Nurse-led Collaborative Quality Improvement Project on Denture Care Initiatives in HKEC Cluster Hospitals

Abstract Description

Proposed Topic (Most preferred): :

Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)

Authors (including presenting author) :

LIU YK(1), SIN TCS(1), PUN KL(2), MOK LC(1), WONG WYW(3)

Affiliation :

(1)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, (2)Nursing Services Division, Tung Wah Eastern Hospital, (3)Patient Safety Risk Management, Quality and Safety Division, Hospital Authority

Introduction :

Dentures are important prostheses in reconstruction of patients’ masticatory performance, which in turn, improves their nutritional status. Loss of denture adversely affects patient intake, communication and dignity. Since denture loss incidents recurrently happened in HKEC cluster hospitals, a pilot project on Denture Care Initiatives was implemented in 2023.

Objectives :

1.Reduce denture loss through
i) standardizing denture container
ii) establishing workflow on denture care, and
iii) promoting patient education
2. Raise staff awareness of proper handling of dentures

Methodology :

i. Review on Denture Loss incidents
A review of denture loss incidents in HKEC cluster hospitals from Sep 19 to Aug 22 was conducted. The reasons for denture loss included improper storage, ineffective clinical handover, unawareness of patients’ dentures. Denture loss typically occurred during inpatient stays, particularly after mealtime / patient’s vomiting and patient transfer.

ii. Denture Care Initiatives The pilot project was implemented across all HKEC cluster hospitals from May 23 to Oct 23. Cluster-designed transparent denture containers, bedhead signages, and patient information leaflets were provided to patients with detachable dentures. Over 1,000 denture containers were distributed in designated wards. Training sessions on denture care, related clinical handover, documentation, and management of missing dentures were conducted for frontline nurses, patient care assistants and catering staff.

iii. Collection of feedback Questionnaires were distributed to patients, relatives and nurses to comment on this program.

Result & Outcome :

Of the 80 questionnaires returned, around 90% of them agreed that the dentures container was eye-catching and dentures were easily visible in the transparent container. Besides, the denture container with label was less likely to be discarded accidentally. Moreover, 92% of respondents expressed that the content of the information leaflet effectively delivered denture care education to patients. All respondents agreed that the standardized denture signage could remind staff of proper handling of patient’s dentures as necessary. With the established workflow on denture care, clinical staff became more aware of the importance of clinical handover and documentation, and related nursing care, including proper storage of dentures and patient education.

In summary, the project enhanced staff awareness on proper handling of patients’ dentures and minimized the risk of denture loss. The project will be continued in all inpatient units in HKEC. In the long run, the Cluster Nursing Services Division (NSD) will align with Head Office NSD to reduce denture loss incidents in clinical areas.