AHKNS issue 87

Effects of a postoperative delirium care bundle to prevent postoperative delirium in geriatric hip fracture patients (SMART) programme on postoperative delirium among patients with hip fracture: A quasi-experimental study - Tsang Lap Fung

Alternative strategy to discuss advance care planning in the community. Lee Chi Wai

say goodbye: A card game to facilitate advance care planning discussion - Agnes YIP Wing Ki/ Anna WONG On Na/ Queenie KWAN Ching

而另一方面，因應疫情而推行將面授技術課改為小班教學，令學生對實驗室設備及講師的需求大幅上升。 有別於以往，疫情下的教學模式未能安排每位學生在理論課後緊接進入實驗課，理論和實踐間的時間被逼 拖長，學生未能利用實驗課的實踐加深對知識的印象，以上種種因素難免為學生掌握及練習臨床護理技巧

薪。詳情請參閱人力資源通告第13/2022號。

2,022

2,232

2,581

(精神科) 12,298 5,676 2,838

as at 31.3.2022 12,915 13,735 14,600 15,560 16,565 17,675 18,795 20.035 21,340 22,725 24,070 25,545 27,145 28,780 30,235 31,750 33,350 35,040 36,765 38,595 40,515 42,545 44,555 46,655 48,860 51,095

w.e.f. 1.4.2022 13,240 14,080 14,965 15,950 16,980 18,120 19,265 20,540 21,875 23,295 24,670 26,185 27,825 29,500 30,990 32,545 34,185 35,915 37,685 39,560 41,530 43,610 45,670 47,820 50,080 52,370

HMPS Point 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

HGPS/MPS Point 26 27 28 29 30 31 32 33 34(33A) 35(33B) 36 37 38 39 40 41 42 43 44 45(44A) 46(44B) 47 48 49

as at 31.3.2022 53,500 55,995 58,635 61,415 64,270 67,295 70,465 73,775 74,515 75,265 78,385 82,105 85,870 89,845 93,710 97,745 101,965 106,340 110,170 117,580 121,790 126,220 130,760 135,470

w.e.f. 1.4.2022 54,840 57,395 60,100 62,950 65,875 68,975 72,225 75,620 76,380 77,145 80,345 84,160 88,015 92,090 96,055 100,190 104,515 109,000 112,925 120,520 124,835 129,375 134,030 138,855

註冊護士 護士長/ 資深護師/ 病房經理 登記護士

高級護士長/ 部門運作經理/ 顧問護師/ 護理總經理

Effects of a poStoperative deliriuM cAre bundle to prevent postoperative deliRium in geriaTric hip fracture patients (SMART) programme on postoperative delirium among patients with hip fracture: A quasi-experimental study

Background

Postoperative delirium (POD) is a common complication experienced by geriatric patients following hip fracture surgery. The incidence of POD in various countries ranges from 13.0% to 64.0%. POD can influence the rehabilitation progress of patients, thereby increasing the healthcare burden. Despite concerted efforts by orthopaedic team in recent years, the POD incidence rate in geriatric patients with hip fracture remains high. The study aimed to develop an evidence-based intervention to reduce the incidence of POD in geriatric patients with hip fractures and examined its effectiveness.

Methods

This study was composed of two phases. Phase I was an integrative review to identify the most effective interventions to reduce the incidence of POD in patients with hip fracture. The review findings were used to guide the development of an evidence-based intervention programme. Phase II aimed to evaluate the effectiveness of the evidence-based intervention programme using a quasi-experimental study. Eligible patients were recruited and allocated to receive the SMART (poStoperative deliriuM cAre protocol to reduce postoperative deliRium in geriaTric hip fracture patients) programme or standard care based on time phases. Data were collected at various time points. The effects of the SMART programme were analysed by using the generalised linear models, linear logistic and multiple regression. Recommendations and the completion rate of recommendations made were described.

