American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org 23 rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ 1 Safe Patient Handling Among Pediatric Burn Patients: A Collaborative Movement C. Robert Bennett CCRN, CPNP-AC Pediatric Nurse Practitioner Maricopa Integrated Health System Debra Pope PT Physical Therapist Maricopa Integrated Health System Disclosure Information I have no disclosures Accreditation Statement APSNA is an approved provider of continuing nursing education by NAPNAP. The NAPNAP contact hours is accepted by ANCC. Objectives • Describe the impact of occupational injuries in health care. • Review definition of high risk patient handling tasks. • Discuss the importance of safe patient handling practices for pediatric burn patients. • Describe the implementation of Safe Handling Practices.
Transcript
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
1
Safe Patient Handling Among Pediatric Burn Patients: A Collaborative Movement
C. Robert Bennett CCRN, CPNP-AC Pediatric Nurse Practitioner Maricopa Integrated Health System Debra Pope PT Physical Therapist Maricopa Integrated Health System
Disclosure Information
I have no disclosures
Accreditation Statement APSNA is an approved provider of continuing nursing education by NAPNAP. The NAPNAP contact hours is accepted by ANCC.
Objectives
• Describe the impact of occupational injuries in health care.
• Review definition of high risk patient handling tasks.
• Discuss the importance of safe patient handling practices for pediatric burn patients.
• Describe the implementation of Safe Handling Practices.
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
2
Background
• Occupational injuries cause lost work time and attrition from nursing, pose an increased risk for permanent disability.
• Up to 52% of nurses complain of chronic back pain, and 12% of nurses annually leave the profession due to back injuries (ANA, 2009).
• Safe patient handling essential for avoiding musculoskeletal injuries in health care workers.
• During last fiscal year, 13 occupational injuries were reported at the Arizona Burn Center.
Purpose
In the inpatient setting safe patient handling practices may be beneficial for repositioning, lifting, transferring, and mobilizing pediatric patients
A high risk patient handling task is:
• Any patient-care assignment that pushes the limits of human capabilities, including those that require lifting a heavy load, sustained awkward position, bending/twisting when performing the task
• Excessive reaching to get the task done • Tasks of long duration that contribute to fatigue • Tasks that require excessive force on one or
more joints or body parts
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
3
Top 10 myths about Safe Patient Handling
Safe patient handling myths:
• Body mechanics training is effective in preventing job-related injuries
• Back belts are effective in reducing risks to caregivers
• Nurses who are physically fit are less likely to be injured than nurses who are not physically fit
• It is safe to lift a 200-pound patient • Mechanical lifts are not affordable • If a facility buys lifting equipment, staff will
use it
Safe patient handling myths:
• Lifting patients is the only high risk patient
handling task • Injuries to nurses can be prevented by
careful screening of nurses before hiring. • Use of mechanical lifts eliminates the risks
involved in manual lifting • If a facility has a no-lift policy, healthcare
workers (HCW) will stop lifting
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
4
Evidence based standards for safe patient handling and mobility
• Establishing a culture of safety, which includes ensuring safe levels of staffing, creating a non-punitive environment, and developing a system for communication and collaboration
• Implementing and sustaining a safe patient handling and mobility program
• Incorporating ergonomic design principles to provide a safe environment of care
• Selecting, installing and maintaining safe patient handling technology
Evidence based standards for safe patient handling and mobility
• Establishing a system for education, training
and maintaining competence • Integrating patient-centered assessment,
care planning and technology; including safe patient handling in reasonable accommodations and post-injury return to work policies; and establishing a comprehensive evaluation system
Source: ANA, “Safe Patient Handling and Mobility: Interprofessional National Standards”
States where SPH is enacted
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Why Pediatric Burn Patients?
• Pediatric burn patients typically experience prolonged length of stay, and are at risk for complications related to immobility
• Value of safe patient handling in children often underestimated
• Movements may be unpredictable due to pain, post operative state, and use of narcotic medications
• According to the 2010 International Pressure Ulcer Prevalence survey, the two highest risk groups for facility acquired pressure ulcers were Pediatric ICU patients (10.4%), and Burn Unit Patients (9.9%)
Why Pediatric Burn Patients?
• National Institute for Occupational Safety recommends using safe handling practices for children who weigh greater than 35 pounds (Walters, 2007)
• In 2007, National Institute of Health reported one in five children are overweight
• More pediatric patients are becoming “Bariatric”
Then & Now
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Implementation
• System-wide Safe Patient Handling and Mobility program developed at MIHS
• Safe handling policies and program model developed by interdisciplinary team
• Equipment selected and installed in Burn Center during January 2014
• Staff education for proper use of ceiling lift system performed by vending company
• Safe Patient Handling champions available for unit support
• Monthly evaluation to review patient handling injury data
Stakeholder Common Goals
• Facilitate early mobility • Restore physical
function • Prevent complications
associated with immobility
• Reduce risk for patient and staff injury
• Decrease facility financial burden related to patient and workers compensation claims
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Implications for practice
• Safe Patient Handling practices may enhance patient mobility and overall outcomes for pediatric burn patients while decreasing risk for occupational and patient injury; thereby helping children return to childhood quicker, and nurses stay at the bedside longer
Lift Long and Prosper!
Acknowledgments
• Thank you to the Safe Patient Handling Committee at MIHS
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
(2010). The demographics of suspected deep tissue injury in the United States: An analysis of the international pressure ulcer survey 2006 – 2009. Advances in Skin & Wound Care, 23(6), 254-261.
Nelson, A., Motacki, K., & Menzel, N. (2009) The illustrated guide to
safe patient handling and movement. New York, NY: Springer Publishing Company.
ANA. (2013). Safe patient handling and mobility: Interprofessional
national standards (1st ed.). Silver Spring, MD: American Nurses Association.
