April 2006 / Issue NO. 94 MITA (P) No.003/01/2006  
     
Cover Story
We are 10!
  Awards Galore:
GCEO Employee Excellence Award for Allied Health
GCEO Excellence Award for Operational Efficiency
Dr Goh Siang Hiong (Medical Mentor)
Medical Focus
  Patient Success Stories:

Sleepy No More
Back to Sweet Dreams
Caring for Our Patients
Bed Booking Made Easy
CGH QC Teams Win Gold
What's On
Malay Stroke Public Forum
Trauma Conference 2006
GP CME Event
   
 

CGH QC Teams Win Gold

No detail is too insignificant for our nurses when it comes to improving patient care. The two nursing teams won Gold at the recent National Innovation and Quality Circle Convention (NIQCC) on 23 Mar 2006.

2nurse

The “Simply Amazing” team led by Senior Nurse Manager King Foong Meng noticed that call bells are not always within patient’s reach. Call bells that are placed at patients’ bedside are very important. In emergency situations where the patient suffers from chest pain, shortness of breath or collapses, it is the only communication device between patients and nurses and every second counts.

From the survey conducted on 50 patients over 5 wards, it was found that 80% of patients could not reach the call bell when they needed it. The main reason is because the original metal clip that anchors the call bell onto the bed railing is small and gets lost very often. As a result, call bells are misplaced under the pillow, dropped onto the floor, on the locker, or head panel. Occasionally, call bells are mistakenly left dangling on the drip stand by relatives.

To solve the problem, the team looked at using cable tie, safety pins, metal holders before chancing upon a telemetry pouch which inspired them to design a call bell holder. They came up with a disposable call bell holder made with a soft, non-woven material that can be hung from the bed railings. Being disposable, it reduces the risk of cross infection among patients. The team also worked with the vendor to use a luminous coloured material so that it is easier for patients to locate the call bell at night.


After implementing the call bell holders at selected wards in July 2005, the percentage of call bells not within patients’ reach fell to just 3%. With good results, the team is keen to share their ideas with nursing homes where the bedbound elderly patients may face a similar problem with call bells.

The “ICU” Team led by Senior Nurse Manager, Sim Lam Keow looked at ways to improve the method of disposing human waste disposal in the Intensive Care Unit. At Medical ICU, where patients are less ambulant, about 42 bedpans and urinals (receptacles) are used every week.

The traditional way of cleaning receptacles is a slow and inefficient process. An automated sanitiser is used to wash reusable plastic and stainless steel receptacles using a heat and water cycle. Each cycle uses 45 litres of water and takes 7.4 minutes to wash only 2 urinals and 1 bedpan at one time. As a result, dirty receptacles may have to be stacked up in the sluice room waiting for their turn in the wash.

Stubborn stains are common for bedpans and these require repeated cycles or manual washing. This incurs additional water, electricity consumption and manpower. There is also a potential risk of infection if soiled bedpans are issued to patients so staff need to spend extra time inspecting washed bedpans to ensure they are thoroughly cleaned.

Working with staff from Maintenance and Materials Management Department, the ICU team surveyed the market and found a system which uses receptacles made of biodegradable materials and a macerator which converts the used receptacles to pulp. The macerator uses only 30 litres of cold water to liquidise the pulp and a cutter blade reduces the pulp into a fine slurry which can be flushed into the hospital’s sewage drain. It takes only 3 minutes to dispose 4 receptacles per cycle.

After switching to the new macerator system in March 06, disposal process time was reduced by 72%, water consumption by 55% and electricity consumption by 18.7%. Although cost of purchasing these receptacles have increased, we believe in the long run, there will be overall savings. Furthermore, the system eliminates cross infection arising from patients using an inadequately cleaned bedpan. Patients also appreciate not sharing bedpans or urinals with other patients.