Lap Fung TSANG, Kwok Wei SO Winnie, Cho Lee WONG Jojo, Chun Kwan WONG, Ching Yan KONG, Hang Cheong CHENG

Result

In Phase I, CGA using a team-based model and multi-factorial intervention were identified as the effective approach to reduce patients with hip fracture from developing POD according to two systematic reviews and one RCT. Other strategies were regarded as significant components to reduce POD. Based on the findings from the integrative review and the inputs from clinical management team, and guided by the Neuman Systems Model (NSM), the SMART programme was developed. It comprised five major components, namely (1) constipation prevention; (2) dehydration prevention; (3) cognitive impairment improvement; (4) a staff education session; and (5) (6) a pamphlet educating patients and their relatives about POD after surgery. Other strategies were obtaining advice from a team of delirium liaison nurse (DLN) and using a recommendation list.

In Phase II, a total of three hundred and eighty eligible participants (190 in the control group and 190 in the intervention group) were recruited. The incidence of postoperative delirium (POD) was 14.7% in the control group and 5.8% in the intervention group (X2 = 8.26, d[f] = 1, p = 0.004). Using log-binomial regression, patients in the intervention group had a lower risk of POD development than those in the control group after adjusting for the use of laxatives before surgery, premorbidity and the Abbreviated Mental Test score before surgery (risk ratio = 0.4, 95% CI: 0.18-0.88, p = 0.023). Using linear regression, compared to patients in the control group, patients in the intervention group had a significantly shorter hospital stay in the intervention group after controlling for potential confounders (regression coefficient = -0.22, SE = 0.09, p = 0.013, on log-transformed length of hospital stay). A significant effect of the SMART programme on improving AMT score to patients was noted after controlling for potential confounders (regression coefficient = 0.39, SE = 0.14, p = 0.006). However, the SMART programme did not show a significant effect on the duration and severity of POD, and the incidence of falls after surgery, before or after adjusting for potential confounders.

Conclusion

The SMART programme effectively reduced the incidence rate of POD among geriatric patients with hip fracture, shortening the length of hospital stay, and improving AMT score to geriatric patients with hip fracture. However, the SMART programme did not significantly affect patients with hip fracture on the duration and severity of POD, and the incidence of falls after adjusting the confounders.

Alternative strategy to discuss advance care planning in the community

Lee Chi Wai

Background

Health care professionals quite often encounter dilemmas when caring for patients who have not made decisions related to the care priorities at end-of-life (EoL). Further, their families may not know the patients' preferences. Knowing the wishes of the patients could enhance the sense of control and dignity, facilitate the decision-making process, and ultimately provide the person with a good death (Delgado-Guay et al., 2016). Although death is the natural path for every human being, only a minority of people in Chinese culture would talk about death with others. Death has long been a taboo in Chinese culture (Bosma, Apland & Kazanjian, 2010). When suddenly a person comes to a terminal condition and is incapable of making a medical decision, nobody knows the care preferences, just leaving neglect and regret.

Advance care planning (ACP) is a process in that people express their values, wishes and priorities of care at the final stage of life according to their preferences, at any age or whether they are healthy or in sick (Bischoff et al., 2013; Gilissen et al., 2020). It is also the practice of discussing and recording the preferences of care for people who cannot make the medical decision because of loss of mentally or communication ability (Brinkman-Stoppelenburg et al., 2014; Simon et al., 2019; Sudore et al., 2014). The advantages of effective ACP are decreasing hospitalisation rates and hospital deaths, reducing health costs, and increasing treatment concordant with people's wishes (Martin, 2016; Yonashiro-cho et al., 2016). ACP acts not only in communication with a mentally competent adult but also includes family members and healthcare professionals (Andreassen et al., 2017; Bristowe et al., 2015; Hospital Authority Ethics Committee, 2019).

It is essential to set the goals of care in advance care planning. This discussion requires a comprehensive and stepwise pathway. It may be difficult for people to start the dialogue. Given the cultural characteristics of the Chinese, the people in Hong Kong tend not to plan, discuss, and record their preferences of care or priorities at the end-of-life. They may be unclear what are the priorities, do not know what issues are essential in making a medical decision. Go Wish Card Game (GWG) provides opportunities to the target population and prompts them to consider their priorities and convey such information to their significant others. Ultimately, the awareness of ACP can be enhanced, and people can have a dignified death. The purpose of this research is to identify the care preferences and priorities of community-dwelling adults at the end-of-life and evaluate the impact of using the GWG to promote advance care planning in the community.

