Authors: (including presenting author): :
Wong KL(1), Lau LW(1), Wong SW(1), Hung SC(2), Wong WM(2), Lam MS(2)
Affiliation: :
(1) Commuity Nursing Services, Yan Chai Hospital (2) Department of Medicine, Yan Chai Hospital
Keyword 1: :
noninvasive hemoglobin measurement SpHb device
Keyword 2: :
Non-invasive SpHb device
Introduction: :
The World Health Organization (WHO) defines anemia as hemoglobin (Hb) levels below 13 g/dL in men and 12 g/dL in women. Anemia is prevalent among older adults (10%-30%) and common in Residential Care Homes for the Elderly (RCHE), causing nonspecific symptoms that worsen chronic conditions and requires doctors’ orders, blood sampling, transportation, and laboratoryprocessing, which is uncomfortable for frail residents and increases healthcare reduce quality of life. Timely hemoglobin (Hb) monitoring prevents disease progression and unnecessary blood transfusions. Traditional invasive Hb testing workload. Noninvasive spectrophotometric hemoglobin (SpHb) devices offer on-site, rapid results for prompt action and cost-effectiveness in community.
Objectives: :
This program was focused on RCHE residents under Yan Chai Hospital (YCH) Community Geriatric Assessment Service (CGAS) with high risk of anemia, Hb decline included End-of-life (EOL) residents, anemia history and ad-hoc anemia-related symptoms. It aimed to use the non-invasive device to monitor high risk group of anemia residents, enable early detection of abnormal Hb trends for timely intervention, optimize anemia management to improve residents’ quality of life, reduced emergency admission and unnecessary healthcare resource use.
Methodology: :
At January 2024, working group of the enhancement program has been formed, defined the high-risk of patient groups for hemoglobin drop were discussed and endorsed in the YCH CGAS Workgroup Meeting. The eligible participants were adults aged over 60 and under YCH CGAS follow-up, they were diagnosed with anemia, iron supplement adjustment needs, ad hoc anemia symptoms, and risk of Hb drop status, e.g. EOL. Portable non-invasive SpHb device was used for SpHb monitoring routinely every 2 months or blood test intervals and ad-hoc when required cases. Standardized device training was provided to all CGAS nurses. For each participant, CGAS nursesassessed SpHb result with physical assessment and latest Hb data trend. Abnormal findings triggered CGAS physician consultations and prompt actions, including clinical admission, early blood taking, or continuous monitoring by device if need.
Result & Outcome: :
Implemented from July 2024 to November 2025, the program assessed 488 residents with 100% completion and 5 cases showed failures. No emergency admissions for anemia occurred. Found eight residents with abnormal SpHb readings led to CGAS doctor consultations with interventions: three residents need tailored drug adjustment, arranged blood sampling and clinical admission respectively and six residents keep observation and stay in RCHE. The program demonstrated the feasibility SpHb monitoring in community, enhanced clinical outcomes, optimized unnecessary resource use and evolved from a pilot to an evidence-generating research initiative.
