Page 111 - Hospital Authority Convention 2018

Parallel Sessions

PS4.1 Collaborative Service Programmes 16:15 Room 221

Transdisciplinary Seating and Wheelchair Service in Prince of Wales Hospital – A 20-Year Collaboration of
University, Hospital Authority and Corporate Community Support
1
2
Cheung A , Lau A , Chan HL 3
1 Occupational Therapy Department, Prosthetic and Orthotic Department, Physiotherapy Department, Prince of Wales Hospital, HOSPITAL AUTHORITY CONVENTION 2018
3
2
Hong Kong
The Seating Clinic and Wheelchair Bank has been serving the disabled children for 20 years since it was established in 1996.
It was the first of its kind dedicated to help children with the most severe neuromuscular diseases in Hong Kong with the
collaboration of Prince of Wales Hospital, The Chinese University of Hong Kong, The Hong Kong Polytechnic University and
Corporate Community Support.
The seating clinic is supported by a multidisciplinary team including Paediatric Orthopaedic Surgeon, Rehabilitation Engineer,
Physiotherapist, Occupational Therapist, Prosthetist-Orthotist and Technical Assistant. It provides an one-stop clinical
service to the children with multiple disabilities, thereby taking care of their medical, functional and educational needs by
means of detailed clinical assessment and intervention. The Wheelchair Bank is funded by corporate community to equip the
bank with hardware of specialised seating, mobility devices and technologies.
The unique concept of wheelchair bank is to maximise the usage by recycling the wheelchairs and sharing among the needy
children. With the establishment of the bank of different models, size and modular component, our clinic provides a whole
range of specialised systems for therapeutic seating management. This collaboration model has benefited more than 537
children with more than 6,000 wheelchairs and devices prescribed and customised to patients in the past 20 years. The
wheelchair loan service has provided more than 750 times of wheelchair loan. There was a maximum of 10 loans for a single
wheelchair and maximum of eight loans for a single client until skeletally mature.
Our multidisciplinary team provides services to children through a transdisciplinary approach based on the experience Monday, 7 May 2018
accumulated over the past 20 years.
In addition to providing tertiary services to the needy children, we also establish international connections, and collaboration
for knowledge exchange as well as the unique “BANK” concept and team approach model to other local centres with a
mission to benefit more children.

PS4.2 Collaborative Service Programmes 16:15 Room 221

New Territories East Cluster Pressure Injury Prevention Programme: A Three-Year Collaboration Programme
between Occupational Therapists and Nurses in Prince of Wales Hospital
Leung TLF
Department of Occupational Therapy, Prince of Wales Hospital, Hong Kong
Pressure injury prevention is always the top priority in in-patient care, as it can lead to life threatening complications such
as sepsis, cellulitis or even bone and joint infections. High incidence of sacral ulcer development during in-patient hospital
stay was recorded, especially on oncology patients with prolonged prop up in bed due to orthopnea, ascites, bone pain,
edema etc. According to the data from the Prince of Wales Hospital (PWH) from March 2016 to November 2016, sacral ulcer
incidence rate is 81.8%, which is the highest among different sites of pressure ulcers development, and is far higher than the
ankle and heel ulcer, the second highest incidence accounting for 5.1%.
In view of the high incidence of sacral ulcer and potential lethal complications, there is an urgent need for new strategy to
prevent sacral ulcer development in patients at risk.

On the other hand, the heel is at increased risk of ulceration due to its posterior prominence and lack of padding over the
calcaneus. All bedridden patients need to be considered at risk of pressure ulcers on the heels. Clinical evidence concerning
the efficacy of pressure redistribution surfaces or heel protection devices is sparse. Existing evidence suggests that pressure
redistribution surfaces vary in their ability to prevent heel pressure ulcers, but there is insufficient evidence to determine
which surfaces are optimal for this purpose.

As heel pressure ulcer ranks the second in incidence, evidence-based approach is urgently needed to determine the
effectiveness of available heel protection devices for the prevention of heel pressure ulcer.
Occupational therapists and nurses in PWH have worked together closely for the past three years in improving the service in
preventing pressure injuries with different innovative ideas.

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