HEALTH & SAFETY IS EVERYONE’S JOB

SO IT DOESN’T BECOME ANYONE’S PROBLEM

Hygiene

The Need for Better Hand Hygiene• In Canada, healthcare associated infections (HCAI's) affect more than 220,000 people every year and kill 8,000 – 12,000.1• Hand hygiene, a very simple action, remains the primary means to reduce HCAI's and the spread of antimicrobial resistant organisms.• HCAI's lead to long-term disability, preventable deaths, and additional financial burden on the healthcare system.2• Compliance by healthcare workers with optimal hand hygiene is considered to be less than 40%.3• Global research indicates that improvements in hand hygiene activities could potentially reduce HCAI rates by up to 50%

When should hand hygiene be performed?

In health care, hand hygiene is required: Before and after contact with any patient/resident, their body substances or items contaminated by them Between different procedures on the same patient/residentBefore and after performing invasive proceduresBefore preparing, handling, serving or eating food or feeding a patient/resident After assisting patients/residents with personal care (e.g. assisting patient to blow nose, toileting or doing wound care)Before putting on and after taking off glovesAfter performing personal functions (e.g. using the toilet, blowing your nose)When hands come into contact with secretions, excretions, blood and body fluids (use soap and running water whenever hands are visibly soiled)

FALLS AND INJURIESThe Nursing best practice guidelines on the CNO and RNAO websites includes falls and injuries as one of the issues that needs active awareness and proper education.

On the Safer Health Care Now website they have a Reducing Falls and Injuries from Falls Getting Started Kit . This kit explains why Fall prevention awareness is so important.

According to the Canadian Institute for Health Information, falls were the cause of 57% of all injury-related hospitalizations, and more than three quarters of all in-hospital deaths in those admitted for an injury.

• Among Canadians age 65 or older, most injury hospitalizations followed a fall (77% for males, and 88% for females).

• Falls are also the second leading cause of both head and spinal cord injuries (35% and 37%, respectively).

• The majority of specific fall-related hospitalizations for head injuries were falls on or from stairs or steps (25%), slipping, tripping or stumbling (17%) and falls from one level to another (11%).

• Ninety percent of all hip fractures in seniors are the result of a fall, and 20% of those suffering such an injury die within a year of the fracture.

• Families are often unable to provide care, and• 40% of all nursing home admissions occur as a result of

falls by older people.

Falls and injury from falls have a significant impact on the individual, organizations providing health care services and the health care system overall.

A PERSON CENTERED APPROACH TO CARE CAN REDUCE THE RISKS OF FALLSBiological and medical risk factorsBehavioural risk factorsEnvironmental risk factorsSocial and Economic risk factors

Low beds, bed alarms, an emphasis on understanding patient agitation and behavior, and other non-restraint interventions introduced at an inpatient geriatric psychiatry ward reduced the number of falls by close to 60%, - according to Ben Inventor, C.N.P., of Rush Medical Center in Chicago, and colleagues.

This is not just an issue for psychiatry units. There are many in-patients that are high risk because of environmental factors or because of symptoms associated with stroke, dementia, medications, motor skill deficiencies and mental deficiencies.

Helping families, health care providers and patients realize ALL the factors that contribute to falls will lead to safer care and support for patients during and after their stay.Teaching family members or the patients support network to perform health and safety inspections of their environment will lead to greater awareness for everyone and help reduce preventable injuries

Many dementia and stroke patients cannot communicate verbally what they are feeling. Sensations like pain, needing to use the bathroom, being hungry, being scared are expressed behaviorally. This can lead to greater risk of injury to patients and staff.This can also be true for someone who has a language barrier.

The Canadian Falls Prevention Curriculum notes that the most effective falls prevention interventions use a multifactorial approach targeting selected individuals or groups of older persons based on their risk profiles. Taking into account the best evidence and research, the Curriculum presents a comprehensive falls prevention model, BEEEACH, incorporating the following categories:.

B.E.E.E.A.C.HBehaviour change--a common goal of all strategiesEducation--of program participantsEquipment--appropriate use of mobility aids and assistive devicesEnvironment--in the home and public placesActivity--physical and socialClothing and footwear--appropriate for risk reductionHealth management--including medication reviews, vision tests, bone health, healthy nutrition and hydration and chronic disease management

Patient Centered care leads to a safer work environment. Ben Inventor and his colleagues at the Rush Medical Center in Illinois conducted a study that showed patient centered care can significantly reduce the amount of falls on a unit. http://www.medpagetoday.com/MeetingCoverage/DCC/10664)

They conducted a study on a geriatric psychiatric unit where most patients also had other complex medical issues which led to elevated risk for falls. The study was to see if changing the approach of care to one that was called “Person-centered care” would reduce falls and injuries.

