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Kaleida Health SPHM Programs

Safe Patient Handling for All Healthcare Workers, Understanding the Risk

Associated with Working in the Home Care Industry.

Paula Pless-Director SPHM Kaleida Healthppless@kaleidahealth.org

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Kaleida Health SPHM Programs

What impacts Home Care?What can be done to improve safety

for the ; Home Health Care Workers Care providers who are Family or Friends Patient Safety, Client Safety or Resident

Safety

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Kaleida Health SPHM Programs What did Homecare look like on that

first visit? Nurses wore heels, caps, capes and white They carried 1 little doctor bag-no pager,

no cell, no IV’s, no equipment, no treatment bags, no pepper spray, mace, stun gun.

The patient was sitting in a chair fully dressed waiting for the visit with a snack ready to share, eager to have a visitor, or someone to take their temperature, cook a hot meal do some light housework.

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THENDress, one bag and heels

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NOW 4 bags on her body, 1 bag pulled,

cell phone and pager.

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Kaleida Health SPHM Programs An estimated 12 % of nurses leave

the profession annually. An estimated 52% of nurses

complain of chronic back pain.

Home Health Care Workers face-violence, abuse, MVA’s, Slips & trips, MSD’s, CTD’s, GET LOST!, are alone

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Kaleida Health SPHM Programs

Did you know that In 1997 LOS was 7.1 days v.s. LOS in 2003

5.7 days 5 Million Americans are over 85 49 Million Americans are over 60 First wave of baby boomers are about to

become 60.Who is going to take care of them, who is

going to take care of us?

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Kaleida Health SPHM Programs

What are some of the Impacts? Shorter hospital stays Sicker patients leaving hospitals Sub-acute care taking place in the home. Insurance coverage has changed No OT services in most hospitals Poorly staffed S.W dept Disconnect between D/C planners and

Home Care Agencies

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Niagara County

OrleansCounty

ErieCounty

GeneseeCounty

WyomingCounty

ChautauquaCounty

CattaraugusCounty

AlleganyCounty

Services cover : 8 Counties

Certified

Licensed

Pediatrics/Maternal-Infant

Number of clients treated in 2006- approximately 25,000 Number of referrals in 2006 - 16,280

Visiting Nursing Association of WNY, Inc.VNA Home Care Services-est.1885

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Kaleida VNA Services CHHA Nursing Home Health Aide Occupational Therapy Nutritional Medical Social Services Speech/Language Pathology Physical Therapy

SPPCHHA (Services to Women & Children - Prenatal & Postnatal) Nursing Home Health Aides Respiratory Therapy & Supplies Medical Social Services Occupational Therapy Physical Therapy Speech/Language Pathology

LSHHCA Nursing Nutrition Breast pumps & Accessories Respiratory Therapy & Supplies Home Health Aide Personal Care Physical Therapy Occupational Therapy Speech/Language Pathology

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Kaleida Health SPHM Programs Adult Children don’t live in the area.

Elderly live alone.

Adult children are working, caring for their own children and their parents.

Frail elderly care for frail elderly.

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Kaleida Health SPHM Programs Who supports/assists the healthcare

workers efforts in the home environment? “I need an arm in Room 222”“Hello anyone out there?” “No you sit down before you fall” “I will take

care of your Husband” “Which one is the patient?”

“I want to do his/her treatment so please leave him/her in bed”

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Kaleida Health SPHM ProgramsHome environments are used to care for

dependent, critically ill patients.

“No equipment,this is my home” {pts. say}

“it is their home” {workers say}“Never not in their home” {children say}“I am a visitor in their home” {staff say}

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Can you say vaccination time? Do you think anyone said no to her?

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Kaleida Health SPHM Programs

Did you know that SW’s, OT’s, D/C Planners & Liaison positions have been cut?

Patients leave the hospital before they have even gotten out of bed or used a toilet!

D/C Planners sometimes don’t see the patient, ask about the home environment, or speak to the people that the patient tells them will be assisting with their care in the home! “OH Yeah my neighbor will change my dressing” “He can flush my PIC line too”

No Equipment is discussed or ordered prior to D/C.

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Kaleida Health SPHM Programs

So with all those impacts how do we keep everyone safe?

Everything in Homecare has changed but the way we deliver care has remained

the same.

In the words of Dr. Phil-

”how's that working for you?”

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Look at that stride!

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Kaleida Health SPHM Programs

Quote from a 1898 Nursing text book

“Occasionally the complaint is made that a nurse has injured her back or strained herself in some way in moving a patient. This will generally be because she failed to do the lifting properly”

(Hampton, 1898, p.102).

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Kaleida Health SPHM ProgramsWhen is it easier to get the King of the

Castle to agree to allowing the necessary equipment in to the home?

When they are vulnerable in a hospital bed wanting to go home at any cost wearing a gown that exposes their backside?

OR You open the case they are in their castle

sitting on their thrown, with a cigarette in their mouth,their dog growling at you and their King size bed on the second floor?

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Kaleida Health SPHM Programs Communicate-who are all the

Stakeholders? Assess-who is qualified and invested to

provide an appropriate assessment? Have the tools necessary to do the job-

Hospital bed, lift, Non-Friction Sheets, caregiver support,3-Position Lift Chair

Use an Admission Agreement-smoking, pets, equipment brought in to the home.

Develop a Plan of Care-include safety, communicate to the next person

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Kaleida Health SPHM Programs When don’t you open a case? Does your

agency say no to a case? Do you expect the support person to be

present when you open the case? Do PT and NSG open the case together HHA in the Home when PT or NSG is there Equipment is preordered to be delivered

prior to D/C or on the day of D/C. Your agency is a SPHM care provider, it is

in your admission agreement.

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Kaleida Health SPHM Programs What is hurting us? Stand Pivots #1 transfer used-need equipment Manual lifts-need equipment Treatments/wound care-need equipment-LE’s done

with patients OOB Incontinent care-need equipment Carrying numerous heavy bags in to the home-

need equipment on wheels, supplies left in homes Driving-need safe driving course, maps, agency

rules about returning calls and pages while in car

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Kaleida Health SPHM Programs

Kaleida’s VNA has implemented a SPHM Policy & Program with Leadership “Buy In”.

Formed an Ergo Committee Conducted a SWOT analysis Began to write a SPHM Policy Purchased equipment Began training, “Buy In” and problem

solving Break the Myth-Educate

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The National Nursing Shortage is Expected to Increase by 30% by the Year 2020. Will We Still be Caregivers?

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Kaleida Health SPHM Programs-WNY VNA 120 Years of Service