Authors: (including presenting author): :
CHO CY(1), LI KY(1), LEE SH(2), CHUNG SC(1), LEUNG SS(1), TSANG SC(1), CHEUK A(2), TANG HL(2), CHAN WMM(1,3)
Affiliation: :
(1) Community Health Care, Kowloon West Cluster (2) Department of Medicine & Geriatrics, Princess Margaret Hospital (3) Central Nursing Division, Princess Margaret Hospital
Keyword 2: :
Medical Social Collaboration
Keyword 3: :
Continuous Ambulatory Peritoneal Dialysis Care
Keyword 4: :
Residential Care Homes for the Elderly
Introduction: :
Continuous Ambulatory Peritoneal Dialysis (CAPD) is the predominant treatment modality for end stage renal failure patients in Hong Kong. When patients are incompetent in CAPD care and lack of home support, relocation to a RCHE may be necessary to ensure continuity of care. RCHE carers play a vital role to follow CAPD procedures strictly to avoid complications. Following a 30% rise in RCHEs in Kwai Tsing district, the unavailability of updated RCHE list providing CAPD care have hindered discharge planning and suboptimal CAPD care may lead to increased hospital admissions and patient suffering. PMH Community Health Care team collaborated with PMH Medicine & Geriatrics / Renal team and PMH Medical Social Services Unit to enhance CAPD care in RCHEs and reduce hospital utilization.
Objectives: :
(1) To enhance RCHE carers’ knowledge and skills in CAPD care (2) To assess and identify RCHEs with up-to-standard CAPD care
Methodology: :
A workgroup was formed in April 2024 to develop the enhancement plan. This pilot model promoted patient-centered care and engaged all stakeholders, including Licensing & Regulation Branch of Social Welfare Department, Patient Group: Renal Mutual Help Association and RCHE superintendents. Educational talk was conducted via webinar in September 2024 for RCHEs in Kwai Tsing and Tsuen Wan districts. 23 CAPD patients in 12 Kwai Tsing RCHEs under PMH Renal were visited by all involved sectors from October 2024 to March 2025 with onsite assessment of RCHE environment and CAPD procedure done using newly revised checklist.
Result & Outcome: :
105 RCHEs (99%) with 262 staff attended the educational talk with 19% improvement in knowledge scores and over 96% positive feedback. 1 RCHE showed suboptimal performance and refresher training was arranged. The program, during which 4 patients passed away, demonstrated remarkable patient outcomes at 6 months: a 60% reduction in emergency admission (52 to 21), complete elimination of CAPD-related peritonitis (3 to 0) and contamination (2 to 0). This innovative model of MSC on CAPD care effectively enhances CAPD care for renal patients in RCHEs and supports sustainable, cost-effective practice with ongoing performance monitoring.
