P#2 - TIME AND MOTION STUDY: THE IMPACT OF …...P#20 - COMMUNICATING UNIQUENESS Marg Catt....
Transcript of P#2 - TIME AND MOTION STUDY: THE IMPACT OF …...P#20 - COMMUNICATING UNIQUENESS Marg Catt....
P#2 - TIME AND MOTION STUDY: THE IMPACT OF EMAR
Sandra Dudziak1, Michael Betel2, Jean Clark1. 1Revera Inc. , Mississauga, ON, 2MediSystem Pharmacy,ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) The adoption of an eMAR system allows for better performance on medication quality measures as
well as preventing medication errors.
2) Medication pass time is lower in eMAR homes versus non-eMAR?
3) What happens to the freed up time that becomes available?
What is the Goal of your Poster? Nurses need a way to help ensure that medications are properly
administered and tracked in an efficient and safe manner.
What were the findings/results and conclusion of the Poster? Quantitative Results: Based on the 6
homes, here were the aggregate results: 1. 51% of nursing time was spent on the Medication Pass 2.
14% savings in time in eMars Homes that could potentially be directed to other Resident care activities.
(representing 2.2 hours savings a week). 3. Medication pass – the time required is higher in the non-
eMars homes 4. Processing order – the time required is higher in the eMars homes and this may due to:
a. Forcing compliance to follow correct processes and guidelines b. Forcing compliance with regulations
c. Emphasize the improved safety for Resident and compliance to regulations because of eMAR 5. The
time spent in clinical activities was also significantly higher in the eMar equipped homes.
P#17 - WHERE IS THE OCCUPATIONAL THERAPIST IN LONG TERM CARE?
Margot McWhirter. Shoppers Home Health Care, LTC Division, Toronto, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Inform delegates about Occupational Therapy Services in LTC - current and potential roles
2) Stimulate thoughts and discussion around Occupational Therapy Services in LTC
3) Encourage colloboration between Occupational Therapists, administrators, researchers, and policy
makers at efforts to improve quality of life and quality of care for LTC residents.
What is the Goal of your Poster? To engage key stakeholders to advocate for increased access to
Occupational Therapy Services in LTC
What were the findings/results and conclusion of the Poster? Occupational Therapists working in LTC
are deeply committed to this area of practice, and many are willing to become involved in advocating
for a funding model that supports the full scope of OT skills. In doing so, they hope to raise the profile of
their profession while contributing to LTC residents' overal health and quality of life.
Intended Audience - Administrators, Director of Nursing.
P#18 - IMPROVING FUNCTIONAL COGNITION AND ADL PARTICIPATION FOR RESIDENTS IN LONG TERM
CARE THROUGH OCCUPATIONAL THERAPY
Karen Fisher. PT Health, Senior's Wellness Divison. Hamilton, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Innovative rehabilitation interventions to improve the quality of life for residents that reside in long
term care facilities.
2) Impact of occupational therapy services on resident's ADL performance and functional cognition.
3) Success stories from the implementation of the pt Health occupational therapy program.
What is the Goal of your Poster? To introduce the breadth of occupational therapy practice in long term
care and the direct impact on quality of life for the residents.
What were the findings/results and conclusion of the Poster? Residents on the occupational therapy
program have demonstrated improvement in ADL performance through MDS outcome measure (ADL
long score) and/or documented evaluations by the occupational therapist. In addition, a number of
residents on the cognitive training program also demonstrated cognitive improvement reflected through
their score on a standardized outcome measure (RUDAS) and/or ability to completed different level of
cognitive tasks
Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors.
P#19 - IMPROVING RESIDENT CARE THROUGH COLLABORATION AND EMPOWERMENT OF STAFF TO
IMPLEMENT BEST PRACTICES IN SKIN CARE
Laurie Yates1, Fran Kleinsteuber2. 1Creek Way Village, Burlington, ON, 23M Canada, Milton, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Decribe the implementation of a skin care prevention program.
2) Discuss how implementing the skin care program led to a sense of empowerment for the PSW and an
enhanced team approach, including the registered staff .
3) Describe how a good skin care program can help to decrease cost and enhance resident care
outcomes.
What is the Goal of your Poster? To demonstrate how implementing best practices in skin care can not
only improve resident care but help to empower the hca and enhance staff collaboration
What were the findings/results and conclusion of the Poster? The key result of implementing this
program was the atmosphere of empowerment for the PSW and a team approach to resident care.
