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Safety Sitter Education. Claudette Johnson Manager 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:
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Safety Sitter Education Claudette Johnson Manager 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
Observation Assistant Dos and Don’t CAN CAN NOT Ambulate unsteady patients Feed patients Touch IMEDS without nurses' direction Hold a patients arm down (staff should use mitts or medicate patient) • Ambulate steady gait patients • Set up trays • Unplug IMEDS only if directed by Nurse • Talk and calm patient down 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
Handoff Stakeholders INEFFECTIVEHANDOFFS • Wrong treatment • Delay in Diagnosis • Adverse events • Patient dissatisfaction • Increase hospital cost • Increase length of stay
Common handoff Issues Causes of Failure Causes of Success Open to change Understand purpose of Change. Preparedness and education Commitment to making a difference Management Support • Ineffective Methods • Time constraints • Change • Lack of focused research on healthcare and handoff • Lack of Efficiency • Lack of commitment
Implementation • Up-to-date information on the following: Diagnosis, Care, Condition and Changes • Limited interruptions • Sufficient time allocated • Process for verification- repeat back read back
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 IT IS NOT…
Change For 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.
