SaferCare Texas

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Health Worker Safety: A Priority for Patient Safety

Patient Safety is a global priority. In recognition of this, the World Health Organization (WHO) established World Patient Safety Day in May 2019 as an annual event.  The objectives of this initiative are: 1) increase public awareness and engagement, 2) enhance global understanding, and 3) spur global solidarity and action to promote patient safety.

The origin of this day is firmly grounded in the fundamental principle of medicine – First, do no harm.

Patient Safety is a relatively young discipline that emerged on the heels of the Institute of Medicine (IOM) report, To Err is Human, which reported 44-98,000 deaths per year were attributed to medical error — adverse events.  Initially, this work was focused on care in the hospital setting. Twenty years later, we now recognize that harm occurs in ALL health care settings, and we also know that most of the harm associated with adverse events is preventable.

It is also reported in the literature, that medical errors in the U.S. are considered the 3rd leading cause of death at 440,000 per year, behind heart disease and cancer. 

Since these reports, we have made great strides to improve patient safety in the U.S., but we still have opportunities to improve.  The focus on patient safety is moving into other health care settings like ambulatory care.  This is the new face of patient safety.

Patient Safety Day 2020

 

This year, the COVID-19 pandemic has brought to light existing issues among health care professionals related to burnout and mental health issues, such as depression and anxiety.  This is a global problem. Issues such as health care associated infections, workplace violence, bullying and harassment, stigma, psychological and emotional disturbances, illness, and even death. Working in a stressful environment increases the likelihood of errors which can lead to patient harm or harm to a fellow team member. 

At SaferCare Texas, our mission is to eliminate preventable harm. We do this through education, advocacy, and by challenging traditional thinking as it relates to quality and safety in any health care setting. This year we want to join World Patient Safety Day 2020 and bring awareness to health care worker safety. This year’s theme is:

Health Worker Safety: A Priority for Patient Safety

You might be thinking, how does health care worker safety impact patient safety?  The truth is if health care workers do not feel safe in their work environment, how can we expect them to keep patients safe. 

Going back a little further, let’s define safety. In my humble opinion, the best definition of safety is: a dynamic non-event.  Think about it.  In order to keep everyone safe, the organizational culture must prioritize safety in the workplace.  To do this, leaders must set the tone and role model that everyone safe is a priority.  Safety is the foundation of the organizational culture.

This year’s World Patient Safety Day slogan is:  Safe healthcare workers, Safe patients. It is very timely. Health care has a long history of being a stressful environment.  I have worked in health care for more than 30 years and have experienced it first-hand.  Let’s face it – we are all humans. We are fallible, and we make mistakes.  However, working in a stressful environment increases the likelihood of errors that can result in harm to a patient or a team member. 

The ongoing experience of health care workers across the globe during this pandemic is a great example – lack of personal protective equipment (PPE).  Imagine working in an environment and not feeling safe.  This is a real issue impacting health care workers every day and can lead to mental health issues such as depression, anxiety, even suicide.   It’s a real problem.  We need to empower health care workers to speak up and voice their concerns about working conditions.

Another important workplace issue is violence, physical assault by patients, caregivers or even team members as well as verbal abuse, harassment, and bullying.  Yes, this happens often in health care and is not acceptable.  Workplace violence also contributes to the mental health issues described above.

Globally, an estimated 264 million people suffer from depression. Depression is one of the leading causes of disability.  And many people who suffer from depression also suffer with symptoms of anxiety.  Mental health issues such as this have a significant economic impact related to lost productivity.  The global estimated cost is $1 trillion/year.  And, in many cases, these issues are preventable.  

This is why psychological safety is so important.  If you are not familiar with the term, psychological safety in the workplace is the belief that you won’t be punished when you make a mistake.  Yes, when you make a mistake. Acknowledging your humanness is the first step.  Because psychological safety in the workplace is so important, the WHO also issued the following Call to Action:  

Speak Up for Healthcare Worker Safety

At SaferCare Texas, we challenge you to be empowered and to empower your colleagues to speak up, let someone know if you do not feel safe in your work environment.  In addition to this, the Institute for Healthcare Improvement (IHI) recently launched a campaign on psychological safety called “Your Psychological Personal Protective Equipment (PPE).  This campaign outlines strategies that both individuals and leaders can do to promote mental health and wellbeing.

You can find more information about IHI’s psychological safety campaign here. 

