Authors: (including presenting author): :
Kwok Y(1), Yuen WT(1), Cheung YH (1), Lam HY (1)
Affiliation: :
(1) Ortho rehab ward 3L, Department of Medicine, Haven of Hope Hospital
Keyword 1: :
surgical wound infection
Keyword 3: :
wound care team
Keyword 4: :
silver dressing
Keyword 5: :
evidence based program
Introduction: :
Patients admitted to orthopedic rehabilitation wards following hip fracture surgery are at increased risk of wound infection due to advanced age, impaired mobility, and incontinence. Surgical wound infection can delay rehabilitation progress and compromise patient safety. In 2025, baseline data demonstrated a persistent burden of wound infection, with monthly wound swab positive cases ranging from 3 to 9, Review of existing practices revealed variation in wound assessment, documentation, dressing selection, and aseptic technique, highlighting the need for a structured, ward based approach to enhance surgical wound safety and care quality.
Objectives: :
1.Establish a ward based orthopedic wound care team to provide structured oversight and support. 2.Develop and implement standardized wound care guidelines to improve consistency of practice. 3.Reduce the risk of surgical wound infection through early identification, evidence based intervention, and systematic monitoring.
Methodology: :
A ward based orthopedic wound care team was established in November 2025, comprising 3 Advanced Practice Nurses and 3 Registered Nurses under ward level leadership. The team reviewed baseline infection data, existing practices, and current evidence on surgical wound infection prevention, including appropriate use of silver dressings. A structured wound management framework was developed and implemented from January 2026. Key interventions included staff training on surgical wound management, establishment of a dedicated communication platform for wound team coordination, and mandatory wound inspection by team members on the day following admission. Standardized guidelines were introduced to guide dressing selection and review schedules. Individualized care plans were implemented to minimize urine soiling and water exposure during bathing. Standardized wound photo techniques and structured wound documentation using a dedicated eDOC template were implemented to enhance continuity and monitoring. Aseptic practices were reinforced, including hand hygiene, use of sterile gloves, appropriate skin disinfection, and standardized application of silver dressings. Advanced, water resistant dressings allowing joint movement were adopted to support rehabilitation needs.
Result & Outcome: :
The establishment of a ward based orthopedic wound care team and standardized guidelines improved consistency of wound assessment, documentation quality, and adherence to aseptic practices. Staff accountability and access to wound expertise were strengthened through mandatory inspections and coordinated team oversight. Early identification and timely management of wound issues were enhanced. Ongoing prospective data collection and analysis are in progress to evaluate the impact on surgical wound infection rates, staff competency and patient safety.