There was a decrease in our pressure ulcers and incontinence related skin breakdown. As a result we
were able to decrease our wound care supply budget with a focus on prevention. The streamlined
product focus decreased confusion for the PSW in relation to product options.
Intended Audience - Administrators, Director of Nursing, Other.
P#20 - COMMUNICATING UNIQUENESS
Marg Catt. Temiskaming Lodge, Jarlette Health Services, Haileybury, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Review existing tools used to communicate individualized resident care needs to all direct care staff
and families.
2) Facilitate the communication of care needs by using only one venue for this = best use of existing
technology and documentation program.
3) Reduced human resource time related to updating of information.
What is the Goal of your Poster? To share with other long term care providers the efficient use of our
technology, which has resulted in enhanced communication of resident care needs, less "places" to
enter changes, resulting in reduced HR time to perform updates.
What were the findings/results and conclusion of the Poster? All staff members, families and residents
appreciate enhancement of communication of resident individualized care needs.
Intended Audience - Director of Nursing, Houskeeping/Laundry, Other.
P#21 - TOP 10 BEHAVIOURS OF AN EFFECTIVE VERSUS INEFFECTIVE QUALITY IMPROVEMENT TEAM
Cheryl Ho. The O'Neill Centre Long Term Care Home, Toronto, ON
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Identify the top 10 behaviors of effective versus ineffective quality improvement teams
2) Provide a self assessment framework which viewers can rank their own team effectiveness.
3) Provide strategies for improving the effectiveness of quality improvement teams.
What is the Goal of your Poster? To provide real life examples of behaviors within teams which are
representative of effective and ineffective functioning and what impact this can have on their quality
improvement initiative. As well, to allow an opportunity to rank their own quality improvement teams
and receive practical strategies for improvement.
What were the findings/results and conclusion of the Poster? Positive quality outcomes need a strong
and effective team as the foundation to support them. Sometimes quality improvement teams need a
little quality improvement themselves. There are objective markers of effective and ineffective teams.
How do you rank your team?
Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors,
Houskeeping/Laundry, Other.
P#22 - BETWEEN THE GENERATIONS: INNOVATIVE INTERGENERATIONAL PROGAMMING IN LTC
Christine Keenan. Revera- Fenelon Court LTCC, Fenelon Falls, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) 1. Communicate specific ideas and strategies to implement intergenerational programs
2) 1. Promote intergenerational programs and community partnerships that enhance quality of life for
residents, family and staff
3) 2. Showcase the success of the program through visual aides, articles, awards
What is the Goal of your Poster? 1. To demonstrate how Fenelon Court fosters and supports living
human habitats by incorporating children into the daily life of the home following person-centred care,
EDEN and KIN philosophies 2. To demonstrate how Fenelon Court integrates person centered care by
giving residents meaningful roles, sense of purpose and participation in the community. 3. To develop
meaningful and important community partnerships
What were the findings/results and conclusion of the Poster? -Improved Quality of Life -Employee
engagement -Strong partnerships within the community -Children involved in reading program showed
an improvement in conversational skills -Local Service club met their goal of improving literacy in the
community
Intended Audience - Activity Directors.
P#23 - THE BUTTERFLY PROJECT
April Beckett. Community Nursing Home, Port Hope, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To have all the residents in the home enjoy and care for the butterflies. Provide residents with
physical and emotional interaction that the program was able to provide.
2) Encourage resident to take care of the garden outside and ensure that the plants are watered daily.
3) Provide resident with other programs surrounding the butterfly’s i.e. Crafts, information sessions,
independent learning.
What is the Goal of your Poster? To create excitement within the home and to provide residents with a
very interactive program. Residents to leave the program with the knowledge of butterflies and their
lifecycle.
What were the findings/results and conclusion of the Poster? Each session was evaluated to determine
the effectiveness of the program. This was done to ensure that each program met the resident’s needs
as well as providing the same program next year. Each session had various numbers of participants but
each program was very well attended, at times more room was needed with more residents, families
and staff wanting to participate. The Butterfly Release Party had approximately 30 residents attend with
staff and family participation. Families loved the idea and thought it was a great initiative. Residents
thoroughly enjoyed this experience. Some residents even shed a tear when they released the
butterflies; comparing it to their children when they had moved on. Staff also enjoyed this project. They
would walk with residents to the various butterfly homes that were on display and talk about them. You
could often hear conversations on the floors regarding the butterflies.