Author: Tracy Chamblee, PHD, APRN, PCNS-BC, CPHQ, CPPS – Clinical Executive at SaferCare Texas

To Lose A Son: A Father’s Despair

Author: John Sims, MSN, RN, CNL – Director of SaferCare Texas

Today, September 10, marks Global Suicide Prevention Day, with the month of September being recognized as National Suicide Prevention Month. For some people it’s just another awareness day on the calendar, but for me it hits closer to home. 

Clay’s Story

 

Three years ago, I lost my beautiful son to suicide. 

 

John Clayton Sims, named after my paternal grandfather, was my oldest son and a great man. As a child, Clay was well behaved even with his struggle in school due to a dysgraphia diagnosis. This led to my wife and I’s decision to hold him back in third grade. Unfortunately, his classmates quickly noticed his third-grade retention and immediately poked fun at him, igniting extreme sadness.

 

His behavior slowly started to change when he entered his teenage years. He became more aggressive and started drinking excessively. I rationalized these behaviors as hard adolescent challenges but felt powerless to change them. 

 

After the 9/11 terrorist attacks, Clay made a commitment to serve his country and join the Army. I was a proud father. After basic training, my family and I went to visit him and were greeted by a new Clay. His glowing, confident appearance was something I had not seen in quite some time. He seemed to have found a new life purpose. 

 

Sadly, he sustained a knee injury during a 16-mile ruck march and was honorably discharged. He returned home and shortly thereafter began to experience several mental health issues. While in intense, outpatient-alcohol treatment, the psychiatrist suspected bipolar disorder, and recommended long-term inpatient treatment for confirmation. His long-term therapy abruptly ended despite insurance appeals. Following his pre-mature discharge from treatment, Clay transitioned to sober houses with strict guidelines; he had to take his meds (for his bipolar disorder) and attend meetings. Clay resided in two sober houses before leaving on his own will after 7 months. 

 

Not long after, we received that dreaded knock on the door that our beautiful 23-year-old son had taken his own life. My worst nightmare had come true, leaving a permanent hole in my heart. 

 

I, among many others in my family, have been left trying to navigate the devastating grief and unanswered questions. We torment ourselves wondering if we did enough, did we do too much, what if we had tried this, or that, and so on. We have found ourselves in the endless circle of “what-ifs.”  

 

Thankfully, we have had a great support system. Our church friends and family responded by providing emotional support, meals, and housecleaning. We joined a local bereavement support group “Survivors of Suicide”, an excellent vehicle for shared, painful emotions. The rawness of this group proved too painful for my grief, so we transitioned to an eight week Trauma Grief Class. Eye Movement Desensitization and Reprocessing (EMDR) therapy also helped us minimize the intense emotion associated with our son’s death. 

 

Three years later, we still attend family counseling around this topic.  Thus far, we have been unable to find closure, but do find temporary peace sharing his story, hoping it opens a dialogue for those in similar circumstances. 

Suicide Prevention

 

With suicide rates rising, I felt compelled to share Clay’s story and hope to bring awareness and prevention measures to those in need. 

 

Sadly, suicide ranked 10th in leading causes of death overall in the U.S. in 2017, claiming more than 47,000 lives, and 800,000+ globally according to the CDC. Over 121 individuals’ complete suicide on a daily basis. 

 

Additionally, the environment we are living in today due to Covid-19 has elevated levels of adverse mental health conditions, substance use, and suicidal ideation. According to a recent CDC study, mental health conditions are disproportionately affecting specific populations, especially young adults, Hispanic persons, black persons, essential workers, unpaid caregivers for adults, and those receiving treatment for preexisting psychiatric conditions. 

 

It’s crucial that we pay attention to warning signs and reach out when we think someone is in need. Below I have compiled a list of suicide awareness resources for you to use to help prevent this health crisis. 

 

·      National Suicide Prevention Lifeline – can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.  1-800-273-8255 

·      American Association of Suicidology  is an association for mental health and public health professionals, researchers, suicide prevention and crisis intervention centers, school districts, crisis center volunteers, survivors of suicide loss, attempt survivors, and… 

·      Crisis Text Line Text HOME to 741741 from anywhere in the United States, anytime. Crisis Text Line is here for any crisis. A live, trained Crisis Counselor receives the text and responds, all from our secure online platform. The volunteer Crisis Counselor will help you move from a hot moment to a cool moment.

·      The Dougy Center – The National Center for Grieving Children and Families provide support in a safe place where children, teens, young adults and their families grieving a death can share their experiences.  

