Page 211 - Hospital Authority Convention 2018

Service Enhancement Presentations

F6.4 Enhancing Partnership with Patients and Community 10:45 Room 421

Enhancement Project on Safe Specimens Management in Residential Care Homes for the Elderly
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Kwan WS , Lau LW , Ko WC , Tam FKS , Chan SK , Cheng PPP 2
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Community Nursing Service, Central Nursing Division, Yan Chai Hospital, Hong Kong
Introduction HOSPITAL AUTHORITY CONVENTION 2018
Over 4,100 elderly living in 41 Residential Care Homes for the Elderly (RCHEs) were covered by Yan Chai Hospital (YCH).
Hundreds of specimens were collected and transported from RCHEs to hospital each month. Due to human errors of RCHE
staff, however, a lot of incidents related to wrong specimen collection, management and transportation were reported leading
to delayed treatment or irreversible consequences. Community Nursing Service (CNS) initiated this project to enhance safe
practice in RCHEs.
Objectives
To ensure RCHE staff perform: (1) proper patient identification; (2) appropriate specimen collection; (3) effective specimen
transportation; (4) prompt and precise treatment provided; and (5) correct spillage management of RCHE staff.
Methodology
In Jul 2016, CNS formed a workgroup to collect specimen handling problems during RCHE visits and analysed the root
causes. To ensure RCHE staff understood the standard of specimen management and transportation: Specimen Collection
and Management Manual, education video, photo guides (showing good practices) and tailor-made specimen container
(keeping specimens in upright position in accordance with the laboratory standard) were developed and distributed to all
RCHEs. Besides, on-site training was organised to coach staff. Skill and knowledge assessments were undergone before
and after training. Furthermore, a self-checking system was established for RCHEs to guide and control the specimen
transportation process.

Results
After data collection and analysis, the common specimen related problems in RCHEs were identified and grouped into five
categories: Improper patient identification, inadequate patient preparation, unclear specimen collection process, incorrect
transportation, and inappropriate spillage management. Having provided the standard items and on-site trainings to 39
RCHEs (224 staff) from August to September 2017, knowledge and practices were significantly improved (83% to 100%).
For instance, almost all staff knew to mark collection date and time on specimens (Pre: 63%; Post: 99%). They understood
sending specimens to hospital within recommended time (Pre: 60%; Post: 100%) and how to disinfect the container and
spillage management (Pre: 76%; Post: 100%). Many RCHEs had adapted the self-checking system (over 91%) and specimen
container (100%) for transportation.
For evaluation, the incident number and time spent on handling problems were significantly reduced from 20 to 7 cases (reduce
65%) and from 130 to 79 minutes (reduced by 39%).

Conclusion
The project demonstrated a concerted effort from YCH CNS and successfully enhanced safe practice of specimen
management and self-checking system of specimen transportation. RCHE staff appreciated as it enriched their knowledge
and skills a lot. The manual, education video, photo guides and specimen container were very useful which helped
standardising their practices and different procedures as well. Tuesday, 8 May 2018

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