Format:
PDF and Word DOC
Size:
8.5” x 11”
Intended audience:
Captains of turn teams
Best used:
Use this checklist when turning a patient to ensure the procedure is done safely and the chance of injury is minimized.
Checklist used by turn team captains in San Diego's 2 North/South Med-Surg units when the team turns or lifts a patient, to ensure the procedure is done safely and the chance of injury is minimized.
Checklist used by San Diego's 2 North-South Medical-Surgical teams to help conduct safety observations while the team turns or lifts a patient.
The 2 North-South medical-surgical units in San Diego were identified as high-injury departments.
One year, the combined team saw 16 patient-handling injuries. Before that, the number was 18. Repetitive back and shoulder injuries were most common. As a result, management was told to eliminate injuries—fast.
The first step in the action plan required staff members to undergo Workplace Safety training on how to conduct safety observations. Each person then conducted three observations a week on teams turning patients and submitted those observations to a collection box in the department. The observations were logged into the Workplace Safety web-tracking tool.
Previously, only charge nurses and managers conducted the observations. But getting everyone involved kept proper patient-handling techniques constantly at the forefront of team members’ minds.
Getting buy-in from staff members was another challenge, so it didn’t feel like another thing on top of their regular workload.
“Make sure you communicate—and with some degree of consistency—to everyone,” nurse manager and RN Erlinda Aquino says. “And hard-wiring it so people understand it’s not just the flavor of the month.”
The UBT adapted a checklist of key things that should be done when turning a patient, such as ensuring a patient’s bed rails have been lowered. Turn-team captains referred to this checklist at every patient turning.
To help morale and maintain safe patient-handling techniques, the UBT set small, attainable goals the department could celebrate.
The team had a pizza party when it reached the first 100 days without an injury, then again after accruing no injuries for the month of July, which historically had been the units’ highest injury month.
“In the beginning, you have to consistently remind people,” says Tess Patiag-Limcuando, RN. “People felt that doing those steps just added to the time, not realizing that it would cost them a whole lot more time if they hurt themselves.”
It was also important to focus on the positive.
“Instead of emphasizing the negative, present it like, ‘I care about you; I want you to be safe.’ Versus: ‘You’re in trouble,’” Aquino says.
San Diego's 2 North-South Medical-Surgical team dramatically reduces patient-handling injuries by having all staff members conduct regular safety observations.
Erlinda C. Aquino, Erlinda.C.Aquino@kp.org, 619-528-5976
The San Diego Ophthalmology group had earned the dubious reputation as a high-injury department.
They had a quarterly injury rate of 23.6 and problems ranged from carpel tunnel to back issues. The majority of complaints was caused by sitting at the computer for long periods, typing and doing repetitive motions like using a mouse.
Medical assistants and technicians also frequently complained about having trouble navigating the cluttered, unsafe vision lanes—the small alcoves where nurses and medical assistants evaluate patients before escorting them to exam rooms.
Being flagged a high-injury department, the team was determined to identify the causes of the injuries and how to prevent them from occurring.
The department took Workplace Safety training and instituted a number of measures to identify and fix potential hazards at all four ophthalmology departments. Those measures included ergonomic evaluations, new chairs and foot rests, and installing stretch break software on all computers.
They conducted regular safety checks and created the “I Spy” program, which has previously injured workers conducting safety observations to identify potential problems.
The team also revamped the department’s vision lanes.
These often were cramped and potentially unsafe environments with electrical cables stretched across the narrow floor. Computers and blood pressure carts created additional tripping hazards.
“You had to maneuver around patients and wheelchairs, and generally feel confined, waiting to trip or bend wrong,” says Anna Garcia, a medical assistant and UBT member.
So, they mounted blood pressure machines and KP HealthConnect computers on the walls, instead of using carts. They purchased new chairs for patients, particularly for older patients who have difficulty getting into narrow spots or are in wheelchairs.
By moving power outlets closer to the mounted equipment, electrical cords were no longer in the way. And they painted the walls that ophthalmologists used during eye examinations.
“The nice thing is if I need to maneuver now, it’s not a move I’m going to regret later on when I get home, when my back is hurting,” Garcia says.
Ophthalmology went 335 days without an injury.
But keeping workplace safety in everyone’s awareness was a challenge.
“The equipment makes a difference, but our behavior also makes a difference. It takes a while for that to happen. It doesn’t happen overnight,” Vickie Lance, assistant department administrator says.
Feedback from people outside the UBT also proved invaluable.
“I’ve been in this department for 15 years and I didn’t know there was a problem. Once we saw it on paper, it made a big impact,” Lance said. “And the visual picture of before and after is wonderful. It makes us feel like we’ve accomplished something.”
San Diego's ophthalmology team reduced ergonomic workplace injuries while also clearing their vision lanes, which had posed serious safety hazards for medical assistants and patients.