'Safe Moves' are better for patients, workers
'Safe Moves' are better for patients, workers
Linking safe patient handling to fall prevention
Moving patients safely isn't just a way to protect workers. It also improves the mobility of patients while preventing falls core components of patient safety and satisfaction.
Integrating those goals into a single Safe Moves Initiative produced better outcomes for patients and employees at Memorial Hospital and Health System of South Bend, IN. Musculoskeletal injuries declined by 37% in the first year of the new program. In 2007, just one musculoskeletal disorder injury involved days away from work.
Patient falls fell below the benchmark of 4 per 1,000 patient days. And patients felt more secure with the lift equipment.
Most compelling, though, was the impact on individual patients. One open heart surgery patient had been in the hospital for about 52 days. He weighed about 300 pounds, and it was difficult for nurses to move him. His skin was ashen, and he was disoriented and somewhat combative. He breathed through a tracheostomy.
With a new mechanical lift, nurses were able to get him up into a chair several times a day. He became more alert, and within three days, he was able to move to an intermediate unit. Three days later, he transferred to an extended care facility.
"We saw such a vast improvement in his care and his condition," says Tamara Vasta, RN, COHN, employee health manager. "He was smiling and very cooperative. It was amazing the impact of just getting up and being able to have a little more normalcy in your day."
Meanwhile, the nurses on the unit also had relief from the exhaustion and strain of moving him, and his transfers no longer required the disruption of several employees to help.
"There is a direct correlation between employee safety and patient safety, and employee satisfaction and patient satisfaction," says Vasta.
First step: Investment in equipment
The Safe Moves Initiative began with a detailed proposal to buy lift equipment and other assistive devices. Vasta wanted to prevent back pain and injury and reduce workers' compensation costs and days away from work. When the Joint Commission made fall prevention one of its National Patient Safety Goals one of the top priorities for the accrediting agency Vasta and her colleagues saw an important connection.
In her proposal, she detailed the hospital's patient fall rate and noted that the hospital was starting a bariatric surgery program, which would create new challenges for patient handling. She presented nurse testimonials about the difficulties of moving patients and the ease of the lifts. She took senior managers for a "ride" in the lifts to show them what the patient would experience.
She even included some photos of the South Bend trash collectors who don't even have to lift a garbage can to dump it into the truck. The trucks now are equipped with lifting devices.
The patient perspective was particularly compelling. Administration agreed to spend $300,000 on new lifts and assistive devices, which they bought from Arjo (now ArgoHuntleigh) of Roselle, IL.
While Vasta and a safety team were working on reducing employee injury rates, a fall prevention team was trying to reduce patient falls. Another team, Move to Improve, wanted to improve patient mobility as a way to create better outcomes and shorter hospital stays.
"All three of our goals were so interlocking, it ended up being a perfect match for us," says Carol Whiteman, MSN, CCRN, RN.BC., CCNS, clinical nurse specialist for acute care adult services, who spearheaded the Move to Improve effort.
Now, every patient receives a mobility assessment to determine mobility needs and fall risk. That is included in the Cerner electronic medical record software. If the patient is at risk of falling, a falling star symbol is placed on their door to alert staff.
Memorial now has a policy for patients to sit up when they eat either in a chair beside their bed or in a bed that converts into a chair. And lift equipment plays a double role to help patients become more independent.
For example, the Stedy device can be pushed up to a bedside. The patient holds onto the bars to stabilize himself into a standing position. The patient can then hold onto the bar while walking, or can sit on a foldable seat on the Stedy and be pushed into a bathroom for toileting.
"We are doing a better job of making sure that patients get up," says Whiteman.
Whiteman is trying to determine the impact of assistive devices on hospital complication rates and length of stay, although with so many variables, those data are difficult to derive. However, anecdotally, patients are more satisfied with the equipment, she says.
From an employee health perspective, the Safe Moves Initiative means more clout and support for equipment that will prevent injuries. Linking worker safety with patient safety is the key, says Vasta. "You have to break out of your silo and start looking at the bigger picture of how equipment impacts overall patient care," she says.
Moving patients safely isn't just a way to protect workers. It also improves the mobility of patients while preventing falls — core components of patient safety and satisfaction.Subscribe Now for Access
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