Abstract

Background: A nationwide study on homelessness in 2019 reported high prevalence of poor health among rough sleepers in Singapore. There are rough sleepers supported by volunteers and community partners within Singapore General Hospital service boundary. Community nursing team engaged Ministry of Social and Family Development (MSF) Partners Engaging and Empowering Rough Sleepers (PEERS) Network and Homeless Heart, a volunteer group, to reach out to this vulnerable population and to understand challenges faced by volunteers. The learning needs survey among 39 volunteers was conducted and showed that less than 8% of them were equipped with basic healthcare knowledge and skills. The top three learning needs were i) healthcare resource for homeless (92.1 %), ii) mental Health (68.4%), iii) basic triaging skills (68.4%).
 Interventions: A virtual volunteer training programme was developed based on survey findings and inputs from PEERS Network during COVID-19. It was further extended to shelter operators supporting rough sleepers. The training was conducted by community nurses on alternate weekend from February to March 2022. The mode of delivery included didactic teaching and case discussion. A referral process to community nursing for rough sleepers requiring assistance in chronic disease monitoring was established to ensure care continuity. 
 Outcomes: A total of 46 participants attended training. All found the program content was useful, relevant to their volunteer activities, and easy to understand. Nearly 80% will recommend this program to their peers. Till date, a total of 5 referrals to Community Nurse Posts were made by volunteers. Nurses conducted health coaching and medication re-consolidation to rough sleepers and also guided volunteers for the subsequent follow up.
 Learning Points and Future Plan: It is the first training programme provided by community nurses to volunteers and staff supporting rough sleepers. The programme was tailored to meet participants’ experience and learning needs. Community nursing will further collaborate with PEERS for outreach events and provide onsite training to facilitate effective learning experience. Moving forward, community nurse team will extend the training program to other community service provides and grassroots volunteer, to support the residents’ physical and psychological well-being in the community .

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