co- ena safe work environment updates october 10, 2013 heather finch rn, bsn, cen billie ratliff,...
TRANSCRIPT
![Page 1: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/1.jpg)
CO- ENACO- ENA Safe Work Environment updates Safe Work Environment updates
October 10, 2013October 10, 2013
Heather Finch RN, BSN, CEN
Billie Ratliff, LCSW
Shawna Zautcke, RN, CEN
![Page 2: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/2.jpg)
IntroIntro
• Who we are• Objectives
– Highlights from the ENA Safe Work Env. Intensive held- June 2013
– How we relate or incorporate info
– Workplace Violence and the work done at Memorial-UCH (ED WPV-Task Force)
– Identify current legislative status/future initiatives (Sharon Sperry)
![Page 3: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/3.jpg)
THANK YOU!THANK YOU!
3
ENA Connections, August, 2013
![Page 4: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/4.jpg)
HighlightsHighlights
![Page 5: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/5.jpg)
Presented TopicsPresented Topics
How to manage difficult patients– T.A.C.T. Therapeutic Alternatives in
Crisis Training• Helpful to decrease restraint use in ED• Stresses descalation and behavior
awareness
– Informative to know other programs are available
– Memorial uses CPI
(Mona Kelley, MSN, RN)
![Page 6: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/6.jpg)
Team Safety at the BedsideTeam Safety at the Bedside
• Strong Teamwork– Improve outcomes, patient satisfaction,
staff satisfaction, reduce liability, reduce errors
– TeamSTEPPS™– Communication Tools
• IPASSTHEBATON• SBAR• POLO
![Page 7: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/7.jpg)
Team Safety & Conflict Team Safety & Conflict Resolution Resolution
• Develop safe environment where staff feel comfortable to question safety issues– DESC Script
• D-Describe the specific resolution• E-Express your concerns about action• S-Suggest other alternative• C-Consequences should be stated
– CUS • I am concerned• I am uncomfortable• This is a Safety Issue
![Page 8: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/8.jpg)
Team Safety & CoachingTeam Safety & Coaching
• Defined – A process that enables learning and development to occur and thus performance to improve
• Goals– Help ensure the team has what they
need to be successful• Skills, Knowledge, Opportunities,
Capabilities• Positive, real time feedback, sets them up
for success(Deena Brecher, MSN,RN,APRN,ACSN-BC,CEN,CPEN)
![Page 9: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/9.jpg)
Medication SafetyMedication Safety
• “Most errors result from complexity of healthcare system and not individual recklessness or incompetence”Create safer systemsManage “at risk” behavior
Strategies at Memorial includeRed basketsTwo patient identifiersHigh risk medications checked by 2 RN’sPediatric medications checked by 2 RN’s
(Susan Paparella, RN, MSN)
![Page 10: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/10.jpg)
The Healthy NurseThe Healthy Nurse
• Compassion Fatigue
• Healthy work environment
• Human Error
• Just Culture
• Transformational Leadership(ENA Topic Brief, February2013)
![Page 11: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/11.jpg)
Risk AnalysisRisk Analysis
• Reviewed Methods of Risk Analysis
– Proactive Risk Assessment (PRA)– Root Cause Analysis (RCA)– Apparent Cause Analysis (ACA)
(Kathy Szumanski, MSN,RN,NE-BC)
![Page 12: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/12.jpg)
Liability Risks of Emergency Liability Risks of Emergency NursesNurses
Risk Control StrategiesRisk Control Strategies• Scope of Practice• Documentation• Communication
• Increased monitoring for patients– Administered pain meds– Psychiatric crisis– Return within 24, 48, 72 hrs
![Page 13: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/13.jpg)
Our Story…Our Story…
• Our Journey• Dept – Central, CU4, North ED• Basic staff makeup/ basic
organizational structure
![Page 14: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/14.jpg)
ED WPV Task ForceED WPV Task Force
14
![Page 15: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/15.jpg)
IntroductionIntroduction• Definition
– “Any act of aggression , physical assault, emotional or verbal abuse, coercive or verbal abuse, coercive or threatening behavior that occurs in a work setting and causes physical or emotional harm.” (ENA, 2010, Emergency Nurses Association position statement).
![Page 16: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/16.jpg)
StatisticsStatisticsNurses are 3 times more likely to experience
violence than any other professional groupHealthcare workers are more likely to be
attacked at work than police officers or prison guards (NIOSH, 2002)
Healthcare workers suffer 4 times more non-fatal assaults than the private sector (US Dept of Labor Statistics, 2001)
Estimated that 70% of violent events in health workplace are underreported (Luck, Jackson, and Usher, 2007)
![Page 17: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/17.jpg)
Who we are…Who we are…
Interdisciplinary team includes:
Employee Health, Safety, Security, ED Central (RN and Tech), ED North (RN), Behavior Health, ED Team Lead, CNS, FNE, ED physician champion, Risk & Quality/Regulary –support
![Page 18: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/18.jpg)
The Big PictureThe Big Picture
18
![Page 19: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/19.jpg)
PurposePurpose • Mission of ED Workplace Violence Task Force
– Support overall employee health and well-being with a focus on workplace violence Prevention, Recognition, Response, Reporting and Recovery
• WPV FOCUS FOR 2013 - TYPE II
– **Patient to Staff – Staff to Staff– Visitors to Staff
![Page 20: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/20.jpg)
Drilling down…Drilling down…
21
![Page 21: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/21.jpg)
Goals…Goals…
• ST GOAL – improve WPV incident/injury reporting in the EDs (rationale – need accurate reporting data in order to develop effective interventions).
• LT Goal – use improved reporting data to develop effective interventions aimed at helping staff be better prepared to prevent, manage and respond to WPV as well as reducing WPV
![Page 22: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/22.jpg)
Plan…Plan…
• Pre-Survey (22 line-item survey monkey)
• Education – 90 day– Define, Zero tolerance/support,
Reporting process, addressing barriers, – Huddles, email, CBT
• Post- Survey
23
![Page 23: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/23.jpg)
TimelineTimeline
![Page 24: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/24.jpg)
Additional InterventionsAdditional Interventions• Following up on reports…• Communication with police re:
reporting• Safety Alerts• Data trending to include incidents
not just injury– Consolidating data….
25
![Page 25: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/25.jpg)
Preliminary Survey InfoPreliminary Survey InfoSurvey Pre- June Post-Sep
Respondents 96 106
Define WPV –verbal 85% 92%
Define WPV- Physical 98% 99%
Define WPV-Bullying/har
76% 84%
Exp Verbal in past 3 mo
75% 68%
Unreported 53% Data still pending
Exp Phys in past 3 mo
34% 19%
Unreported 39% Data still pending
Not sure if Zero toler policy
25% 12%
Is leadership commited?
65% 87%26
![Page 26: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/26.jpg)
Reporting dataReporting data
• Still pending….• Anecdotally…..reporting incidents
via our internal quality reporting system increased.
27
![Page 27: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/27.jpg)
Next Steps…Next Steps…
• Resiliency• Lateral violence• Trend reporting• Modify reporting form• Expand work to other units
28
![Page 28: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/28.jpg)
29
A word from Sharon…A word from Sharon…
Legislation Future intiatives
29
![Page 29: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/29.jpg)
30
Questions?Questions?
30
![Page 30: CO- ENA Safe Work Environment updates October 10, 2013 Heather Finch RN, BSN, CEN Billie Ratliff, LCSW Shawna Zautcke, RN, CEN](https://reader035.vdocuments.net/reader035/viewer/2022062422/56649efe5503460f94c13a1e/html5/thumbnails/30.jpg)
3131