Clinical Project on Ceiling Lifts - Assignment Example

Assignment 2: Request for Proposal for Clinical Project ------------------------------------------------------------------------------------------------ From: (Project Lead): __Mary Jacob__ TO: Client/ organization/service unit Client Name Contact numbers My work place Director Introduction During the past two years of my practice as a nurse at a long term care facility, I was able to realize the significance of introducing newer techniques to transfer patients and need for educating the staff regarding body mechanics and safety of both the residents and staff. Statistical data from the organization reveals that the number of staff absentees due to musculoskeletal injuries and related ailments increased up to 32% (Facility’s statistical data, 2010). Within the last two years, number of staff seeking medical and surgical treatments for knee and back injuries increase day by day. The already existing staff shortage has worsened just because of unavailability of proper equipment and lack of knowledge to handle the existing ones and body mechanics. The residents and families are also concerned about staff shortage in the facilities, as this would result in the residents are not receiving quality care. I propose to introduce the new ceiling lift at our nursing home. Project Purpose Statement Installation of ceiling track lifts systems to replace the mechanical lifts in the nursing home. The ceiling lifts are used to lift patients from bed, chair or any other resting place. The ceiling track can as well be installed at homes and consist of lift motors. They travel along a mounted track on the ceiling. The portable lift ceiling motor is less expensive compared to permanent ceiling lift attached to the track. The installation charges are lower if the tracks are installed in more than one room. If the installation is to be done at home, installation fee will be cheaper if the tracks are installed where the clients frequently visits. The portable ceiling lift are preferred because they are light, small and disconnecting from tracks is easier and fast (Motion Specialities, 2013). The ceiling lifts project will require a reasonable budget for purchasing the equipment and installation. The finance can be obtained from my business profits, savings, borrowing or loan from a financial institution. Mechanical lifts require two caregivers and if only is present it may cause serious injuries when transferring the patient. Most mechanical lifts have led to civil lawsuits due to malfunction or improper use. The ceiling lift systems will decrease injury cases and reduce maintenance fee. Background (Supports the Strategic Decision, builds evidence professionally and articulates context) Most hospitals have opted to installing ceiling lifts. The ceiling lifts have been come common especially when new buildings are built. The main advantage of ceiling lift system is simple and fast to move and transfer patients on horizontal direction. The other advantage is that the ceiling system track does not occupy any floor space and still work efficiently on small washrooms and bathrooms (T.H.E. Medical, 2002). Benefits of ceiling to the patient include: 1. Reduced bruises and skin injuries 2. Reduced dislocation and falls 3. Comfort and safety guaranteed 4. Satisfactory and quality care Benefits of ceiling to the caregivers include: 1. The care givers are motivated hence morale increase 2. Less injury cases 3. Muscle fatigue and pain reduction 4. Age is not an issue 5. A caregiver who is pregnant or injured can still attend to the patient 6. The caregiver has more energy at the end of each shift Benefits of ceiling to the employers include: 1. Resident safety 2. Less staff injuries 3. Less lost days 4. Less sick leave and overtime 5. Good retention of caregivers 6. Less restricted workdays (Collins, Nelson, & Sublet, 2006) The environmental scan shows that the ceiling lift systems are used by nurse managers, nursing home owners, safety and health professionals, administrators, and workers to attend their patients both at home and institution. Governments all over the world came together and scanned the environment on ways which they can ensure patient safety and proper handling of patients. The following sectors were part of the campaign: 1. Nursing homes 2. Hospitals 3. Pre- hospital medical services 4. Home healthcare 5. Hospice 6. Home care. A study showed that health institutions with no patient lifts lead to patient injury, extra expenditure due to lawsuits, time loss and low staff turnover. Nursing homes with no lifts expose the nurses to musculoskeletal injury or disorder which are mostly related to patient handling. Safety & Health Assessment & Research for Prevention (SHARP) is supporting this project to ensure zero resident handling disorders since 2001. This project is termed to solve and achieve short and long- term goals (Washington State Dept. of Labor & Industries). The table of Budget for this proposal is charted in Appendix A. Time plan for implementation of the proposal Appendix B (The Occupational Health & Safety Agency for Healthcare in BC (OHSAH), 1999, p. 5) The proposal to introduce the ceiling lifts is expected to be accomplished in a time frame of 6-8 months including the time for planning .This time period can be allocated into various ‘phases’ or segments.(OHSAH,199,P: 5).Initial stage starts with the time for forming the team to pilot the ceiling unit with the proposed number of members. The second phase will focus on initiation and improvement of information (‘knowledge’) facets. ‘Development of communication’ plans will continue along the entire time plan of the proposal as it is the basic component of the proposal’s progress and on which the approval, implementation and success of the project depends.In phase 2, the ‘needs profile’ based on the ‘injuries’ is formed .The setting of objectives provides transparency to the advancement of the plans and for the evaluation process. Other significant aspects at this juncture are the formation of budget, and creation of appeal for proposal. Assessment of ‘resident risks’ commence at this phase; it will be stretched through the entire period of the project as the ultimate beneficiary of the proposal should be the resident. Education and in-service plans will be