Safe patient handling in safer healthcare environment

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Safe patient handling in safer healthcare environment

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Safe patient handling in safer healthcare environment

  1. 1. SAFE PATIENT HANDLING IN safer healthcare environment Brought to you by
  2. 2. On the phone… Chris Barton SEIU 1199NW Dan Donahue Providence St. Peter Hospital Brenda Suiter Washington State Hospital Association Lynn LaSalle MultiCare Health System Barbara Silverstein Department of Labor & Industries Brought to you by
  3. 3. Credo “Patients should not be harmed by the care that is intended to help them, nor should harm come to those who work in health care” Crossing the Quality Chasm, 2001 Brought to you by
  4. 4. Agenda  Safe Patient Handling Law BackgroundSafe Patient Handling Law Background  Safe Patient Handling WebsiteSafe Patient Handling Website  Law TimelinesLaw Timelines  Equipment requirements and fundingEquipment requirements and funding  QuestionsQuestions Brought to you by
  5. 5. Safe Patient Handling Legislation  Governor Gregoire signed EngrossedGovernor Gregoire signed Engrossed Substitute House bill 1672 on March 22,Substitute House bill 1672 on March 22, 20062006  Bill became law on June 21, 2006Bill became law on June 21, 2006  Legislation makes safe patient handlingLegislation makes safe patient handling part of how hospitals provide care bypart of how hospitals provide care by adding this requirement to DOH hospitaladding this requirement to DOH hospital licensing requirementslicensing requirements Brought to you by
  6. 6. Background The law was supported by:The law was supported by:  Service Employees International UnionService Employees International Union Local 1199NWLocal 1199NW  United Food & Commercial Workers’United Food & Commercial Workers’ UnionUnion  Washington State Hospital AssociationWashington State Hospital Association  Washington State Nurses AssociationWashington State Nurses Association Brought to you by
  7. 7. Why was the law enacted?  To improve the safety of healthcareTo improve the safety of healthcare employees and patientsemployees and patients  Provide funding to hospitals implementingProvide funding to hospitals implementing safe patient handling programssafe patient handling programs  To improve nurse retentionTo improve nurse retention  To reduce costs to hospitalsTo reduce costs to hospitals Brought to you by
  8. 8. Nurses lift an estimated 2 tons per shift Do the math: Number of patients/day Number of lifts/patient Average weight/patient 4 X 6 X 170 = 4,080lbs/day We Know… Brought to you by
  9. 9. We know…  38% of nurses suffer work-related back38% of nurses suffer work-related back injuries requiring time away from workinjuries requiring time away from work  12% of nurses consider leaving nursing due12% of nurses consider leaving nursing due to low back pain at average age 39to low back pain at average age 39  Nurse aides have also experiencedNurse aides have also experienced significant injurysignificant injury Brought to you by
  10. 10. “Zero-Lift” Program  Lifting programs have been proven to beLifting programs have been proven to be effective. WHS’s Workers’ Compensationeffective. WHS’s Workers’ Compensation “Zero Lift Program” has experienced“Zero Lift Program” has experienced remarkable success:remarkable success:  Patient Handling injuries had decreased by 43%Patient Handling injuries had decreased by 43%  Time loss frequency rates had decreased by 50%Time loss frequency rates had decreased by 50% Brought to you by
  11. 11. Safe Patient Handling Steering Committee  Collaboration developed to provideCollaboration developed to provide tools andtools and modelsmodels that will help hospitals implement safethat will help hospitals implement safe patient handling programs.patient handling programs.  Healthcare UnionsHealthcare Unions  Department of Labor & IndustriesDepartment of Labor & Industries  Physical and Occupational TherapistsPhysical and Occupational Therapists  Employee Health ManagersEmployee Health Managers  Urban and Rural Hospital AdministratorsUrban and Rural Hospital Administrators  Washington State Hospital AssociationWashington State Hospital Association  Washington Hospital Services’ Workers’Washington Hospital Services’ Workers’ Compensation ProgramCompensation Program Brought to you by