Methods

A descriptive survey design was adopted to identify the care preferences and assess the impact of using the GWG on people to promote advance care planning in the community setting. The researchers adopted the GWG to facilitate the target population to think about their care priorities and convey such information to their significant others. The Coda Alliance developed the GWG in 2006, is an easy-to-use and structured tool that consists of 52 cards with short statements covering major themes about end-of-life care, including autonomy, control of symptoms, communication, family issues, financial, practical and spiritual dimensions (Lankarani-Fard et al., 2010; Menkin, 2007; Osman et al., 2018).

The study was conducted between May and October 2021. All eligible participants were recruited from the community centres in Hong Kong. Convenient sampling was adopted to recruit study participants. Invitation letters or calls were sent to a group of Caritas Community Centres and non-governmental organisations. The inclusion criteria were Hong Kong citizens aged 18 or above, who had fluency in speaking Cantonese or English and reading Chinese or English. The exclusion criteria were persons with cognitive disability or mentally incompetent. The researchers liaised with the in-charge of the community centres in various districts and organised meetings with the potential participants to attend the information and GWG session. The researchers gave a 10-minute briefing to the participants describing the research, its aims, and the part that participants were expected to play at the start of each GWG session. An information sheet with the research details and the researcher's contact particulars were provided to participants before signing the consent forms.

Each participant was given a pack of the GWG and a record of the care preferences for ranking their priorities when they picked the Go Wish Cards up to 10 for "very important", 10 for "somewhat important", and 10 for "not important". After playing the GWG, the research assistant conducted a survey with the participants. A self-developed questionnaire with three sections was used: (A) demographic data, for example, age, gender, marital status, education level, employment status, religion, and personal health status of participants; (B) five questions 5-point Likert scale from strongly agree to strongly disagree to discuss the thought and plan of participants after completing the GWG; (C) five open-ended questions used to collect qualitative information about participants’ wish and medical decision-making. Participants were encouraged to communicate their records of preferences with families and healthcare professionals at the debriefing session. Data were analysed by descriptive statistics.

Result

A total of 238 participants were recruited from 15 community centres in various districts of Hong Kong. The majority of the participants aged between 61 and 90 (90.7%), 79.8% were female, 58% and 22.3% were married and widows. Most of the participants received secondary education (40.8%), 221 (92.9%) of participants claimed had no disability, 144 (60.5%) had chronic illnesses, 145 (60.9%) were retired, and 75 (31.5%) were homemakers.

Of 86.5% of participants who expressed agree and strongly agree to know more about advance care planning after playing the GWG, 174 (73.1%) and 143 (60.1%) agreed to discuss their care preferences with spouse or relatives and health professionals respectively. Whenever the participants became cognitive incompetent, 189 (79.5%) expected their close relatives to make medical decisions for them. Of 191 (80.2%) participants agreed that ACP could help people make medical decisions and prioritise care at the end-of-life.

Some participants stated that it was beneficial for the GWG to reveal their care preferences and priorities at the final stage of life in the open-ended questions. They had decided to let their spouse and children make medical decisions on their behalf if they were mentally incompetent. However, some participants claimed that relatives turned them down when they wanted to discuss ACP.

After analysing the record of the care preferences from the 238 participants, the top 10 “very Important” and top 10 “Not Important” preferences of ACP were illustrated in Tables 1 and 2.

Table 1. Top 10 “Very Important” preferences in ACP 1 I want to talk about what I have done in my life.

1 I don't want to suffer. 2 I don't want to be a burden to my family. 3 I want to maintain my dignity. 4 If I'm going to die anyway,

I don't want to be kept alive by machines. 5 I don’t want to die alone. 6 I want my family to get along. 7 I want to be kept clean and comfortable. 8 I don't want to suffer from shortness of breath. 9 Don't cry while I am dying or around my body after I die. 10 I want my family to respect my wishes.

Table 2. Top 10 “Not Important” preferences in ACP

I want a chance to say "goodbye"

I want to be kept warm.

