safety sitter education
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Safety Sitter Education
Claudette JohnsonManager of Nursing
Support Services
CONTINUOUS OBSERVATION
Provide a safe environment for patients whose physiological, mental and behavioral status puts them at
risk of harming self and others.
Used for patients:
suicide, 5 point restraints & behavioral risk
ROLE OF OBSERVATION ASSISTANT
Monitor patient behavior & safetyProvide safe environmentProvide reassurance and redirectionPrevent Falls and Injury
Keep patient:safe, engaged, in control, dignified
OBSERVATION ASSISTANT DOS AND DON’T
CAN
Ambulate steady gait patients
Set up trays
Unplug IMEDS only if directed by Nurse
Talk and calm patient down
CAN NOT
Ambulate unsteady patients
Feed patients
Touch IMEDS without nurses' direction
Hold a patients arm down (staff should use mitts or medicate patient)
Know that PCTs who are sitting can provide PCT care.
The nurse will need to update sitter for any changes.
Sitters will be passing information to each other
REASON FOR CHANGE
Focus on
patient
recovery
Utilize OA efficiently
Patient safety
Cost effectivene
ssTherapeutic presence
BENEFITS
Keep patient safe
Keep patient and family engage
Keep patient in control
Facilitate patient Recovery
Utilizing OA efficiently
WHO WILL BENEFIT
Family
Staff
PATIENT
HANDOFF
STAKEHOLDERS
Wrong treatment
Delay in Diagnosis
Adverse events
Patient dissatisfaction
Increase hospital cost
Increase length of stay
I N E F F E C T I V E
HANDOFFS
Leadership
Patient
Staff
RESOURCES
COMMON HANDOFF ISSUESCAUSES OF
FA ILURE
Ineffective Methods
Time constraints
Change
Lack of focused research on healthcare and handoff
Lack of Efficiency
Lack of commitment
CAUSES OF SUCCESS
Open to change
Understand purpose of Change.
Preparedness and education
Commitment to making a difference
Management Support
Up-to-date information on the following:
Diagnosis, Care, Condition and ChangesLimited interruptionsSufficient time allocatedProcess for verification- repeat
back read back
IMPLEMENTATION
NURSE-SITTER TOOL
to improve safety as well as patient and staff satisfaction. Purpose
Patient: Room # _____ Date ____Shift______Hand off information for any sitter will include:What is wrong with patient? ____________________________Why do they need a sitter? _____________________________Diet/ fluid restrictions: _________________________________Activity- independent or with assist ______________________Specifics about their care ______________________________Time for their meal breaks, what time they are expected back - SPECIFIC TIME _______________________________________Who will relieve them for their break? ____________________Phone number: Charge: Break Relief: ____________
OA/PCT Signature:________________ Date:____________
SITTER HANDOFF GUIDELINES
Hand off information for any sitter staff will include:
1) What is wrong with patient? Why is a sitter needed? (Hip replacement but is sun downing tries to get out of bed after 7 pm)2) Diet/ fluid restrictions (NPO, 1 cup of water every shift)3) Activity- independent or not (can get up by himself, can get up safely with walker)4) Specifics about their care (examples: quick with hands must watch IV or Foley, bolts out of bed, confused, watch for visitors)5) Time for their meal breaks, what time expected back -MUST be a SPECIFIC TIME (not 1 hour from now but instead 0445)6) Who will relieve sitter for their break (Julie, PCT and her phone # is____) - OA for suicides have to watch the patient at all times and should not be standing by the door looking for help.
WHAT IS ASSERTIVENESS
I T IS NOT…
Aggressive
Hostile
Confrontational
Ambiguous
Ridiculing
PILOT STUDY
Begins February 08 to March 08,
2011Forms available in
the Float Pool room
Send completed sheets to
Claudette JohnsonQuestions: call Claudette at
x.7959
Survey to assess the success of the PILOT STUDY
Survey
For:
all OAs random RN/ PCT
Deadline:
October 1, 2011
Return to:
Claudette Johnson
3W
ChangeFor
Safety
And more importantly,
change for our
Patient
REFERENCES
Agency for Healthcare Research and Quality (2005). 30 safe practices for better health care: Fact sheet. Retrieved March 19, 2011, from
http://www.ahrq.gov/qual/30safe.htm
Institute of Medicine. Committee on Quality Health Care in America. (2000). Errors in health
care: A leading cause of death and injury. In L. Kohn, J. Corrigan, & M. Donalsdson (Eds.) To Err Is Human: Building a Safer Health
System. Washington, D.C: National Academy Press.
Joint Commission on Accreditation of Healthcare Organizations. (2008). 2009 national patient
safety goals [electronic version]. Joint Commission Perspectives, 28(7), 12. Retrieved March 19, 2011, from
http://www.jcrinc.com/common/PDFs/fpdfs/pubs/pdfs/JCReqs/JCP-07-08-S1.pdf
Northwest Community Hospital (NCH), (2011). Nurse- Sitter handoff tool.
Nothwest Community Hospital. (2011). Pre-assessment of sitter needs survey.
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