Tuesday, April 29, 2014

Education and Training

Profile: SOMC Keeps Caregivers Competent on Equipment Use Portsmouth, Ohio

Southern Ohio Medical Center (SOMC) includes safe patient handling as a core element of its annual “D-Day” testing regimen. Nurses review mechanical equipment use with staff ergonomists during orientation and as part of their annual competencies.

Profile: AnMed Health Features Staff Talent to Motivate Safety Anderson, South Carolina

AnMed Health employees take pride in writing, producing, and "starring" in worker safety training videos. Employees respond better when they see familiar faces; they find this form of training efficient and effective.
Training and education are critical to the success of any safe patient handling program, especially training on proper patient handling equipment use and ongoing education about the benefits of safe patient handling. By educating all staff, including physicians, about your safe patient handling program, hospitals can reduce instances of a clinician asking or expecting colleagues to move patients in an unsafe way.

Training can range from onsite demonstrations of equipment use and maintenance to broader safe patient handling education programs and national conferences. The following are some ideas for a comprehensive approach to safe patient handling education and training:
  • Make sure that all relevant workers are trained on using the mechanical lift equipment. Caregivers should feel comfortable using the equipment. If the caregiver uses the equipment correctly and efficiently, patients will feel more comfortable too.
  • Refresh, remind, and require ongoing training. Programs tend to be less successful over time if they do not receive adequate attention. Including safe patient handling procedures and policies in annual competency sessions is one way to remind workers of the program's importance and promote equipment proficiency. In Safe Patient Handling and Mobility: Interprofessional National Standards, the American Nurses Association recommends that hospitals establish systems for education, training, and maintaining competencies.
  • Consider mentors and peer education champions. In addition to monitoring new employees, nurse managers and other "safety champions" can serve as mentors and peer coaches in every unit, reminding their colleagues how and when to use safe patient handling procedures and equipment.
  • Train caregivers to check each patient's mobility every time. Every patient has unique characteristics and mobility capabilities. It is important to assess these regularly, and to communicate each patient's level of mobility and need for assistance to all relevant caregivers.
  • Engage patients and their families. Patients may not understand the need for mechanical equipment at first. You can engage them in safe handling by explaining to them and their families that it is for their safety as well as the workers' safety. OSHA has developed a patient education poster* that hospitals can use to promote the use of safe patient handling equipment.
Read more about safe patient handling education and training:
  • In 2010, the National Institute for Occupational Safety and Health created a Web-based training presentation and CD-ROM titled "Safe Patient Handling Training for Schools of Nursing." This material, developed by cooperative effort among the National Institute for Occupational Safety and Health, the Veterans Health Administration, and the American Nurses Association, helps instructors design training programs that encourage the use of safe approaches to handling patients and contribute to the prevention of musculoskeletal disorders.
  • The Minnesota Hospital Association (MHA) created a Tool Kit for Hospital Staff on safe patient handling that includes a number of educational materials for families and patients and a "Safe Patient Moving SuperUser Training*" presentation. Hospitals can download the MHA Road Map to a Comprehensive Safe Patient Handling Program* and use the materials provided for their own training, as long as they cite MHA.

Wednesday, April 23, 2014

Safe Patient Handling Equipment

 Having a successful safe patient handling program means more than owning equipment: it means having the right amount of equipment that is right for the job and easily accessible to workers when they need it. Here are some ways to get the right equipment for your hospital:
  • Involve your front-line staff in testing and selecting equipment. The people who actually move patients are a valuable resource when determining the equipment most appropriate to each unit.
  • Choose equipment based on the specific lifting, transfer, and movement needs of each unit and patient population.
  • Make sure the equipment is conveniently located, readily available, and accessible so that staff can use it without keeping patients waiting or delaying other tasks.
  • Put systems in place to ensure that mechanical equipment is maintained and supplies such as slings and transfer sheets are kept clean and stocked. Staff cannot use mechanical equipment if it is broken or not charged. Further, equipment that has not been maintained properly could result in injuries to both caregivers and patients.
  • Consider partnering with an equipment vendor. Vendors can help you develop your safe handling program, host equipment fairs, troubleshoot issues, answer questions, and maintain and replace equipment.
  • Design with safe patient handling in mind during construction and remodeling. It is easier and more cost-effective than retrofitting. In Safe Patient Handling and Mobility: Interprofessional National Standards, the American Nurses Association recommends that hospitals incorporate ergonomic design principles to provide a safe environment of care.
The following resources will help you identify the right equipment for your hospital:

