Regional Nursing Services. When Theory Turns To Practice Lisa Russomanno, Operations Manager Lela Fishkin, Nursing Supervisor

Transcription

1 Regional Nursing Services When Theory Turns To Practice Lisa Russomanno, Operations Manager Lela Fishkin, Nursing Supervisor

2 Who We Are Regional Nursing Services has provided top quality home health care for over 25 years. Accredited by CARF Canada Contracted care provider to the Central and Central West Community Care Access Centre Contracted care provider to the Regional Municipality of York Proud Members of the OHCA and CHCA

3 Continued Service providers in the GTA, York Region, South Simcoe and Peel Region Canadian owned and regionally based Dedicated to maintaining the highest standards of home health care to consistently meet or exceed your needs and expectations

4 Continued Services provided include but not limited to ; Personal Support Workers Nursing (RN and RPN) Homemaking Physiotherapy Occupational Therapy Speech Language Pathology Social Work Case Management Discharge Planning

5 COMING SOON.. RNS Health & Wellness Centre Focus on your health today for a better tomorrow Where health is the destination, wellness is the journey * Dr. Jim Nicolai Our Expertise: Physiotherapy Kinesiology Registered Massage Therapy Chiropractor Active Rehabilitation Acupuncture 483 Holland St. West, Unit 1, Bradford, Ontario, L3Z 0C1 T F E [email protected]

6 Client #1 Client in his 70 s Resided with his spouse & son Recent decline in health status Returned home on Home First Program Was receiving home support, nursing, physiotherapy, & occupational therapy Was mentally capable Active LTC referral

7 History of Falls 1 st Fall Reported by family attempt to get out of bed in the middle of the night without assistance Care Providers not aware 2 nd Fall May have slipped out of bed onto the floor limited bed mobility PSW Agency and son reported fall to CCAC OT Involved from hospital d/c until a few days prior to call reporting the falls PT Scheduled to begin day after falls reported

8 Investigation Five weeks after discharge from hospital, patient was found dead at home Cause of death external pressure to the neck causing asphyxiation Identified as a preventable death

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11 Learning From Experience Restraints and/or Entrapment Devices Safer option for this patient Family not educated about managing patient s risk of falls

12 Continued Root Cause Analysis for System Improvements Patient s son, CCAC and service providers participated Opportunities for improvements were identified: Equipment best practices, restraint alternatives, risks associated with the use of restraints Communication Education

13 What Else Did We Learn? There is no consistent definition for restraints No legislation governing home health Not enough quality education available to different disciplines

14 So What Did We Do? RNS conducted a thorough review around restraint education Findings = there is not enough quality education available to the different professional streams RNS reviewed internal Policies

15 More Actions Immediate Actions Taken by RNS De briefing of employees involved with the first patient Memo was written and sent out by mail to all employees Memo was also verbally broadcasted into RNS internal system to ensure all employees received the message Subject of restraints was incorporated into quarterly Meet and Greets

16 Revised Orientation to include the subject of Restraints Revised the Home Risk Analysis to include the use of restraints Implemented an Acknowledgement Form for clients/caregivers to sign off on

17 Did Our Efforts Succeed? 2 nd Client Story RNS PSW read the memo and heard the broadcast As a result, PSW contacted RNS Supervisor regarding a client who was being restrained in bed by family RNS Supervisor immediately conducted a Home Visit, met with the family and explained to them the implications regarding the use of restraints Supervisor also notified CCAC CC, QRS was initiated by RNS

18 Second Client Story CCAC Care Coordinator was able to contact and meet with the family and arranged an OT visit within 2 days Alternative safety measures were implemented. The client is now safe without the use of restraints

19 Different Outcome What was the difference between the 2 outcomes? Education Communication Multiple conversations on risks of restraint use with family Potential adverse event was prevented

20 In Closing Elements of success: Teamwork Education Eyes & Ears Communication

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