initiated at stage 3 and it will be an ongoing process, hence should be plotted until the implementation phase of the time plan. I have the tentative idea to utilize the expertise of the educator at the regional health authority where the ceiling lifts are already in use. The next step is the formation and development of ‘policies and procedures’; in this fourth stage, the facilities’ policies will be reviewed and necessary alterations will be performed. This will assist the staff to refer and learn the objectives and safety measures involved in ceiling lifts. The policies will also enlighten the knowledge of the newly recruited and minimally experienced staff in regards to lifts and transfers. Evaluation of the proposal happens in the next and fifth phase. This evaluation will be useful to study the progress of the plans and will help to recognize any hindrances for the implication stage or for the approval of the budget. In the next step, it will be prudent to launch a group including the company representative, president and secretary of the Project Committee and /or the maintenance personnel. The demos and trials of the equipment materialize at this stage and any unpredicted difficulties or problems can be identified as well. The next preparatory phase is devoted to a final review of the whole project and confirmation of availability of supplies and fund prior to installation. ‘Implementation’ of the actual equipment happens in the next step—the execution phase. Once the ceiling lifts are implemented and everything works well, the evaluation and monitoring for any problems will ensue. Communication strategies to evaluate the success of the program will be necessary to confirm that the residents, family members and the staff are satisfied with the new project.(OHSAH,1999,p.5).After presenting my proposal to my group, they suggested that it should have a time line of about 6 months to implement. Project Objectives Research projects conducted by Workers’ Compensation Board, BC, in 1998 verify with evidence of statistical data that20 injuries occurred in one year at one of the facilities and 11 staff lost work time at that facility within the same year. At this juncture, I propose to introduce the new ceiling lift at our nursing home, with the following objectives: Improved patient outcome and satisfaction: Canadian Health Care system always prioritises patient safety as crucial. Efforts and reports of by National Steering Committee on Patient Safety steered the establishment of Canadian Patient Safety Institute in 2003. Best practice and evidence based nursing techniques: Transfer of residents can be unsafe due to advanced age, cognitive dysfunction, body weight, aggression or agitation of the resident and environmental factors like crowded and cluttered rooms. Evidence based practice of patient transfer can be based on factors like proper body mechanics, use of proper and suitable equipment, staff education, proper work culture, and sufficient rest periods for the staff. Initiative for staff education and in-service to improve staff satisfaction: Staff education is one of the cores of quality care and it helps “to attract, retain, and develop staff members who provide hands-on service and support to the residents and families” (Louis Brier Hospital, 2012). To reduce absenteeism, retention of work force: Nursing staff normally have the habit of ‘sacrificing’ for the comfort and wellbeing of the patients. But they neglect the fact that their laxity and culture of patient care increases their risk of developing musculoskeletal disorders. Finally the number of staff absence escalates and affects the functioning of the organization. Equipments like ceiling lifts can remarkably reduce staff absenteeism. Family satisfaction and community oriented resident care: Assessment criteria for quality of care and ‘quality indicators’ at nursing homes are based on various factors like space allocation, standards of physical and social care, with focus on the dignity of the residents. Execution strategies of the proposal: The proposal will be clearly communicated to the whole staff body at the staff conferences and memos. The committee members and stakeholders will be informed about the objectives and framework of the program and the effectiveness of implementing and introduction of a novel technique and equipment. Checklists and worksheets will be displayed and circulated during executive meetings and staff in-services. Policies and procedures of the facility will be reviewed regarding safety and use mechanical lifts for transfer of residents. Changes in policies and development of new policies will be done for the successful implementation of the program and for quality and standard purpose. A team involving Nursing staff, physiotherapist and healthcare aide will be allocated to evaluate the success of the new proposal. In order to introduce the new equipment, the company will be requested to provide experimental equipment and a company representative to demonstrate the smooth functioning of the same. Once the approval is made, the installation of the ceiling lifts at residents’ room can take place. Sometimes a temporary change of rooms and beds may be required in order to mount the ceiling lifts. Once the system gets installed, periodic follow-ups are required to monitor any defects or disadvantages. Proper handling and maintenance will be necessary for the accomplishment of the program. Critical Success factors of the proposal: One of the very basic and crucial factors that contribute to the success of the proposal for a new equipment installation is the ‘physical environment’ of the long-term care facility. Safety of the of the aged population, the quality of life and the factors causing stress to staff are other components that should be taken into account while analysing the factors that will affect the proposal’s success Anjali Joseph, 2006. Residents should be able to feel that they have their ‘personalized’ environments and atmosphere and independence, as opposed to a passive role in their self-care. They should have easy access to world outside the care home as well. More than the above mentioned aspects, availability of finance by approval of budge, and cooperation and willingness from the part of staff to accept the new system will be some other factors to be