Authors (including presenting author) :
Shek MK (1), Cheung HH (1), Lui WK (1), Ng YB (1)
Affiliation :
(1)Medical and Geriatric, United Christian Hospital
Introduction :
Hospital Authority has allocated manpower and resources to meet the incremental service in winter surge. A Rapid-Response Nursing Squad (SQUAD) established in acute medicine ward 9B to enhance the management of Influenza-like illness (ILI).
Objectives :
1. Provide rapid response to influenza confirmed or suspected cases 2. Enhance collaboration with physician to the management of ILI 3. Relieve the workload of ward nurses 4. Cultural changes on early specimens processing for early diagnosis / treatment 5. Increase team spirit and commitment in service
Methodology :
Time frame: Winter-surge of 2018-2019 Squad members: Leaded by 1 APN with infection control certificated & assisted by 1 RN. SQUAD is operated in volunteer basis with no extra resource use. Areas of work: 1 Proactively and rapidly assists in nasopharyngeal aspirate (NPA) or swab (NPS) and Sputum/Tracheal aspirate collecting and providing interventions for difficult cases. 2 Provides active surveillance of laboratory results on top of routinely screening by ward physicians and nurses. Rapidly response to influenza positive cases and alert to physicians and nurses. 3 Additional alert provided to on-call physician of the condition changes of ILI cases in non-official hours. 4 Active surveillance of laboratory results to assist on-call physician and department in-charge nurse to manage isolation room utilized by ILI cases.
Result & Outcome :
In December of 2018, total 94 requests of NPS/NPA (n=94) made for patients admitted from AED, in which 74 specimens (78.7%) collected within 1 hour from time of request and 17 specimens (18.1%) collected by SQUAD. The influenza A positive rate is 7.4%. Total 37 requests of sputum for PCR influenza A/B/RSV (n=37) made for patient admitted, in which 31 specimens (83.8%) collected within 24 hours from time of request and 24 specimens (64.9%) collected by SQUAD. The influenza A positive rate is 8.1%. 13.5% of patients with difficulty in yielding sputum referred to chest physiotherapy by SQUAD. Highlighted that rate of sputum specimens collected within 24 hours improved from 43% (n=35) in November to 83.8% in December. An increasing trend of influenza positive rate noted. Advice of infection control provided to both physicians and nurses timely. Commitment and team spirit developed throughout. SQUAD is affirmed in significantly improving the efficiency of specimens collecting, inter-disciplines collaboration and ward nurses’ workload relieving with quantitative data support. SQUAD is an exemplar of cultural changes on early specimen saving in busy department. Along with the severe influenza surge in deep winter, SQUAD would be one of effective against measures.
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