Authors: (including presenting author): :
Chong WT(1), Chan SN(1), Cheuk MW(1), Tai TL(1), Yu TL(1), Ip WH(2), Lo YK(2), Kwong SS(2), Pang HS(1), Wan MC(1)
Affiliation: :
(1) Medicine and Geriatrics Department, Ruttonjee & Tang Shiu Kin Hospitals
(2) Physiotherapy Department, Ruttonjee & Tang Shiu Kin Hospitals
Keyword 1: :
Contracture Patients
Keyword 2: :
Long-staying
Keyword 3: :
Infirmary Ward
Introduction: :
Infirmary patients are often fragile, making them highly susceptible to injury. Since 2023, five fracture cases have occurred in the infirmary ward without apparent cause. Studies consistently shows that the fracture risk among long-staying care residents is significantly higher than that of community-dwelling adults of similarly aged. To prevent further incidents, an enhancement program aimed at preventing fractures in long-staying contracture patients was initiated in November 2024.
Objectives: :
1. To reduce the incidence rate of all types of fractures in the infirmary ward.
2. To enhance staff awareness regarding frailty care and the signs of fractures.
3. To ensure safe mobilization and nursing care for patients in the infirmary ward.
Methodology: :
The program, involving nurses, patient care assistants (PCA) and physiotherapist working in the infirmary ward. It is organized into three phases: pre-training assessment, training and post-training assessment from November 2024 to May 2025.
1.Pre-Training assessment: -Initial fracture incidence data was recorded, followed by a pre-knowledge test. 7 questions knowledge test used to assess the care for dependent/ contracture patients during activities such as turning, changing clothes, and bathing. 2.Training:
-An indicator diagram of fragile body locations was placed at each patient’s bedside to increase staff and caregiver awareness. -Two workshops, including return demonstrations were conducted in February 2025, led by physiotherapists who demonstrated special techniques for handling contracted limbs.
-Educational talks with videos about fragility fractures to reinforce learning.
3.Post-training assessment:
-Same assessment tool from the pre-training phase was used to evaluate the training effectiveness.
Result & Outcome: :
23 staffs (12 nurses and 11 PCAs) participated. The average score on the pre-intervention knowledge test was 4.48, while improved to 6.09 on the post test. After the educational session, all staff reported increase familiarity and confidence in handling dependent patients or patient with contractures, during care activities. The prior training average score on the practical skills was increased from 34.52 to 42.96 in the post training. Following the implementing of the safe mobilization practices in December 2024, no fractures have occurred. Conclusions
The enhancement program has successfully improved the quality of care for long-staying contracture patients.
