Safe Patient Handling Initiative - UCLA Health

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Safe Patient Handling
Initiative
January 29, 2014
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BACKGROUND – Injury Rates
• The CDC rates musculoskeletal injuries from
overexertion in healthcare occupations as one of the
highest rates of injuries among all U.S. industries. Data
from the Bureau of Labor Statistics (BLS) showed that
in 2011, the average rate of overexertion injuries across
all industries were 38 per 10,000 FTEs. By comparison,
the overexertion injury rate for hospital workers was
twice that average (76 per 10,000 FTEs) during the
same time period.
• The single greatest risk factor for overexertion injuries in
healthcare workers was from manual lifting, moving
and/or repositioning of patients.
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BACKGROUND – AB 1136
• On January 1, 2012, the Hospital Patient and Health Care Worker
Injury Protection Act (aka Safe Patient Handling) became effective.
This law required general acute care hospitals to adopt a safe
patient handling policy as part of their Injury and Illness Prevention
Program.
• Requirements included: replacing manual lifting and transferring of
patients with powered patient transfer devices, adding trained lift
teams, training staff on safe patient handling practices and
investigating injuries associated with patient handling.
• The general lifting restriction is 35 pounds
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UCLA’S Plan
• UCLA has been ~75% compliant due to current lift
teams
• Lifting restriction is 35 pounds, so lift team can’t handle
all patient lifts with present staffing.
• Have also selectively purchased equipment and started
training staff
• Product demos conducted over past 8 months;
multidisciplinary teams
• Decided on Arjo-Huntleigh and SAGE products
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Implementation Plan
LIFT TEAMS:
• Focus on ICUs & step down units (where heaviest lifting
needs are)
• Available for consultation / special circumstances on the
floors
• Lift Team will have a set of equipment to use
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Implementation Plan, cont.
EQUIPMENT:
• Selectively purchase equipment for each unit, based on
unit’s lifting needs
• Be sure lifts are readily available to staff; “parking
spaces” identified on each unit.
• Most supply items are single patient use items available on unit supply carts
• Materials Management to track par levels; available
through Owens & Minor
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EQUIPMENT
• Maxi Move (Arjo):
hoyer lift)
For max/dependent patients (like a
• Sara Plus (Arjo): For moderate assistance for standing
up; can be used for transfers to chair, toilet, commode
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EQUIPMENT
• Sara Stedy (Arjo): For min-moderate assist; patient
must be able to stand and grip; for transfers to chair,
toilet, commode
• Flites (Arjo): Antifriction sheet used for lateral
transfers, bed repositioning, etc.
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EQUIPMENT
• Maxi Air (Arjo): Blow up air mattress for lateral
transfers; bariatric patients, etc.
• Maxi Sky (Arjo): Ceiling lift, for future consideration.
Rooms need to be retro fit.
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EQUIPMENT
• Prevalon Bed Sheet (SAGE): Used for bed
repositioning, lateral transfers; stays under the patient
• Includes positioning wedges and liner (can use chucks)
• Single patient use – issued to patient
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EQUIPMENT
• Prevalon Chair Sheet (SAGE): Used for chair
repositioning
• Line with chucks
• Single patient use
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TRAINING
• Core
team at each campus:
Training coordinator
Rehab
Lift Team
2 Nursing champions per unit (day/night shift)
• 1 full day training for core teams
• Create “Culture of Safety”
• ICU staff will be trained by lift team, as equipment is
deployed
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TRAINING
• Spend 1 week on each nursing unit
• Day and night shift hours
• Coordinator and unit champions to make sure all staff
are trained
• After training, spend rest of the week on the unit
coaching, problem solving, retraining, etc.
• Training algorithms & resource binders available,
including pictures of each lift
• Competency forms for files
• HR Tracking
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TRAINING
• After initial training, return to each unit for additional
training, problem solving, etc.
• Accountability if employee refuses to use lift
• Part of unit orientation for new hires
• Include in annual competencies, as needed (should be
high frequency use!) (plan in progress)
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IMPLEMENTATION TIMLINE
• October:
Proposal approved
Equipment ordered
• Early-mid November:
Training for core teams
• Mid-November: Deploy SAGE products to ICUs
• December, 2013 – February, 2014: Unit training
• To
date, ~100 champions and ~200 staff nurses trained
• February, 2014: Unit retraining, if necessary
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PUBLICITY- Training Stickers
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PUBLICITY – Badge Holders
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PUBLICITY – Flyers
Plus lots of emails, presentations, and articles!
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Sustaining the Program
Safe Patient Handling Coordinator
• Full time FTE
• Health System position (both campuses)
• Duties:
Investigate injuries; maintain statistics
Follow new legislation; insure compliance
Provide training / retraining
Track new products; replace what doesn’t work
Help track usage and par levels
Represent UCLA at UCOP level
Make regular rounds / trouble shoot
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REPORTING & OVERSIGHT
• Environment of Care Committee
• Workman’s Comp Strategy Group
• Periodic updates to Health System Leadership
• Regular follow up with Unit Directors and other
department heads
• UCOP Safe Patient Handling Task Force
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NEXT STEPS
• Finalize the Safe Patient Handling Coordinator
• Policy approval
• Finalize plan for initial and annual competencies
• Complete training on the inpatient units
• Complete training in other areas: OR, ED, Radiology
areas, Escort, Gonda, Transport, etc.
• Create blog for SPH champions & equipment feedback
• Closely track injury reduction!
• Involvement on UCOP level
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SPECIAL THANKS
• Erik Eggins, Safety Department
• Materials Management
• MOC
• Loading Dock
• Facilities
• Nursing Leadership
• Rehab & Lift Team
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