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Peer Leaders:. Roles and Resources. Peer Leaders: Roles and Resources. Mary Willa Matz, MSPH VHA Patient Care Ergonomics Program Manager/Consultant Occupational Health Science Researcher Industrial Hygienist VISN 8 Patient Safety Center of Inquiry James A. Haley VA Hospital
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Peer Leaders: Roles and Resources
Peer Leaders: Roles and Resources Mary Willa Matz, MSPH VHA Patient Care Ergonomics Program Manager/Consultant Occupational Health Science Researcher Industrial Hygienist VISN 8 Patient Safety Center of Inquiry James A. Haley VA Hospital Tampa, Florida (813) 558-3928 (813) 558-3990 fax mary.matz@va.gov
Peer Leaders Peer Leaders are the Key to Program Success… • Implement Program • Maintain Program
PL Roles/Responsibilities Peer Leaders as Agents of Change
“If you want to make enemies, try to change something.”Woodrow Wilson
The Realities of being a SPHMPL Change Agent Ultimate Goals/Purposes are broad… • Responsibility is to assist in implementation of a SPHM Program that.. • Promotes significant Thought Changes • Promotes significant Behavior Changes • Creates an effective ‘Culture of Safety’
The Realities of being a SPHMUPL/Change Agent A ‘SPHM UPL/Change Agent’ facilitates… • staff buy-in • staff input during SPH Program development and implementation • maintenance of the SPH Program over time (SPHM Follow-up study) • attainment of goals of the SPH Program
The Realities of being a SPHMUPL/Change Agent To be an effective change agent, a PL needs…. • Knowledge of… • Why you’re doing it (Rationale/background) • What it includes (Program elements) • What you’re going to do it with (Program materials/tools) • How you’re going to do it (Action Plan)
The Realities of being a SPHMUPL/Change Agent To be an effective change agent, a PL needs…. • Communication Skills… • How to listen effectively • How to share & transfer knowledge effectively • How to coach peers
Peer Leaders • Back Injury Resource Nurses (BIRNS) – VA • ErgoCoaches – Netherlands • Ergo Rangers – BJC Healthcare • Back Injury Resource Staff (BIRS) – Select Medical
PL Benefits ErgoCoaches • Take responsibility as • Problem-owners • Solution-owners • 1 – 2 per unit • Knowledge Transfer mechanisms • Annual conference • Newsletter • Help desk • Website
PL Benefits ErgoCoaches • Facilities w/ ErgoCoaches had significantly lower sick leave due to Musculoskeletal disorders • Synergy between • Work of thousands of ErgoCoaches • National Support Group • Governmental working conditions covenants (Knibbe, & Knibbe, n.d.)
PL Benefits Co-Worker Benefits • Employee involvement • Enhances worker motivation • Increases job satisfaction • Leads to greater acceptance of change in workplace (OSHA Ergonomic Guidelines for Nursing Homes, 2003)
PL Benefits Co-Worker Benefits • Staff are empowered • Channel to voice ideas/suggestions • Opportunity to have input in making work environment safer • Increased competence in performing job • Increased sharing of knowledge/best practices • Fosters Culture of Safety
PL Benefits Example of PL Benefit • Lifts not being used on night shifts. • Why? Batteries were being charged on night shifts because no back-up batteries. • Solution: Buy extra battery packs so lifts can be used 24 hours per day.
PL Representation • Representative from all areas where patient handling occurs • Nursing • Radiology • Therapy • Escort • Others • Suggestion: 1 PL per shift per unit/area
PL Selection Eligibility • Any direct patient care staff (i.e., RN, LPN, CNA, PT, OT, diagnostic tech, etc.) • Has at least 6 months experience with handling patients • Employed on unit for at least six months or a PL in another area previously • Anticipates working on unit at least one year or more
Respected by colleagues & management Satisfactory performance evaluation Responsible and reliable Flexible Takes initiative/proactive Good time management skills Outgoing Resourceful Assertive (appropriately) Interest in SPHM/Safety Maintains good relationships w/ management PL Selection Qualities
Patient handling experience Effective oral/written communication skills Physically able to perform job duties Critical thinking skills (appropriate for duties) Ability to teach peers using established training programs Informal Leader – credible with & respected by peers Computer skills Ability to learn, apply, and transfer new knowledge PL Selection Skills
PL Roles/Responsibilities • Act as Unit/AREA ‘Change Agent’ • Act as UNIT/AREA SPHM Champion • Demonstrate Systems Thinking
PL Roles/Responsibilities • Maintain current knowledge • Of… SPHM issues, technology, best practices • Through… PL meetings, trainings, Outlook • Equipment ‘Super User’
PL Roles/Responsibilities • Facilitate SPHM “Knowledge Transfer” • Safety Huddles • Algorithms • Policy • Coaching
PL Roles/Responsibilities • Facilitate SPHM “Knowledge Transfer” • Training • In-services/Small Groups/One-on-one • Peers, Managers, Patients/families • Topics: Program Elements, Equipment Use, Safety Concerns, Best Practices, etc.