·      How to Talk to a Child about a Suicide Attempt in Your Family (Rocky Mountain MIRECC) This guide is intended to provide you with some of that support, and also share other resources that may be helpful for you now and as your family recovers.

·      The Jason Foundation – The Jason Foundation, Inc. (JFI) is dedicated to the prevention of the “Silent Epidemic” of youth suicide through educational and awareness programs that equip young people, educators/youth workers and parents with the tools and resources to help identify and assist at-risk youth.

·      The Jed Foundation empowers teens and young adults with the skills and support to grow into healthy, thriving adults 

·      Lifeline Chat is a service of the National Suicide Prevention Lifeline, connecting individuals with counselors for emotional support and other services via web chat. All chat centers in the Lifeline network are accredited by CONTACT USA. Lifeline Chat is available 24/7 across the U.S. 

·      Man Therapy gives men a resource they desperately need. A resource to help them with any problem that life sends their way, something to set them straight on the realities of suicide and mental health, and in the end, a tool to help put a stop to the suicide deaths of so many of our men. 

·      Mental Health America is the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all. 

·      My3 App lets you stay connected when you are having thoughts on suicide.  

·      National Action Alliance for Suicide Prevention is the nation’s public-private partnership for suicide prevention. Current priority areas include: transforming health systems, transforming communities, and changing the conversation.

·      National Organization for People of Color Against Suicide primary focus and mission is to increase suicide education and awareness. We offer unique opportunities for outreach partnerships and community education efforts directed at communities of colors across the nation. 

·      Now Matters Now teaches Mindfulness, Mindfulness of Current Emotion, Opposite Action and Paced breathing. These skills are part of Dialectical Behavior Therapy or DBT, proven to be helpful for people considering suicide.  

·      Parents, Families, Friends, and Allies United with LGBTQ People (PFLAG) mission is to build on a foundation of loving families united with LGBTQ people and allies who support one another, and to educate ourselves and our communities to speak up as advocates until all hearts and minds respect, value and affirm LGBTQ people. 

·      Safety Planning Tools is a written, prioritized list of coping strategies and resources for reducing suicide risk. It is a prevention tool that is designed to help those who struggle with their suicidal thoughts and urges to survive. 

·      SAVE was one of the nation’s first organizations dedicated to the prevention of suicide. Our work is based on the foundation and belief that suicide is preventable and everyone has a role to play in preventing suicide. Through raising public awareness, educating communities, and equipping every person with the right tools, we know we can SAVE lives.

·      The Society for the Prevention of Teen Suicide mission is to reduce the number of youth suicides and attempted suicides by encouraging public awareness through the development and promotion of educational training programs. 

·      StopBullying.gov provides information from various government agencies on what bullying is, what cyberbullying is, who is at risk, and how you can prevent and respond to bullying. 

·      Suicide Prevention Resource Center is the only federally supported resource center devoted to advancing the implementation of the National Strategy for Suicide Prevention. SPRC is funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) under grant no. 5U79SM062297 and is located at Education Development Center.

·      Teen’s Health gives you the tools and confidence to make the best health choices. TeensHealth.org is part of the KidsHealth website. 

·      The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people under 25.

·      Emdria.org a resource for learning more about EMDR therapy and to locate an EMDR therapist in your area       

·      Veterans Crisis Line – If you’re a Veteran in crisis or Service member in crisis — or you’re concerned about one — there are caring, qualified VA responders standing by to help 24 hours a day, 7 days a week.

·      Wounded Warrior Project is committed to helping those living with PTSD

Including Your Students in Classroom Hygiene

Back to school with Covid

We have all been told that the best practices for keeping yourself and others safe during the COVID-19 pandemic include frequent hand hygiene, social distancing, and wearing masks. With schools opening back up, these guidelines can be difficult to implement. Additionally, CDC guidance for opening schools safely includes cleaning desks, doorknobs, sinks, and frequently touched surfaces in classrooms on a frequent basis; this potentially increases the workload significantly for teachers. 

To make these difficult times a little easier for our teachers, below are some ideas on how to include your students in classroom cleaning and proper hand hygiene.

