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) :
Yau NM(1), Ho WL(1), Tan Z(2), Lam HWC(1), Ng WMC(2), Ngai KP(3), Lee SC(1), Lam PL(3), Lui N(1), Chan KH(2), Tang V(1), Li WH(1), Wong SF(3)
Affiliation :
(1)Community Nursing Service, Kowloon Hospital (2)Community Geriatric Assessment Service, Kwong Wah Hospital (3)Community Nursing Service, Our Lady of Maryknoll Hospital
Introduction :
Urinary catheter (UC) is common in hospitalized patients, they may remain catheterized and discharge to the community. Risk of complications, such as haematuria, catheter blockage, pain and urethral erosion etc, rises for prolonged UC users are common in the community. Proper care of UC can reduce the risk of UC-associated complications. Long-term community care of the UC thus becomes essential. Securement of the UC is one of the essential practices but always be neglected, however there was lack of clear instruction on the method of urinary catheter securement. It is therefore needs to be more explicit instructions on the method of urinary catheter securement and to promote and raise the awareness of UC securement.
Objectives :
1.To prevent the complications of UC in Residential Care Home Elderly (RCHE). 2.To improve catheterized residents' satisfaction and quality of life of in RCHE. 3.To enhance knowledge of UC securement among Health Care Workers (HCWs) 4.To improve compliance on UC securement in RCHE.
Methodology :
A tailor-made empowerment program was implemented to a targeted RCHE which occurrence of UC complication are common. The program included: 1. Developed a modified way of UC securement to fit the community's situation which endorsed by urology nurse consultant. 2. Conducted an educational talk to HCWs for knowledge enhancement. 3. Conducted return demonstration workshop on UC securement for skills assessment. 4. Made a video of UC securement demonstration with QR code for quick reference. 5. Conducted a “Pre-test” vs “post-test” questionnaire before and after 4-weeks for knowledge assessment. 6. Performed ongoing monitoring of the compliance of HCWs and occurrence of the UC-associated complications by community nurse. 7. Conducted a satisfactory survey to collect catheterized residents’ opinions before and 4-weeks after.
Result & Outcome :
In 4-weeks implementation periods, 13 HCWs and 9 catheterized residents were recruited. There were no occurrence of complications including haematuria, urethral erosion and dislodgement and also no unscheduled home visits for these related complications. In the satisfaction survey, residents feel less pain and discomfort in relation to UC after proper UC securement. The average score on the Faces Pain Scale decreased from 3 to 0.8. HCWs’s knowledge of UC securement increased; the average score on "post-test” questionnaire was 91%. All the HCW knows that the UC needs to be secured. In skills assessment, all the HCWs comply in all critical items. The overall compliance rate was 84.4%. The compliance rate of UC securement gradually increased from 77% to 100% in the implementation period. All HCWs have gained awareness and improved their practice of UC securement. UC securement is a crucial practice. The program proved proper UC securement helps reduce the risk of related complications of UC and promote quality of life of residents. Small change makes a great difference. The outcome of the program tells us that every small step and care that we pay attention to, a significant benefit would be brought to our vulnerable patients. It is essential for the community nurses to promote UC securement and put effort to ensure our patients live in the community with a safe and quality of life.
