Page 200 - Hospital Authority Convention 2017

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

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