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Engaging patients, promoting physical and mental well-being
As Senior Nurse Manager of Ward 63C at Singapore General Hospital, Yuan Long Xia and her team of nurses handle patients from both the Internal Medicine and Geriatric Medicine departments. They make special effort to ensure the 66-bedded ward is an elderly-friendly, restraint-free environment for their patients.
“Most of our patients are elderly with dementia who have behavioural problems that can be triggered by drugs, dehydration and infections,” said Long Xia.
“Their family members or caregivers may not be able to cope with their behavioural changes. Through our observation and assessment of the patients, we help to stabilise them before referring them to nursing homes or community hospitals,” she added.
After reading numerous studies on how engagement games could help the elderly improve their physical health and cognitive abilities, Long Xia’s team carefully evaluated and selected a series of video games as rehabilitative therapy for patients at Ward 63C.
The games utilise a black box sensor that can detect the movement of the patient’s arms and limbs, and are played using a TV screen at the activity room. Because of the COVID-19 pandemic, infection prevention was a key consideration so the team opted for games that did not require patients to wear any equipment. The nurses also considered how engaging, intuitive and inclusive the games were, so that patients with varying abilities would be able to play.
“The games had to embrace gamification principles such as having an engaging narrative and enhanced visuals, to draw and maintain a patient’s interest as well as instil a sense of achievement and gratification by showing the player’s progress and offering rewards,” said Long Xia.
With strict visitation guidelines amidst the pandemic, the games have helped keep patients engaged while adhering to safe management measures at the ward. “Patients have fun trying to catch a fruit, drive a car, and learn how to make sandwiches by simply moving their arms and limbs. These activities improve their muscle strength and flexibility while stimulating brain activity,” she said.
After each game session of 10 minutes, the patients were observed to be calmer, happier, and were able to rest for longer periods. A patient, who had never played a video game before, commented that the games made him feel much younger.
Long Xia and her team are currently working with physiotherapists to evaluate how the games can be adapted to facilitate or enhance rehabilitation exercises for patients who have limited body movement due to their medical and post-operative conditions. The team is also exploring other engagement games and expanding the initiative to other wards to benefit more patients.
Continuous learning goes online for staff and patients
Before the COVID-19 pandemic, SingHealth Polyclinics (SHP) nurses had to undergo a training programme on wound management at SHP’s head office.
Despite being unfamiliar with virtual platforms initially, Joanna Tan, Nurse Clinician at Punggol Polyclinic, and her team started a blended training programme, which comprised Zoom sessions and face-to-face training with strict adherence to infection prevention and safe management measures.
To make the training fun and interactive, Joanna incorporated quizzes and encouraged participants to share their experiences. “The nurses found this method of training refreshing, and they liked the convenience of not having to travel to the training location,” the 51-year-old said.
The nurses are not the only ones benefitting from such tech-driven initiatives. Recognising that patients can also benefit from telemedicine, Joanna guided Enrolled Nurses (ENs) to provide video consultation (VC) on wound dressing for suitable patients.
“There was a bedridden patient who had a pressure injury on his buttock. Through the VC, we observed how his domestic helper dressed his wound and realised that she had difficulty holding the forceps while cleaning the wound. So we reinforced the necessary steps for her to practise, and her skills improved after subsequent tries,” said Joanna.
After each VC session, Joanna would discuss with the ENs on how to improve patient care, while they share about the challenges they face and how to tackle them.
Having a positive and open mind enables Joanna to better adapt to changes in times of uncertainty. She and her team will continue to review and identify other training programmes that can take place virtually without compromising on the learning experience.
For more inspiring stories of our nurses, read the 2021 Singapore Health Special Nursing Issue, produced in conjunction with Nurses’ Day.