Hand Hygiene Ideas

  • Have hand sanitizer available at the classroom door, and use a “gel in, gel out” procedure: students sanitize their hands every time they enter and exit the classroom
  • Allow 5-10 minutes for students to wash hands at the beginning of the day, before lunch, after recess, and at the end of the day at a minimum. Have students remain at their desks until it is their turn to wash their hands.
  • Have 1-2 students be “handwashing detectives” to watch their classmates wash their hands and sing a song that lasts 20 seconds
  • Have students decide on a class song that is sung while washing hands or using hand sanitizer
  • Come up with “Class Clean Rules” that are repeated at the beginning of the day to reinforce hand hygiene and wearing masks
  • Show short, educational videos on how to wash hands at the beginning of the day, or before students will wash hands
  • Do a handwashing experiment to show students how many germs can live on our hands and surfaces – https://www.cdc.gov/healthyschools/bam/teachers/epi-handwashing.html

Classroom Cleaning Ideas

  • 3-5 minutes before a class period ends, distribute disinfecting wipes to each student so they can wipe down their desks and seat
  • Play a “clean-up” song while students are wiping down desks
  • Make students the “Sheriff of Germ Town” – have students put sheriff stars stickers/badges on their shirts before getting ready to clean desks and chairs, play some Western music while cleaning, and have 1-2 “Super Sheriffs” wipe down doorknobs and other commonly touched surfaces
  • Make desk and surface cleaning part of the routine with hand hygiene – at the start of the day, before lunch, after recess, and at the end of the day. Start with desk and surface cleaning and end with hand hygiene.
  • If using disinfecting spray and paper towels, have one student pass paper towels out to other students while you spray the desks
  • Similar to the handwashing experiment – include an experiment that grows bacteria collected from doorknobs and classroom surfaces so students can see why it’s important to clean. https://www.sciencecompany.com/Bacteria-Growing-Experiments-in-Petri-Plates.aspx

For more information on how to reopen schools safety, check out our Asthma 411 resources page. 

Author: Lilly Hammack, OMS-IV, MS, RDN

Communication Barriers in Health Care

When people think patient safety, health literacy probably isn’t the first thing that comes to their mind. Yet, clear communication plays an essential role in preventing patient harm. For this reason, addressing health literacy has become a primary objective for our team.

Here are some common questions about health literacy and why it’s a crucial part of our health care system.

What is health literacy?

Health literacy is defined as the degree to which individuals have capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.1

What are some red flags that may indicate low health literacy?

You cannot simply look at a person and determine if they are health literate and some people do a pretty good job covering up their inability to read. But there are particular groups of patients who are more likely to have challenges with health literacy compared to others. For instance, the elderly and those who did not complete high school are more likely to have challenges with health literacy. Also, even well-educated people may not understand health care or be too stressed from a diagnosis or unplanned illness to understand. It’s always best to assume all patients have some difficulty of understanding.

What are some examples where health care professionals inadequately communicate important information to patients?

I’m sure many of us have walked into a conversation or started a new career and had no idea what acronyms or industry terms meant. The same thing applies in health care. Inadequate medication directions, complex graphs, small print font ,and complex forms can all lead to misunderstandings and misinterpretations.

What actions should be taken to reduce the chance of patients misinterpreting health information?

It all comes down to your communication methods. Well-written patient materials, such as forms and educational information, that are appropriate for everyone is key. Here are some starter tips to consider when enhancing your communication techniques:

  • Bold and highlight important information
  • Use plain, non-medical jargon
  • Speak clearly and at a moderate pace
  • Limit instruction to 3-5 key points
  • Repeat the key points
  • Use illustrations if necessary

Finally, it is always vital to provide a non-threatening environment where patients feel comfortable to speak up and ask questions.

What safeguards are in place or should be in place to ensure information is clearly communicated and accurately understood?

It’s crucial that your patient understands what you are saying. To ensure they comprehend what you are communicating, we suggest using the teach back method. The teach-back method is a way of checking understanding by asking patients to state in their own words what they need to know or do about their health. It is a way to confirm that you have explained things in a manner your patients understand and reteach as needed. 2

Please see our infographic below to learn the consequences and economic impact of low health literacy. 

For additional information about health literacy, check out our programs: What About Mom, WebLitLegit, C.L.A.S. Training, and Abating Maternal Mortality.

Feel free to reach out to our team for assistance or questions regarding health literacy.

Sources 

1. S.C. Ratzan and R.M. Parker. Introduction, National Library of Medicine Current Bibliographies in Medicine: Health Literacy. (Bethesda, MD: 2000). 

2. Internet Citation: Use the Teach-Back Method: Tool #5. Content last reviewed March 2020. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html

Wear A Mask, Save a Life

Have questions about wearing a mask? Why masks are important? Or how to wear one properly? Watch our video below for answers to your mask wearing questions.