Authors (including presenting author) :
Ms. Lo Ka Man Carmen (1) Mr. Mak Cheuk Hang Thomas(2) Dr. Kwok Ka Bon ( 3) Dr. Hung Yuk Wah (3) Ms Wong Siu Wan (1) Ms. Lam Suet Wai Tiffany(1) Ms Leung Hin Wan (2) Ms Lau Mei Yan (2) Ms. Cheng Mum Yee Amy (1) Mr. Lau Wing Keung (2) Dr. Fan Chi Ho (3)
Affiliation :
1: Register nurse, Department of Orthopaedics and Traumtology, Joint Replacement Centre, AHNH 2: Department of physiotherapy; AHNH 3: Department of Orthopaedic and Traumatology, Joint Replacement Centre, AHNH
Introduction :
Post op wound care is utmost important to prevent deep seated infection after total joint replacement. Traditionally, significant resources were spent in this area. New one-stop service between Physiotherapist and Joint speciality nurse team was launched to streamline postoperative screening and basic wound care. We aim to detect complications at early stage and provide timely attention and intervention, thus improve patient satisfactory and reduce the chance of re-admission. This also empowered allied health and reduce the burden of SOPD clinic, which enable more effective utilization of resources.
Objectives :
Through this program, we aim to achieve following outcome
1: enable timely identification and management of wound complication( improve surgical outcome and patient satisfactory) 2: reduce unplanned readmission through AED
3: enhance effective utilization of resource by reduce SOPD booking
Methodology :
Structural Designed program involve
Phase 1: Well Designed Training program for wound care for Physiotherapist to improve their knowledge Phase 2: before operation, Concept for PT-Nurse co-care for postop wound management was introduced in order to improve patient awareness and acceptance new model of care Phase 3: Physiotherapist take active role of screening of outer dressing of wound during rehabilitation period. Fast Track walk in clinic to Joint Specialty nurse will be referral is any wound complication was suspicious. Before the development of this pathway, patients inevitably have to either consult A&E dept or GOPC appointment which definitely causes delay in wound management.
Result & Outcome :
-Decrease O&T SOPD TJR FU by 330 attendances. -From Jul 2017 to Jun 2018, 161 post-op. TJR patients were referred to nurse clinic for further wound management: 80 % of them required further management for wound infection; 3 % for joint assessment; 17% for other issue (e.g. drugs counselling or referral to other AH service); 10 % of referred patients need same-day O&T doctor consultation (e.g. for medication prescription or investigation.) Conclusion: with well designed protocol and patient education, our new model of care can improve surgical outcome ( reduce complication and unplanned readmission), but also enhance better utilization of medical resources
Co-location with:
