Turn-Team captains

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.