Timely initiation of dialysis is vital to chronic kidney disease stage 5 (CKD5) patients. Literatures reviewed that unplanned urgent initiation of dialysis was associated with poorer outcomes and early pre-dialysis education enhanced greater likelihood of elective dialysis. Pre-dialysis education is referred by renal physician when patients are approaching CKD5 and carried out in renal nurse clinic in Hong Kong. However, the average non-attendance rate of the new appointment in five renal nurse clinics under Hospital Authority (HA) was undesirable with 15.28% (n=288) from May 2017 to July 2017. Therefore, evidence-based practice (EBP) was applied to decrease the non-attendance of new appointment in these clinics. Method: Applying the John Hopkins Nursing Evidence-based Practice (Practice question, Evidence, Translation) Model, a new phone reminder service was implemented from July 2018 to September 2018 in these five renal nurse clinics. The clerks of the involved clinics called patients attending the first pre-dialysis education one week before appointment. Maximum three calls within two days were delivered. If the patients could not be contacted, voice messages were left to their message boxes if available. Changing of appointment was allowed upon patient??s request. The content of the reminder was standardized by a script and the compliance of the clerk was audited by a renal nurse with a standard audit tool. Results: Collectively 267 patients were booked for first pre-dialysis education during the intervention period in five renal nurse clinics. 24 patients requested changing appointment. 15 patients defaulted, the average non-attendance decreased from baseline 15.28% to 5.29% which was statistically significant (p=0.001). Conclusion: The judicious use of current best evidence to reduce the non-attendance rate of first pre-dialysis education in out-patient setting may be effective to reduce the possible risk of unplanned urgent initiation of dialysis to safeguard our patients.

Background: Fasciotomy is essential for the prevention and management of compartment syndrome on limbs. The traditional method is to wet to dry dressing to the wide laid open wound to well prepare the wound bed for closure. Most fasciotomy wounds will require delayed primary closure and there may require number of surgeries.
Patients and method: Applied Evidence Base Practice (EBP) by using Negative Pressure Wound Therapy (NPWT) to the patients who suffered compartment syndrome with fasciotomy among five Orthopaedic and Traumatology units in Hong Kong hospital Duration: May, 2018 to Jan, 2019 Results: The usage of NPWT is increasing by 7% to 40% (n=8). The mean of wound closure times (day) of NPWT group is 15.86 days more than non-NPWT group. In the large wound size group, the mean of wound closure times in NPWT group is 3.42 days lesser than non-NPWT group. Conclusion: Usage of NPWT is more common in managing fasciotomy wound not only target on fasten the wound closure time but also benefit on edema control, promote granulation, decrease bacteria load and cosmetic appearance, but also for early reconstruction and rehabilitation. NPWT is tends to apply on large fasciotomy wound with effective wound bed preparation for wound closure.

A chemical eye injury is when a chemical gets into the eye and harms it. Different types of chemicals can cause a chemical eye injury. Examples include chemicals found in cleansing products, bleach, hair dyes, and lawn fertilizers. Some chemicals cause only mild or short-term symptoms. Other chemicals can cause severe damage, including scarring of the cornea or vision loss. How mild or serious an injury is depends on the type of chemical, how long the chemical is in the eye and how far into the eye the chemical spreads. Without prompt intervention, irreversible visual loss and cutaneous disfigurement may prevail. However, there is variation in practice in giving nursing intervention to adult patient with chemical eye injury in emergency departments. There is no standard operating procedure in Hospital Authority. Therefore, there are variation in methods, solutions, skills, time and performers. Our group aimed to find out the best evidence to deal with chemical eye injury to the adult patients while attending the emergency department by conducting a literature search with the Johns Hopkins evidence base practice framework. Finally, there are recommendations on such issue with the translation timetable into practice by the trail run in 5 local emergency departments.

Background Our hospitals Digestive Medicine Centre has a diverse patient population including those who may not understand English and/or Chinese. Patients who come to our centre for colonoscopy arrangement require adequate and clear instructions of bowel preparation. As colorectal cancer is the second leading cause of death in Hong Kong and third leading cause of death in the world, it is our foremost priority to ensure that colonoscopy preparation is optimal to ensure complete and accurate examination of the whole colonic lining. Patients must follow a strict pre-endoscopy diet and bowel prep protocol. According to the literature, many patients reported experiencing unpleasant, difficult and disruptive care during the bowel preparation process for a colonoscopy. Up to 25% of patients are not given adequate bowel preparation instructions. A visual educational leaflet may increase patient understanding of the procedure and improve bowel preparation. Purpose and Problem Statement Currently, we provide written instructions for patients for patients who are undergoing colonoscopy. The PICO question is: Does the implementation of visual instructional cards improve patient compliance on bowel preparation for a colonoscopy? Design and Method By obtaining the bowel preparation results from the endoscopy report. It divided into four parts: Good, fair, poor and not mentioned. Using descriptive statistics to analyze pre and post data. Implementation Plan With the support from Hong Kong Sanatorium and Hospital medical group doctors, four visual instructional cards were implemented with simple Chinese and English wordings. The four visual instructional cards are: how to take Pico-Prep, how to take Klean-Prep, the ready of the stool color for colonoscopy and the importance of a clean colon. These instructional cards were used in three centres: Digestive Medicine Centre, Gastroenterology and Hepatology Centre and endoscopy centre as a trial. Results The results were collected from September 2018. A total of 91 cases were reviewed and surprisingly found that 86% cases have good bowel preparation while there is no report without mention how the bowel preparation is. To compare with the same period with 127 cases reviewed by not using the visual instructional cards for bowel preparation education, there are only 37% cases have good bowel preparation