PL Roles/Responsibilities • Follow unit injuries & close calls • Act as Unit liaison w/ Infection Control, Facilities Management, Equipment Manufacturers, etc.
PL Roles/Responsibilities • Follow Equipment Use/Management • Conduct Ergonomic ongoing environmental/ergonomic evaluations • Perform walk-throughs to assess equipment use and function (Equipment Use Checklist - Handout A-1)
PL Roles/Responsibilities • Monitor Staff Competency (Staff Skills/Competency Check-off - Handout A-2) • Monitor UNIT SPHM Program • PL Activity • Program Status • Program Compliance
PL Roles/Responsibilities PL Activity/Status Log(Handout A-3) • UPL’s Perception (weakness) • Complete weekly • Utility • Track PL activities/dose – Justifies need for PL program • Use as indicator for acceptance & effectiveness of SPH program • Champion Use • evaluation tool • determine problem areas • Suggest: Develop web-based data base with reporting capabilities
PL Roles/Responsibilities • Insert facility-specific and unit-specific roles/ responsibilities in Unit SPH Binders
Monitoring PL Competency • PL Competency Assessment (Handout A-4) • PL Activity/Status Log (Handout A-3)
Suggested PL Training • Background/History/Patient Handling Injuries/Legislation • Ergonomics and Biomechanics of Patient Handling • Evidence/Research Findings • SPHM Program elements: • Patient Care Ergonomic evaluation process • Patient Handling equipment • PL (job description/duties) • After Action Review • Algorithms • SPHM Policy/Directive
Suggested PL Training • Risk analyses • Patient Handling Equipment/Slings • Program implementation/Maintenance Strategies/Facilitators • PL (UPL) Log • Culture of safety Concept • Change theory/strategies • Knowledge transfer concept/theory • Social marketing • Program Facilitators/Barriers
Suggested PL Training • Peer Education/Coaching • Conducting competency assessments • Adult education principles • On-the-job (OJT) training principles • Coaching
Implementing a PL Program • Determine PL roles for facility/unit/area. The PL role may differ by clinical area. • Determine number of UPLs needed for each unit/area. The number of UPLs required may differ by clinical area. • Review PL Selection Criteria • Meet w/ nurse managers/supervisors to discuss PL roles, selection, and number required for the clinical unit/area. • Facilitate selection of UPLs.
Implementing a PL Program • Conduct PL orientation/training. Several training may need to be offered to capture all UPLs. • Facilitate PL training by equipment manufacturers in order to attain ‘Super User’ status. • Hold regularly scheduled meetings. Initially, one every two weeks is suggested, then monthly meetings are satisfactory. • Ensure all UPLs are on Outlook • Create facility Outlook PL Mail group.
PL Resources Resources • Facility SPHM Champion/Coordinator • SPH Presentations/Materials from this conference • Safe Patient Handling & Movement: A Practical Guide for Health Care Professionals, Ch. 7 (A. Nelson, editor) • AORN Ergonomic Guidelines for the PeriOperative Environment (AORN website) • NAON Ergonomic Guidelines for Orthopedics/Rehabilitation • Tool for Prioritizing High Risk Tasks (Handout A-5)
PL Resources Resources • SPH Unit Binder (Handout A-6 - Table of Contents) • Easily accessible location on each unit • Install on VAMC Network
Peer Leaders Program Facilitators
Ways To Assure Success & Sustain Program • Succession Planning (related to turn-over, change of position, change of unit, etc.) • Nurse Mgr/Safety Champion responsible for identifying new PL after notification that current PL resigns, transfers etc. • Open PL course to others to gain Tempo/CEU credits
Ways To Assure Success & Sustain Program • Redundancy • Have PL Binder accessible on each unit • Provide one PL per shift per unit • Peer Leader Back-up (if only 1 UPL/unit) • From UPL’s unit • From other unit
Ways To Assure Success & Sustain Program • Hold regular meetings • Patient care responsibilities interfere • Stay connected through email helps but not as good as face to face • Ensure management supports time for meetings
Ways To Assure Success & Sustain Program • Marketing Unit Peer Leaders (Handout A-7)
Safe Patient Handling & Movement Program Peer Leaders are the Key to Program Success… • Implement Program • Maintain Program
Never underestimate the ability of a small group of committed individuals to change the world. Indeed, it is the only thing that ever has. Margaret Mead
Peer Leaders: Roles and Resources QUESTIONS/COMMENTS??