Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Liu SK(1), Shiu TM(1), Chan PS(1), Law SF(1)
Affiliation :
Burn Unit, Department of Surgery, Queen Mary Hospital
Introduction :
Due to the advances in burn treatment, burn-related mortality has been reduced especially in developed countries, the focus of burn care is shifted not only acute care but also rehabilitation. Long term conditions such as wound problems, skin care, exercise training, scar management, psychological and social problems are existed after discharge. However, poor adherence to burn rehabilitation was noted and it has a major impact on clinical outcomes such as scarring, deformity and dysfunctions.
The focus of self-management program is to change the paradigm from paternalistic to collaborative relationship. Self-management is to build up patient equipping ability in problem solving, decision making, and appropriate use of resources and has led to improved patient engagement, adherence, and better quality of care.
Objectives :
1)To assist adult burn patients in understanding their health problems and increase their confidence level throughout the patient journey.
2)To acquire burn patient in knowledge gained and make prompt decision about burn rehabilitation
Methodology :
Burn Self-Management Education(BSME) was implemented in one local adult burn unit by designated burn nursing staff from acute care to rehabilitation starting from January to September,2023. During the acute phase, designated burn nurses introduced “Burn Patient Journey” to participants. “Burn Patient Journey” helps burn patients to visualize and understand all the steps throughout the entire care process of seeking, receiving, and continuing care.
Upon discharge, designated burn nurses taught participants focused post burn care with the aid of prepared teaching material. Brief Action Planning (BAP) was used to guide the selected patients in setting goal-oriented behaviors action planning.
Burn rehabilitation knowledge questionnaire, confidence level (self rating from 0 to 10) were collected upon discharge and 1st out-patient attendance. Treatment adherence, specialist out-patient attendance, compliance in allied health referral were collected at out-patient setting.
Result & Outcome :
Total 25 burn adult patients (M=15; F=8) were involved in self-management education. The mean TBSA of burn injuries (%) was 10.84+/-6.58. Subgroup analysis was also done according to different burn depth, which prone to scar formation.
Confidence level was increased 41% from 5.48 +/-1.12 (acute phase) to 6.84 +/-0.74 (upon discharge) and 8.0 +/-0.81 (1st follow up)(p< .0.01).
Higher confidence level was observed at low-risk group than high risk group at acute phase and upon discharge with significant result
Burn patients acquire higher(35%) knowledge gained in handling the
process of post burn rehabilitation(p<0.001).
Overall treatment adherence against wound care, skin care, itchiness, pain control, exercise, and scar management were 72% to 88%. High level of specialist outpatient attendance (95%) and compliance in allied health referral (78%)were observed. Overall satisfaction toward self-management teaching is 4.4 out of 5.
Incorporation of self-management throughout burn patient can empower burn patients with higher confidence level and knowledge level in managing their own condition.
