Page 200 - Hospital Authority Convention 2017
P. 200

Parallel Sessions
      HOSPITAL AUTHORITY CONVENTION 2017


             PS14.4    Community Outreaching Services                                    14:30  Room 221

            A Trial without Catheter for Patients in the Community
            Li KKY
            Community Nursing Service, Princess Margaret Hospital, Hong Kong
            Introduction
            Trial without Catheter (TWOC) is an indispensable and integral part of indwelling urinary catheter management. TWOC
            performed in the community for non-ambulatory patients allows timely procedure with reduced risk of untoward events in
            hospital, elimination of patients’ toil, reduced cost in transportation to hospital, and decreased burden of hospital services.

            Objectives To generate a new model of service on TWOC for patients in the community; (2) to facilitate timely TWOC and
            prevent unnecessary admission of patients; and (3)  to enhance patient experience in their home environment.

            Methodology
            “A TWOC Model for Patients in the Community” is a quality improvement model in Princess Margaret Hospital Community
            Nursing Service (CNS) with its groundwork supported by evidence, cross-specialities collaboration and staff empowerment.
            A thorough literature search on TWOC was conducted and the best available evidence was identified for formulating the
            model. Cross-specialties collaboration was established among Urology, Accident and Emergency, Medical and Geriatric
            departments for expertise opinions and further refinement of the model. Achieving clinical competency with respect to
            advanced practice development  has  been  emphasised as  central  to risk reduction  and  assurance  of  quality care.  Before
            implementation of the model, CNS nurses were trained with knowledge and management on TWOC. Staff competency on
            TWOC was ensured by audits at patients’ homes.

            Results
            The TWOC Model was implemented in December 2015. Until the end of January 2017, 152 TWOCs were done with a success
            rate of 63%. Mean age of the patients was 80 years. 55% of them were male and 63% were living in elderly homes. Patients
            with unsuccessful TWOC were arranged earlier follow-ups or clinical admission for TWOC in accordance with the model.

            Conclusions
            “The TWOC Model for Patients in the Community” is an innovative approach in local area in delivering standardised and
            evidence-based practice on TWOC for non-ambulatory patients at their homes. This model promotes the optimal outcomes
            of TWOC for a patient with indwelling urinary catheter. Further research would be conducted to explore the predictors of
            successful TWOC.






      Wednesday, 17 May



































   198
   195   196   197   198   199   200   201   202   203   204   205