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Following is a question by the Dr Hon Kwok Ka-ki and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January 30):
Question:
It has been reported that last month in Queen Elizabeth Hospital, a paediatric phlebotomist administered intravenous drip on a 19-month-old baby girl, but the syringe needle was subsequently dislocated, causing the saline solution to go into the muscle; and as the dislocation was not detected until four hours later, the baby girl's arm had swollen and turned purple. Some healthcare personnel explained to the baby girl's parents afterwards that the failure to detect promptly the dislocation of the syringe needle was related to severe manpower shortage. In this connection, will the Government inform this Council whether it knows:
(a) the number of phlebotomists currently employed in each of the public hospitals;
(b) the scope of the duties of phlebotomists working in public hospitals, and whether duties (such as administration of intravenous drip) apart from blood taking are included; whether the relevant guidelines have specified that phlebotomists may carry out duties apart from blood taking in paediatric wards and geriatric wards; if so, of the criteria for formulating such guidelines; if this is not specified in the guidelines, the reasons for that;
(c) whether the Hospital Authority had provided any pre-service training for phlebotomists in the past three years; if so, of the number of attendances of phlebotomists in such training and the average hours of training they received; if not, whether it has any plan to provide such training; if it has, of the details; and
(d) the number of medical incidents involving phlebotomists which occurred in public hospitals in each of the past three years, together with a breakdown by the hospitals and departments involved?
Reply:
President,
To relieve the heavy workload of frontline doctors in public hospitals, the Hospital Authority (HA) has implemented a number of pilot doctor work reform programmes since 2007. Under the programmes, Patient Care Assistant (PCA) grade staff (including Clinical Assistants) have been recruited in various acute general hospitals in phases to provide 24-hour blood-taking services and other relevant patient care technical support services. This measure has proved to be effective in alleviating the workload of healthcare staff and improving their working environment and is well received among the staff.
My reply to the various parts of the question is as follows:
(a) As at the end of December 2012, there were 516 Clinical Assistants (CA) under the PCA Grade in HA, mainly working in the acute general hospitals. The number of CA in each hospital cluster is as follows:
Hospital Cluster Number of Clinical Assistants
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Hong Kong East 50
Hong Kong West 43
Kowloon Central 79
Kowloon East 99
Kowloon West 108
New Territories East 100
New Territories West 37
Total 516
Note: As the timeline of implementing the pilot doctor work reform programmes varies among hospital clusters, coupled with the difference in the number of acute general hospitals under each hospital cluster, as well as the difference in specialties available in and services provided by the hospitals, the number of CA employed in each hospital cluster differs as well.
(b) and (c) The duties of CA include blood-taking from adult and paediatric patients; carrying out blood glucose and haemoglobin tests, taking blood with the use of aseptic technique for bacteriological cultures, conducting electrocardiograms for patients, and performing general intravenous cannulation procedures.
All staff performing the duties of CA have to attend a training course organised by HA. Only those who have passed the assessment and have been awarded a certificate will be formally offered appointments. The CA course lasts for around one year and covers training on blood-taking techniques, electrocardiogram examination and intravenous cannulation etc, including 35 hours of classroom training and 3 hours of written assessment, so as to ensure that the CA staff are well acquainted with the knowledge, techniques and procedures of blood-taking, electrocardiogram examination and intravenous cannulation. Besides, CA trainees are required to undergo 315 hours of clinical practice and pass the skills assessments, and to undergo 6 months of supervised on-the-job training, so as to ensure that upon completion of their training, they are fully capable of performing the work of blood-taking, electrocardiogram examination and intravenous cannualtion in clinical settings, with a view to maintaining the service standard and quality. From 2010 to 2012, about 1 110 staff have completed the training course.
Blood-taking from adult and paediatric patients is one of the CA's routine duties. With the training provided by HA, they are fully capable of performing their duties in order to relieve the workload of other frontline healthcare personnel (including doctors and nurses).
(d) According to HA's records, the number of clinical accidents involving PCA staff (including CA) reported in the past three years are as follows:
Hospital Cluster 2010 2011 2012 Overall
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Hong Kong East 3 5 5 13
Hong Kong West 14 7 20 41
Kowloon Central 2 2 6 10
Kowloon East 13 3 7 23
Kowloon West 7 10 12 29
New Territories East 4 12 15 31
New Territories West 10 17 19 46
Overall 53 56 84 193
Note: The above figures cover all cases of accidents involving staff of the PCA grade (including accidents involving PCA staff who are not CA). These cases are of varying degree of severity and only a minority of them was serious cases.
Ends/Wednesday, January 30, 2013
Issued at HKT 15:07
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