Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
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) :
Kwan YYF, Tsui AYY, Woo CW, Chung RKF, Leung DCK, Li SCY, Ng RLH, Wu AYT, Chan JSP, Cheung EYY, Leung KKL
Affiliation :
Physiotherapy Department, Kowloon Hospital, Hospital Authority
Introduction :
The healthcare system is facing great challenges from infectious organisms among hospitalized patients. Under strict infection control measures and patient isolation, in-hospital rehabilitation is considerably affected. Hospital statistics showed that length of stay in medical patients with infectious organisms in Kowloon Hospital was almost double of their counterparts. Progressive deconditioning is expected due to long stay and restricted rehabilitation.
Objectives :
Implement effective Physiotherapy measures with adherence to infection control policy and vigilant infection surveillance for continuing in-patient rehabilitation at Kowloon Hospital.
Methodology :
Patients with infectious diseases are only allowed with ward-based training to reduce risk of transmission. Several measures have been adopted to continue physiotherapy training under isolation policy. First, exercise equipment, devices and walking aids were categorized and provided for the same cohort of patients during ward-based training. They were placed inside the designated cubicle to minimize cross infection. Second, disposable and single-patient-use equipment was used whenever possible to replace reusable equipment. Third, disposable disinfectant wipes were used for immediate and effective cleansing of used equipment. Forth, designated staff with infection control training were assigned to provide physiotherapy service to isolated patients and to minimize number of staff in contact with these patients in order to control the spread of infectious microbes.
For contact cases under infection surveillance, special arrangements were implemented to allow exercise session in Physiotherapy Department. Patient portering flow was reorganized with these patients arranged at the last training session at the gymnasium for more thorough cleansing and disinfection afterwards. A designated area at the gymnasium was assigned for the same cohort group of patients for exercise. Disposable disinfectant wipes were accessible in the gymnasium and patients were encouraged to use the wipes to clean the equipment after each use, and maintain their hand hygiene with sanitizer before and after training sessions. Posters on infection control management were displayed in the gymnasium for easy reference. More importantly, key training on infection control measures especially on the appropriate cleansing and disinfection methods on top of regular training was provided to all supporting staff responsible for cleansing duty.
Result & Outcome :
All in-hospital patients continued physiotherapy training despite under isolation policy and patients reported satisfaction especially in the special arrangement of exercise sessions in the gymnasium. All supporting staff were provided with up-to-date information and key training which allows them to have confidence in managing patients and equipment with potential infection risks.
