as a youth advisory group, proactively offering younger nurses' insights and influencing practical nursing development strategies. 


Results
The NOYG campaign promoted colleagial empowerment by achieving high participation (Tripling from 498 in 2018 to over 1,500 in 2024) and positive event evaluation (Scores rose notably from 4.78 to 5.78 out of 6). Team members and volunteers were effectively nurtured to become future leaders committed to upholding the nursing legacy. Workforce stabilisation has substantially improved, with attrition among younger nurses (< 6 years of service) decreasing by 21.2% (From 1,521 in 2022/23 to 1,199 in 2024/25), alongside a record- high response rate (85%) in the HA Focused Staff Survey, where 94% of respondents expressed intention to remain in HA. Furthermore, the campaign positively influenced HA' s public image and organisational branding through active promotion on social media, reaching over 76,000 followers and enhancing its attractiveness to potential nursing talent.


Conclusions
The NOYG team will continue to commit in building a supportive environment and nurturing a happy, professional, and mission- driven nursing community where every nurse, regardless of generation, is empowered to shine.