Movi ving the he Hea eart rt of t the he Frontli line e Rhonda Turner, RN, MSN-LD, CSPHA Building a Case for SPHM Sustainability Banner Health
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, Objectives 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
Do you have a SPHM and Falls Prevention team partnership within your Poll Question organization? #1 (Pick one) 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?
A. Frontline RN What representation B. Frontline Techs, Poll Question from the CNA’s, #2 bedside to c- Transport… suite do you (Select all C. C-Suite have on your D. Manager PT/OT that apply) fall prevention E. Risk/Injury and SPHM Prevention teams?
Who A o Are y e you ou K Key S Stake H Hold olders? Frontline – RN’s, C-Suite Managers Transport CNA’s, ED Techs Risk Environmental Management Services Supply Financial Employee Safety Dietary
Transparency Key eys t to Establishing Partnerships 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
When was the last time your A. Never team reviewed Poll Question B.Less than 1yr. the focused #3 (Pick One) C.Between 1-3 yrs. gaps within D.Yearly 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 Nine Slides 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
• 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 o Innovate ate!!! “Live in the land of implementation” Gail Powell-Cope
Do you have A. RN’s taught by yearly, peer Education or Peers Poll Question to peer, B. Only for CNA, Techs, frontline Transport #4 focused C. Combined yearly (Select all education for all roles hands –on D. No skills labs that apply) E. We did – but because with of cost, had to stop 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
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 Pr Pre-Fall H ll Huddle le Proactive Peer Collaboration to Prevent Falls Two Pilots, Blended Best Practice Facility to System Wide Practice
Fl Floor R Res escue Gaps recognized in floor rescue Manual lifting Using flimsy slide boards 6-7 people using reposition sheets
Action plan resulted from a “Fall with Injury” Fall Reflections Root Cause Analysis • 5 Stations taught by a multidisciplinary team Skills Lab • Director /Sr. Manager = SBAR of why we are here • Charge RN or Educator = Proactive How do you reach the heart of the bedside report, room placement, 4-eyes caregivers?? on ~Tiffany Hettinger, CNO ~ • 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
Outco tcomes Second Victim Syndrome • Very evident as staff moved through • Caregivers carry so many burdens Personal Commitment to Fall Prevention • 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 • T ake your education opportunities 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 of a f a shif ifting c cult lture Staff talking in huddle are more engaged Proactive partnerships when planning for the day Increased conversations Leaders are stepping up and with fall prevention reaching out
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
What is the one action item you will commit to over the next year? A. Establishing engaged intradisciplinary Poll Question SPHM and Fall Prevention team #5 B. Comprehensive gap assessment C. Developing a business case (Pick One) 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.
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