Intended Audience - Activity Directors.
P#24 - INNOVATION IN FALLS PREVENTION: WE HAVE AN APP FOR THAT!
Janusz Kaleta. Cedarvale Terrace Long Term Care Home, Toronto, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To share how a visual representation of falls allows for expedient and effective dissemination of data
to front line staff.
2) To demonstrate how existing technology (Apps/tools) can effectively be used to improve safety in
Long Term Care environment
3) To encourage Proactive rather than Reactive approach to Resident's Safety
What is the Goal of your Poster? Data demystification App is a tool allowing for a visual representation
and mapping the incidence of falls throughout the facility which can point to a specific pattern relative
to exact time, location, shift or particular day when the fall occured.
What were the findings/results and conclusion of the Poster? Because nursing staff in LTC homes
provide care 24/7 it is possible to track falls continuously on a monthly basis. The recorded data SELF-
Arrnages into clusters (colour coded on the tool) and leads to identification of emerging themes i.e.
multiple falls at early morning hours, specific location and / or association with specific risk factor.
Intended Audience - Director of Nursing.
P#25 - MANAGING THE RISK OF POWER MOBILITY IN THE LONG TERM CARE SETTING
Marleen Van Laethem1, Alex Mouret2, Sarah Trenker1. 1St. Joseph's Health Care London, London, ON,
2McKenzie Lake Law Firm, London, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To guide other long term care homes in developing the necessary "building blocks" to manage power
mobility (assessment/ identification of less serious to more serious "accidents"/ power mobility
agreement/ monthly team meeting/ ongoing monitoring/ policy
2) To provide other long term care homes with a background around understanding power mobility to
help them face challenges: a) at Mount Hope LTC, we analyzed "accidents" over a six years and
discovered patterns related to diagnoses and high risk driving beh
3) To guide other long term care homes in understanding the legal and ethical implications of power
mobility in the LTC setting.
What is the Goal of your Poster? The goal of the poster is to review Mount Hope’s current process for
managing risks of power mobility devices, provide a summary of the literature related to managing
power mobility and review patterns related to diagnosis and high risk driving behaviors. The poster also
considers ethical and legal questions such as whether the use of a power wheelchair is a right or a
privilege; whether Long Term Care homes might be liable for accidents caused by residents; legal
questions with regard to power mobility devices and driving while impaired, and how best to balance
respect for residents’ autonomy with our desire to ensure a safe environment.
What were the findings/results and conclusion of the Poster? 1. A comprehensive literature review
identified that there is very limited literature on this topic in the English-based literature as this is an
emerging topic. Key articles are summarized. A further list of references can be provided. 2. Residents
with a diagnosis of multiple sclerosis had the greatest number of driving occurrences (accidents),
followed by residents with multiple diagnoses , then CVA's, head injuries and ALS. 3. At Mount Hope
speeding and driving in an aggressive manner are the most common high risk behaviors which occur.
Driving impaired occurs much less frequently.
Intended Audience - Administrators, Director of Nursing, Other.
P#26 - “IMPROVING POTENTIAL FOR POSITIVE OUTCOMES BY UTILIZING INDIVIDUALIZED
CONTINENCE CARE ASSESSMENTS OF RESIDENTS IN CANADA AND THE UNITED STATES”
Kathy Burt, Shelley Gallant, Cara Stone, Diane K. Newman, Angela Douglas. SCA Personal Care, Oakville,
ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Assessment tools for incontinence management utilized by healthcare professionals across care
settings generally do not fully define the characteristics to be considered when providing best care,
since they are mostly limited to a collection of numerical
2) This system was validated across over 400 care homes in the long-term care setting with a companion
taxonomy utilizing ADLs and other insights to define the needs for each resident. Over 15,000 residents
were evaluated through the process to formulate a m
3) Across the continuum of care, Individuals who experience incontinence face the risk of being
inaccurately assessed and not receiving the most effective care plan to support greater dignity and
independence. The TENA Portraits™ process provided additional
What is the Goal of your Poster? Across the continuum of care, Individuals who experience
incontinence face the risk of being inaccurately assessed and not receiving the most effective care plan
to support greater dignity and independence. The TENA Portraits™ process provided additional
understanding of the base and contributing factors for this condition, leading to heightened awareness
among care staff. This helped influence staff understanding of how to complete more comprehensive
assessments and care plans for improving the quality of care.
