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) :
Wong Y W, Cheung CM, Sun LF, Wong ML, Wong YY, Chan K
Affiliation :
Department of TB and Chest (DTBC), Wong Tai Sin Hospital
Introduction :
Pressure Injury (PI) poses a formidable challenge, inflicting not only physical discomfort upon patients but also extending their hospitalization duration. “aSSKINg” Model is adopted for PI prevention, which includes seven components, and executed by the following interventions: Assess risk- by using Braden score to perform an initial and continuous assessment, Surface - providing appropriate pressure relieving surface during lying or sitting, Skin inspection – performing daily head-to-toe skin inspection to enhance early detection of skin change, Keep moving - regular turning schedule, daily sitting out and refer physiotherapist and occupational therapist for mobilization or walking exercise, Incontinence and moisture - applying Vaseline after cleansing during napkin round to prevent skin damage, Nutrition - monitoring patients’ appetite and monthly body weight, and refer dietitian if necessary, and Give information – providing education to nurses and care giver that increase the awareness and knowledge about PI. In 2022 at WTSH, the “aSSKINg” Model was implemented to reduce PI rate by enhancing early and accurate assessment and giving information to patients and relatives.
Objectives :
(1) to enhance the risk assessment by using Braden score; (2) to provide education to patient and care giver; (3) to reduce PI rate in DTBC (with all measures).
Methodology :
(1) providing education section of “aSSKINg” model and reinforce the assessment using Braden score with Pre-test and Post-test to nursing staff, (2) performing secondary review of Braden score rating to compare the rating accuracy before and after providing training to nurses, (3) providing educational materials to all patients or caregivers who are recruited in this project.
Result & Outcome :
(1) education section with pre-test and post-test was provided to total 42 nurses in May 2023, 88.1% nurses have higher marks on post-test, (2) from February 2023 to December 2023, a total of 1854 patients’ Braden score were secondary reviewed by pressure injury linked nurses. Among them, 1122 patients scored below 23. In February 2023, the accuracy of Braden score rating comparing primary rating with secondary review was 46.15%. Following the implementation of an educational section for nurses, the accuracy increased to 71.43% in December 2023. (2) from 2Q22 to 4Q23, the PI rate in DTBC decreasing from 1.4 to 0.0.