considered at my organization. Evaluation: My group suggested that I should evaluate, and it should be done with the committee at a regular basis in every quarterly to determine the progression of the program. I will follow up with staff the facility records to view any reduction in staff injuries. Studies reveal that with the implementation of devices to aid lifts and transfers at long term care immensely decrease the incidence of musculoskeletal injuries among staff, decrease absenteeism and sick calls in the workforce, and that the education of staff and in-services enormously increase patient safety and diminished numbers of falls and injuries. Sometimes implementation of safe lifts and transfer equipment without extensive educational program or wide alterations in organizational policies also can be effective, if provided with sufficient demos, descriptions and literatures of the equipment available to the staff when providing patient /resident care. The evaluation expected of my proposal of implementing ceiling lifts would be made successful by maintaining a regular pattern of staff meetings and one-on-one communication with the staff as most of the HCAs of the facility are new and have only limited hours of education regarding safe lifts and transfers. As cited above, our organization also will be able to reduce the sick calls and absenteeism due to musculoskeletal injuries, shoulder pains and related illness due to heavy lifting and faulty practices when handling the residents. According to assignment instructions, each member of the group of the class was expected to present their proposal through Skype conferences and obtain their peers’ comments. Our group of three also completed our online discussions in 2 sessions of 45 to 60 minutes each. We appreciated the efforts and proposals that were done by each of the group members. Additional comments and opinions were also provided. The brief note regarding my proposal as per my group members is given below: About education of staff, Monica suggested that from her own experience, the vendors should be included during educational sessions from the very beginning. She stated that when they buy beds, they always contact the vendors. I should include the room for contract for maintenance and repair, as this will help for accreditation. Monica suggested that it would be beneficial to find out how many companies make these lifts and to have a few of them demonstrate their product so that the committee can pick the best and bargain for a reasonable price. May recommended that I should be paying attention to the diversity and best practice aspects while implementing my proposal. She also suggested having ongoing consultation with the staff members regarding the progress of the new system after installation. Even though the proposal for a ceiling lift is genuine for the safety, comfort and ease of the patients and caring staff members, there are certain limitations or practical difficulties involved. First of all, I am not sure whether the administration will readily approve for a total budget of $25,000 dollars for the purchase of equipment, training of staff and other miscellaneous expenses. In order to implement the program of lifts and transfers using the proposed ceiling lifts, the number of staff on each unit would have to be increased to at least 2 for each unit. Currently our facility is facing severe shortage of workforce and there is pressure from the higher authorities to the management to limit hiring in order to save money. Even the basic supplies are sometimes curtailed with low funds available for the local management and executive Director. At this juncture, I might have to convince the higher level authorities the need for my proposal. Another limitation which I might expect is the lack of co-operation from the staff. Many older members of the healthcare aids and nursing staff may be reluctant to accept change as they may fear that any changes may be threat to their daily routines with which they are comfortable and happy so far .Education and communication to convince them the real necessity and advantages of using ceiling lifts might be a challenging task in front of me. The relatives and family members of the residents may disagree with the use of any new equipment as they might be concerned about the safety of their beloved ones. Sometimes the older community of the facility also can hinder the plans for any kind of new lifts as they may feel nervous and express fears of unknown reason. Last but not least, the implementation of ceiling lifts will evolve some required rearrangements at residents’ room due to installation of the accessories and attachments; the rearrangement may be another barrier that will have to be overcome. Conclusion: Lifting is a dominant occupational back stressor for health care personnel. It is essential to preserve a healthy team of staff and to maintain the quality of service at the organization while minimizing the musculoskeletal injuries and sprains. This will lessen the staff absenteeism and avoid unnecessary expenditure and disproportion of organizational budget. Appendix 1 Budget Financial Report Total funds received from $25,000:  Contribution from other funding sources (specify source): General Budget   Table 1 — Approximate costs for purchase and installation of various types of hoists Type Cost Wheeled hoist $2,500 – 7,500 Stationary hoist $2,500 – 3,000 Ceiling lift $3,000 – 12,000 Hoist service contract (per year) $200 – 500 Appendix B Reference Collins, J. W., Nelson, A., & Sublet, V. (2006, February). Safe Lifting and Movement of Nursing Home Residents. Retrieved March 12, 2013, from www.cdc.gov/niosh/docs/2006-117/.../2006-117.pdf Motion Specialities. (2013). Ceiling Track Lift Systems. Retrieved March 2013, 11, from http://mobilitybasics.ca/ceiling-lifts/ceilinglifts.php T.H.E. Medical. (2002). The Ceiling Lift- Stratus Portable. Retrieved March 2013, 12, from http://www.just-patient-lifters.com/page2.html The Occupational Health & Safety Agency for Healthcare in BC (OHSAH). (1999, July 5). Ceiling Lift Program Guide. Retrieved March 13, 2012, from http://www.ohsah.bc.ca Washington State Dept. of Labor & Industries. (n.d.). Safe Patient Handling. Retrieved March 12, 2013, from http://www.lni.wa.gov/Safety/Research/SafePatient/Default.asp Read More