  12. 12. Law Timelines  February 1, 2007February 1, 2007 – establish safe patient– establish safe patient handling committeehandling committee  December 1, 2007December 1, 2007 – implement safe patient– implement safe patient handling programhandling program  January 30, 2010January 30, 2010 – acquire lifting– acquire lifting equipmentequipment Enforced by the Department of HealthEnforced by the Department of Health Brought to you by
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  14. 14. Poll Question Brought to you by
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  17. 17. Flow Chart Brought to you by
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  22. 22. February 1, 2007 Establish a safe patient handlingEstablish a safe patient handling committee with at least half of thecommittee with at least half of the committee being direct care staffcommittee being direct care staff Brought to you by
  23. 23. Establishing a Committee  Recruit Participants (50% direct careRecruit Participants (50% direct care staff)staff)  Elect committee chair and co-chairElect committee chair and co-chair  Develop meeting schedule andDevelop meeting schedule and protocolsprotocols The primary responsibility of the committee is toThe primary responsibility of the committee is to establish, implement and monitor the Safe Patientestablish, implement and monitor the Safe Patient Handling Program.Handling Program. Brought to you by
  24. 24. Labor Management The Steering Committee recommendsThe Steering Committee recommends union involvement in committeeunion involvement in committee development and decision makingdevelopment and decision making Brought to you by
  25. 25. Poll Question Brought to you by
  26. 26. December 1, 2007 Establish a safeEstablish a safe patient handling programpatient handling program Brought to you by
  27. 27. Safe Patient Handling Program Safe patient handling program shall include andSafe patient handling program shall include and hospitals must:hospitals must: 1.1. Implement a safe patient handling policyImplement a safe patient handling policy 2.2. Conduct a safe patient handling hazardConduct a safe patient handling hazard assessmentassessment 3.3. Develop a process to identify the appropriate useDevelop a process to identify the appropriate use of the safe patient handling policy based onof the safe patient handling policy based on patient needs and availability of equipmentpatient needs and availability of equipment 4.4. Conduct an annual performance evaluationConduct an annual performance evaluation 5.5. Consider the feasibility of incorporatingConsider the feasibility of incorporating equipment when constructing or remodeling aequipment when constructing or remodeling a hospitalhospital Brought to you by
  28. 28. Establishing a Safe Patient Handling Program 1.1. Implement a safe patient handling policy forImplement a safe patient handling policy for all shifts and units of the hospitalall shifts and units of the hospital It is recommended your safe patient handlingIt is recommended your safe patient handling committee draft a policy togethercommittee draft a policy together 2.2. Conduct patient handling hazard assessment.Conduct patient handling hazard assessment. Include variables such as patient handlingInclude variables such as patient handling tasks, types of nursing units, patienttasks, types of nursing units, patient populations, and the physical environmentpopulations, and the physical environment Brought to you by
  29. 29. Establishing a Safe Patient Handling Program 3.3. Facilitate the development of standardsFacilitate the development of standards for assessing each patient and theirfor assessing each patient and their activitiesactivities A.A. Get input for department staffGet input for department staff B.B. Include how to document and shareInclude how to document and share information across shifts and departmentsinformation across shifts and departments C.C. Consider using algorithmsConsider using algorithms Brought to you by
  30. 30. Establishing a Safe Patient Handling Program 4.4. Conduct an annual performanceConduct an annual performance evaluation of the program to determine itsevaluation of the program to determine its effectiveness-report results to your safeeffectiveness-report results to your safe patient handling committeepatient handling committee 5.5. When developing architectural plans,When developing architectural plans, consider the feasibility of incorporatingconsider the feasibility of incorporating patient handling equipment into thepatient handling equipment into the designdesign Brought to you by
  31. 31. What Makes a Successful Program? Analyze what works already in your hospital:Analyze what works already in your hospital:  Existing practicesExisting practices  Attitudes about changeAttitudes about change  Administration’s supportAdministration’s support  Organizational cultureOrganizational culture  Barriers to changeBarriers to change  Current patient flowCurrent patient flow Brought to you by
  32. 32. Know Current Practices  Department practices and techniquesDepartment practices and techniques already used for handling their patientalready used for handling their patient populationpopulation  Who is influential in each departmentWho is influential in each department the leaders of co-workersthe leaders of co-workers Brought to you by
  33. 33. Educate Your Hospital  Committee members to their role on theCommittee members to their role on the team, empower them to do their workteam, empower them to do their work  Management - for staffing, so teamManagement - for staffing, so team members can attend meetings and do theirmembers can attend meetings and do their workwork  Keep the committee informed of theirKeep the committee informed of their accomplishments so they feel successfulaccomplishments so they feel successful Brought to you by
  34. 34. Campaign – Build Momentum  Use every modality possible to share whatUse every modality possible to share what is being planned and implemented:is being planned and implemented:  Recruit an Administration sponsor who willRecruit an Administration sponsor who will speak directly to the care giversspeak directly to the care givers  Design in accountability of managers,Design in accountability of managers, supervisors, charge nurses, house supervisorssupervisors, charge nurses, house supervisors and direct care givers; to know when the teamand direct care givers; to know when the team meetings occur, who the members are,meetings occur, who the members are, department’s need for equipment, whatdepartment’s need for equipment, what systems and techniques will change, processessystems and techniques will change, processes for acquiring what they need, etc.for acquiring what they need, etc. Brought to you by
  35. 35. Inform Your Patients, Families, and Visitors  Advertise in brochures, newsletters,Advertise in brochures, newsletters, hospital bulletin boardshospital bulletin boards  Create expectationsCreate expectations  Make the work of the committee public,Make the work of the committee public, positive and rewardingpositive and rewarding Please visit website to view a sample marketing materialsPlease visit website to view a sample marketing materials Brought to you by
  36. 36. Individual Patient Assessment Brought to you by
  37. 37. Risk & Needs Assessment  Measures to eliminate or reduceMeasures to eliminate or reduce patient handling risks must bepatient handling risks must be identifiedidentified  Conduct an analysis of injuriesConduct an analysis of injuries  Identify and prioritize patient handlingIdentify and prioritize patient handling risksrisks  Assess patient mobility needsAssess patient mobility needs  Conduct an inventory of patient handlingConduct an inventory of patient handling equipmentequipment  Identify environmental and system barriersIdentify environmental and system barriers Brought to you by
  38. 38. Learn From Your Mistakes Conduct annual performance evaluationsConduct annual performance evaluations of the:of the:  System’s policySystem’s policy  Committee’s workCommittee’s work  Program effect on injuries & fallsProgram effect on injuries & falls  Equipment UseEquipment Use Brought to you by
  39. 39. Annual Performance Evaluation Brought to you by
  40. 40. Change Can Be Hard Have activities with rewards for individualHave activities with rewards for individual care givers and departments:care givers and departments:  Informal brown-bag lunchesInformal brown-bag lunches  Departments can compete against eachDepartments can compete against each otherother  RodeosRodeos Brought to you by