I want my family to bring me the food I like.

I want to know what's going to happen next.

I want to be alert when I die.

I don't want to die at home.

I'd like to travel to _ before I die.

It's OK if my loved ones cry or laugh around me. 10 I would like to have a religious object next to my bed.

Discussion

People commonly spend their final stage of life in the hospital or infirmary setting. Although the research samples were adopted from the community setting, apparently the clients of the community centres usually belong to the elderly group and might have a chronic illness or more. By understanding the preferences and care priorities, dignified and respectful care can be provided. The findings of the research can enrich the knowledge of health care professionals and community workers, to promote and plan the advance care planning of the clients. Also, the findings can be infused in the teaching and learning contents for the health care trainees. The sample size is small because the data collection period fell on the pandemic of COVID-19. It affected the participants’ interest and attendance in the community centres. Instead, this study adopted the GWG as an alternative strategy, to facilitate the participants to consider their preferences of care priority at the final stage of life. It encouraged the participants to share their preferences, in another way to promote the concept of ACP in the community. Ultimately, the awareness of ACP can be enhanced, and people can have a dignified death.

Conclusion

The findings of this study support adopting an alternative strategy to facilitate and promote ACP in the community. Most of the participants belonged to the elderly group with various chronic illnesses. They appreciated the GWG helping them to list their care preferences at end-of-life, also planned to discuss the record of ACP preferences with families and significant others. The findings of this study add to the emerging body of knowledge to inform health care professionals and community workers from the community perspective. To facilitate medical decision-making and to promote advance care planning of the citizens in Hong Kong at their final stage of life, further research is required to develop appropriate strategies in the context of practice. Advance care planning provides a platform for individuals, families and health care professionals to communicate personal wishes for end-of-life care. Such dialogues should not be limited to a medical-oriented focus, as wishes would have to be interpreted in a personal context.

References

Andreassen, P., Neergaard, M. A., Brogaard, T., Skorstengaard, M. H., & Jensen, A. B. (2017). The diverse impact of advance care planning: A long-term follow-up study on patients' and relatives' experiences. BMJ Supportive & Palliative Care, 7, 335-340. doi:10.1136/bmjspcare-2015-000886.

Bischoff, K. E., Sudore, R., Miao, Y., Boscardin, W. J., & Smith, A. K. (2013). Advance care planning and the quality of end-of-life care among older adults. Journal of American Geriatric Society, 61(2), 209–214. DOI: 10.1111/jgs.12105.

Bosma, H., Apland, L., & Kazanjian, A. (2010). Cultural conceptualisations of hospice palliative care: more similarities than differences. Palliative Medicine, 24(5), 510-522. Brinkman-Stoppelenburg, A., Rietjens, J. A. C., & van der Heide, A. (2014). The effects of advance care planning on end-of-life: A systematic review. Palliative Medicine, 28(8), 1000-1025. DOI: 10.1177/0269216314526272.

Bristowe, K., Horsley, H. L., Shepherd, K., Heather, B., Carey, I., Matthews, B., … Murtagh, F. E. M. (2015). Thinking ahead – the need for early advance care planning for people on haemodialysis: A qualitative interview study. Palliative Medicine, 29(5), 443–450.

Delgado-Guay, M. O., Rodriguez-Nunez, A., De la Cruz, V., Frisbee-Hume, S., Williams, J., Liu, D., Fisch, M. J., & Bruera, E. (2016). Advanced cancer patients' reported wishes at the end of life: A randomised controlled trial. Support Care Cancer, 24, 4273-4281. DOI 10.1007/s00520-016-3260-9.

Gilissen, J., Pivodic, L., Wendrich-van Dael, A., Gastmans, C., Stichele, R. V., Engels, Y., Vernooij-Dassen, M., Deliens, L., & Van den Block, L. (2020). Implementing the theory-based advance care planning ACP+ programme for nursing homes: Study protocol for a cluster randomised controlled trial and process evaluation. BMC Palliative Care, 19(5), 1-18. https://doi.org/10.1186/s12904-019-0505-7.

