safety sitter education task force september 30, 2012 all about safety sitters
DESCRIPTION
Definition: A safety sitter is an individual trained to observe and sit with a patient to keep them safe A safety sitter may be an Observation Assistant (OA) or a Patient Care Technician (PCT). PCT safety sitters should perform functions of a PCT for the patient they are sitting for For the purposes of this training, we are not referring to sitters used for : – suicide precautions or – behavioral restraints in the inpatient setting Safety SittersTRANSCRIPT
Safety Sitter Education Task Force
September 30, 2012
ALL ABOUT SAFETY SITTERS
The learner will be able to…1. Identify what actions should be taken prior
to requesting a safety sitter2. State how to request a safety sitter3. Familiarize and utilize strategies to keep
patient safe
Objectives
Definition: A safety sitter is an individual trained to observe and sit with a patient to keep them safe
A safety sitter may be an Observation Assistant (OA) or a Patient Care Technician (PCT).
PCT safety sitters should perform functions of a PCT for the patient they are sitting for
For the purposes of this training, we are not referring to sitters used for :– suicide precautions or – behavioral restraints in the inpatient setting
Safety Sitters
To provide strategies in addressing the increasing need of safety sitters
To inform staff of available resources in addressing the safety needs of patients
To efficiently use our sitter resources
Purpose of Safety Sitter Education
A Safety Sitter Algorithm has been created as a reference to guide staff in identifying patients needing safety sitters
The algorithm, policy and resources are available on the intranet site under:
Contents Safety Sitter The following slides will highlight key points
in the algorithm
Safety Sitter Algorithm
The initial steps in using the algorithm involve determining patient’s behavior.
The nurse will: ~ Assess the patient and attempt to identify the cause
of the behavior ~ Address the cause with an appropriate intervention ~ Notify the Administrative Supervisor if suggested
strategies are ineffective
Safety Sitter Algorithm
Safety Sitter Algorithm
There IS an improvement in
patient’s behavior– Collaborate with the
doctor and charge nurse– This may involve
additional diagnostic testing, a MET or even a transfer to a more appropriate unit
This is NO improvement in patient’s behavior
– Initiate appropriate strategies to keep patient safe
– Use your resources– Consult with families to
see if they can be of assistance
– Offer private sitters if needed
Addressing Patient Condition
Strategies to Keep Patient Safe
Use of Delirium Protocol
The Delirium Protocol is an excellent resource to assess patients who may be developing delirium. It should be used for:
– Assessing patients at risk for development of delirium– Identifying possible precipitating factors for development of delirium
and possible nursing actions– Identifying appropriate interventions for prevention/treatment of
delirium Comfort and Spirituality Meals and hydration Mobility Communication and orientation Relaxation and Sleep Medication Management
Highlights of Delirium Protocol
Encourage family participation Offer religious objects and reading
materials Prevent or treat constipation
and/or urinary retention Offer toileting every 2-3 hours Provide companion and assist with
feeding and meals Use relaxation activities- activity
cart, breathing techniques, music, hand massage, Sleep promotion, non-medication alternatives- music
Orient to the environment- use reminiscence, life review & conversation. Review “Who Am I”
Use of stuff animals for the elderly
Early mobilization and regular exercise as medically allowed
Pain assessment Range of motion exercises 3
times daily for bedrest patients Allow patient participation
Ensure hearing aides and glasses are used and in working order. Offer hearing enhancer or magnifiers.
Consult with physician about appropriate medication management
Consult with pharmacy regarding medication interaction
Consult with Geriatric APN – Julia Knight
Highlights of ProtocolsRounding
& Pain Management
Culture of caring - 4 PsPain- Assess pain and medicate PRNPotty- Offer toiletingPosition patient every 2 hoursPresence
Fall Prevention
Assess patient risk Identify patient at risk Use of yellow socks Call light accessible Bed alarm as
necessary
CIWA/ DT PatientsCIWA/DTPatients
Highlights of Protocols
Purpose: provide direction and medication management of patient in DTs
Highlights~Medicate every 2 hours~Follow CIWA protocol
Purpose: provide companionship and diversion for patients
Highlights~ call x. to request for
AAT visit~Follow AAT guideline on
what is appropriate~ no visit with isolation
patients
Animal Assisted Therapy
Sleep Enhancement Protocols
Patient Activity Progression Protocols
Highlights of Protocols
Purpose: assist patients in promoting relaxation conducive to sleep
Highlights~ Use of music~ Promote a quiet
atmosphere~ Medication, if appropriate~ Bath/Backrub at night~ Warm milk
Purpose: Increase activity to avoid boredom and relieve restlessness
Highlights~ ambulate when appropriate,
if restless~ restless in bed- get patient
up to a chair
Purpose: Provide diversion activities to occupy patients time
Locations- Each unit has one. refer to each unit for location
Purpose:Provide warmth and comfort
Follow thermoflect policy
Highlights of ResourcesUse of Care /Book
CartsUse of Thermo-flect
Blanket
Families are an untapped resource Families can be brought in to assist in
keeping their loved one safe– Families are familiar with patient routines at home and may
know strategies to keep patient calm and safe– Familiar voice or face can be calming to patients
Families can hire outside assistance and use an Agency Sitter (List on the intranet)
Role of Families
Unit Charge Nurse Unit Manager Unit CNS/Clinical Educator Unit GRN (Geriatric Resource Nurse or Gero Certified RNs) Geriatric APN (Julia Knight x. ) Consult with Pharmacy (x. ) Consult with Mental Health (x. ) NICHE Module Safety Sitter Intranet Site (Intranet->Content-> Safety Sitter
education) Administrative Supervisors (x7933) Safety Sitter Education Task Force Members
Unit Resources
When the Administrative Supervisor (AS) is called, they will consistently ask:
– Patient behavior– Intervention Attempted– Family available– How will you keep patient safe if sitter is not available
The AS can help determine if an NCH sitter is available
Role of Administrative Supervisor
If a sitter is provided, the unit will have give sitter report:
– Nurse must give sitter handoff sheet to sitter and give report to sitter on details outlined on the sitter handoff sheet
– Identify PCT resource for sitter for sitter breaks and other issues
– Provide extension number for charge nurse and patient’s nurse to sitter
– Round on patient every hour
Sitter usage needs to be reassessed every 2 hours
Notify supervisor of changes in sitter need
Safety Sitter IS Available
If a sitter is not available, the unit will be asked to:– Ask family to stay with patient– Assign own unit PCT or rotate watching patient.– Consider strategies & diversion activities– Consider Bed alarm, mitts and other device– Consider use of restraints as last alternative
Safety Sitter IS NOT Available
Scripting Guide for Staff
Conclusion
Contact your leadership or
Safety Sitter Education Task Force
QUESTIONS
Thank you for your commitment to improve patient care by effectively utilizing staff,
maximizing use of our resource and more importantly, keeping our patients safe.
10.21.12