lutheran senior services why we choose interact ii tools
TRANSCRIPT
Lutheran Senior ServicesWhy we choose Interact II Tools
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Where we started…
Data poor
Health Care Reform
Growth of short stay rehab program
Move to Evidence Based Practice
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Tools We Are Using
Resident Transfer Form
Change in condition cards
Care Maps
SBAR
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TRANSFER
ENVELOPE
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Change in Condition Cards
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CARE
MAPS
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Define a Process
Clinical Guidelines for Management of LRI
Assessment / Observation standards• Review Broncho-pulmonary assessment in Optimus• Define guidelines for staff
Communication• Build Profile order set “Management of URI”
– Nursing orders Assess Bronchopulmonary status BID and prn Provide additional fluids Encourage coughing and deep breathing Encourage mobility Monitor VS and O2 Sat BID and prn
– Physician orders IV fluids Antibiotic therapy Oxygen therapy Nebulizer treatments Portable CXR CBC BMP
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Process (cont.)
• CARE PATH: Symptoms of Lower Respiratory Infection (INTERACTII)– SBAR Communication as a guide to communication with physician
Education• Develop powerpoint education tool covering the steps defines in
Assessment and Communication• Skills training
– Completing a respiratory assessment Equipment: Lung sound recordings, Double ear stethoscope
– Understanding the findings of the assessment
Monitoring• Track hospitalizations and review using Quality Improvement Tool
(INTERACTII)• Report quarterly and include in quality Dashboard
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Staff Education
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Assessing Lung Sounds
http://www.easyauscultation.com/lung-sounds.aspx
http://www.wilkes.med.ucla.edu/lungintro.htm
http://www.cvmbs.colostate.edu/clinsci/callan/breath_sounds.htm
http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html
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Challenges and Successes
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Data FindingsRe-Hospitalization Rates
Dec Jan Feb March April ytd0%
5%
10%
15%
20%
25%
30%
The Next Step…
Partnering with Hospitals