PTvisitor

Hello- I am a PT at a small, rural hospital working on implementing a safe patient handling program. Right now our facility has a pretty good culture of safety for both patients and staff but I want to improve the day to day safety for our nursing staff (and other patient care staff) Some of our more challenging areas are in the ED, radiology department, and OB. It seems that many of the nursing staff are too willing to "sacrifice" their own safety for the patients but often times it's just because that's they way they've "always done it". Other times the staff is truly not aware of the safety concerns of how patients are being moved. One of the policy changes that I am pushing for is a #35 lifting limit which will then require short track ceiling lifts in at least some of the ED, OB and radiology rooms as well as a change in or lateral transfers. We will also need some specific algorithms or other assessment tools for nursing staff to use to determine appropriate method of transfer. My questions for you are: 1) What assessment tools to determine safe transfer method do you use (or have used) that have been easy to use, convenient, etc . The VA algorithms look good but is something more general easier to actually use in your day to day work flow? 2) How can I facilitate a change in thought process in our OB and ED nurses so that they will see that safe transfers are good for both them and the patients. 3) What are some ideas to make sure that using the equipment is just as convenient and efficient as not using it. Realistically, equipment does no good when it's too far down the hall to be easily grabbed and used 4) Have you used friction reducing devices such as the Hover Matt? How do you like them? How are they logistically used at your facility? One thought is to have them go out on the ambulances and they would stay with the patient from home to ED to Med Surg- has anyone seen that? 5) What have you seen in radiology departments for safe patient handling? One challenge is that our staff are not really formally educated in transfers and safe handling so they don't always seen the safety concerns. We do inservicing with these departments but it still doesn't seem to be enough. How does the radiology staff know how to transfer a patient in you facility? What if the patients are coming in through the ED or even straight from the community? 6) Anything else you would offer as advice? Thank you! I am fortunate to work in a great facility that already does many things right. I not only consider myself an advocate for the patients but also for my fellow co-workers, so I want to do this right and make sure it's successful.

I scrolled down and was glad to see anatomy coloring books! Very helpful to me as a visual learner,too. Can't recommend them enough. Taking the time to understand WHY things are named what they are can be useful. For example if you know obliquus means roughly "going at an angle" it can help figuring out what is what when looking at a structure in real life. Helps to cut down on rote memorization and improves longer term learning, in my opinion. One of the most helpful things I learned in undergrad was in a psych class called "Learning and Memory" and that is that the REPEATED RECALL of information is more important than the cramming into your brain :) How that helped me study is that I would spend more time drawing out structures like the brachial plexus, branches of the arterial system, etc and forcing recall of the names as I drew them. It really helps to focus your studying to only the things you can't recall and not waste so much time on the things you already know. At the beginning of the exam I would quickly draw out my diagrams to refer to as I took the test.

Boy- it does sound like increased staffing would really help in your situation Some of the things that lowered falls at our facility were : EVERYONE on staff asks "is there anything I can do for you before I leave". This could be anything from repositioning in the recliner, getting a glass of water, getting a patient's comb, finding a specific tv channel etc. This can free up time for the nursing staff by lessening the running around to answer call lights for little things. It also can alert the nursing staff to pain or need to toilet before the patient tries to get up on their own so we can be more proactive and less reactive (also improves patient satisfaction) Our housekeepers check each room as they clean for turn-over and make sure there is a gait belt in the side table drawer. That has been a life saver for those times the patient is getting up out of bed and you know they're unsteady but you can't really leave the room to find a gait belt either.

Thank you for your reply. Our facility has been considering a transition to EPIC and I did like the ease of transfer of information from the ancillary notes to the nursing side. It is my impression that the nursing care plan on the electronic record would be the "legal" document and that the paper kardex would be more of an informal tool used by the nursing staff for hand off communication and guiding care throughout the stay. Do the nurses typically create the kardex from the electronic care plan along with their own assessments, observations and such? I am not really familiar with this part of nursing practice so don't want to make a suggestion to our RNs that is completely off base. Is it common practice for the nurse to review the notes of the other team members daily (on med surg)? I wouldn't imagine the RN could read every note entirely at each shift but a summary of each discipline? Or just when there is an issue or concern to be clarified? I have done my share of educating physicians as to how to access my notes so I can feel your pain there :) We spend soooo much time documenting it is a shame no one reads our notes lol I am fortunate to have such close communication with all the team members on a daily basis. Being at a small facility has a big advantage that way. Fewer chances for things to slip through the cracks when everyone has the mind set that "the buck stops here" with safety, discharge planning, etc. Also, I am very new here but want to extend my condolences to all of you that have been grieving over the events of the last week. This community is obviously a blessing to many and I pray for comfort for family, friends and this community.

Hello- I am the lead inpatient PT at a small CAH. Our patients are primarily med/surg and swing bed patients. I have been looking online for resources regarding interdisciplinary care planning, best practices for hand off communication between disciplines etc. This forum seems to be very active with lively discussion :) so I'm hoping for some ideas and recommendations that have worked for others. Our facility uses an EMAR with PT/OT documenting electronically as well as adding to the nursing care plan electronically. Many of the nurses prefer using the kardex and therapies typically write the care plan there as well. Additionally, we update the white boards in patient rooms with the pt's current level of mobility, need for assist, recommendations for ceiling lift etc. Each discipline's daily documentation has a section that carries over to the nursing multidisciplinary summary for ease of access to the nurses, physicians and other providers. If there is some extremely critical information that I feel the nurses should be aware of I have the option of documenting that in the nursing assessment section so it will definitely be seen by the RN. In general, therapies at our facility have a good relationship with the RNs, CNAs, physicians and other providers so there is a lot of face to face communication individually as well as a daily team meeting with all disciplines represented. I feel very blessed to be working in a facility with such good communication because I know it is quite rare. However, I feel that some of the documentation tends to be redundant and I would like to pare it down a bit. It is quite time consuming and difficult to make sure all of the places I document are saying the same thing at the end of each day :) Would you mind sharing how this is handled at your facility? Some of my specific questions are: 1) Do the therapists document on the kardex themselves or do the nurses update based on the care plan? Or on face to face reports? 2) Do you have access to the therapy notes and ,if so, what information do you find helpful to you? 3) How detailed are the portions of the care plans initiated by therapy? Or do the therapist even enter items on the nursing careplan?? 4)Anything else that you've found to be helpful as you collaborate with therapies? Thank you!!