  41. 41. A Successful Program  Adheres to the requirements of the lawAdheres to the requirements of the law  Meets all deadlinesMeets all deadlines  Uses the available toolsUses the available tools  Involves your safe patient handling team inInvolves your safe patient handling team in decision makingdecision making  Shares experiences, ask questionsShares experiences, ask questions Brought to you by
  42. 42. Washington Regulatory Requirements1  When developing architectural plans forWhen developing architectural plans for constructing or remodeling a hospital orconstructing or remodeling a hospital or unit, the hospital must consider theunit, the hospital must consider the feasibility of incorporating patient handlingfeasibility of incorporating patient handling equipment or design needed to incorporateequipment or design needed to incorporate equipment later.equipment later. 11 RCW 70.41.390RCW 70.41.390 Brought to you by
  43. 43. Before The Blue Prints  Get all levels of staffGet all levels of staff involvedinvolved  Think about all possibleThink about all possible scenariosscenarios  Place real users in a mockPlace real users in a mock up of the design conceptup of the design concept and simulate simulationand simulate simulation  Full scale simulation withFull scale simulation with props or3-D computerprops or3-D computer simulationssimulations Brought to you by
  44. 44. Working Space Transfer to Bed (Add 12” all around the bed for bariatric patient)  Transfer bed /wheelTransfer bed /wheel chair or bed tochair or bed to stretcher: 1500 mm 5’stretcher: 1500 mm 5’  Transfer with floor liftTransfer with floor lift or bed/geriatric chairor bed/geriatric chair 1800 mm 6’ (ceiling1800 mm 6’ (ceiling lift saves 12”)lift saves 12”)  Space for care giverSpace for care giver and rest chair 100 mmand rest chair 100 mm 39”39”  Door room widthDoor room width 1220 mm (48”) for1220 mm (48”) for bariatric patientbariatric patient *Adapted from Jocelyn Villeneuve, Design for Safe Brought to you by
  45. 45. Single Bed/Bath Room Layout  Total Space ~180 sq ftTotal Space ~180 sq ft  Side nearest the door 6’Side nearest the door 6’ for a transfer involvingfor a transfer involving floor device add 12” forfloor device add 12” for bariatricbariatric  Window side 47”Window side 47”  Foot of Bed 47”Foot of Bed 47”  Bed faces the doorBed faces the door privacy maintainedprivacy maintained with curtain, betterwith curtain, better observation and transferobservation and transfer (working) space(working) space  Door width 1220 mmDoor width 1220 mm (48”) for bariatric patient(48”) for bariatric patientBrought to you by
  46. 46. Bathroom Space Make sure equipment,Make sure equipment, staff and patient can fit instaff and patient can fit in space.space. • 36” door36” door • 24” minimum clearance on24” minimum clearance on each side of toileteach side of toilet • Retractable bars attachedRetractable bars attached to wall for client transfersto wall for client transfers assisted by 1-2 care giversassisted by 1-2 care givers • Wheel Chair rotation 5’Wheel Chair rotation 5’ diameterdiameter • Toilet weight toleranceToilet weight tolerance needs to be 600+ lbsneeds to be 600+ lbs Brought to you by
  47. 47. January 1, 2008  A hospital shall develop procedures for hospitalA hospital shall develop procedures for hospital employees to refuse to perform or be involved inemployees to refuse to perform or be involved in patient handling or movement that the hospitalpatient handling or movement that the hospital employee believes in good faith will expose aemployee believes in good faith will expose a patient or a hospital employee to an unacceptablepatient or a hospital employee to an unacceptable risk of injury.risk of injury.  A hospital employee who in good faith followsA hospital employee who in good faith follows the procedure developed by the hospital inthe procedure developed by the hospital in accordance with this subsection shall not be theaccordance with this subsection shall not be the subject of disciplinary action by the hospital forsubject of disciplinary action by the hospital for the refusal to perform or be involved in thethe refusal to perform or be involved in the patient handling or movement.patient handling or movement. Brought to you by
