ANA and SPHM Is this a safe work environment? A Decade and Counting - - PDF document

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ANA’s 360 Degrees View of Safe Patient Handling & Mobility /Falls

Session C508 ‐ Thursday, March 22, 2018: 1:15 PM ‐ 2:15 PM

Panel Presentation

Ruth Francis, MPH, MCHES Dee Kumpar, MBA, BSN, RN, CSPHP Jennifer Berry, MSN, RN, CNRN Renee Neidhardt, MSN, RN‐BC Rhonda Turner, MSN, RN, CSPHA Seun Ross DNP, MSN, CRNP‐F, NP‐C, NEA‐BC

Disclosures

Dee Kumpar is a Clinical Consultant for Hill‐Rom. The other presenters for this presentation have disclosed no conflict of interest related to this topic.

Panel Objectives

• Elucidate the use of the ANA National Standards to establish a culture of safety and

create a sustainable program.

• Describe the role of SPHM in both Early Mobility and Falls Prevention programs for

the patient; ad Healthcare worker injury prevention for the clinician.

• Demonstrate the tools utilized to develop and sustain a successful SPHM/Falls

Program

ANA and SPHM A Decade and Counting

Ruth Francis, MPH, MCHES

Is this a safe work environment?

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Is it safe at your workplace? ANA’s Involvement With SPHM SPHM Interprofessional National Standards For more information… References

• American Nurses Association. (2013) Safe Patient Handling and Mobility

Interprofessional National Standards.

• American Nurses Association. (2011). 2011 Health & Safety Survey Report. LCWA

Research Group.

• Department of Labor, Bureau of Labor Statistics. (2011). Nonfatal Occupational

Injuries and Illnesses Requiring Days Away from Work

The Research Supporting Mobility

Dee Kumpar, MBA, BSN, RN, CSPHP

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Patient: Potential Complications of Immobility

Respiratory: VAP associated with 10‐11 days more in ICU. Respiratory tract infections, atelectasis, and pulmonary embolism.1

• 1. Knight J, et al. Nurs Times. 2009;105(21):16‐20.
• 2. Knight J, et al. Nurs Times. 2009;105(22):24‐27.
• 3. Nigam Y, et al. Nurs Times. 2009;105(23):18‐22.

Cardiovascular: postural hypotension, cardiac muscle atrophy, orthostatic intolerance, and deep vein thrombosis1 Hematologic: anemia1 Skin: $43k average cost of care for stage III/IV pressure ulcers in acute care and additional 4 days in LOS.3 Musculoskeletal: Strength loss of 50% in first 3‐4 weeks take about 4 weeks to recover. osteoporosis, muscle atrophy and weakness, and contractures.3 Neurological: delirium, depression, anxiety, forgetfulness, and confusion1 Renal: calculi2 Gastrointestinal: constipation and fecal impaction2

Patient Benefits from Early Mobility

Titsworth WL, et al. J Neurosurg. 2012;116:1379–1388.Winkelman C, et al. Intensive Crit Care Nurs . 2012;1‐12. Balas M, et al. Crit Care Med. 2012;40:12. Data on File. 199711; Page 4.

Advancing Mobility to Improve Outcomes Focus on Fall Prevention

• Most frequently reported adverse

incident in adult inpatient units.

• 700K – 1M patients fall per year.
• 30% to 50% of hospital patient falls

result in physical injury.

• 4% to 6% result in serious injury.
• 11,000 fatal falls in hospitals/ year.
• Increased length of stay.
• 21% more likely to be readmitted

to the hospital within 30 days of discharge.

• 2.7 times more likely to be

discharged to post‐acute care.

• Caregiver injury

Protecting Patients by Mobilizing Earlier and Often

Preventing Falls in the Epilepsy Monitoring Unit

Jennifer Berry, MSN, RN, CNRN

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Epilepsy Monitoring Unit

• 6 Bed Monitored Unit
• Part of 36 bed neuroscience/ORL unit
• Fall risk characteristics of EMU patient differ from

standard inpatient

• Younger
• More alert
• Falls occur within 3 days of admission
• In the bathroom

Preventing Falls

• It is not a case of if but when the patient has a seizure
• Just as likely to happen out of bed
• Options:
• Keep the patient in bed
• Allow to ambulate freely
• Ambulate within arms reach
• Ambulate with a gait belt
• Something else?

Using Technology

• Started using mobile lift with safety vest to

ambulate patients in the hallway

• Not practical in the confines of a patient

room

• Installation of ceiling lifts offered a new
• ption
• Tracks that extended into

the bathroom

Why is this different?

• It doesn’t just

reduce the risk of fall and/or injury

• It prevents the fall

from happening

References

• Pati, S., Kumaraswamy, V. M., Deep, A., Chung, S., Plueger, M., Kiyota, G., &

Treiman, D. M. (2013). Characteristics of falls in the epilepsy monitoring unit: A retrospective study. Epilepsy & Behavior, 29(2013), 1‐3. doi:http://dx.doi.org/10.1016/j.yebeh.2013.06.013

• Spritzer, S. D., Riordan, K. C., Berry, J., Corbett, B., Gerke, J. K., Hoerth, M., . . . Noe,
• K. H. (2015). Fall prevention and bathroom safety in the epilepsy monitoring unit.