This method of care requires “A deeper understanding and appreciation for why a person behaves the way he does”

Over the course of about two years, the team beefed up standard fall prevention to include the following: -Soothing lighting and background music. -Low beds with bed alarms and soft floor mats on either side of the bed. -A six-bed intense monitoring area without other furniture for patients with a higher risk of falls or under physical restraint due to medical or behavioral reasons. -Reconfiguration of staffing to provide a full-time night shift monitor for the intense monitoring area. -Cushy chairs (Carefoam) that cradled patients in a reclining position that both decreased restlessness and made it difficult to rise without assistance. -Medication review with modification of psychotropic drugs as needed.

This combination of approaches reduced the number of falls to an average of 6.7 per month in the unit by the end of the two-year period in February 2007. (prior to this program the high average was 18 falls per months.)The frequency has since dropped to an average 4.5 falls per month, said Patrick O'Brien, R.N., also of Rush and a co-author on the study. The interventions were unable to eliminate falls entirely, particularly among patients who were subject to multiple falls, which chart review showed was frequently in association with agitation, unsteady gait, and attempts to move around without assistance. Once the foam chairs were introduced, these frequent fallers did not fall on subsequent hospitalizations, which resulted in a dramatic drop in the unit's overall fall rate. The intense monitoring rooms also were consistently associated with lower fall rates than regular rooms over time. But no single intervention accounted for all the benefit, Inventor said. "Therefore, we recommend ... an interdisciplinary approach tailored to each individual need."

Some Ideas for Health and Safety AwarenessFALLS AND INJURIESLife size snakes and ladder type game on First Aid.- I made several of these for a young women’s camp that I direct for a week in the summer. The 190 young women ages 12-18 had fun moving around the life size game board and answering trivia questions about first aid and emergency situations. The person slides down bandaids instead of snakes and climb up either thermometers, stethescopes or other items instead of ladders. There are challenge squares where the player has to splint and sling a person’s arm or show how to treat shock or something else related to home injuries.Could work with “operation”, “Life” style games,

Jeopardy type game on home safety- A game designed to help develop awareness on safety and wellness. Different health and safety categories Have departments challenge each other and have finals after a few weeks of challenges. Secure a grand prize for the champion at the end. This gives an opportunity to raise awareness over months

Health and Safety Trivia game in cafeteria ( on tv screens or trivia cubes “Think Outside the Box” (trivia facts on Health and Safety on the outside of the box. Show ways everyone can be active in community wellness)

Fortune Cookie- Give or sell Health and Safety Fortune cookies. Put a health and safety tip on fortunes as a fun way to raise awareness.

Health and Safety awareness design contest. Lots of the staff, volunteers, patients and visitors at William Osler are very talented and looking for a reason to show off those talents. Let them make posters, video submissions, safety songs or other talents to raise “Wellness and health and safety issues”.

Power point movies created on Health and Safety issues such as Hygiene, fall prevention, pandemics, etc. to be shown in cafeterias or on Osler net. Have a department challenge to see who can make the best Health and Safety video. With points for creativity, knowledge, involvement of unit members and overall best video. Have a “premier night” and then have the videos on the website. Have a grand prize for the winning department of Lunch.

“Health and Safety No Joke” Comedy and open mike night. Allow staff and their families perform their talents, in between acts there will be a power point movie clip or slide on a safety issue. The MC will tell a joke involving a situation and then goes into the clip on the safety issue. Could even raise funds for campaign.

Health and Safety blog with tips on safety issues, a forum for staff to share stories and a way to open even more communication about Health and Safety Issues.This can include preventative health and wellness issues, work safety, mental and physical wellbeing, etc.

Health and Safety trivia facts placed on posters in bathroom stalls and on elevators. Health and Safety flyers and trivia game pages left in common areas and for patient and their families or handed out to staff. This could also be done with email or a website with games, facts and tips for Health and Safety both at home and at work.

Units should have a portable dvd player with screen so that patients that are at high risk for falls or bed ridden can still access patient education videos and could even view .jpg images of test results when consulting on their care with physicians. It would also be a method to let patients listen to music to calm them or lift their spirits.