What were the findings/results and conclusion of the Poster? As tested, the TENA Portraits™ process
complemented the MDS assessment process, providing more comprehensive evaluations to improve
understanding of the individualized needs of each resident. This data was then reviewed with staff to
assist in forming recommendations to generate more complete and effective plans for continence care,
promote more appropriate product selection, and identify opportunities for restorative toileting
programs to improve quality of life.
Intended Audience - Administrators, Director of Nursing, Activity Directors, Other.
P#27 - ACCREDITATION AND COMPLIANCE: SYNERGIES AND DIFFERENCES FOR ONTARIO'S LONG-
TERM CARE HOMES
Sandra Pitters, Toby Yan. Accreditation Canada.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Identify the similarities and differences between the Accreditation Canada Qmentum program and
the Ontario Long-Term Care Homes' Quality Inspection Program (LQIP).
2) Outline the value that each program brings to improving quality in long-term care homes in Ontario.
3) Outline the future directions of the Qmentum accreditation program based on evaluation results.
What is the Goal of your Poster? Questions have been raised about the differences between the LQIP
process and accreditation process and the value- add of accreditation. The goal of the poster is to clarify
the unique contributions to improving quality in long-term care homes in Ontario made by the
Qmentum accreditation program and the LQIP. The poster will also identify future directions of the
Qmentum program based on evaluation results.
What were the findings/results and conclusion of the Poster? In the summer of 2012, Accreditation
Canada undertook a comparison of the Qmentum accreditation program and the Ontario LQIP program.
The primary role of the LQIP is to assess compliance against legislation. MoHLTC’s inspection process
focuses on regulatory requirements that address potential and actual resident risk. The foundation of
Qmentum is the evaluation of quality and promotion of quality management and safety through the
examination of systems and resulting outcomes.
Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors.
P#28 - LTC MEDICAL DIRECTOR LEARNING NEEDS SURVEY
Evelyn Williams, Sid Feldman, Lila Graham, Andrea Moser. Ontario Long Term Care Physicians, Oshawa,
ON.
Contact: [email protected], [email protected], [email protected]
Key Learning Objectives of the Poster:
1) Share results of LTC medical director survey identifying perceived and unperceived learning needs of
physicians working in LTC homes. Survey covered medical administration, quality improvement,
program management, legislative requirements and leadership q
2) Identify key topic areas for focused education for Medical Directors working in LTC
3) Outline education strategy for Medical Director training for Medical Directors in Ontario LTC homes
What is the Goal of your Poster? to engage the sector in discussion regarding the role of Medical
Directors in LTC homes. Review the learning needs of Medical Directors working in LTC homes and how
proposed new educational strategies can support quality medical leadership within LTC homes
What were the findings/results and conclusion of the Poster? Learning needs covered many aspects of
current Medical Director role in LTC homes including quality improvement, program management,
involvement in mandatory programs and legislative requirements.
Intended Audience - Administrators, Director of Nursing, Other.
P#29 - ENHANCED RECREATION DOCUMENTATION: IMPROVED RESIDENT CARE, CUSTOMER SERVICE
AND EFFICIENCIES
Wayne Connelly1, Ron Martyn2. 1The Wexford Residence Inc.,Scarborough, ON, 2Silver Meridian,Whitby,
ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Create measurable outcomes relative to resident engagement in activity programs, resulting in
program modifications for validated improvements in resident recreation experiences.
2) Improve customer service through the utilization of automated reporting to residents and significant
others of resident engagement successes.
3) Demonstrate professionalism in recreation program documentation when reporting findings and
results with key stakeholders (clients, customers, other care disciplines, surveyors and inspection
teams).
What is the Goal of your Poster? Demonstrate how computerized documentation in a recreation
department resulted in: improvements in recreation programming for residents; expansion of the
overall scope of the recreation department programming; increased customer service; and greater
efficiencies in the utilization of staff time.
What were the findings/results and conclusion of the Poster? Over a period of 18 months the goals of
the project were achieved, and ongoing improvements continue to be realized through the
establishment of new, more challenging benchmarks.
Intended Audience - Administrators, Activity Directors.
P#30 - THE JAVA MUSIC CLUB - REDUCING LONELINESS AND DEPRESSION IN LONG-TERM CARE
Kristine Theurer. Java Music Club, Inc., Surrey, BC.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) 1. To share research on a new culture within recreation programming that focuses on residents
helping residents and the benefits of implementing a standardized structure within long-term care
homes, assisted living or retirement homes and adult day servic
2) 2. To highlight the use of mutual support groups as a foundation to a mentorship program that equips
residents to seek out and support those that are lonely and isolated.
3) 3. To evaluate the implementation of mutual support groups within the long-term care sector and the
impact on mental, emotional and physical health.
What is the Goal of your Poster? To share the results of a study on the development and evaluation of
mutual support groups within the long term care sector.
What were the findings/results and conclusion of the Poster? Resident reports and observations in the
study indicate positive benefits including a decrease in loneliness and helplessness and increased coping
skills. Participating staff describe how the unique group structure fosters active participation of those
with moderate-severe cognitive impairment.
Intended Audience - Administrators, Director of Nursing, Activity Directors.
P#31 - PILOT PROJECT: ETHICAL ISSUES IN TRANSFER FROM LONG TERM CARE TO OSLER EMERGENCY
DEPARTMENT
Jill Oliver, William Osler. Health System, Brampton, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To provide the audience with an example of an ethics-oriented Quality Improvement project that
involves hospital and long term care
2) To identify and describe the methods used by the project to promote change
3) To identify the sorts of ethical issues that can be involved with transfers to hospital that residents
either (1) did not want, or (2) could not benefit from.
What is the Goal of your Poster? The poster provides a summary of an ethics-based Quality
Improvement project that has been undertaken by William Osler Health System in 2012-2013, and
involves partnerships with three Long Term Care Homes that transfer residents to hospital
What were the findings/results and conclusion of the Poster? The poster identifies the ethics-related
issues that can be involved with decision making that precedes a resident's transfer from Long Term
Care to the Emergency Department. The poster also summarizes the methods used to promote change
within that decision making.
Intended Audience - Administrators, Director of Nursing, Other.
P#32 - IMPACT OF QUARTERLY INTERDISCIPLINARY MEDICATION REVIEWS ON RESIDENT CARE IN A
CANADIAN LONG TERM CARE FACILITY
Denis O'Donnell. Medical Pharmacies Group Limited, Pickering, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Describe the potential advantages and disadvantages of conducting quarterly medication reviews as a
regularly-scheduled face-to-face meeting involving the primary care physician, the clinical unit nurse and
the clinical consultant pharmacist.
2) List the most common medication issues identified during the interdisciplinary quarterly medication
reviews.
3) Describe the types of interventions resulting from the medication issues identified uring the
interdisciplinary quarterly medication reviews.
What is the Goal of your Poster? To showcase a recently completed clinical research study completed at
the Baycrest Apotex Centre, an Ontario long term care facility, designed to evaluate the impact of
quarterly medication reviews conducted iusing an integrated team approach.
What were the findings/results and conclusion of the Poster? 1821 medication reviews involving 536
residents were analyzed by an independent reviewer. A total of 1952 medication-related issues were
identified during medication reviews. The 3 most common drug-related problems categories were:
unnecessary drug therapy, too high of a dose, and the need for additional drug therapy. 2452
documented interventions occurred during the medication reviews with approximately 95% of residents
having received at least 1 intervention. The 3 most frequent drug-related interventions were:
discontinuation of a medication, decreasing of a dose, and initiation of a new medication. Nearly 450
orders for therapeutic monitoring were generated during the medication reviews. Therapeutic drug
categories commonly targeted during the medication reviews included: proton-pump inhibitors, H2-
antagonists as well as neuroleptics. Approximately 70% of proton-pump inhibitors and H2-antagonists
evaluations resulted in dose reduction or discontinuation of medication. The majority of neuroleptic
evaluations resulted in no change of therapy regimen, but 20% of evaluations resulted in
discontinuation or dose reduction of neuroleptic orders. The results of this study demonstrate that an
interdisciplinary medication review is an effective method to monitor resident’s health status, identify
drug-related problems, and implement drug and non-drug related interventions. The collaborative team
approach may enhance the assessment of residents’ therapeutic outcomes and coordination of
monitoring activities. The interdisciplinary approach used by the Apotex Centre ensures that medication
concerns are addressed immediately during a medication review without a communication delay.
Intended Audience - Administrators, Director of Nursing.
P#33 - LET'S DINE TOGETHER - A DINING PROGRAM FOR LONG TERM CARE
Monica Stanuch, Eatonville Care Centre, Etobicoke, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To educate on a holistic approach to reducing responsive behaviours during meal times, and
drastically improving the dining environment and overall quality of life.
2) The relationship between a homelike, social, environment and adequate nutrition.
3) That the program is transferable to different settings and can help diverse populations (i.e. in need of
socializing, responsive behaviours, high nutritional risk).
What is the Goal of your Poster? To educate members of the long term care community on an effective
and cost efficient way to reduce responsive behaviours around meal times, increase food and fluid
intakes, and improve the overall dining experience in long term care homes.
What were the findings/results and conclusion of the Poster? By changing the set up and appearance
of a typical long term care dining room, and adding a staff member to interact with residents on a social
level, the dining experience is transformed into a comfortable, social activity which resulted in positive
changes. Residents that were exhibiting responsive behaviours, mainly leaving the dining room and/or
showing a general disinterest in food, no longer regularly experienced these behaviours. Meals are now
very seldom disrupted due to behaviours, whereas prior to the program, this was a daily occurrence.
Food and fluid intake has increased in residents, which is evident in the 2.42% average weight gain after
6 months participating in the program. Psychosocial improvements have also been noted - residents are
happier at meal times, laughing, smiling and socializing. This is a simple program to implement in order
to improve the quality of life in any long term care home.
Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors,
Other.
P#34 - SHIFTING THE FOCUS TO SEEING THE POSSIBILITIES: ONE HOME’S JOURNEY IN RESTRAINT
REDUCTION
Juanita Goodhand. Unionville Home Society, Unionville, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To share alternate methods and strategies for restraint reduction; policy and procedures; resource
tools.
2) To provide the road map to success to achieve a least restraint model of care.
3) To share lessons learned and provide recommendations to others to establish best practices
What is the Goal of your Poster? To share key learnings and results achieved through the quality
improvement initiative that focused on establishing the best practice of a least restraint model of care.
Discuss the approach followed to achieve the desired results
What were the findings/results and conclusion of the Poster? •Myths and misperceptions for use and
lack of awareness of the risks associated with restraints by staff, resident/families was a barrier to
physical restraint reduction; •Lack of awareness of alternative methods in lieu of restraint by staff and
resident/families i.e. PASDs, side rails for mobility only not safety etc. led to resistance for change;
•Ambiguity of restraint policy led to misinterpretation of its use; •Restraint reduction wasn’t
systematically reviewed as an entire process which led to fragmentation in approach versus a
consolidated effort across the interdisciplinary team; •Staff required additional education and training
to build their skills to support the strategy for restraint reduction; •Families needed support to shift
their personal beliefs through a combination of resource material and 1:1 education that focused on
procedure, benefits, risks and advantages; •Documented evidence of the trial period for restraint
removal for selected residents led to a change in practice and personal belief and management for its
use; •A consolidated systematic team approach created an new system for restraint use; •Established
an accountability framework to measure the outcomes of the changes; •Documented evidence of trial
outcomes, assisted in reducing the skepticism of residents, family and staff who were resistant to a
restraint free model of care. As a result, our physical resident restraint use decreased from July 2012 to
February 2013 decreased from 31.03% to 7.5%.
Intended Audience - Administrators, Director of Nursing, Activity Directors, Other.
P#35 - THE INTEGRATION OF STROKE BEST PRACTICE INTO LONG TERM CARE RESIDENT CARE
PLANNING
Gwen Brown, Stroke Network of Southeastern Ontario, ON, Alda Tee, Central East Stroke Network,
Barrie, ON, Donna Cheung, South East Toronto Stroke Network, Toronto, ON, Sharon Trottman, The
West GTA Stroke Network, Etobicoke, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) To show how to access stroke best practice care plans using the RAI MDS assessment tool and Tips
and Tools resource material together.
2) Increase the awarenes of staff working in Long term Care Homes of available stroke best practice
resource materials
3) Stroke-specific resident care plans can support/augment existing care plans and facilitate
individualisation of best practice interventions for stroke residents in Long Term Care.
What is the Goal of your Poster? To enhance awareness and facilitate the uptake of stroke care best
practice in Long Term Care by linking stroke best practice information with the RAI-MDS assessment
tool.