Friday, April 18, 2014

Facilitating Change

Establishing and maintaining a successful safe patient handling program will likely require a culture change throughout the hospital. In Safe Patient Handling and Mobility: Interprofessional National Standards, the American Nurses Association recommends that employers and healthcare workers partner to establish a culture that emphasizes safety as the top priority above competing goals.
According to ANA's standards, a culture of safety includes acknowledgement of the risk, a commitment to provide resources to consistently achieve safe operations, a blame-free environment where workers can report errors or incidents without fear, and an emphasis on collaboration across sectors and settings.
“High reliability” principles that go beyond equipment and procedures help create a prevention-based culture of safety, and in turn benefit patient safety as well. Worker involvement in every step of the process, including policy development, equipment selection and placement, education, and evaluation, will help ensure a successful program and safety for all.
Modeling safe patient handling behaviors is key to facilitating change. Along with overall safety coordinators, many hospitals have dedicated safety champions or “coaches” on each floor or unit to encourage their colleagues to follow safe patient handling policies and procedures. These individuals continually remind and educate their peers about the program and promote a cultural mindset of safety. Nurse managers also can help to support and reinforce the program with staff.
Read more about facilitating a culture of safety in hospitals*:
  • Safe patient handling advocates often hear a lot of reasons why hospitals choose not to invest in mechanical lift equipment or other safe handling procedures and policies, or why equipment does not get used after they have made the investment. "Safe Patient Handling: Busting the Myths*" provides facts that safety champions can use to promote safe patient handling.
  • The Joint Commission reprinted a 2013 feature from Healthcare Executive, "The Power of Zero: Steps Toward High Reliability Healthcare*," about steps hospitals can take toward creating a culture of high reliability healthcare.
  • In 2008, the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality published Becoming a High Reliability Organization: Operational Advice for Hospital Leaders*, which presents the thoughts, successes, and failures of hospital leaders who have used concepts of high reliability to improve patient care.

Monday, April 14, 2014

Facility & Patient Needs Assessments

Facility Needs Assessments

It is easier and more cost-effective to design for safe patient handling and movement during construction and remodeling than to retrofit. Many healthcare facilities lack conveniently located storage space, so finding a convenient place to park portable lifts can be a challenge. When designing new buildings, additions, and renovations, it is important to plan for equipment use and storage. "Prevention Through Design," for example, is a national initiative led by the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health to minimize hazards and risks early in the design process. The Joint Commission's Environment of Care standards also promote building designs that protect patients, visitors, and staff.

The following resources can help hospitals assess their facility needs:

Patient Needs Assessments and Algorithms

Every patient has unique characteristics and abilities that need to be assessed on a regular basis. Each patient should have a systematic assessment—focused on the patient's mobility—to protect both the patient and caregivers against injury. In Safe Patient Handling and Mobility: Interprofessional National Standards, the American Nurses Association recommends adapting each patient's plan of care to meet his or her mobility needs and specifying appropriate technology and methods.
The following resource provides several algorithms to help caregivers assess their patients' needs:

Tuesday, April 1, 2014

Policy / Program Development

"Lessons learned" from successful safe patient handling programs contribute to many proven best practices* to consider when starting a new safe patient handling program or evaluating an existing program. For example, having a written policy facilitates complete implementation and sustained success, while consistent management leadership can "set the tone" and make safe patient handling a visible priority. Also, a program is more likely to be successful if nurse managers and frontline staff are involved early in the development of the program.
Safe patient handling policies establish expectations that staff will use the safest techniques to accomplish patient handling tasks, and that administrators will provide equipment and resources to support staff efforts. In addition, proper training on equipment use is necessary, as are accountability and a commitment to the overall culture of safety. Policies should address the importance of using lift equipment correctly and following proper handling procedures to ensure both patient and worker safety. Safe patient handling policies should be designed as a pledge from administrators and staff to protect patients and workers, and should include clearly articulated goals and expectations.

How-to Guides

The following resources may be useful for hospitals interested in starting a safe patient handling program:

More Resources

The following resources may be useful for hospitals interested in starting a safe patient handling program: