Authors: (including presenting author): :
Luk CH(1), Chan ISB(2), Cheng TF(1), Cheng TY(1), Tam YH(2), Yan RLH(1), Graham CA(1)(3), Hau ESS(1), Lo KY(2), Tang HT (2), Yan PK (1)
Affiliation: :
(1) Accident and Emergency Department, Prince of Wales Hospital, (2) Accident and Emergency Department, Queen Mary Hospital, (3) Accident and Emergency Medicine Academic Unit, The ChineseUniversity of Hong Kong
Keyword 1: :
Nurse-initiated water cooling
Keyword 2: :
Minor thermal burns
Keyword 3: :
Quality improvement
Keyword 4: :
triage assessment
Keyword 5: :
Staff education
Keyword 6: :
Workflow compliance
Introduction: :
Evidence suggests that nurse-initiated triage burn first-aid can improve outcomes for patients attending Accident and Emergency Departments (AED) with minor burn injuries. We evaluate a Continuous Quality Improvement project that implements a nurse-initiated water-cooling workflow in Prince of Wales and Queen Mary Hospital.
Objectives: :
(1) To enhance nursing care through improved triage assessment and timely nurse‑initiated water cooling for minor burn patients. (2) To raise awareness among nursing staff of first aid, particularly water cooling, in managing minor burn injuries.
Methodology: :
A structured education programme for AED nurses at PWH and QMH covered burn first aid rationale with aligning the international standard, the new nurse‑initiated water‑cooling workflow, and documentation standards. Pre‑ and post‑training questionnaires assessed knowledge gains. Triage notes were audited against three compliance criteria (time of injury, pre‑arrival water-cooling information, water-cooling initiation for eligible patients) to evaluate workflow adoption for minor burn injuries.
Result & Outcome: :
For staff knowledge:103 respondents among 109 staff (total target nursing staff in two EDs) (response rate ~94%), pre‑training knowledge scores improved from a mean of 5.64 to 7.27(out of 8) post‑training, with statistically significant difference (p < 0.01）, confirming the education programme’s effectiveness. For triage compliance improvement: during study periods (27 February–26 April 2024 and 2025)148 minor burns patients attended the two ED study sites at both hospitals, “time of injury” documentation rose from 55.6% (37/66) to 88.1% (73/82) (p < 0.01); “pre‑arrival water cooling” documentation increased from 10.6% (7/66) to 59.8% (49/82) (p < 0.01). Nurse‑initiated water-cooling for eligible patients rose from 0% (0/9) to 76.2% (16/21) at PWH (p = 0.018) and reached 46.7% (7/15) at QMH, where it had not previously been routine practice. These results demonstrate that the education programme successfully enhanced staff awareness and triage compliance for timely burn first aid, thereby improving overall nursing care for minor burn patients.
