Authors: (including presenting author): :
WONG CH (1), WONG KL(1), CHEUNG KY(1), YIP OW(1)
Affiliation: :
1.Accident and Emergency Department (A&E), Tseung Kwan O Hospital (TKOH)
Keyword 1: :
Emergency Nursing Service
Keyword 2: :
Minor injury and illness
Introduction: :
High patient attendance has led to long waiting times in TKOH A&E especially for category 4 (semi-urgent) and category 5 (non-urgent) patients. This situation has caused public dissatisfaction. Evidence from foreign countries such as the United Kingdom and Australia shows that nurse-led services can significantly reduce patient waiting times. These countries commonly use trained nurses as the first point of contact in A&Es, with patient outcomes, including recovery time, reattendance, and symptom improvement, showing no significant difference compared to physician-delivered care. Therefore, implementing a nurse-led enhanced service for minor injuries and illnesses could reduce waiting times while maintaining optimal patient outcomes. In TKOH A&E, nearly 10% of the attended category 4 and category 5 cases involve minor injuries or illnesses such as wound lacerations, animal bites, and sports injuries. Piloting an enhanced emergency nursing service for minor injuries and illnesses in TKOH A&E could address this service gap. According to established guidelines, nurses provide a holistic service to these patients and are responsible for assessment, investigation, treatment, and formulating a discharge plan, which will be endorsed by an emergency medicine specialist or above.
Objectives: :
1.To reduce waiting times for category 4 and category 5 patients. 2.To improve patient satisfaction and provide quality service.
Methodology: :
A departmental guideline was created in early July 2025. Three trained and qualified nurses were engaged in the service. The pilot service was implemented in phases. Phase I commenced on August 25, 2025, with one session of service scheduled on Mondays and Tuesdays. It progressed to Phase II on November 3, 2025, with two sessions scheduled on each Monday and Tuesday. The service could be gradually extended to other weekdays in the future.
Result & Outcome: :
From August 25 to December 23, 2025, 152 patients were recruited into the pilot service at TKOH A&E. The median waiting time for recruited cases was significantly improved by 139 minutes compared to other category 4 cases on the same dates. The mean waiting time for category 4 cases was 214 minutes, which improved to 78 minutes for the recruited cases. No reattendance within 48 hours and adverse events were reported. Data will be regularly retrieved and evaluated to ensure a safe and optimal extended emergency nursing service for patients.
