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Up, Up, and Away

Broward Health Medical Center - Quality Expo 2013
by

Theresa Sosa

on 30 July 2014

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Transcript of Up, Up, and Away

PRICELESS Employee Back Injuries Due to Patient Handling Fiscal Year (FY) 2006-2009 Matrix Diagram Criteria Unit CCU CVICU AICU RCU Average
Daily
Census Survey:
# of Patient
Transfers &
Assistance Patient Acuity-
Average Length
of Stay Level of
Mobility/
Immobility # of Beds for
Equipment
Utilization High Medium Low Level of Impact Selection of Unit for Installation of Ceiling Lifts Allocation of Equipment Cause of Employee Back Injuries Due to Lifting & Repositioning Baseline Data FY 2006-2009 Other Lifting Pushing Pulling Turning 33% 41% 13% 9% 4% Affinity Diagram Procedure for proper body
mechanics specific
to patient lifting Reporting of near misses
as well as incidents Formal training in proper techniques Focus on patient
related injuries Lack of
knowledge/awareness Best practice/
literature search MD orders consistent w/
current resources Lift Team/Turn Team Inconvenient location of equipment Minimal storage space Identification of
high risk units Physically demanding patient lifting tasks Gantt Chart Latest
technology Appropriate to needs Availability to staff Implementation Plan (Tree Diagram) Goals Reduce employee back injuries by 10% Reduce cost by 60k Z Slider
order information Acquire Adequate Equipment Z Slider Order Information Capital Equipment Requests Hoyer Lift Slings Ordered 80k
Approved Research State of the Art Equipment Phase Out w/
New
Equipment Hoyer Lift
Operational Vendor
Demo of Equipment Hill-Rom
Selected Prioritize
Units Delivery and
Installation of
Equipment Address
Environmental
Challenge Unit Survey
Conducted Assess
Storage
Location of Equipment Patient
Weight Data
Analyzed Analysis of
Injury Data Identification of
High Risk Areas for
Allocation of
Equipment Develop Process
to Obtain Supplies Provide
Education &
Training Staff Survey
Conducted Address
Culture
Change Identification
of Super Users Transition from
"Safe Lifting" to
"Safe Patient
Handling Program" Identification
Showcase Unit
-RCU Regroup: Increase Clinical Input & Collaboration
(P.T., Nursing) Develop Policy
& Procedure Internal
Marketing
Campaign Health Stream
Classes Brainstorming! -Need proper equipment -Identify high risk units -Patient related injuries
vs. Staff injuries -Improper body
mechanics -Lack of
knowledge -Under reporting
of near misses -MD orders inconsistent with current resources -Minimal
storage space -Insufficient
availability of equipment People Lack of Resources "Lift Team"
"Turn Team"
Best Practices
Literature search Lack of Staff Knowledge Awareness Minimal focus on patient related injury
No formal training in proper technique MD Orders Inconsistent with
current resources Policy &
Procedures No Identification -
High Risk Units Physically demanding
patient handling tasks Lack of Proper Body
Mechanics Procedure Specific to
patient handling Cause and Effect Diagram: Employee Injuries Due to Patient Handling Employee
Injuries Due
to Patient
Lifting Equipment Lack of Appropriate Equipment Need for research
Latest technology Under Utilization of Patient
Information In Power Chart Environment Equipment Not
Available To Staff Inconvenient location Minimal Storage Space High Risk Areas Not identified
Needs not addressed Staff Survey - Analysis of Patient Handling Tasks 38% 21% 26% 15% Transferring from
Bed to Chair Repositioning in Bed Ambulating Lateral Transfers Staff Survey - Analysis of the Physically Demanding Patient Handling Tasks 58% 17% 7% 18% Pulling (50) Pushing (21) Turning (56) Lifting (175) Workers Compensation Expenditures for Employee Back Injuries
Due to Patient Lifting & Repositioning FY 2009-2011 Cost of WC
Back Injuries # of Back
Injuries 17 19 18 $70,429 $37,802 $13,803 $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 2009 2010 2011 Force Field Analysis Driving Forces Restraining Forces Staff
Resistance Reluctant
to Change
From Manual Lifting Budgetary
Restraints Logistics Need for
Additional Equipment Best
Practice -
Evidence
Based Critical
Care -
Staff
Requests Vendor
Partnership Equipment Selection &
Training Organizational Link - Sustaining Results Safety
Officer Board Performance
Measurement
Report -Regional
Quality Council -Patient Care
Safety Key Group Environment
of Care
Committee Quality
Assessment
Oversight
Committee OOB orders FY 09 FY 10 FY 11 FY 12 Workers Compensation Expenditures and
Employee Back Injuries Due to Patient Handling $70,429 $37,802 $13,803 $7,252 17 19 18 7 Hoyer Lift with Sling Implemented Repositioning Sheet for
Lateral Patient Transfers & Repositioning Mobile Equipment Ceiling Lift Evaluated Existing Equipment
and Conducted Staff Education Guidelines for the Safe Use of Z-Sliders Purpose 1. Using the orange Z-Slider friction-
reduction sheet helps reduce the risk
of back injuries that can result from
transferring, lifting and repositioning
patients. 2. The Z-Slider minimizes the potential for patient discomfort, skin tears, shearing and bruising. Using the Z-Slider Safely • To maintain safe body mechanics, there should be a minimum of two staff performing a patient transfer, one on each side of the bed.

