Movi ving the he Hea eart rt of t the he Frontli line e - - PowerPoint PPT Presentation

Movi ving the he Hea eart rt of t the he Frontli line e Building a Case for SPHM Sustainability

Rhonda Turner, RN, MSN-LD, CSPHA Banner Health

Objectives

Know who your key stakeholders are when it comes a building and sustaining a comprehensive SPHM program. Create a SPHM gap assessment using the 8 ANA SPHM standards, set your vision, and take your business case to the C-Suite. Learn how to follow through with implementation and gain creative solutions to shift the culture from within.

Build y your F Foundation

• Introduction of the

“Implementation Guide to the 8 ANA SPHM Standards”

• Research Best Practice
• Visit established cultures

Poll Question #1 (Pick one)

Do you have a SPHM and Falls Prevention team partnership within your

• rganization?

A.Yes, regular blended meetings B.We collaborate C.No D.We don’t have teams

Organ anize

Find s someone w with common g goal

• What is your overarching mission?
• What is your vision?
• What is your action plan?

Poll Question #2 (Select all that apply)

• A. Frontline RN
• B. Frontline Techs,

CNA’s, Transport…

• C. C-Suite
• D. Manager PT/OT
• E. Risk/Injury

Prevention What representation from the bedside to c- suite do you have on your fall prevention and SPHM teams?

Who A

• Are y

e you

• u K

Key S Stake H Hold

• lders?

C-Suite Managers Frontline – RN’s, CNA’s, ED Techs Transport Supply Financial Risk Management Employee Safety Environmental Services Dietary

Key eys t to Establishing Partnerships

Transparency Support Flexibility Policy

Northern Colorado Hands-On SPHM Pilot to system implementation

• First class on December 10, 2015:

Taught by RN, CNA, PTA, and COTA

• Open to all who are interested, not

mandatory

• PT/OT, Transport, and Critical Care

Services committed to send all new staff through

• Mix of 203 RN’s, RN Managers, CNA,

PT/OT Staff, Radiology Techs, EMT’s, &Transport

• Taught at all 3 Facilities – became

mandatory for all new hires

Poll Question #3 (Pick One)

• A. Never

B.Less than 1yr. C.Between 1-3 yrs. D.Yearly

When was the last time your team reviewed the focused gaps within your fall prevention and SPHM practice?

Sample of Gap Assessment

Other Gap Assessments available by searching:

• OSHA SPHM Assessment
• ANA SPHM Assessment

Gap A Assessment

Key Components f for B r Business C Case

• 1. Introduction
• 2. What we are asking for
• 3. System SPHM Gap Assessment- top 4 needs
• 4. Vision of Hands On Education
• 5. Vision of Updated Online Education
• 6. 5-year Workman’s Compensation Analysis

(System)

• 7. Example of Pilot Class and Outcomes
• 8. 2-3 year vision
• 9. References

Nine Slides

• How do we get started???

Where do we go for support???

• What do we need???
• Is it possible????

Yes – I ‘ll take…hmm 7 patient repositions 6 stat transfers. Throw in one floor retrieval Oh - and I’ll also take one trip to the ER for my coworker

Drive ve – thru Mentality ty

• When staff are stretched

between competing priorities

• Shortcuts are taken when

staff don’t have the tools or education regarding SPHM

• Patient safety is

compromised in the blink of an eye

Look at these numbers…

• Epidemiologic studies have found that falls occur at a rate of 3–5 per 1000

bed-days, and the Agency for Healthcare Research and Quality estimates that 700,000 to 1 million hospitalized patients fall each year.

• Patients in long-term care facilities are also at very high risk of falls.

Approximately half of the 1.6 million nursing home residents in the United States fall each year

• 2014 report by the Office of the Inspector General found that nearly 10% of

Medicare skilled nursing facility residents experienced a fall resulting in significant injury.

2005 – Texas passes legislation for SHPM as mandated practice It 2019 – only 10 other states have joined Texas

ARHQ , 2019 and Hudson, 2005

Ti Time t to

• Innovate

ate!!!

