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Abstract

Introduction: Hong Kong is a over-crowded and aging population city. Complex health needs has made Community Nurses (CNs) a tremendous workload. In Kowloon Hospital’s Community Nursing Service (CNS), over 70% of cases are wound care. CNs pay lots of effort and home visits to support wound care, especially stage 3-4 wound. Another problem is wound care dressing materials and different wound care experiences confuse Community Nurses (CNs) in making a competent clinical judgment. Hence, effective wound care and debridement can accelerate wound healing and reduce bed days in turn (Wounds UK, 2013). Wound debridement enhancement program was thus carried out in January 2018 in Kowloon Hospital CNS. Objectives: • Enhance wound care knowledge and technique • Evaluate the standard of Conservative Sharp Wound Debridement (CSWD) among community nurses • Reduce home visits by speedy wound healing Methodology: The program was implemented in two phases – Training & Audit Phase 1 • A booklet of wound dressing products quick reference and wound care tips was produced • Carry out a training lecture on CSWD to CNs in order to enhance their knowledge and align the practice • Workshop was conducted for CSWD. Skill-transfer and assessment of CSWD was directly conducted to colleagues Phase 2 • Audit on CSWD and wound care were carried among those CNs who achieved the CSWD requirements • Audit report and recommendation were introduced in the CNS in order to increase the alertness and alignment of wound care Result: Before the program, CNs used to follow the wound care advices from different specialties e.g. orthopaedic, surgical or medical unit background. CNs is not confident enough in making clinical judgment on wound care, especially CSWD. After the program, majority of CSWD procedure (98.17%) compliance rate met the standard criteria of the procedure. 96.3% CNs expressed confidence to perform CSWD in the community, 100% of CNs agreed that they got more knowledge to care different type of wounds in the community. When compares the pre and post program for 3 months, wound healed cases increased from 728 cases/3 months to 748 cases/ 3 months. 260 home visits were saved after the program in 3months. Conclusion: CNS care for numerous frailty and advanced age of community clients. Safe and effective wound care is very important. It is not only improved quality of care in speedy recovery. Promotion of wound healing allows CNS spare more home visits to care and support these clients. After this program, number of home visits has been significantly. Clients’ wellbeing and cost effectiveness could also be improved

Biography

So Ching Lee is working at Kow Loon Hospital, Hong Kong

E-mail: fannysoching@yahoo.com.hk