• Write the full patient name on the orange Z-Slider. The Z-Slider can be used more than once on the same patient as long as it is not visibly soiled.

• Place the Z-Slider on the bed under the draw sheet with arrows facing in the direction the patient is to be moved.

• Once the transfer is completed, remove the Z-Slider from under the patient by rolling the patient onto his/her side and pull the Z-Slider out. MMIS# 43533 IS TO BE USED TO ORDER A ROLL OF 25 Z-SLIDERS. DON’T BE WITHOUT ANY ON YOUR PATIENT CARE UNIT! Purchasing Information: You can lift and transfer patients with minimal effort and maximum safety using an overhead ceiling lift. It's safe and easy to use for both the patient and the caregiver. Especially suited for gait
training and
horizontal lifting. Golvo Most suitable for horizontal
lifting situations (bed to chair). Viking Major
Stakeholders
&
Potential
Impact Safety
Officer (Team Leader) Education CNS', Super Users &
Dept. of Learning Clinical Staff RN's, PCA's Purchasing &
Materiels Supplies &
Equipment Vendor Equipment &
Training Ancillary
Support Depts. Rehab &
Transportation Quality/
Patient Safety Improve
Patient
Experience Administration Financial Support Employee
Health Reduce
Employee
Injuries Reduce
Employee
Injuries Sabina For patients with
limited mobility (sit to stand). Safe transfers to and from a sitting position. Roll On Need for
Education & Training Address Environmental Challenges Acquire
Adequate
Equipment Project
Selection &
Purpose Current
Situation
Analysis Solution
Development Project
Implementation Implementation Plan (Tree Diagram) Goals Reduce employee back injuries by 10% Reduce cost by 60k Acquire Adequate Equipment Z Slider Order Information Capital Equipment Requests Hoyer Lift Slings Ordered $80,000
Approved Research State of the Art Equipment Phase Out w/
New
Equipment Hoyer Lift
Operational Vendor
Demo of Equipment Hill-Rom
Selected Prioritize
Units Delivery and
Installation of
Equipment Address
Environmental
Challenge Unit Survey
Conducted Assess
Storage
Location of Equipment Patient
Weight Data
Analyzed Analysis of
Injury Data Identification of
High Risk Areas for
Allocation of
Equipment Develop Process
to Obtain Supplies Provide
Education &
Training Staff Survey
Conducted Address
Culture
Change Identification
of Super Users Transition from
"Safe Lifting" to
"Safe Patient
Handling Program" Identification
Showcase Unit
-RCU Regroup: Increase Clinical Input & Collaboration
(P.T., Nursing) Develop Policy
& Procedure Internal
Marketing
Campaign Health Stream
Classes Implementation Plan (Tree Diagram) Goals Reduce employee back injuries by 10% Reduce cost by 60k Acquire Adequate Equipment Z Slider Order Information Capital Equipment Requests Hoyer Lift Slings Ordered 80k
Approved Research State of the Art Equipment Phase Out w/
New
Equipment Hoyer Lift
Operational Vendor
Demo of Equipment Hill-Rom
Selected Prioritize
Units Delivery and
Installation of
Equipment Address
Environmental
Challenge Unit Survey
Conducted Assess
Storage
Location of Equipment Patient
Weight Data
Analyzed Analysis of
Injury Data Identification of
High Risk Areas for
Allocation of
Equipment Develop Process
to Obtain Supplies Provide
Education &
Training Staff Survey
Conducted Address
Culture
Change Identification
of Super Users Transition from
"Safe Lifting" to
"Safe Patient
Handling Program" Identification
Showcase Unit
-RCU Regroup: Increase Clinical Input & Collaboration
(P.T., Nursing) Develop Policy
& Procedure Internal
Marketing
Campaign Health Stream
Classes Results FY 2009 FY 2012 17 7 FY 2009 FY 2012 ulture change requires commitment C O ngoing education is critical to success C ollaborative teamwork and buy-in
are essential $70,429 $7,252 Life without Injury is Mobile SPH Equipment Testimonials in CCU with the
with the RCU Ceiling Lift Testimonial Shayleen Francis, Asst. RN MGR & Joan Smith, RN A Startling Statistic! Workers Compensation Costs per Fiscal Year 2 2 10 3 Critical Care Med/Surg. 12 Total 5 Total 3rd Qtr.
FY 2010 1st Qtr.
FY 2011 Initial Improvement Action Validation
Z-Slider Education 15 10 5 0 Number of Patient Skin Injuries 58%
Decrease OSHA - Occupational Safety & Health Administration Musculoskeletal Disorder Incidence Rate 2010 249 155 85 Healthcare
Workers Freight, Stock
Materials
Movers Construction
Laborers Rate per 10,000 workers. 250 150 50 Viking Patricia Rojas, RN
& Diane Schiraldi, PCA Jeff Spindler 5 Atrium RN &
Atasha Bird, Ph.D, Physical Therapist Sabina Establishing unit based Safe Patient Handling Champions. Additional Sustaining Measures Implementation of a process to ensure newly hired personnel are trained on Safe Patient Handling equipment.
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