Many prevention practices are in place to protect hospitalized seniors from falls including educational activities for nursing and support staff, patient orientation activities, reviews of prior falls, and modifications to the environment. Environmental modifications include reducing ward or room obstacles, adding extra lighting and grab bars in bathrooms, and lowering bedrails and bed height. Other approaches address transfer and mobility issues with scheduled ambulatory and physical therapy activities and attention to footwear (e.g., non-skid socks). In addition, hospitals have incorporated strategies to assist cognitively impaired patients by: educating family members to deal with confused patients; minimizing sedating medications; and moving confused patients closer to nursing staff

BackWellness

AndSafety

Follow the Minimal Lift Policy so that you work smartly and safely.Use another health care worker or a mechanical lift when needed

Since Health Care is such a demanding field it is Vital to take care of your Joints, muscles, bones,And entire body.Proper exercise, nutrition, Stress management and Other healthy choices can Make the difference

Workplace Violence and Harassment The Ontario Hospital Association’s Health and Safety bulletin stated “The prevention of workplace violence and harassment is not about doing the work safely but rather, it is about working with each other in an environment of respect and tolerance. This extends beyond the workplace and considers the individual’s work-life conditions.”There are many ways that to help create a more aware and respectful work place. Education helps everyone realize how they can make a difference in the environment and lives of those around them.

People are more accepting of each other and work together more effectively when they can relate to the other person. Finding similarities in each other’s stories and learning of the struggles that make a person who they are is a way of breaking down barriers and creating bonds that may have never been discovered.

When it is co-workers that are causing work stress it can be an almost overwhelming prospect for victims to face each day. Research and studies have shown that workplace bullies and abuse are a very prevalent issue in hospitals. It can lead to lack of productivity, absenteeism, stress illnesses and employees leaving their jobs. Workshops and awareness campaigns can help employers work through these situations.

Some studies suggest that approximately 50% of the work force have experienced or Witnessed bullying

The Be One Workshop

The workshop is designed for anywhere from 40 to 100 individuals. It can be done in smaller groups but is most effective in an environment where more employees have participated. It will begin with everyone participating in some “get to know you” improvisational exercises. This will hopefully help everyone feel more comfortable with the group and to just have fun while “de-stressing” so that they can more easily open up and get the most out of the day

CHANGE- BE ONE

The participants then break up into small groups of five. The groups will then complete a “I wish that people understood about me….”Participants are asked to write their obituary. To think of what they want their legacy to be. If you could share one thing about yourself to the world what would it be…

”Your greatest fear…” exercise:Have health care provider participants to close their eyes and picture their loved one in the hospital, or being a patient headed for surgery in a hospital…think of the fear you would face….think of the stress of that scenario….What would make that better for you? How would staff help comfort you? Now add not being able to see clearly anymore, not hearing clearly, not understanding the language or being able to communicate back…Imagine all of a sudden needing someone to do everything for you..and not being able to communicate anything in return that is comprehended by others. How does that feel? Are you scared?

(Each member of the group will have the chance to experience this through foggy glasses, ear plugs, being “stuck” in a chair with Velcro, being challenged to communicate without words.) They will be given instructions in another language and having stimuli to create confusion around them…Think of how a patient feels…

Everyone has a story and you can be a bright chapter of it…

Be ONE…Every person around you is in need of something …a comfort- be One, a laugh- be one, a listening ear- Be One, Compassionate care- Be One. The world is in need of heroes who will stand up and make a difference- Be One.Each participant is then given the opportunity to share how they intend to “Be One” in their lives and with their “Calling To Care”.These health care professionals then take what they learned and implement it on their unit through example.

Health & Safety Slogans

Your good health is your greatest wealthEven in a hi-tech world, your eyes are still your greatest asse"You must be the change you wish to see in the world." - Mahatma GandhiThe door to Safety swings on the hinges of common sense.Safety is success by purpose - Not Accident.Safety awareness saves lives.Check your shoes and don't let your day slip away.Be aware Take careSafety begins with No. 1Safety begins with teamworkWork smarter not harderWe need you - work safelySafety starts with S but begins with youThe door to safety swings on the hinges of common senseSafety is a state of mind - Accidents are an abscence of mindA wound neglected is a wound infectedNormal speed meets every needStop accidents before they stop youLook sharp don't get cutBefore you start be safety smartSafety is a full time job - don't make it a part time practice