Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
YU TLA (1), CHAN TS (1), HO SKS (1), CHONG WT (1), CHIANG YL (1), KWOK WH (1), PANG HSI (1), KNG PLC (1)
Affiliation :
(1)Department of Medicine and Geriatrics, Ruttonjee and Tang Shin Kin Hospitals
Introduction :
A PEG tube, also known as a percutaneous endoscopic gastrostomy tube, is a medical device that is inserted into the stomach through the abdominal wall. It is used to provide nutrition and hydration to individuals who are unable to eat orally and are not suitable for feeding through a Ryles tube. In Central Infirmary Ward, patient with PEG tube is not common. Around 3-5 patients require PEG care. Colleagues must have sufficient knowledge in caring for PEG tubes. Over the past 2 years, loss of senior experienced nurse has resulted in a knowledge gap in PEG care. A significant number of junior staff are not familiar with PEG care and the process of changing PEG tube. Lack of familiarity can lead to potential complications and compromised patient care. It is essential to update information and enhance the staff's knowledge and competency on PEG care.
Objectives :
To enhance nurses' knowledge and competency in providing safe care for patients with PEG tubes and performing PEG reinsertion by conducting online training sessions and workshops. To evaluate the effectiveness of the training by administering online quiz and conducting on-site skill assessments.
Methodology :
A customized PEG care online training was created by workgroup of PEG care for nursing personnel. Online training includes comprehensive lecture on PEG tubes, video of procedures for PEG reinsertion, and cue cards of nursing care on the PEG site. It also provides guidance on troubleshooting and managing complications related to the PEG site. All nursing staff are required to complete an online quiz both before and after the training, as well as provide feedback via the tap. The training materials are accessible to targeted colleagues on their own platforms, allowing them to access the content at any time and from any location without restrictions. Designated nurses conduct individual skill reassessment to ensure that target participant are proficient in PEG care and are competent in performing routine change of PEG tube in their nursing role.
Result & Outcome :
Total 15 nurse who attended the training session showed a significant improvement of over 80%. All staff are more confident in managing PEG complications and PEG care. Total 10 nurses have attended the training workshop for change of PEG tube and have completed the skill return-demonstration assessment. The overall compliance rate of nursing care in changing PEG procedure is over 97%. Over 80% of participants satisfied with the training program. Around 90% of participants would recommend this training to other colleagues. Precisely 80% of participants agreed that new online training has achieved the objectives. Through the implementation of this improvement project, nursing staff have been provided with a comprehensive learning opportunity to enhance their knowledge of caring patients with PEG tubes, ultimately leading to improve patient outcomes and ensure quality and safety. The return-demonstration of the procedure for changing PEG tubes has proved to be a valuable experience for new nursing staff, allowing them to solidify their skills and gain proficiency in managing complications related to PEG tubes.