Epilepsy & Behavior, 48(2015), 75‐78. doi:http://dx.doi.org/10.1016/j.yebeh.2015.05.026

Safe Patient Handling & Mobility Programs in Action!

Renee Neidhardt, MSN, RN‐BC

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SPHM History

• 2008 – Veterans Health Administration (VHA) Safe Patient

Handling & Movement Program ‐ Department of Veterans Affairs (VA)

• VHA Directive 2010‐032, Safe Patient Handling Program and Facility Design
• 2013 ‐American Nurses Association, Safe Patient Handling &

Mobility: Interprofessional National Standards

• 2016 – VHA, Center for Engineering & Occupational Safety and

Health (CEOSH), Safe Patient Handling and Mobility Guidebook. VHA SPHM Program Process

SPHM Implementation & Ongoing Program Success Collaboration is Key!

Implementing the ANA, SPHM: Interprofessional National Standards Charlie Norwood VA Medical Center SPHM Program Success

Putting ANA’s Safe Patient Handling and Mobility Standards into practice: The Charlie Norwood VA Medical Center’s journey.

American Nurses Association, American Nurse Today (9)8.

In 2018 the CNVAMC SPHM Program continues to show a decrease in reported incidents rates related to lifting and repositioning!

*Automated Safety Incident Surveillance Tracking System

Benefits of SPHM Programs

Crea ting a Culture of Sa fety ha s its Benefits!!!

References

American Nurses Association, (ANA). (2014). Navigating the new safe patient handling and m obility inteprofessional national standards webinar –CE:1. Retrieved from http:/ / eventcenter.commpartners.com/ se/ Meetings/ Playback.aspx?meeting.id=218810. American Nurses Association, (ANA). (2013). Safe patient handling and m obility: Interprofessional national

• standards. Across the care continuum . Silver Spring, MD: Nursesbooks.org.

Gallagher, S. (2013). Im plem entation Guide to the Safe patient handling and m obility: Interprofessional national

• standards. Silver Spring, MD: Nursesbooks.org.

Neidhardt, R. (2014). Putting ANA’s Safe Patient Handling and Mobility Standards into practice: The Charlie Norwood VA Medical Center’s journey. American Nurses Association, Am erican Nurse Today (9)8. Veterans Health Administration, (VHA), Department of Veterans Affairs, (VA). (2010). Safe Patient Handling Program and Facility Design. VHA Directive 2010-032. Retrieved from https:/ / w w w .va.gov/ vhapublications/ View Publication.asp?pub_ID=2260

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Igniting SPHM from Facility to System to Community

Rhonda Turner, MSN, RN, CSPHA

SPHM & Fall Prevention Journey

2016 Begin where you are. Lead with purpose. Go with energy.

~Tiffany Hettinger, 2017 NCMC CNO~

2013

2015 2016 2012

Began reigniting facility SPHM Team October – Asked to Lead Western Region and Co-Lead BH System Team

VA SPHM Conference 2017

Quality and Innovation with SPHM and Fall Prevention

• Pre‐fall Huddle – Proactive peer collaboration to

decrease patient falls

• Floor Rescue Algorithm –Supporting BH Policy 13204.2,

everyone has a role with floor retrieval utilizing SPHM Technology

• SPHM Hand –On Class ‐ Designed 1.5 hour class, trialed

in NOCO – approved by BH System Nursing Executive Council 8/3/2017

• System Mandatory Education – yearly education

regarding SPHM and Fall Prevention

• Post Fall Huddle Process –Developed tool working with

system Fall team to guide staff in the event of a fall

“Live in the land of implementation” ~Gail Powell‐Cope~ An effective SPHM program requires a complex interplay among a number of disciplines and departments. The goal of the program is to create a partnership between employers and healthcare workers that implements and supports safety goals.

Gallagher, 2013, p. 26

WHAT ARE WE UP AGAINST?

Seun Ross DNP, MSN, CRNP‐F, NP‐C, NEA‐BC

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Program Silos

Improved Patient Outcomes

Goals of Initiative Integration Maximize efficiency of resources Achieve consistent terminology across initiatives & disciplines Maximize effectiveness of interventions Improve integration of patient care initiatives for care planning Improve quality of care for the patient Reduce likelihood of injury to either patient or caregiver Safe Mobility Prevents Falls AND Prevents Clinician Injury

Early Mobility

LINKING IT ALL TOGETHER: QUALITY & SAFETY FOR THE CAREGIVER AND PATIENT

Open Discussion and Contact Information

Updated SPHM News & Resources ‐ www.anasphm.org

Ruth Francis – ruth.francis@ana.org Dee Kumpar – dee.kumpar@hill‐rom.com Jennifer Berry – Berry.Jennifer@mayo.edu Renee Neidhardt ‐ renee.neidhardt@va.gov Rhonda Turner – twoTurnerSPHM@aol.com Seun Ross – seun.ross@ana.org