Adolescents and Health
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Transcript Adolescents and Health
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About me
Started as housekeeper in a nursing home
Progressed from CNA, LPN, RN, BSN, MSN, CNE
Restorative Nurse, Staff Development, ADON
Graduate work in nursing education with focused
projects and thesis on back injuries in healthcare
workers
Currently direct a Nurse Aide Program, teach in a BSN
program, staff education consultant, small business
owner
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My Interest
Specifically interested in back injuries because of
family history
Responsible for staff and student training in body
mechanics
Professional curiosity about nurse aide back injuries
as an understudied population sparked graduate
school research
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Purpose
Discuss current research into occupational
injuries in nursing and graduate research
Strategies for injury prevention including staff
and student education
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Statistics
Nurse aides, orderlies and attendants are the 2nd highest occupation
for MSD’s and RN’s are 5th (Dept of Labor 2006)
Rising rates of overweight and obese pts. are compounding problem.
In 2007–2008, about one-third of adults were obese and about
two-thirds were overweight or obese (CDC 2010)
CNAs may be at greater risk for injury than RNs (Li, Wolf, & Evanoff,
2004)
Nature of their work
Lack of empowerment
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American Nurse Association Statistics
ANA estimates 12% of nurses leave annually r/t back
injuries
Nurses use 30% more sick leave annually due to back
pain when compared to the general workforce
Over 52% of nurses complain of chronic back pain and
38% of the nursing workforce has been affected by
back injuries
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My Research
Survey sent out to nurse aides in Colorado
Gathered information on
-Demographics
-Employment
-Dichotomous and Likert style questions about
injuries, training, equipment and facilities
-Open ended question asking what CNA
perceived as the hardest part of their job
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Findings
46% reported having hurt selves while lifting, moving, or
helping a patient
40% reported having hurt back while lifting, moving, or
helping a patient
78% of those reporting back injuries were working in nursing
home at time of injury
CNA workplace training: M=3.23
CNA school training: M=3.69
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Findings (cont.)
Training on back injury prevention received at work and
school but not applied
Meaningful proportion (43%) noted that hardest aspect of
their jobs were….
Having too many patients and/or not enough help
Poor communication
Being “looked down on” by nurses, having poor relationships
with nurses with whom they worked
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Implications
Work-related injury, especially back injury, is an important
issue in work life of CNAs
Culture change needed; easier to “put up”
than get help or complete necessary paper work
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Implications (cont.)
Staffing implications
Owning own role in less than ideal CNA-Nurse working
relationships
On-going prevention education needed
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Contributing factors to MSD
Quick movements, repetitive movements
Combative patients
Long work hours and overtime
Work schedules
Staffing shortages
Heavy lifting, bending and twisting
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Evidence-Based Interventions and
Challenges
Patient handling equipment
No-lift Policies
Training on proper use of equipment and
devices
Lift teams
Ongoing education
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Patient Handling Equipment
Hi/Low beds, mobile lifts, ceiling mounted lifts, lateral
transfer aides
Challenges
Cost
Staff training
Time
Equipment selection for each patient
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No-Lift Policies
Use of equipment to move patients to reduce manual
lifting
Challenges
Putting equipment in place before policy is implemented
Time
Staff buy in (Nonpunitive approach)
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Training with Equipment
Ongoing training in the use of equipment and devices
Challenges
Training staff across shifts, staff turnover
Reinforce training
Training on equipment only used sporadically
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Lift Teams
“Two physically fit people, competent in safe lifting
techniques, working together to accomplish high-risk
patient transfers.”
Challenges
Logistics of providing a team 24/7
Cost
Managing workload
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Ongoing Education
Annual body mechanics reviews
Challenges
Education alone has proven ineffective for MSD safety
Qualified instruction and return demonstration is key (ideal
to spot check workers on the job)
Consistent training for new employees and f/u within first
90 days
Training to specific patient needs is difficult
Modeling behavior by peers
Cost
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Emerging Interventions and
Challenges
After-action reviews
Clinical tools
Peer leaders
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After-Action Reviews
Ways for health care providers to learn from their
own mistakes as well as mistakes of others
Challenges
Support and timely response by management
Time constraints
Staff fear and embarrassment
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Clinical Tools
Patient assessment tools to standardize ways to assess
patients and decide on appropriate lifting and care
techniques
Challenges
Staff training (turnover, reinforced over time)
Integration into routine processes (admissions, COC)
Communication between staff
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Peer Leaders
Specially trained staff who works on-site with staff to
make practice changes and improve safety
Challenges
Incentives
Support and timely response by management
Choosing appropriate peer leaders
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Helpful Work Practices
Assess patient and yourself
Eliminate or reduce manual lifting when possible
Get help and ask patients to help
Mentally plan
Good working height
Check equipment
Proper body mechanics
Use your legs, keep patient close
Do not twist when turning (pick up or pivot feet)
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Make Education Count!
Modeling behaviors
Ongoing training and assessment
Return demonstrations (with real
patients)
Positive reinforcement system
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Help!
Facebook- Injured Nurses Network of America
Nurse and Health Care Worker Protection Act of 2009
(S.1788)
Full text
http://www.govtrack.us/congress/billtext.xpd?bill=s1111788
ANA- http://www.anasafepatienthandling.org/
Work Injured Nurses Group (WING)
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S. 1788 Summary
Nurse and Health Care Worker Protection Act of 2009 - Requires the Secretary of Labor to propose a
standard on safe patient handling and injury prevention to prevent musculoskeletal disorders for directcare registered nurses and all other health care workers that requires the use of engineering controls to lift
patients and the elimination of manual lifting of patients through the use of mechanical devices, except
where patient care may be compromised. Requires health care employers to: (1) develop and implement a
safe patient handling and injury prevention plan; (2) provide their workers with training on safe patient
handling and injury prevention; and (3) post a uniform notice that explains the standard and the
procedures to report patient handling-related injuries. Requires the Secretary to conduct unscheduled
inspections to ensure compliance with safety standards. Allows health care workers to: (1) refuse to accept
an assignment in a health care facility that violates safety standards or for which such worker has not
received required training; and (2) file complaints against employers who violate this Act. Prohibits
employers from taking adverse actions against any health care worker who in good faith reports a violation,
participates in an investigation or proceeding, or discusses violations. Authorizes health care workers who
have been discharged, discriminated, or retaliated against in violation of this Act to bring legal action for
reinstatement, reimbursement of lost compensation, attorneys' fees, court costs, and other damages.
Requires the Secretary of Health and Human Services (HHS) to establish a grant program for purchasing
safe patient handling and injury prevention equipment for health care facilities.
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Success Stories
San Francisco General Hospital- Lift teams and equip
Camden Nursing Home (Maine)- Lifts
Kennebec LTC (Maine)- Lifts, assessment tools, gaitbelts,
comprehensive training, safety rewards
Six LTC facility cohort study
6 facilities, 1728 participants, 6 year pre-post intervention
Equipment, zero lift, training (45 minutes-2 staff, return demo on
residents)
73% reduction in workers’ comp claims
Equipment and training expenses recovered in less than 3 years
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Personal and Professional
Interventions
Presentation of research findings at nursing conferences,
webinars
Discussion of findings with students, peers, colleagues, friends
and family
Student training, modeling, and reinforcing behaviors
Assist with local facilities -annual training, return demos
Formation of Occupational Training Solutions (OTS) to produce
a product that could be used to prepare and retrain safe and
competent caregivers
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Basic Nursing Training
Supplements
Product Development
Basic Care Skills for Nurses and Nursing Assistants
More than 50 skills are covered on 5 DVD’s in this OTS Basic Nursing video series.
Demonstrating basic nursing care from real nurses on real people
Videos are divided into easy to follow modules. Additional learning resources and assessment
tools are included in our package.
Each skills video includes:
Clear and concise skills demonstrations
Modeling of compassionate interactions between caregivers and patients
Bonus instructional features with tips on “Things to Remember” and “Things to Report” when
caring for patients
Safe and competent care tips throughout each video
Proper lifting and back safety techniques modeled throughout. Module of 8
different transfer techniques included
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Thank you!
Questions? Email me!
Patricia Graham
[email protected]
Product Information at
www.basicnursetraining.com
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