Kwong Wah Hospital Hospital Authority
Community Nursing Services

Introduction


The KWH Community Nursing Services, established in 1979, is one of the medical teams under the HA’s outreach services, covering private residential care homes and stay-home patients in Yau Ma Tei, Mong Kok, Tai Kok Tsui, Tsim Sha Tsui and Hung Hom. Patients receive comprehensive assessment during home visits by community nurses, who will take account of individual needs, draw up and implement relevant care plans. For patients with more complex conditions, a “case management approach” will be adopted by the community nurses to monitor their health indicators and liaise with other healthcare services for provision of holistic and continuous care.

Objectives
  • Improve the self-care capacity of patients
  • Enhance the self-management capacity of patients and their carers
  • Facilitate rehabilitative treatment for stay-home patients by working with hospitals and the community support network
  • Promote primary health education in the community

Service Targets
Types of stay-home patients receiving care and treatment under community nursing service:
  • Patients who are unable to attend hospital/clinic/other facilities due to old age, frailty, disability or mobility handicap
  • Patients who require regular follow-ups and monitoring of treatment efficacy at home
  • Recently discharged patients in need of support in specialist nursing care
  • Chronic patients with more complex conditions who are followed up under the “case management approach”

Scope of Services

Chronic Disease Management: cardiac rehabilitation, pulmonary rehabilitation, diabetes care, stroke rehabilitation and renal care
Specialist Nursing Care: post-surgical care, wound and drain care, ostomy care, geriatric care, post-natal and infant care, continence care and palliative care
Rehabilitation Counselling: utilisation of community resources, referral & coordination, nutrition & diet counselling, feeding tube care, medication management, home risk assessment, home rehabilitative exercise training, home infection control education and community health education


Application Procedures

Community nursing service is open to patients who meet the above criteria through referral by medical personnel. Please enquire with the community nursing service centres, hospital wards, specialist or general out-patient clinics for details.

Fees

Home visit services are charged per visit at a rate determined by the HA. Those with financial difficulties may apply for fee remission through medical social workers.