safe patient handling & movement (sph&m) at the va san diego healthcare system kathleen l....
TRANSCRIPT
![Page 1: Safe Patient Handling & Movement (SPH&M) at the VA San Diego Healthcare System Kathleen L. Dunn, MS, RN, CRRN-A, CNS](https://reader035.vdocuments.us/reader035/viewer/2022070407/56649e395503460f94b2b216/html5/thumbnails/1.jpg)
Safe Patient Handling & Movement (SPH&M) at the VA San
Diego Healthcare System
Kathleen L. Dunn, MS, RN, CRRN-A, CNS
![Page 2: Safe Patient Handling & Movement (SPH&M) at the VA San Diego Healthcare System Kathleen L. Dunn, MS, RN, CRRN-A, CNS](https://reader035.vdocuments.us/reader035/viewer/2022070407/56649e395503460f94b2b216/html5/thumbnails/2.jpg)
Where we were in 2000 Most patient movement
was being done manually. Some areas had 1 mobile
lift, which was rarely used. Nurse injuries were
frequent & costly. SCI had highest nurse injury
rate in the entire hospital.
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Transfers such as “quad” pivots, 2-person lifts, and 2 person “sheet pulls” were
common.
Sheet Pull2-person lift
Quad Pivot
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Where we were in 2000
Traditional body mechanics training was included in orientation and reviewed annually.
Those injured were required to repeat this training.
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February-April 2001 VASDHS staff attended VISN 8
Safe Patient Handling & Movement Conference.
We saw the light! Solicited support for
program within Nursing Service
Presented to PIC & approved for PIT chartering.
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Costs of Injuries: FY02 VASDHS
30 nurse injuries associated with patient handling and movement tasks
17 occurred on the Spinal Cord Injury Center resulting in $162,815.53 in charge back (direct) costs.
With indirect costs being 4-10X that of direct, it is estimated that in FY02, the SCI unit had over $650,000.00 in costs related to nurse injuries caused by patient handling and movement.
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Fall 2001-Summer 2002• Banned manual lifting (2 person
lifts & “quad pivots”) on SCI unit.• Established SPH&M committee.• Collected pre-project baseline
data.• Planned and held 2 equipment
fairs.• Trial install of 4 ceiling track lift
systems in SCI over 2 months.
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SCI Patient Room
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SCI Inpatient
Room
Single-track ceiling lift
for two beds in one room.
Auto return to preset height.
Battery Charge position
Sling hook on bedside cabinet
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SCI Inpatient Room
Patients are issued a sling at
admission that stays on their bedside
closet hook.
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Privacy Curtain ModificationsCurtains split & Velcroed
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SCI Clinic
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SCI clinic exam room
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SCI Therapy Gym
Single-track ceiling lift over
P.T. parallel bars.
Scales allow measurement of % weight
bearing.
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Use of Ceiling
Track Lift for
Suspended Gait
Training
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Transverse-track ceiling lift over therapy mat
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Cost Savings: Phase 1 $150,000 spent for Phase 1
(SCI) ceiling track lift installation in October 2002.
October 2002-March 2003: Zero (0) SCI nurse injuries
related to transfers or lifting. 1 SCI nurse injury related to
patient turning. Estimated costs savings:
$600,000 for Phase I pilot
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Nursing Injuries r/t Patient Handling & Movement
012
32
4
6
9
11
65
8
50.0
40.0
50.0
18.2
11.1
0.00
2
4
6
8
10
12
2002Q1 2002Q2 2002Q3 2002Q4 2003Q1 2003Q2
# of
Inju
ries
0.0
10.0
20.0
30.0
40.0
50.0
60.0
%
SCI All Nursing Percentage
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June-July 2003Presentation of Phase 2. proposal to Status of Funds
Approximately $600,000 for equipment approved for Phase 2.
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October-December 2003
Installation of Phase IIPartial ceiling track lifts on all inpatient units.
New mobile lifts obtained for most areas.
“No-Lift” (SPH&M) Nursing & PCS Services Policy approved.
Staff Education & Training.
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Develop “Champions” for culture change.
VASDHS – PINs (Preventing Injuries Now facilitators). Includes non-nursing staff as well.
Credible peer leaders.Ongoing hazard identification.Train-the-trainers.Implement algorithms in all
units/areas.
Strategies
PIN
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Transfer to and from:* Bed to Chair* Chair to Toilet* Chair to Chair or* Car to Chair
Does the patient
have UE strength
?
Ability to bear weight
Is the patientcooperative?
Use ceiling lift or portable floor lift with full body sling and at least one care giver.
Use full body sling lift and 2
caregivers.
Is the patient
cooperative?
Caregiver assistance not needed;Stand by for safety as neededFull
Partial
Yes
No
No
No
No
Yes
Sample Algorithm
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Other Examples of
Re-Engineering at
the VASDHS
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ICU Ceiling Track Lifts
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Wall Mounted System in Med-Surg areas
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Dialysis Ceiling Track Lifts
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Radiology Ceiling Track Lifts
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Morgue Lift
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Where are we now?ALL OF VASDHS – •Complete total patient room
ceiling track install: Spring 2007.
•Radiology, MRI, cardiac lab, and Morgue re-engineered.
•Rarely-used equipment bank (Escort).
• Increased compliance and skill in use of algorithms.
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Where are we now? Before: averaged 40+ injuries a
year due to patient handling and movement.
Now: average 20 injuries a year with just partial implementation of the program.
Costs: approx. $950,000 spent on equipment and re-engineering.
Cost Savings: $2.8 million (direct and indirect)
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Policy is now applicable to all direct patient care staff (not just nursing staff) as an MCM (3/06). List of banned manual handling
tasks Universal requirement to use
SPH&M techniques and equipment. Staff, supervisor and
administrative responsibilities detailed.
Where are we now?
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Radiology, Rehab Medicine, and other services represented on Committee, which now reports to Process Improvement Council (PIC).
On-going education & monitoring.
Plans to have input on all patient care equipment purchases from ergonomic stand-point.
Where are we now?
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VA National Directive mandating SPH&M is expected this summer.
Additional $336,000 received as VACO grant for projects through FY ’08
SPH&M Facility Champion position will be implemented by start of FY ’09.
Where are we now?
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VASDHS Safe Patient Handling & Movement MCM
• Defines responsibilities at all levels.
• Applies to all clinical staff.• Lists banned patient/equipment
handling & movement activities.• Defines possible consequences for
staff failure to follow this policy & these rules.
• Contains decision making algorithms.
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Thank You for
Your Attention
!