Authors (including presenting author) :
Lui CW(1), Chan SK(2), Chan WY(1)
Affiliation :
(1)Accident and Emergency Department, United Christian Hospital, (2)Continence Care Service, United Christian Hospital
Introduction :
Selected male patients presented to Accident and Emergency Department (AED) with acute retention of urine (AROU) are managed in the community after insertion of an indwelling urinary catheter (IUC) at AED, with follow up trial of weaning off the catheter (TWOC) at outpatient continence care clinic under ambulatory AROU protocol, a care plan in collaboration with urology and continence care clinics. Prior to discharge, AED nurses provide education on the care of IUC. However, some patients find IUC care challenging and catheter-associated issues leading to AED re-attendance are common. To improve patient education and to reduce catheter–related complications, a CQI project was launched in 4Q2018.
Objectives :
1)To standardize the education contents and process of IUC care
2)To facilitate and improve AED nurses’ competency on discharge education
3)To reduce catheter-related complications
Methodology :
Standardization
•Prepared an education handbook on AROU discharge education •Produced a 7-minute patient education video on IUC care Staff Empowerment
Conducted training programs and designed a 5-item self-rated instrument, with scores ranging from 1 to 10 (maximum score=50), with content validated to measure the efficacy of nursing staff on discharge education. 2 tailed paired t-test was used to compare the mean score before and after the project.
Patient Empowerment
•Developed ‘’Patient Reassessment Tool’’ to assess patients’ readiness on discharge
•Developed ‘’Return-Demonstration Training Kit’’
Patient outcome
Unplanned catheter-related AED re-attendance before-and-after design was compared(3-month pre vs post CQI project)
Result & Outcome :
The project has been implemented between 11/9/18-11/12/18. A total of 52 patients were recruited, 34 in study group and 18 in control group. Feedbacks to the video and education handbook from nurses, patients and their caregivers were positive. The unplanned catheter-related AED re-attendance before FU was 17.6% (6/34), compared to 27.8% (5/18), significantly reduced after the project. Also, the mean score (N=10) of nursing staff’s self-efficacy on discharge education was much higher after the project (44.2 Vs 28.1, p<0.001). This project successfully improved the quality of care on AROU patients and enhanced discharge education. The risk of catheter-related AED reattendance was also reduced. Due to the excellent result, this program is adopted as a standard of care for managing AROU patients discharged on IUC in our department.
Co-location with:
