Kaleida Health SPHM Programs

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Kaleida Health SPHM Programs

• Safe Patient Handling for All Healthcare Workers,
  Understanding the Risk Associated with Working in
  the Home Care Industry.
• Paula Pless-Director SPHM Kaleida Health
• ppless_at_kaleidahealth.org

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Kaleida Health SPHM Programs

• What impacts Home Care?
• What can be done to improve safety for the
• Home Health Care Workers
• Care providers who are Family or Friends
• Patient Safety, Client Safety or Resident Safety

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Kaleida Health SPHM Programs

• What did Homecare look like on that first
  visit?
• Nurses wore heels, caps, capes and white
• They carried 1 little doctor bag-no pager, no
  cell, no IVs, no equipment, no treatment bags,
  no pepper spray, mace, stun gun.
• The patient was sitting in a chair fully dressed
  waiting for the visit with a snack ready to
  share, eager to have a visitor, or someone to
  take their temperature, cook a hot meal do some
  light housework.

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THENDress, one bag and heels
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NOW 4 bags on her body, 1 bag pulled, cell
phone and pager.
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Kaleida Health SPHM Programs

• An estimated 12 of nurses leave the profession
  annually.
• An estimated 52 of nurses complain of chronic
  back pain.
• Home Health Care Workers face-violence, abuse,
  MVAs, Slips trips, MSDs, CTDs, GET LOST!,
  are alone

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Kaleida Health SPHM Programs

• Did you know that
• In 1997 LOS was 7.1 days v.s. LOS in 2003 5.7
  days
• 5 Million Americans are over 85
• 49 Million Americans are over 60
• First wave of baby boomers are about to become
  60.
• Who is going to take care of them, who is going
  to take care of us?

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Kaleida Health SPHM Programs

• What are some of the Impacts?
• Shorter hospital stays
• Sicker patients leaving hospitals
• Sub-acute care taking place in the home.
• Insurance coverage has changed
• No OT services in most hospitals
• Poorly staffed S.W dept
• Disconnect between D/C planners and Home Care
  Agencies

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Visiting Nursing Association of WNY, Inc.VNA
Home Care Services-est.1885
Orleans County

Niagara County
? ?
? ? ?
Services cover 8 Counties Certified
? Licensed ? Pediatrics/Maternal-Infant
? Number of clients treated in 2006-
approximately 25,000 Number of referrals in 2006
- 16,280
Genesee County
? ? ?
Erie County
Wyoming County
? ? ?
? ?
Allegany County
Cattaraugus County
Chautauqua County
? ? ?
? ? ?
? ?
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Kaleida VNA Services

• CHHA
• Nursing Home Health Aide
• Occupational Therapy Nutritional
• Medical Social Services Speech/Language
  Pathology
• Physical Therapy
• SPPCHHA (Services to Women Children - Prenatal
  Postnatal)
• Nursing Home Health Aides
• Respiratory Therapy Supplies Medical Social
  Services
• Occupational Therapy Physical Therapy
• Speech/Language Pathology
• LSHHCA
• Nursing Nutrition
• Breast pumps Accessories Respiratory Therapy
  Supplies
• Home Health Aide Personal Care
• Physical Therapy Occupational Therapy
• Speech/Language Pathology

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Kaleida Health SPHM Programs

• Adult Children dont live in the area.
• Elderly live alone.
• Adult children are working, caring for their own
  children and their parents.
• Frail elderly care for frail elderly.

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Kaleida Health SPHM Programs

• Who supports/assists the healthcare workers
  efforts in the home environment?
• I need an arm in Room 222
• Hello anyone out there?
• No you sit down before you fall I will take
  care of your Husband Which one is the
  patient?
• I want to do his/her treatment so please leave
  him/her in bed

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Kaleida Health SPHM Programs

• Home environments are used to care for dependent,
  critically ill patients.
• No equipment,this is my home pts. say
• it is their home workers say
• Never not in their home children say
• I am a visitor in their home staff say

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Can you say vaccination time? Do you think
anyone said no to her?
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Kaleida Health SPHM Programs

• Did you know that SWs, OTs, D/C Planners
  Liaison positions have been cut?
• Patients leave the hospital before they have even
  gotten out of bed or used a toilet!
• D/C Planners sometimes dont see the patient, ask
  about the home environment, or speak to the
  people that the patient tells them will be
  assisting with their care in the home! OH Yeah
  my neighbor will change my dressing He can
  flush my PIC line too
• No Equipment is discussed or ordered prior to
  D/C.

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Kaleida Health SPHM Programs

• So with all those impacts how do we keep everyone
  safe?
• Everything in Homecare has changed but the way we
  deliver care has remained the same.
• In the words of Dr. Phil-
• how's that working for you?

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Look at that stride!
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Kaleida Health SPHM Programs

• Quote from a 1898 Nursing text book
• Occasionally the complaint is made that a nurse
  has injured her back or strained herself in some
  way in moving a patient. This will generally be
  because she failed to do the lifting properly
• (Hampton, 1898, p.102).

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Kaleida Health SPHM Programs

• When is it easier to get the King of the Castle
  to agree to allowing the necessary equipment in
  to the home?
• When they are vulnerable in a hospital bed
  wanting to go home at any cost wearing a gown
  that exposes their backside?
• OR
• You open the case they are in their castle
  sitting on their thrown, with a cigarette in
  their mouth,their dog growling at you and their
  King size bed on the second floor?

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Kaleida Health SPHM Programs

• Communicate-who are all the Stakeholders?
• Assess-who is qualified and invested to provide
  an appropriate assessment?
• Have the tools necessary to do the job-Hospital
  bed, lift, Non-Friction Sheets, caregiver
  support,3-Position Lift Chair
• Use an Admission Agreement-smoking, pets,
  equipment brought in to the home.
• Develop a Plan of Care-include safety,
  communicate to the next person

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Kaleida Health SPHM Programs

• When dont you open a case? Does your agency say
  no to a case?
• Do you expect the support person to be present
  when you open the case?
• Do PT and NSG open the case together
• HHA in the Home when PT or NSG is there
• Equipment is preordered to be delivered prior to
  D/C or on the day of D/C.
• Your agency is a SPHM care provider, it is in
  your admission agreement.

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Kaleida Health SPHM Programs

• What is hurting us?
• Stand Pivots 1 transfer used-need equipment
• Manual lifts-need equipment
• Treatments/wound care-need equipment-LEs done
  with patients OOB
• Incontinent care-need equipment
• Carrying numerous heavy bags in to the home-need
  equipment on wheels, supplies left in homes
• Driving-need safe driving course, maps, agency
  rules about returning calls and pages while in
  car

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Kaleida Health SPHM Programs

• Kaleidas VNA has implemented a SPHM Policy
  Program with Leadership Buy In.
• Formed an Ergo Committee
• Conducted a SWOT analysis
• Began to write a SPHM Policy
• Purchased equipment
• Began training, Buy In and problem solving
• Break the Myth-Educate

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The National Nursing Shortage is Expected to
Increase by 30 by the Year 2020. Will We Still
be Caregivers?

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Kaleida Health SPHM Programs-WNY VNA 120 Years
of Service