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 I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Fung KY (1), Ho SF (1), Tso PS (1), Luk W (1), Wong TFM (1), Yeung TK (1), Cheng KL (2)
Affiliation :
(1) Family Medicine and Primary Health Care Department, Kowloon West Cluster, (2) Kowloon West Cluster and Caritas Medical Centre Infection Control Team
Introduction :
KWC Family Medicine and Primary Health Care Department (FM&PHC) recorded 141,523 wound dressing attendance in 2023. Receiving an enquiry on the environmental hygiene of a clinic, FM&PHC reviewed and optimized the dressing workflow, the environmental setting and the cleansing performance of all GOPCs aimed to prevent cross transmission of multidrug resistant organisms to safeguard patients’ safety.
Objectives :
(1) to optimize the workflow and setting of dressing; (2) to enhance and sustain staff compliance on infection control measures and environmental cleansing and disinfection.
Methodology :
Collaborating with KWC Infection Control Team to review the workflow and setting of dressing. Recommendations were deliberated to frontline staff via training. Outcome measures were determined by: (1) UV florescence audit, (2) Hand hygiene (HH) compliance audit, (3) Satisfaction survey targeting dressing patients and staff.
Result & Outcome :
All 14 GOPCs had a clear segregation between clean and dirty areas. Pre-set dressing trolley was eliminated. Checking CMS alert for Contact Precautions (CP) before performing each dressing was added in workflow. Designated CP dressing cubicles were established. The recommendation checklist on cleansing and disinfection frequency of the items in treatment rooms was designed with cleansing documentation. UV audits were piloted in Lady Trench (LT) and Tsing Yi Town (TYT) GOPC since July and September 2023 respectively. Passing score is 75%. LT averagely scored 91.7% in July, 98.5% in August, and maintained 100% from September onwards; while TYT increased from 78.6%, 91.3%, 95% to 96.5% in each month. Dressing HH compliance audit was conducted in December with 100% compliance in all clinics. From 4th to 16th December, 262 patients and 191 staff from 11 GOPCs completed the satisfaction survey. Full mark is 10 for each question. Patients’ average score on overall cleanliness of treatment room was 9.1; cleanliness of the seats and bedsheet was 9.1; cleanliness of dressing trolley was 9.2; satisfaction and confidence towards the nurses providing dressing were 9.5 & 9.4 respectively; waiting time satisfaction was 9.1. Staff very much agree (rated 9 or above) that the optimized workflow could increase their understanding (69.1%), alertness (69.7%) and performance (69.1%); and UV audit could boost their understanding (65.1%), alertness (62.8%) and performance (67.5%) in environmental cleansing and disinfection as well as preventing cross-transmission.