Hospital Authority Ethics Committee. (2019). Advance care planning (ACP)? Advance directives (AD)? Do-not-attempt cardiopulmonary resuscitation (DNRCPR)? Patients and families should know more!. Hospital Authority. https://www.ha.org.hk/haho/ho/psrm/Public_education2.pdf

Lankarani-Fard, A., Lorenz, K. A., Feld, J. E., & Menkin, E. S. (2010). Feasibility of discussing end-of-life care goals with inpatients using a structured, conversational approach: The Go Wish card game. Journal of Pain and Symptom Management, 39, 637-643. doi:10.1016/j.jpainsymman.2009.08.011.

Martin, R. S., Hyaes, B., Gregorevic, K., & Lim, W. K. (2016). The effects of advance care planning interventions on nursing home residents: A systematic review. Journal of the American Medical Directors Association, https://doi.org/10.1016/j.jamda.2015.12.017.

Menkin, E. S. (2007). Go wish: A tool for end-of-life care conversations. Journal of Palliative Medicine, 10(2), 297-303.

Osman, H., El Jurdi, K., Sabra, R., & Arawi, T. (2018). Respecting patient choices: Using the `Go Wish' cards as a teaching tool. BMJ Supportive & Palliative Care, 8, 194-197 DOI 10.1136/bmjspcare-2017-001342.

Simon, J. E., Ghosh, S., Heyland, D., Cooke, T., Davison, S., Holroyd-Leduc, J., Wasylenko, E., Howlett, J., & Fassbender, K. (2019). Evidence of increasing public participation in advance care planning: A comparison of polls in Alberta between 2007 and 2013. BMJ Supportive & Palliative Care, 9, 189-196. DOI 10.1136/bmjspcare-2015-000919.

Sudore, R. L., Knight, S. J., McMahan, R. D., Feuz, M., Farrell, D., Miao, Y., & Barnes, D. E. (2014). A novel website to prepare diverse older adults for decision making and advance care planning: A pilot study. Journal of Pain and Symptom Management, 47(4), 674-686. https://doi.org/10.1016/j.jpainsymman.2013.05.023

Yonashiro-cho, J., Cote, S., & Enguidanos, S. (2016). Knowledge about and perceptions of advance care planning and communication of Chinese-American older adults. Journal of American Geriatrics Society, 64, 1884-1889.

To say goodbye: A card game to facilitate advance care planning discussion

Agnes YIP Wing Ki Anna WONG On Na Queenie KWAN Ching Man

Background

Advanced care planning (ACP) promotes identification and documentation of individual needs, enables individuals to discuss, consider and document their preferences and wishes for future care before they lose capacity to make decisions (Pollock & Wilson, 2015). It optimizes quality of life of older adults and seriously ill patients through aligning the goal of palliative care (Gramling et al., 2013).

Conversation card game acts as an effective tool to engage people in ACP discussion and is suitable to promote desired health behavior (Kharrazi et al., 2012). Yet, evidence-based tools for ACP in Asian countries are very limited. To address the gap, there is a need to develop a culturally driven, uncomplicated and entertaining card game for Chinese people.

Aim

To develop a card game that can initiate discussion on ACP in Chinese community.

Method

Focus group interviews were performed for elderly, caregivers and healthcare providers, nominal group technique was applied to identify issues considered essential in ACP. Qualitative analysis generated statements illustrating issues considered as essential in ACP discussion. Delphi technique was adopted to ensure the consensus on the importance of issues and universe of content to be discussed in ACP. These essential issues guided the development of the card game. The goal and rules of the card game were also developed.

Result

A total of 31 participants engaged in this study, they had four major concerns in ACP: family issue, affection, medical issue and personal affairs. Sixteen statements of four major concerns were sent to nine expert panel members, satisfactory level of agreement was reached (median = 4 to 5; SD = 0.43 to 1.39). Simple card game design was adopted. Discussion Card included four units: family, affection, medicine and personal affairs. Statements were rephrased in different sentences and scenarios, one sentence or scenario was printed on single Discussion Card to prompt discussion. Immersion in instructional content, playfulness, and peer interaction were considered in drafting the game rules. After initial development process was completed, three healthcare professionals, one experienced scientific researcher and one card game designer were asked to review the card game based on its goal, design, components and organization, playability and playfulness, and usefulness. Generally, comments and feedback were positive, game rules were set and printed on the cards.

