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Caring Science as a Lens to Reframe and Revitalize HAPU Prevention Program

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"In the development of the HAPU Prevention Program, the caring science was used as the theoretical framework. Three Caritas Processes were selected to build a strong infrastructure: Teaching and Learning; Holistic Care; Creating a Healing Environment.
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Published in: Health & Medicine
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Caring Science as a Lens to Reframe and Revitalize HAPU Prevention Program

  1. 1. Kaiser Permanente, Northern California Caritas Consortium 2013 Caring Science as a Lens to Reframe & Revitalize HAPU Prevention Caritas in Action How Caring Science informs and inspires KP caregivers and affirms our commitment to provide our patients and their families exceptional care
  2. 2. Caring Science as a Lens to Reframe & Revitalize HAPU Prevention Intent to Contribute Statement: KP Santa Clara was identified as having the highest hospital acquired pressure ulcer rate in the entire company in 2012. The Data: Metrics prior to development of caring infrastructure: CalNoc, HAPU Data by volume, and 1K/patient days. In the development of the HAPU Prevention Program, the caring science was used as the theoretical framework. Three Caritas Processes were selected to build a strong infrastructure:  First caritas: Teaching and Learning focused on several areas: Failure Modes Effect Analysis, Onsite Visit to KP Sacramento's best practices; understanding the etiology of pressure versus non pressure; bringing a variety of educational offerings to the multidisciplinary team including frontline staff.  Second caritas process: Holistic Care with early identification of pressure ulcers on admission; total head to toe assessment including the skin; performing root cause investigations on all HAPUs to uncover both psychosocial and physiological activities.  The third caritas process is creating a Healing Environment which focuses on the environment to promote sustainability with gains with this HAPU Prevention Program, such as moving from a reactionary to a proactive mode of care delivery and auditing 2 RN Verification for all patients on admission and transfer and those patients with a Braden Score of 16 or less during shift. This Caring Approach has improved the quality of patient care in the area of HAPU Prevention by having improved CalNoc Prevalence and Incidence Study in Quarter 3 and 4 of 2012 and Quarter 1 in 2013 with dramatic reduction of HAPUs in Quarter 4 2012 and Quarter 1 2013. Page 2
  3. 3. Caring Science as a Lens to Reframe & Revitalize HAPU Prevention Inspired Contributor(s) 1 :  Kathy Ricossa -----Service Area: Santa Clara Medical Center: SCL Affiliation: PCS -----Year Shared: 2013 Venue: Caritas Consortium Format: Art, PowerPoint ID #: 15 Page 3 Keyword TAGs: Identifier  Consortium2013-July, Santa Clara, Podium, Poster, Patient Care Services  Education & Staff Dev, Hospital Initiatives, Healing Environments, Patients/Families Descriptor  HEROES, Research and Metrics
  4. 4. Caring Science as a Lens to Reframe & Revitalize HAPU Prevention Story: Respecting Patient/ Family Choice Through Authentic Presence Page 4
  5. 5. Welcome to Kaiser Permanente in Santa Clara! Our Story… Page 5
  6. 6. Cal Noc Prevalence and Incidence Studies Page 6
  7. 7. HAPU Rates by Year 200 180 160 140 120 100 80 60 40 20 0 2009 Page 7 2010 2011 2012
  8. 8. 2012 HAPU Monthly Volume Report Page 8 8
  9. 9. HAPU Prevention Examining the Caritas Processes • Building a Strong Infrastructure  Teaching and Learning  Holistic Care  Healing Environment Reference  Page 9 DiNapoli, P., Turkel, M., Nelson, J., & Watson, J. (2010). Measuring the Caritas Processes: Caring Factor Survey. International Journal for Human Caring, 14(3), 15-20.
  10. 10. Teaching and Learning • 2011-2013 Failures Mode Effects Analysis • Learning from others  Learning from KP Sacramento Best Practices • Bringing these best practices back to our facility • Understanding the difference between pressure and non pressure • Bringing Wound Care educational offerings to the facility  Page 10 Distinguished Speakers; Vendor Days; Webinars
  11. 11. Holistic Care • Identification of pressure ulcers on admission • Examining the entire patient from “hair to toe” assessment • Involving all health care workers in a multidisciplinary approach • Performing Root Cause Investigations for all pressure related skin alterations  Page 11 Uncover all aspects of the patient
  12. 12. Healing Environment • Moving from reactionary mode to proactive approach to identify patients who are high risk • Focus on the environment which promotes keen assessments and prompt interventions  2 RN Verification —  Page 12 Admission, Transfer, During Shift Turning Every 2 Hours
  13. 13. Is the Caring Science Model affecting our patient care outcomes? Page 13
  14. 14. HAPU Rates by Year 200 180 160 184 140 145 120 132 100 97 80 60 40 20 12 0 2009 Page 14 2010 2011 2012 2013
  15. 15. Cal Noc P&I Study Update Page 15
  16. 16. Most Recent HAPU Data by Volume Page 16
  17. 17. 2 RN Verification Admission Page 17
  18. 18. 2 RN Verification on Transfer Page 18
  19. 19. 2 RN Verification During Shift with Braden Score 16< Page 19
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  57. 57. Kaiser Santa Clara Cares About HAPU Prevention Page 57
  58. 58. The Magic of KP Santa Clara Continues… Page 58
  59. 59. Thank you for allowing me to share our story • Contact Information • Kathy.Ricossa@kp.org Page 59 408.851.7804

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