Page 122 - Hospital Authority Convention 2018

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2018

F2.2 Staff Engagement and Empowerment 13:15 Room 421

Enhancing Nursing Roles in Western and Chinese Medicine under Integrated Chinese-Western Medicine Pilot
Programme (Phase II) – Cancer Palliative Care
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Leung PY , Fung SC , Wai NT , Tsang KF , Chan CY , Wong MC , Law YL , Leung H , Chu KM , Tam S , Fung M , Tung Y , Lo
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SH , Wong CS 1
1 Department of Clinical Oncology, Tuen Mun Hospital, Yan Oi Tong - The Chinese University of Hong Kong Chinese Medicine
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Centre for Training and Research, Hong Kong
Introduction
The first Chinese Medicine Hospital in Hong Kong will be set up. The hospital shall provide Integrated Chinese-Western
Medicine (ICWM) services that many areas and parts need to be examined. In the past three years, 270 patients had been
receiving ICWM services in Tuen Mun Hospital. For gaining further experience in Phase II, the ICWM team empowered nurses
to act as administrators, assessors and referrers of Chinese-Western Medicine to acquire practical experience, and fulfill the
needs and requirements of Hong Kong Chinese Medicine Hospital.
Objectives
To develop nurses’ competencies in administration of both Chinese and Western Medicines; (2) to gain practical experience of
management of Chinese and Western Medicines for Hong Kong Chinese Medicine Hospital; and (3) to reduce the workloads
Monday, 7 May 2018 Methodology
of both the Western and Chinese Medicine Practitioners
In 2016, over 1,900 admissions were recorded in the ICWM service area, but not all patients were eligible to receive both
Western and Chinese Medicine. If a patient was interested in Chinese Medicine (CM), nurses should provide information
and have the essential competencies in collaborating with other related professional teams. An ICWM screening toolkit
was developed based on the risk of herb-drug interactions, laboratory results of renal liver function and the international
normalised ratio (INR), financial status and acceptance of CM. Nurses were empowered to perform screening assessments
in advance, before Medical Officers referring cases to Chinese Medicine Practitioners or further blood tests for the patients.
To further improve the effectiveness of work practices, nurses were allowed to take preventive and corrective actions. To
minimise the risks of herb-drug interactions and adverse effects, while ensuring patients that they could take all medications
within the timeframe, nurses were authorised to reschedule the administration of prescribed CMs and WMs. One of the major
barriers of ICWM was lacking shared education and on-job training, so nurses were sent to study relevant CM certificate
courses and acquired basic knowledge directly from on-site CMPs.

Results
Terminal stage cancer patients needed to take multiple medications. The greater the numbers of drugs they took, the more
potential risks would be resulted. Neither medication incident nor patient complaint was reported. The success rate of
referrals increased from 44% to 86%. From the period of screening to start of ICWM services was only 1.02 days. Nurses
acted as a linkage between Western and Chinese Medicine Practitioners and reduced the workload of them.

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