Authors (including presenting author) :
Lo STW (1), Tse HO (1), Pang YC (1)(2)
Affiliation :
(1) Division of Vascular Surgery, Department of Surgery, Pamela Youde Nethersole Eastern Hospital
(2) Division of Vascular Surgery, Department of Surgery, Queen Mary Hospital
Introduction :
- Hong Kong is changing:
o Aging population
o Disease pattern is changing
- Healthcare is changing
o Our knowledge of disease is increasing
o Technological advancement (e.g. telemedicine, AI)
- Standards are changing
o Increasingly high standards of care
o Radiology Imaging is now routine
o Personalised medicine
o Rising patient expectation
Methodology :
For patients with vascular disease:
- an aging population means more patients with vascular pathology. Vascular disease is increasingly recognised and suspected now (due to better education of both medical staff and population).
- Rapid advancement of endovascular surgery in the last decade is transforming the treatment of vascular disease
- Bedside USG has become a valuable diagnostic tool for vascular surgeons
- Multidisciplinary care is required for most vascular diseases
- The provision of care for vascular surgery patients in Hong Kong is still developing; and there are significant differences between service provision of clusters and hospitals.
Result & Outcome :
Role as frontline healthcare provider:
- Wound assessment, dressing, debridement, specialist wound care, follow up
- First line Investigation of vascular disease
o Ultrasound assessment of VV/CVI, DVT, arterial disease including PVD, AVF/G/renal access, VAD management
o TcPO2 measurement
o Toe/Ankle Brachial Index measurement
o Segmental Pressure measurement
- Prescription of treatments including special wound dressing material, graduated compression stockings
- Scrub nurse
Role as leader/co-ordinator/point of contact/gatekeeper
- Referral from Podiatrist, DM nurse, GOPC nurse, Community Nurse, Oncology nurse, Haemodialysis centre staff, nephrologist, orthopedic nurse, Radiographer
- Liason with members of multi-disciplinary team:
o Vascular surgeon, orthopedic surgeon
o Endocrinologist, nephrologist
o DM nurse
o Podiatrist
o Physiotherapist
o Occupational therapist
o Prosthetic and Orthotic specialist
o HBOT specialist
o Smoking cessation nurse
- Logistic co-ordination:
o operation arrangement and consumable equipment
o pre-operative anaesthetist assessment (PAS and POMC)
o urgent and elective diagnostic and therapeutic radiology appointments
o pre and post-op haemodialysis arrangement
o post-operative HBOT feasibility, arrangement for inpatients and outpatients
o follow up appointment transport and co-ordination with other allied health appointments
o Discharge arrangement – MSW, family, Occupational therapist, P&O, Physiotherapist
o Community Wound follow up arrangement
- Patient and their family
o As a convenient and flexible way to advise on appropriate pathways to seek help for common problems in a specialized population.
Depending on their expertise and the limitations of the healthcare setting that they are bound, they can tailor their role to suit the changing need of the population.
