Authors (including presenting author) :
Leung CK(1), Au SM(1), Chan CS(2)
Affiliation :
(1)Geriatric Medical Unit, Grantham Hospital, (2)Occupational Therapy Department, Grantham Hospital
Introduction :
-Pressure relieving device is traditionally decided and applied by nurses in ward. Occupational Therapists (OT) would also prescribe pressure relieving devices for some high-risk cases during their case management. -However, the recommendation of pressure relieving device among the high-risk cases in GMU was unclear as there was no structured/standardized documentation on the pressure injury prevention care plan from OT. Therefore, the communication and monitoring of the implementation of recommended pressure prevention/ relief device or positioning device by OT in ward might be inadequate. -Besides applying the appropriate device, nurses play many other important roles in pressure injury prevention and management. As intergraded team approach, OT could be more proactive in pressure injury prevention among daily patient care.
Objectives :
-To enhance recommendation and monitoring of appropriate pressure relieving/ positioning devices to high-risk cases. -To enhance communication and collaboration between ward staff and OT staff on applying pressure relieving or positioning device by clear documentation.
Methodology :
1.Stocktaking of existing pressure reliving device was carried out in GMU and Occupational Therapy Department. 2.Briefing session on different pressure relieving device available in GMU was conducted by Occupational Therapist to nursing staff in ward. 3.High risk patients (Norton score < 14 on admission) were referred to OT for pressure injury prevention/ management. 4.Appropriate pressure relieving device(s) were prescribed and applied to patient after OT assessment with an instruction sheet attached for each case. 5.Nursing and supporting staff monitored the application of the prescribed pressure relieving device(s) in ward according to the instruction sheet. 6.The instructions sheet were reviewed and updated by OT regularly.
Result & Outcome :
1.Appropriate pressure relieving device(s) could be provided for high risk clients according to recommendation by OTs. 2.Pressure relieving device(s) could be utilized correctly in daily care of patients. 3.The number of hospital acquired pressure injury could be minimized. 4.The awareness of importance and application of pressure relieving device(s) from both ward staff and caregiver could be increased. 1.A total of 101 cases were referred to OT for assessment from 10/2018 – 11/2018. 2.The referral rate to OT for pressure injury prevention for high risk patients is over 80%. 3.The response rate and time of OT for this program are >90% and within 3 working days respectively. 4.There was no hospital acquired pressure injury for selected cases during the pilot period. 5.Among the cases who need pressure relieving or positioning device, heel protector and wedged cushion were the most commonly prescribed device. However, the stock of some pressure relieving/ positioning device was not enough to meet the actual needs. 6.The compliance rate of OT recommendation according to instruction sheet is over 70%.
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