Most Proposed Topic :
Clinical Safety and Quality Service I (projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors: (including presenting author): :
Chow HY(1), Li ML(1), Chun WK(1), Hui MW(1), Chan HY(1), Li OT(1)
Affiliation: :
(1)Department of Surgery, Tuen Mun Hospital
Introduction: :
Indwelling urethral catheters (IUC) are commonly used in healthcare settings to facilitate the management of acute and chronic illnesses for patients. Among the complications of IUC, catheter-associated urinary tract infection (CAUTI) and urethral trauma are commonly found in the catheterized patients. For the IUC maintenance, proper securement of IUC can prevent movement and urethral traction causing trauma. It is recommended that non-ambulant patients, especially those who do not bathe daily, undergo daily cleansing of their meatus. In busy acute wards in Hong Kong hospitals, Patient Care Assistants (PCA) typically perform routine tasks such as changing napkins and bed baths. However, there is often a lack of structured training and governance to ensure optimal practice in surgical wards. To address this situation, an enhancement program was initiated to improve education and care standards for the maintenance of IUC.
Objectives: :
To Promote staff education
To acquire evidence-based practice to facilitate catheter-associated urinary tract infection (CAUTI) prevention
To maintain the standard of care of IUC
Methodology: :
Guidelines of IUC care has been updated, strengthening on the areas of maintenance of urinary catheter system and meatal care. Videos of female and male meatal care and IUC maintenance were uploaded to the department website for easy access and revision. Assessment forms have been formulated. All PCAs in an acute surgical ward were assessed by trained specialty nurses focusing on the current practice in February 2023. Training and coaching was performed afterwards, including individual staff education at the bedside. Evaluation was done again in May 2023. Before and after the program, an assessment was conducted to evaluate the compliance of the application of securement. Satisfaction survey among PCAs was performed.
Result & Outcome: :
Assessments were done to 12 PCAs with a 10-item form, scoring 1 mark each item. Pre-program assessment (mean was 6.5 and median was 7) and post-program assessment (mean was 9.9 and median was 10) were performed with p-value .00222. The compliance rate for the application of securement increased significantly, rising from 27% to 72%. A 6-item satisfaction survey among PCAs showed positive feedback.
Significant improvement was obtained on performance of meatal care among PCAs after education program, including reviewing the videos online and hands-on training. They are satisfied with the program and commented it as useful and practical. It is important to conduct regular coaching and evaluation to ensure quality of maintenance care of IUC to promote patient’s comfort.
