Ms Tze Wing Wong1
1Hong Kong Hospital Authority, Burns Centre, Prince of Wales Hospital, Hong Kong
Background:Burns Centre, Prince of Wales Hospital is one of referral center for extensive burn cases in Hong Kong. It develops the coordination of burn service with their supporting network of Burn Facilities. Also, burn cases of cross-territory and cross center are consulted and transferred to the Centre for management. Therefore, a Burn External Referral form was designed to enable comprehensive clinical handover.
The establishment of Burn External Referral form enhances:
- Essential informations are received before burn patients transfer to Burns Centre.
- Guidance provides to healthcare professionals of other hospitals for managing acute burn stage.
- Referred burn patients receive acute assessment and management safely before transfer.
Methodology:A comprehensive Burn External Referral form was established. Essential and mandatory items for acute burn assessment were included, for example: Burn distribution, fluid challenge with formula, airway assessment, limbs circulation assessment, chemical burn treatment and treatment given prior transfer, etc. Briefing sessions were conducted to surgeons and nurses on the workflow of using the form. And auditing on compliance of Burn External Referral form was evaluated by using checklist.
Result:During Jun. 2016 to Jun. 2017, total 49 nos. of burn referred cases were received and 49 nos. of Burn External Referral forms were audited. Result showed only 87.8% sample forms documented the mechanism of burn injury. Only 47% sample forms showed correct assessment on area of burn injury.
Also, 98% and 93.9% indicated that burn patients’ airway and limb circulation had been examined before transferred. Only 75.5% sample forms had acknowledged the need for tetanus prophylaxis prescription.
Conclusion:The use of Burn External referral form provides guidance to healthcare professionals of referring hospitals for management and stabilization of burn patients. Essential informations are received for preparation for admission in Burns Centre. But, there still need for improvement in evaluating the area of burn injury which affects the treatment regime especially for extensive burn.
Reference:Australian Medical Association, 2006 Safe handover: safe patients. Guidance on clinical handover for clinicans and manager. Canberra ACT.
Ms. Wong Tze Wing is Nurse Consultant in Burn and Plastic Specialty in Prince of Wales Hospital, Hong Kong Hospital Authority. She has extensive experience in burn management and regularly teaches and coaches nursing colleagues in Hong Kong. She also takes part in advances in burn care and is an EMBS course Nurse coordinator.