Implication and Recommendation

It is believed that the card game will facilitate ACP discussion and provide opportunities for participants to express their needs, concerns in end-of-life issues. Further studies are recommended to explore the feasibility and appropriateness of using card game facilitating ACP among Chinese people.

References

Gramling, R., Norton, S. A., Ladwig, S., Metzger, M., DeLuca, J., Gramling, D., Schatz, D., Epstein, R., Quill, T., & Alexander, S. (2013).

Direct Observation of Prognosis Communication in Palliative Care: A Descriptive Study. Journal of Pain and Symptom Management, 45(2),202–212. https://doi.org/10.1016/j.jpainsymman.2012.02.004

Kharrazi, H., Lu, A. S., Gharghabi, F., & Coleman, W. (2012). A Scoping Review of Health Game Research: Past, Present, and Future. Games for health journal, 1(2), 153–164. https://doi.org/10.1089/g4h.2012.0011

Pollock, K., & Wilson, E. (2015). Care and communication between health professionals and patients affected by severe or chronic illness in community care settings: a qualitative study of care at the end of life. Health Services and Delivery Research, 3(31), 1–138. https://doi.org/10.3310/hsdr03310

Phantom Lily >_Megan

The world is a phantom full of different players having their exits or entrances according to their parts of acting.

You say that you enjoy caring the others, but you put on your long face when it happens;

You say that you adore the needs of others, but you spread out with apathy when it arises.

You say that you respect being the profession, but you indulge in your personal obligation when it concerns.

Nothing is either good or bad but thinking makes it so.

Never forget our first initiative with our deeds consistent with our words always.

嘉仁專科醫療集團

副主席： 楊永釗先生 伊利沙伯醫院

楊綺雯女士 明愛醫院 謝健強先生 瑪麗醫院

秘書長： 何鴻坤先生 瑪麗醫院

財政： 梁　耀先生 香港護士中介服務有限公司

副財政： 呂鴻江先生 青山醫院

公關主任： 周昭賢女士 香港兒童醫院 教育主任： 勞偉傑先生 威爾斯親王醫院 助理秘書： 陳煒文先生 百本醫護控股有限公司

蔡曉冰女士 博愛醫院 馮幹華先生 基督教聯合醫院 何崇漢先生 愛護理服務集團 源文錦先生 伊利沙伯醫院

執行委員：

區觀寶女士 基督教聯合醫院 陳淑雲女士 香港罕見疾病聯盟 何家穎女士 九龍醫院 劉麗英女士 衞生署 梁詩慧女士 職業訓練局 盧若琴女士 葵涌醫院 盧若詩女士 督教聯合醫院 麥念慈女士 葵涌醫院 吳偉思女士 衞生署 司徒永裕先生 百本醫護控股有限公司 黃為賢先生 屯門醫院