  48. 48. Employee Rights  Hospitals MUST develop procedures forHospitals MUST develop procedures for employees to refuse to perform or be involvedemployees to refuse to perform or be involved in patient handling or movement task that thein patient handling or movement task that the employee believes “in good faith” will exposeemployee believes “in good faith” will expose a patient or employee to an unacceptable riska patient or employee to an unacceptable risk of injuryof injury Brought to you by
  49. 49. January 30, 2010  Each hospital must complete, at aEach hospital must complete, at a minimum, acquisition of their choice of:minimum, acquisition of their choice of:  One readily available lift per acute care unit onOne readily available lift per acute care unit on the same floor unless the safe patient handlingthe same floor unless the safe patient handling committee determines a lift is unnecessary incommittee determines a lift is unnecessary in the unit;the unit;  One lift for every ten acute care availableOne lift for every ten acute care available inpatient beds; orinpatient beds; or  Equipment for use by lift teamsEquipment for use by lift teams  Hospitals must train staff on policies,Hospitals must train staff on policies, equipment, and devices at least annuallyequipment, and devices at least annually Brought to you by
  50. 50. January 30, 2010  Acquire equipment using your hazardAcquire equipment using your hazard assessment, injury data and with the inputassessment, injury data and with the input of the hospital’s safe patient handlingof the hospital’s safe patient handling committeecommittee Brought to you by
  51. 51. Acquire Equipment  Step 1:Step 1: Establish a safe patient handlingEstablish a safe patient handling committee (50% direct care staff) committee (50% direct care staff)   Step 2:Step 2: Train the safe patient handlingTrain the safe patient handling committee     committee       Step 3:Step 3: Write your Safe Patient HandlingWrite your Safe Patient Handling Policy     Policy       Step 4:Step 4: Assess the risks and needs for eachAssess the risks and needs for each unit in your hospital     unit in your hospital       Step 5: Plan for the purchase of equipmentStep 5: Plan for the purchase of equipment Brought to you by
  52. 52. Our “Challenge” Is: Getting the Equipment & Changing Practice… Getting from manualGetting from manual handling…handling… To safe patientTo safe patient handling…handling… Brought to you by
  53. 53. Where is High Injury Risk Exposure? Inpatient Rooms*Inpatient Rooms* (+ OR, PACU, Rehab)(+ OR, PACU, Rehab)  RepositioningRepositioning  Move up, roll, cleanMove up, roll, clean  TransferringTransferring  Bathroom/CommodeBathroom/Commode  WalkingWalking  Bed to GurneyBed to Gurney  Bed to ChairBed to Chair Example of continuous track from patient room to bathroom *Biomechanical Evidence… William Marras, PhD, CPE Brought to you by
  54. 54. Where to put track…  Committee Decision – Need/Data DrivenCommittee Decision – Need/Data Driven  CCU-Tele-Neuro-Med/Renal-RehabCCU-Tele-Neuro-Med/Renal-Rehab  Remodel DrivenRemodel Driven  Or combo data/remodel, needs to be clearedOr combo data/remodel, needs to be cleared w/committeew/committee  ““Track” As Many Rooms As Possible*Track” As Many Rooms As Possible*  Fixed Lifts – view rooms, plus as follows…Fixed Lifts – view rooms, plus as follows…  Isolation RoomsIsolation Rooms  CCUCCU  Known heavy low mobile patient care areasKnown heavy low mobile patient care areas  Portables (475 lb capacity) 1 per 5 roomsPortables (475 lb capacity) 1 per 5 rooms  Use until you have budget for fixed liftsUse until you have budget for fixed lifts *Tampa General Model Brought to you by
  55. 55. Patient Transfer Devices  Floor lifts/Bariatric Room Set-upFloor lifts/Bariatric Room Set-up  From floor, chair, bed, also sit to stand & walkingFrom floor, chair, bed, also sit to stand & walking  Slider Transfer SheetsSlider Transfer Sheets  Lateral and horizontal transferLateral and horizontal transfer  Ceiling LiftsCeiling Lifts  Repositioning, floor to bed, bed to chairRepositioning, floor to bed, bed to chair  BedsBeds  Chair posit., flexi-foot, TrendelenburgChair posit., flexi-foot, Trendelenburg  Transport devicesTransport devices  Zoom stretcher, bariatric stretcher, “Ergo-tug”Zoom stretcher, bariatric stretcher, “Ergo-tug” This is a cut out of our transfer device locatorThis is a cut out of our transfer device locator Brought to you by
