Authors: (including presenting author): :
Man TM(1), Tang WH(1), Wong WY(2), Yu KM(2)
Affiliation: :
(1)Psychogeriatric Ward, Kwai Chung Hospital, (2)Physiotherapy Department, Kwai Chung Hospital
Keyword 2: :
Fall Prevention
Keyword 4: :
Multidisciplinary Collaboration
Keyword 5: :
Quality of Care
Introduction: :
Psychogeriatric inpatient units face mobility management challenges, as inconsistent assessment practices compromise patient safety. Nursing staff rely on the Morse Fall Scale, which relies on subjective judgment and inadequately captures mobility capabilities. Physiotherapists use the Modified Functional Ambulation Category (MFAC), a validated seven-level classification that provides a detailed mobility assessment. This disciplinary disconnect creates care fragmentation, communication barriers, and safety risks, warranting the systematic implementation of MFAC to bridge interdisciplinary gaps and support HA's commitment to evidence-based care excellence.
Objectives: :
To evaluate collaborative MFAC implementation effectiveness between nurses and physiotherapists in enhancing interdisciplinary care consistency, improving nursing confidence and competency in mobility assessment, increasing caregiver satisfaction, and strengthening interdisciplinary communication in psychogeriatric settings.
Methodology: :
A pre-post intervention design implemented multidisciplinary mobility enhancement across psychogeriatric units. Physiotherapists provided 2-hour structured training sessions on MFAC principles to nursing staff. Nurses integrated MFAC protocols into daily care, interdisciplinary handovers, and discharge planning while delivering standardized caregiver education. The intervention included MFAC-based care pathways, communication tools, and documentation systems. Data collection utilized self-developed 5-point Likert evaluation forms with acceptable to excellent internal consistency (Cronbach's α = 0.765-0.961). Three validated scales measured: (1) nurse confidence and competency (n = 30), (2) interdisciplinary communication effectiveness (n = 21), and (3) family caregiver satisfaction (n = 35, α = 0.911). Pre- and post-intervention changes were analysed using paired-samples t-tests.
Result & Outcome: :
The intervention demonstrated statistical improvements across all measures. Nursing confidence and competency increased from baseline (M=2.6/5) to post-intervention (M=4.7/5), representing 81% improvement (95% CI: 65-97%, p< 0.001, Cohen's d=3.17). Interdisciplinary communication effectiveness improved by 60% from pre-intervention (M=3.5/5) to post-intervention (M=4.7/5; p< 0.001; Cohen's d=1.98). Family caregiver satisfaction was high (M=4.4/5; 88% satisfaction rate). Qualitative feedback revealed educational clarity, clinical utility of MFAC, and enhanced discharge planning. All effect sizes were very large (>0.8), translating to improved patient safety outcomes and reduced assessment variability. Despite promising results, larger multi-site validation is warranted. Findings support hospital-wide MFAC adoption with potential for system-wide implementation across psychogeriatric services.
