Experience of a tertiary acute care hospital in Southeast Asia in initiating patient engagement with the aid of digital solutions.

Introduction: With the goal of patient engagement, an initiative was formulated to equip each patient in the general wards with a tablet whereby they can access their health information and patient education materials and communicate with their healthcare team. This paper presented the methodology of the implementation efforts as well as an evaluation of the preliminary outcomes. Methods: The process of hospital-wide implementation was shared using the implementation research logic model. The bedside tablets were rolled out hospital-wide in a step-wedge manner over 12 months. Barriers and facilitators to this implementation were discussed together with strategies to optimize the situation. Preliminary outcomes of the implementation were evaluated using the RE-AIM framework. Results: The initial adoption rate for the bedside tablet was low. Additional strategies, such as survey audits and provision of feedback, development of education materials for patients, facilitation, and purposefully re-examining the implementation strategies, were used to improve adoption. The trend of adoption increased over the course of 2 years from the start of implementation. Discussion: The initial lower adoption rates may reflect Singapore's paternalistic healthcare culture. While this implementation was driven by the need to move away from paternalism and toward patient engagement, more time is required for significant cultural change.

A survey of pediatric oncology nurses' oral health knowledge, attitudes, practices, and perceived barriers in a Singapore Tertiary Children's Hospital.

AIM: To explore oral health-related knowledge, abilities, attitudes, practices, and barriers of pediatric oncology nurses at an Asian children's hospital. METHODS: A cross-sectional study was conducted via a self-administered anonymized questionnaire. Data was analyzed to summarize knowledge, confidence, and practice behaviors. RESULTS: All sixty-three pediatric oncology nurses responded. Fifteen participants had >80% of the knowledge questions correct. Majority (97.3%) agreed on their roles in helping patients maintain their oral health. However, 75.8% of participants felt need for training in giving oral health advice. Notably, 74.6% checked patients' mouths at least once daily but only 57.1% felt adequately trained. Though a high proportion (>90%) of nurses felt confident to assist with oral care, only 65% would assist patients to do so; "Uncooperative patient" was the major barrier reported. DISCUSSION: Nurses have high general awareness of importance of oral health, but had incomplete knowledge. Compared to previous studies, most (90.5%) did not find performing oral care unpleasant but other barriers might have hindered actual oral care practice. CONCLUSION: Nurses were motivated to assist in oral care of children with cancer but sometimes felt ill-equipped. Updated national and institution guidelines, didactic and hands-on training, and implementation of practical support could be considered.