One Chart to Improve Attendance Rate of Patient Training Session and Activities

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Abstract Summary
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Authors (including presenting author) :
Yeung W(1), Mak YMK(2), Leung TYC(3), Chong SPJ(4), Wan KMJ(5), Lam MYM(6)
Affiliation :
(1)Infirmary Unit, Cheshire Home, Shatin, (2)Nursing Division, Cheshire Home, Shatin, (3)Physiotherapy Department, Cheshire Home, Shatin, (4)Occupational Therapy Department, Cheshire Home, Shatin, (5)Supporting Service Department, Cheshire Home, Shatin
Objectives :
Patients in Cheshire Home Shatin (SCH) are cared in multidisciplinary team approach. Physiotherapists and occupational therapist coordinate different therapeutic training sessions and medical social workers provide a large variety of activities to the patients. Nurses, on the other hand, deliver day to day bedside care and treatments to the same group of patients as well. However, some of the training sessions and activities may crash with nursing care routines and thus delayed or even cancelled. All training sessions and activities were scheduled and listed to wards at least one week before, however, on different papers. Nurses did not have a whole picture of the upcoming activities. The objective of the improvement program is to enhance successful rate of patients attending training sessions and activities and reduce wastage of training sessions and activities offered, as well as the manpower involved.
Methodology :
An improvement program was piloted in 3 wards in SCH including Ward 1, Ward 3 and Ward 8 in September 2018 and fully implemented in all wards in October 2018. A patient activity chart was designed for each ward to provide nursing staff a one page summary of patient activities of the day. Staff will be able identify crashes of activities and make appropriate arrangement in advance, in order to reduce delay or cancellation of patient activities. Nurses of pm shift will enter patient activities of the next day into the char according to the activity lists from Physiotherapy, Occupational Therapy and Medical Social Support Unit. Besides, scheduled nursing activities such as bathing and sitting out were marked on the chart as well. Activities of the same patient falling on the same time slot indicate crash of activities. Nurses will make adjustments or special arrangement accordingly as to avoid the crashes.
Result & Outcome :
Successful rates of attending training sessions provided by PT, OT and activities organized by MSSU were collected. Outcome is measured by comparing the results before and after the improvement program. The successful rates increased from 73.0% (before implementation) to 84.3% (after implementation). On the other hand,questionnaires were collected from nurses and supporting staff. The overall satisfaction was 4.02 out of 5 marks. The average preparation time for the Patient Activity Chart was 6.4 minutes (ranged from 3-15 minutes). 85% of the staff agreed that program improved the rate of successful attendance. 67% agreed that the time for preparing the chart is accetable while % 54% agreed that the chart reduced disturbance during nursing routine.

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