Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
SHUM KS (1), Pang YK (2), Lai YLA (1), Yuen SL (3)
Affiliation :
(1) Department of Surgery, Queen Elizabeth Hospital, (2) Stoma and Wound Clinic, Queen Elizabeth Hospital, (3) Department of Surgery and Combined Endoscopy Unit, Queen Elizabeth Hospital
Introduction :
Pressure injuries (PI) are a significant healthcare concern. Preventing PI in a local surgical department involves multifaceted strategies. At Queen Elizabeth Hospital, fluctuating PI rates in the surgical department highlighted the need for a consistent preventive strategy. Spot checks enable monitoring and evaluating Pressure Injury Prevention (PIP) measures.
Objectives :
This study aimed to enhance the consistency of nurses' practice on PIP measures in surgical wards to mitigate the incidence and severity of PIs among patients. We aim to perform spot-check audits for practice assessment and improvement, ensure preventive measures are consistently applied per patient needs, deliver immediate care and feedback, and benchmark compliance rates of PIP measures for sustained enhancement.
Methodology :
We employed a series of spot-check processes using a modified internal audit form prepared by the Workgroup on Pressure Injury Prevention and Management, Department of Surgery, QEH, with explicit success criteria to standardise data collection and assess PIP strategy efficacy. The process included evaluating at-risk patients with Norton scores ≤14, immediate issue resolution, and direct feedback provision to improve care standards. The compliance rate of PIP measures is calculated, and areas for improvement are identified while recognising successful strategies for data analysis.
Result & Outcome :
The pilot project executed three spot checks on eighteen patients from June to July, yielding compliance rates ranging from 75% to 100%, indicating a potential to ensure consistent PIP measures implementation. Sixteen patients achieved a compliance rate above 90%, demonstrating the staff's effort in PIP practices. Areas needing improvement included communication and education with patients and families, promoting prophylactic wound care products, ensuring device functionality, referring at-risk patients to allied health, performing regular skin checks and clinical photos, and enhancing documentation. Immediate care and feedback are delivered to reinforce PIP strategies during spot-check. Results of the pilot project are shared with the PIP link nurse during the meeting of the Workgroup on Pressure Injury Prevention and Management to increase staff's awareness of the compliance of PIP measures. Future strategies will focus on standardising care through standardised ward rounds, focused spot checks on new measures, and ongoing staff education.
