Emergency Nurse-Led Evidence-Based Practice Initiative: Patient Self-Management of Noncommunicable Disease in the Community.

INTRODUCTION

Emergency department visits are critical touchpoints to engage patients with noncommunicable diseases in self-management support aligned with Hong Kong health care reform and Sustainable Development Goal 3.4. This study examined the effectiveness of an emergency department-based, nurse-led health-promotion intervention to improve chronic disease self-efficacy and strengthen emergency nurses' contribution to primary health care.

METHODS

In a single-blind, randomized controlled pilot trial in an urban emergency department, 92 adults with noncommunicable diseases were allocated to the interventional (n = 46) or conventional group (n = 46). The intervention comprised personalized education on primary health care resources, onboarding to eHealth and HA Go, and 2 months of WhatsApp reinforcement. The conventional group received standard discharge education and informational leaflets. The primary outcome was chronic disease self-efficacy at 2 months, measured using the Chinese Partners in Health Scale. Secondary outcomes were awareness and use of District Health Centre/Express, the Chronic Disease Co-Care Pilot Scheme, and digital platforms.

RESULTS

The interventional group demonstrated significantly higher Chinese Partners in Health Scale scores than conventional care (mean difference, 8.54; 95% CI, 2.53-14.55; P = .0057; Cohen's d = 0.654). District Health Centre/Express visitation increased from 13.5% to 54.1% in the interventional group, whereas it remained unchanged in the conventional group. Chronic Disease Co-Care Pilot Scheme awareness rose from 43.2% to 100% vs 12.5% in conventional (P < .001). eHealth registration increased by 29.7% vs 12.5% (x2 = 7.433; P = .006), and HA Go adoption was higher (odds ratio, 0.5862; P = .007).

DISCUSSION: Emergency department-based, nurse-led health promotion significantly enhances noncommunicable disease self-efficacy and activates primary health care and digital health utilization, supporting integration of emergency nurses into Hong Kong's primary care transformation and progress toward Sustainable Development Goal 3.4.