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): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Wong WY Teresa(1), Fung YF Cherrie(1), Tang TK Chloris(1), Yuen KK Steve(1), Wong KY Rachel(1), Ng KL Frances(1)
Affiliation :
(1)Department of Medicine and Geriatrics, Caritas Medical Centre
Introduction :
Subcutaneous(S.C.) infusion with drugs is now more commonly used in patients who suffered from severe pain. In general Medicine and Geriatrics (M&G) ward setting, the use of S.C. infusions are also increasingly employed for pain and symptom control, as well as rehydration therapy in non-cancer patients. In contrast with PCU settings, nurses in general M&G wards are less experienced in the preparation, administration and monitoring of S.C. infusion especially dangerous drugs such as opioid are frequently used in S.C. infusion. Ensuring competency in knowledge and skills on use of S.C. infusion would be the top priority for promoting patient safety in M&G wards.
Objectives :
(1)To strengthen the knowledge and skills in preparation & administration of S.C infusion (2)To increase the awareness and highlight the potential pitfalls in use of S.C. infusion (3)To promulgate proper documentation and clinical handover regarding use of S.C. infusion.
Methodology :
A comprehensive education program which consisted of 3 sessions were conducted between Sep 2023 to Dec 2023. 1. Lecture-based session: A one-hour lecture with hybrid mode was conducted for all nurses. KWC Palliative Care Nurse Consultant was invited to share her experience and updated evidence-based practice regarding S.C. infusion. Pre- and post-test were provided to evaluate nurse's knowledge improvement. 2. Scenario training session(train the trainer session): A one-hour scenario training session which focus on S.C. cannulation skills, nursing care skills, knowledge, communication and handling with dangerous drugs was reserved for the representatives(n=20) from each M&G ward. Representatives need to audit their ward nurses after the training session. 3. Spot checking session: Spot checking regarding nurses’ compliance on proper documentation and provide standard nursing care for patients with S.C. infusion will be carried out in all M&G wards.
Result & Outcome :
Significant improvement was shown in the pre- and post-test results. The average score increased from 63.2% to 92.6% respectively. The audit results for ward nurses (n=250) regarding S.C. infusion nursing care skills were 100%. Spot checking in M&G ward was performed and the compliance rate was 100% in Mar 2024. Spot checking will continue until all the M&G wards have achieved 100% compliance rate. Based on the above result, M&G nurses showed knowledge and skills improvement towards S.C. infusion care and were able to maintain standard of nursing care with proper documentation for patients.
