The Decennium Changes in Primary Health Care Wound Clinic – Safe, Quality & Efficient

Introduction

The aging people and on time discharge minimized prolong hospitalization, in order to face with the increasing demand and complexity of wound care in Primary Health Care. Before 2009, there is lack of standardization on wound assessment, planning, training and referral system, resulting in unnecessary dressing frequency and heavy workload.

Objectives

To provide safe and effective wound care in primary health care.

Methodology

A structural referral system was launched in 2009, from frontline to wound specialist which frontline nurses are responsible for screening and assessment. Wound link nurse in each clinic would devise a wound management plan and monitor the progress on healing. Wound specialist would initiate advanced investigations and interventions when healing is delayed. Knowledge & skill transfer like wound information update via Department Intranet, Wound Assessment Quick Guide and new wound products sharing class can facilitate frontline staff to tackle the wound problems. Through patient empowerment program (Leg Club and Walk with Diabetes - Foot Care), and a series of poster and educational pamphlet on burn & scald care, varicose, fallacies of wound care and ingrown toe nail care, etc. can arouse the awareness on patient immediate care on wound. Also local Evidence Based Studies on wound pain control and wound shower could build up the confidence on both patients and nursing staff.

Results & Outcome

The statistical dressing attendance in General Out-patient Clinic was dramatically drop around 25.2%, from 85536 in 2008 to 63999 in 2018. However, the numbers of patient were increased around 17.6% from 15802 to 18582 respectively. The healing rate on leg ulcer, burn & scald and traumatic wound have 30-50% speed up. Statistically showed that even increasing service capacity and without any extra nursing manpower and clinic space, the performance on wound care can be effectively delivered. The well establish referral system is getting efficient in wound management. Wound Clinic can provide continuity & safety care by close monitoring and enhanced service quality of wound care in community by early detection and proactive therapeutic nursing intervention and empowerment.