Authors (including presenting author) :
TAM KK(1), TANG WH(1), LAI WS(1), TSUI YC(1), CHENG PY(2), TAM TL(2), LEE MM(2)
Affiliation :
(1) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital (2) Nursing Service Department, Our Lady of Maryknoll Hospital
Keyword 1: :
Patient Safety
Keyword 2: :
Careful Hand Feeding
Introduction :
Dysphagia was common among elderly. Studies suggested geriatrics patients with Alzheimer disease, Parkinson disease or stroke were at risk of suffering from dysphagia, which leading to swallowing difficulty and thus complicated with choking, aspiration pneumonia, malnutrition, prolonging length of stay and even resulting in death.
Healthcare professionals were required to handle elderly with dysphagia in everyday work. Meanwhile, recent sentinel events on diet choosing and feeding also shed light on the safety issue of careful hand feeding.
Thickener and thickening agents were commonly used to increase the viscosity of the liquid, thus beneficial to swallowing among dysphagia patients. Meanwhile, the International Dysphagia Diet Standardization Initiative (IDDSI) has developed a standard that could be used to describe the characteristics of foods and drinks - from the point of view of a person with swallowing difficulties. Therefore, the correct use of the thickener and thickening agents according to the IDDSI standard could highly promote the patient safety on careful hand feeding among the dysphagia patients.
Objectives :
Objective:
(1) To enhance patient safety in careful hand feeding
(2) To promote the correct use of the thickener
(3) To enhance understanding of the IDDSI indication
Methodology :
Methodology:
The project was performed in an in-patient Medical and Geriatric (M&G) male ward. A pretest-posttest design was adopted. All nurses and patient care assistants (PCA) were selected as the target population. The target population were required to participate in an education program on patient safety in careful hand feeding and to complete the 7-question knowledge assessment before and immediately after the education program. Reassessment was done at a 3-month interval also. The 7-question knowledge assessment would be used for follow-up education and newcomer training if the effectiveness of the program was proved. Timeline of the project:
Training materials and the assessment tool of the program were prepared in April 2025.
The education program on patient safety with the pretest and posttest by the 7-question knowledge assessment was done in May 2025.
Reassessment on retention of knowledge would be done in August 2025.
Result & Outcome :
Results:
A total of 41 participants participated in the program, including 32 nurses and 9 PCAs.
After the education program, there were significant improvement in the following aspects:
•Recognizing patients who were dysphagia candidates, from 11.1% of PCAs and 25% of nurses to 100% of PCAs and nurses
•The correct steps in using thickener, from 11.1% of PCAs and 9.4% of nurses to 100% of PCAs and nurses.
•Classifying the differences between starch-based thickener and gum-based thickener, from 33.3% of PCAs and 18.7% of nurses to 100% of PCAs and nurses
•Recognizing the logistic supply of thickener in the ward, from 0% of PCAs and 21.9% of nurses to 100% of PCAs and nurses.
•90.2% of staff passed the reassessment in August.
