A Comprehensive Nurse-led Wound Care Service in O&T - From unit to cluster and from in-patient setting to across the whole patient journey

Abstract Description

Authors (including presenting author) :

Cheng, YCA, Cheung SSS, Ho MW, Yung KT, Mok LC, Chui KW, Ng YM, Wong PH, Lam T, Lam WN, Wong ACF, Wong WK

Affiliation :

Department of Orthopaedics & Traumatology
PYNEH

Introduction :

In the patient-mix of Orthopaedics & Traumatology (O&T), it is recognized that more than 70% of patient has acute or chronic wound. Not only the case load is huge, the types and natures of wounds are moving to a high varieties and complexity.
From the literature, a well-established nurse-led wound care service is found to be cost-effective in maintaining a high quality of services.

Objectives :

To provide cost-effective wound care service to O&T clients in Hong Kong East Cluster (HKEC).

Methodology :

The O&T nurse-led wound care service commenced at PYNEH in 2004. It was continually developed and enhanced in order to meet the escalating service demand. The scope of services was expanded from unit-base to cluster-base. Out-reach, on-site services were provided in a consultation base. It was since a 3-tier wound care model established in 2010 and the O&T Nurse Clinic accredited in 2016, not only in-patient, day-patient and out-patient in O&T with complicated wound problems were also put into the “Care Net” which is managed by a designated nursing team. The team works independently in one hand and on the other well collaborated with medical staff, providing wound care consultation and support services to a wide variety of patients in HKEC.

Result & Outcome :

Over the past 13 years, the yearly case load managed was jumped up from about 420 in 2004 to about 2620 in 2017 (~620% increase). Such development reduced the in-patient length of stay by down-streaming the service to a less costly setting. Average in-patient length of stay in O&T over years was significantly reduced from about 5.5 to 4.8 days (~13% reduction).
Last but not the least, patients could receive a designated, consistent wound care during the whole patient journey no matter he / she located at which settings in HKEC.