雅麗氏何妙齡那打素醫院 楊頌美 女士 百本專業護理服務有限公司 陳煒文 先生 司徒永裕先生

明愛醫院 梁秀雯 女士 楊綺雯 女士

青山醫院 劉楚堯先生 呂鴻江先生 吳祟鑫先生

香港中文大學醫院 李婷婷女士

衞生署 馮雪貞女士 劉麗英女士 吳偉思女士

大口環根德公爵夫人兒童醫院 何婉佟女士

播道醫院 張海珊女士

港怡醫院 陳芷茜女士

香港佛教醫院 黃嘉新女士

香港兒童醫院 周昭賢女士 鍾旻熹女士

愛護理服務集團 何崇漢先生

葵涌醫院 何影雲女士 林健明先生 盧若琴女士 麥念慈女士 葉毅恒先生

九龍醫院 何家穎女士 謝綺媚女士

廣華醫院 俞麗芳女士

北區醫院 鄺志傑先生

南丁格爾醫療護理顧問 梁小冰女士

聖母醫院 黃偉賢先生

瑪嘉烈醫院 賴楚衡女士 李婉儀女士 陸潔貞女士

博愛醫院 詹子玲女士 蔡曉冰女士 威爾斯親王醫院 勞偉傑先生 東區尤德夫人那打素醫院 陳紹基先生 伊利沙伯醫院 楊永釗先生 源文錦先生 瑪麗醫院 何鴻坤先生 江仲如女士 謝健強先生 將軍澳醫院 何慧儀女士 梁婉華女士 黃智健先生 屯門醫院 吳海華先生 黃為賢先生 天水圍醫院 郭偉倫先生 東華護理學院 陳　信女士 林　清先生 東華醫院 李淑儀女士 基督教聯合醫院 區觀寶女士 陳詠鈺女士 馮幹華先生 林茂佳先生 盧若詩女士 蘇蓮歡女士 曾慶玲女士 黃文健先生 王銀池先生 職業訓練局 梁詩慧女士 仁濟醫院 彭澤厚先生 嚴成威先生 嘉仁專科醫療集團 源志敏先生 香港護士中介服務有限公司 梁　耀先生 香港罕見疾病聯盟 陳淑雲女士

Advanced Cardiovascular Life Support (ACLS) Provider Course

Advanced Clinical Pharmacology

Basic Life Support (BLS) Course for Healthcare Providers

Drug Usage for Common Diseases

ECG Strip Identification and Evaluation

How to read ECG? A practical approach

Intensive Course on Medications for Dermatological Disorders and Infectious Diseases

Introduction to Grief and Bereavement Counselling

Neurogenic Communication and Swallowing Disorder

Overview on Laboratory Tests Interpretation

Pediatric Advanced Life Support (PALS) Courses

Positive Psychology

Practical Counseling: Actual Cases and Techniques

Prevention Strategies & Treatments for Migraine & Headache

Psychology for Self-Understanding and Improvement

Recent Advancement of Colorectal Cancer Screening and Gut Microbiome

Rehabilitation Care fo Stroke Patients

Technologies advancement and its application in primary care

The Latest Diet for Hypertension and Stroke

Updates in Modern Wound Management Venipuncture and Blood Taking Technique

香港護士年會2022:疫情下的感染控制

針對性伸展及對抗肌肉疲勞之方法 - 伸展、普拉提及按摩槍的應用

「無藥治療」：專注力不足 / 過度活躍症及學習 / 讀寫障礙的問題

『催眠治療』臨床應用體驗班 - 痛症處理

『催眠治療』臨床應用體驗班 – 腸胃焦慮症 催眠治療臨床應用課程 腰痛知識，你「腰」知道 - 解析最愛都市人的下腰及盤骨痛症狀 精神健康急救 - 基礎課程 認知障礙症(老人痴呆)的認識 認識工作間暴力行為及危機處理方法 護理人員常見長期痛症 慢性肩頸痛 護理人員常見痛症

Apr-22, May-22, Jun-22, Jul-22, Aug-22, Sep-22 Jun-22

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護協去信醫院管理局行政總裁高拔陞醫生跟進醫管局員工返回工作崗位的安排。護協於社交媒體發放跟進醫管局員工返回工作崗位的安排的資訊。

護協去信醫院管理局主席范鴻齡先生反映有關國內醫護團隊馳援醫院管理局一事的三點意見。護協於社交媒體發放國內醫護團隊馳援醫院管理局的建議。

FEBRUARY 2

護協去信醫管局青山醫院醫院行政總監林明醫生跟進護協告示板的安排。護協於社交媒體發放跟進HIGH RISK AREA員工PA房安排的資訊。

護協去信醫院管理局行政總裁高拔陞醫生跟進高風險區工作同業的院內留宿房間安排。

護協去信護士管理局主席羅鳳儀教授轉介註冊或登記護士執業證明書個案。

護協於社交媒體發放跟進護士管理局續辦執業證明書的事宜。

護協去信醫院管理局行政總裁高拔陞醫生跟進重新啟動新冠疫情的抗疫機制。護協於社交媒體發放有關醫管局重新啟動新冠疫情的抗疫機制的資訊。

護協旅遊更改營業時間。