“Live in the land of implementation”

Gail Powell-Cope

Poll Question #4 (Select all that apply)

• A. RN’s taught by

Education or Peers

• B. Only for CNA, Techs,

Transport

• C. Combined yearly

education for all roles

• D. No
• E. We did – but because
• f cost, had to stop

Do you have yearly, peer to peer, frontline focused hands –on skills labs with multiple disciplines?

Sh Shif iftin ing t the C Cult lture – Peer to P r to Peer r Teach ching

Educate with Purpose

Impacting Quality Measures

Fall Prevention Early Moblity Pressure Injury Delirium Pneumonia Injury Prevention

Passion Ignited Frontline Skills Fair

Pr Pre-Fall H ll Huddle le Proactive Peer Collaboration to Prevent Falls Two Pilots, Blended Best Practice Facility to System Wide Practice

Criteria for considering Pre Fall Huddle

• Admitted with a fall or history of fall/falls

at home

• Fall during current hospitalization Nurse

discretion

• Any patient experiencing substance

withdrawal

• Impulsivity
• “Over-Estimators” per the Morse Fall

Scale

• Nurse discretion- only select patients

should be considered

Fl Floor R Res escue Gaps recognized in floor rescue Manual lifting Using flimsy slide boards 6-7 people using reposition sheets

Fall Reflections Skills Lab

Action plan resulted from a “Fall with Injury” Root Cause Analysis

• 5 Stations taught by a multidisciplinary team
• Director /Sr. Manager = SBAR of why we

are here

• Charge RN or Educator = Proactive

bedside report, room placement, 4-eyes

• n
• Falls/SPHM Lead = Prefall Huddle, BMAT,

Morse Fall risk, floor rescue

• CNA = Fall interventions, Chair Alarm,

Safety Trumps Privacy

• Clinical Recourse Leader = How do you

feel when your patient falls and personal commitment to fall prevention

How do you reach the heart of the caregivers??

~Tiffany Hettinger, CNO~

Outco tcomes

Personal Commitment to Fall Prevention

Second Victim Syndrome

• Very evident as staff moved through
• Caregivers carry so many burdens
• Call to Leadership– support must be

given freely – without judgement 3/3 units have met targets in 2018

Hit th t the S Str treets

• Take your education
• pportunities to

your peers

• Partner for roaming

education

• Don’t forget about

the night shift

Don’t forget about the Docs!!

• Show them what tools you

have for early mobility

• Get them on the equipment

so they can encourage their patients

• They can be your best

advocate for your peers and your patients

Evid idence o

• f a

f a shif ifting c cult lture

Leaders are stepping up and reaching out

Staff talking in huddle are more engaged Proactive partnerships when planning for the day Increased conversations with fall prevention

Partner with Your Community

• Teach proactive fall

prevention in the home

• What to do if your family

member falls

• Simple SPHM tricks getting

in and out of the car

• Focus on multi generational

families

Poll Question #5 (Pick One)

What is the one action item you will commit to over the next year?

• A. Establishing engaged intradisciplinary

SPHM and Fall Prevention team

• B. Comprehensive gap assessment
• C. Developing a business case
• D. Implement frontline skills lab
• E. All of the above

References

• Agency for Research and Quality (ARHQ), & U. S \.

Department of Health Services (HHS.Gov). (2019, January). Falls. Retrieved February 2, 2019, from https://psnet.ahrq.gov/primers/primer/40/Falls?q=falls

• Anne Hudson, Mary. (2005). Texas Passes First Law for

Safe Patient Handling in America: Landmark Legislation Protects Healthcare Workers and Patients from Injury Related to Manual Patient Lifting. Journal of long-term effects of medical implants. 15. 559-66. 10.1615/JLongTermEffMedImplants.v15.i5.80

• Gallagher, S. (2013). Implementation guide to the safe

patient handling and mobility interprofessional national standards. Silver Springs, MD: nursebooks.org.

Questions? s?