  56. 56. Ceiling Lifts Portable lift on gantryPortable lift on gantry (xy) configuration(xy) configuration Repositioning is easyRepositioning is easy Full bodyFull body repositioning slingrepositioning sling Seated universalSeated universal slingsling Pam workingPam working with trainingwith training dummy anddummy and ceiling lift.ceiling lift. Brought to you by
  57. 57. December 30, 2010 A hospital may take a credit for the costA hospital may take a credit for the cost of purchasing mechanical liftingof purchasing mechanical lifting devices and other equipment that aredevices and other equipment that are primarily used to minimize patientprimarily used to minimize patient handling by health care providers,handling by health care providers, consistent with a safe patient handlingconsistent with a safe patient handling program developed and implementedprogram developed and implemented by the hospitalby the hospital Brought to you by
  58. 58. B&O Tax Credit  All hospitals qualify for the B&O TaxAll hospitals qualify for the B&O Tax CreditCredit  Hospitals can receive up to $1000 per acuteHospitals can receive up to $1000 per acute care available inpatient bedcare available inpatient bed  The number of acute care availableThe number of acute care available inpatient beds in each hospital is based oninpatient beds in each hospital is based on the year-end financial reports submitted tothe year-end financial reports submitted to the Department of Healththe Department of Health Brought to you by
  59. 59. Poll Question Brought to you by
  60. 60. The Patient Handling Bible Brought to you by
  61. 61. In Summary  Use hazard assessment, injury data andUse hazard assessment, injury data and committee to make equipmentcommittee to make equipment acquisitionsacquisitions  Equipment: key pointsEquipment: key points  Engage your facilities staff & giveEngage your facilities staff & give ergonomic input for construction remodelergonomic input for construction remodel designdesign  Think BIG and spend lots!Think BIG and spend lots! Brought to you by
  62. 62. Thank you Service EmployeesService Employees International Union LocalInternational Union Local 1199NW1199NW Washington State NursesWashington State Nurses AssociationAssociation Regional HospitalRegional Hospital Regional Hospital forRegional Hospital for Respiratory and ComplexRespiratory and Complex CareCare Valley Medical CenterValley Medical Center MulticareMulticare St. Mary Medical CenterSt. Mary Medical Center Valley General HospitalValley General Hospital United Food & CommercialUnited Food & Commercial Workers Union Local 21Workers Union Local 21 Harrison Medical CenterHarrison Medical Center Kittitas Valley HospitalKittitas Valley Hospital United Food & CommercialUnited Food & Commercial Workers Union Local 141Workers Union Local 141 Providence St. PeterProvidence St. Peter HospitalHospital Empire Health ServicesEmpire Health Services Department of Labor &Department of Labor & IndustriesIndustries Washington State HospitalWashington State Hospital AssociationAssociation Swedish Medical CenterSwedish Medical Center WHS Workers’WHS Workers’ Compensation ProgramCompensation Program Brought to you by
  63. 63. Thank you Chris Barton SEIU 1199NW Dan Donahue Providence St. Peter Hospital Brenda Suiter Washington State Hospital Association Lynn LaSalle MultiCare Health System Barbara Silverstein Department of Labor & Industries Brought to you by
  64. 64. Questions Brought to you by
  65. 65. Thank you for participating! Please fill out the evaluation.Please fill out the evaluation. Brought to you by
  66. 66. This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause. Brought to you by
  67. 67. Our views have increased the mark of the 10,000  Thank you viewersThank you viewers  Looking forward for franchise,Looking forward for franchise, collaboration, partners.collaboration, partners. Brought to you by
  68. 68. -011 25464531,-011 41425180,-011 66217387 +-91 9818308353,+-91 9818569476 othermotherindia@gmail.com www.other-mother.in https://www.facebook.com/pages/Other-Mother-Nursing-Crusade/224235031114989?ref=hl http://www.linkedin.com/profile/view?id=326103341&trk=nav_responsive_tab_profile https://twitter.com/othermotherindi https://cparveen.wix.com/other-mother A WORLDWIDE MISSITION Contact Us:- JOIN US www.parveenchadha.com

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