Authors: (including presenting author): :
Chan WC(1), Cheung KC(1), Yu SM(1), Wong KL(1), Ng CY(1), Lai SH(1), Ho SM(2)
Affiliation: :
(1) Ward 13A, Department of Medicine & Geriatrics, United Christian Hospital (2) Department of Medicine & Geriatrics, United Christian Hospital
Keyword 1: :
Nursing Quality & Safety
Keyword 2: :
Quality Improvement Project
Keyword 3: :
Isolation Ward
Keyword 4: :
Nursing Standard
Keyword 5: :
Nursing Care
Keyword 6: :
Senior Review
Introduction: :
Nursing quality is typically assessed through key performance indicators (KPIs), such as fall and pressure injury rates. However, genuine nursing care excellence extends beyond these metrics. In 2025, we launched a quality improvement project in an isolation ward to address gaps in nursing care consistency and the lack of secondary analysis in the unit.
Objectives: :
1. To align essential nursing standards in care delivery
2. To foster a culture of senior reviews for enhanced patient safety
3. To develop actionable improvement plans to elevate care quality
Methodology: :
A comprehensive nursing care checklist was designed, covering 10 categories:
Administrative Processes: Admission, discharge, documentation.
Risk Assessments: Fall risk, pressure injury, suicidal precautions.
Specialty Knowledge: Infectious disease management.
Patient Care: Medication management, nutrition and hydration, nursing care initiatives.
The patient record compliance checking contained 34 yes/no items evaluated across 5 areas: Kardex, bedside folders, CMS, clinical dashboard and digital floor plan at nursing station, and patient bedside. 3 compliance checks were conducted biweekly by an Advanced Practice Nurse (APN) or Ward Manager (WM), who served as the compliance auditor. This systematic evaluation assessed compliance percentages, recognized exemplary staff performance, and identified areas needing improvement while tracking trends.
Result & Outcome: :
Results:
Over one year, 72 compliance checks were performed. High Compliance Rates: Significant achievements were noted in medication accuracy, adherence to nursing documentation standards, and specialized care for infectious diseases.
Areas for Improvement: Key areas identified for enhancement included monitoring patients' hydration status and completing discharge care plans. Improvement plans were implemented, including immediate staff feedback, official ward handover for critical items, reviews of ward logistics, and discussions within the APN/WM team regarding contentious items to reach consensus. Conclusion: The compliance checking initiative successfully aligned nursing care standards within the ward, heightened awareness of excellent nursing care, and provided a secondary analysis of ward performance. A culture of patient safety and continuous improvement have been effectively established. Looking to 2026, the checklist will undergo further review to facilitate additional improvements and transition to eDoc. We aspire to achieve an even higher level of nursing excellence.
