Page 116 - Hospital Authority Convention 2017
P. 116
Parallel Sessions
HOSPITAL AUTHORITY CONVENTION 2017
PS3.4 Nurse Clinic 14:30 Room 221
Multi-disciplinary Approach in Trial without Catheter
Yim MS
Department of Surgery, Princess Margaret Hospital, Hong Kong
Objectives
Hong Kong has an ageing population with continuing growth in public healthcare service demand. In Princess Margaret
Hospital, readmission for trial off urinary catheter has a great impact on hospital resources. In view of the situation, the multi-
disciplinary approach in catheter management and the trial wean off catheter (TWOC) model is adopted to aim at reducing
unnecessary hospital admission.
Methodology
According to the TWOC model, community nurse accepts referrals from surgical and medical units based on the following
criteria:
• Bed ridden patient
• No significant problem when inserting catheter
TWOC
Tuesday, 16 May • Successful TWOC: patient passed urine and residual urine is less than 300ml.
• Unsuccessful TWOC: failed voiding and residual urine more than 300 ml. Advance special outpatient clinic within six to
eight weeks.
• Doubtful case: void less than 100ml urine or residual urine less than 100ml.
Roles of Urology Nurse Consultant
(1) To coordinate with community nurse on the TWOC model; and to provide training and support community nurse when in
doubt.
Results
In 2016, there were 170 patients referred to community nurse according to TWOC model. Of the 41% failed TWOC, 1% was
readmitted for inpatient TWOC and 40% were treated in outpatient clinic. Urologist reviewed patient within eight weeks after
urinary catheter reinserted. Nurse consultant received daily call from community nurse and provided clinical support when
enquiries with case management were made.
Conclusion
The TWOC model has successfully eliminated unnecessary hospital admission and improved patient’s quality of care. This
project can further improve resource allocation and patient care if the service extends to urology patients in orthopaedics
and neurosurgery unit.
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