Authors: (including presenting author): :
Wong YL(1), Lam KF(1), Wong SM (1)
Affiliation: :
(1) Occupational Therapy Department, Tung Wah Eastern Hospital
Keyword 2: :
Patient Safety
Keyword 3: :
Quality Improvement
Introduction: :
Hand mittens are a standard protective device prescribed across the Hospital Authority to ensure patient safety, with Occupational Therapists (OT) conducting assessments to determine the appropriate design. At Tung Wah Eastern Hospital, a continuous quality improvement initiative has identified functional shortfalls in the long-used, tailor-made mitten. "Flipping over" and wear-and-tear were occasionally observed which may hinder the effectiveness of the device. To address these, a new, multi-size design will be implemented in phases, supported by an updated prescription protocol to better suit diverse client needs.
Objectives: :
To improve patient safety and evaluate efficacy of new tailor-made protective device
Methodology: :
A pre/post-implementation study commenced in October 2025. The new mitten design was initially piloted on two geriatric wards prior to a planned hospital-wide rollout.
A multi-method evaluation was conducted, comprising:
1.Staff Satisfaction Surveys: Distributed to nursing staff and Patient Care Assistants (PCAs) to compare perceptions of the old and new designs.
2.Clinical Audits: Spot-checks were performed to quantify the incidence of the malfunction.
3.Cost Analysis: A direct comparison of unit costs between the two designs was completed.
Based on the evaluation outcomes, an in-house clinical guideline was developed to standardize the selection of mitten type according to specific clinical scenarios.
Result & Outcome: :
Monthly usage was approximately 25 pairs. Staff surveys (response rate 78%) showed notable gains on perceived effectiveness (10%) and satisfaction on durability (21.8%). Survey also reported positive feedback on the new mesh design in control of "flipping over" as well as wear and tear. Clinically, the new mittens had a highly statistically significant lower observed "flipping over" rate compared to the original white mitten (p < 0.00001) from clinical audit. A 16%-unit cost saving was achieved (HK$6.90 vs. HK$8.24). The findings validate the new mitten as a cost-effective, patient-centered improvement. It will serve as the primary option, with the original as an alternative, guided by a new clinical protocol. This project highlights OT's essential role in driving interdisciplinary quality improvement.