What were the findings/results and conclusion of the Poster? There was an increase in the number of
pilot project participants accessing the Tips and Tools for Everyday Living as a best practice stroke
resource. 95.8% of survey respondents indicated tha the stroke care plans enhanced their ability to care
for stroke residents. More stroke resources were developed related to the best practice Stroke Care
Plans. It was agreed that the new stroke care plans complimented the existing care plans and could be
combined with them to customise resident care planning. Therefore ,further exploration into integrating
stroke care plans into the existing software platform is recommended for all Provincial LTC Homes .
Intended Audience - Administrators, Director of Nursing, Activity Directors, Other.
P#36 - LONG TERM CARE SCHEDULING CAUSING LONG TERM HEADACHES?
David Bruzzese. Workforce Management, Mississauga, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Manual scheduling causes headaches
2) Different scenarios LTC industry professionals may face on a day to day basis.
3) Synerion provides the solution to manual processes of scheduling. Offering an LTC Scheduler which is
designed to put ease on your day to day operations.
What is the Goal of your Poster? To enlighten long term care professionals on automated scheduling,
schedule compliance, and coverage control.
What were the findings/results and conclusion of the Poster? Contact Synerion for more information
about the Synerion LTC Scheduler.
Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors,
Houskeeping/Laundry, Maintenance, Other.
P#37 - BEHAVIOUR SUPPORT ONTARIO: BEST PRACTICES IN HELPING MANAGE AND DEAL WITH
RESPONSIVE BEHAVIOURS
Lesley Santos. Shepherd Village Inc., Toronto, ON.
Contact: [email protected]
Key Learning Objectives of the Poster:
1) Audience will learn about the BSO initiative in the Central East LHIN and the four change ideas that
were spread and sustained at Shepherd Lodge LTC.
2) Audience will learn about the different best practices (PIECES, Montessori, Gentle Persuasive
Approaches) that has led to the decrease in the number of responsive behaviours and increased staff
capacity in managing behaviours at Shepherd Lodge LTC
3) The utilization & application of PIECES, GPA, Montessori + BAT Tool + Visual Board + Behaviour
Rounds are best practices in helping manage or deal with Responsive Behaviours in LTC
What is the Goal of your Poster? To promote best practices in dealing and managing Responsive
Behaviours in Long-Term Care
What were the findings/results and conclusion of the Poster? The # of Montessori programs (Non-
pharmacological interventions) exceeded the # of PRNs given for behaviours -A combination of
pharmacological & non-pharmacological interventions such as Montessori programs aid residents with
responsive behaviours -Overall, SL remains lower than the provincial average in worsened behaviour
symtpoms (6.7 % vs. 13.5%) - (CIHI Q1 2012) - SL has a baseline of 83 responsive behaviours - The # of
residents with responsive behaviours have decreased from 83 in February to 52 in December 2012 -
There has only been two admissions thus far since the implementation of BSO (1 in June, 1 in August) -
Since the incorporation of best practice approaches such as PIECES, GPA & Montessori, the # of hospital
transfers has reduced There has been increased vigilance in monitoring and tracking the number of
responsive behaviours - DOS (Dementia Observation System) has helped our Home obtain a more
accurate # of responsive behaviours - SL's average # of Responsive Behaviours as per DOS is 496 - We
tracked the # of resident admissions into the BSO program and the # of discharges due to successful
interventions by utilizing PIECES, GPA and Montessori frameworks - So far, there have been 43 residents
with responsive behaviours who were seen by the BSO Team, with 31 discharges thus far - The
Behaviour Assessment Tool (BAT) enables us to track the number of behaviours by month - BAT enables
us to identify the types of responsive behaviours such as wandering, agitation, verbal and physical
responsive behaviour, suspiciousness, agitation, etc and allows us to determine an intervention for each
identified behaviour Success Story using PIECES framework – D.H. -One of resident's behaviours:
opening all residents' windows and removing a window screen. -Resident stated that she opens the
window to "get some fresh air" -BSO RPN checked resident's MAR and saw that she had a PRN puffer -
Staff gave puffer and behaviour ceased. -Information was written on the Visual Board and
communicated to all shifts : If resident is stating she wants fresh air or begins to open windows, staff are
to give PRN puffer -Resident no longer opens windows Success story using GPA and Montessori
Programming – S.T. -Resident’s behaviours: Resistive to care, physical responsive behaviour when staff
render care. Two staff provide care due to resident’s behaviours. -Interventions: BSO staff had one to
one visits with resident, engages him in Montessori programming such as reading newspaper and
listening to Hindu music. -Through effective communication, his needs were met. I.e. Staff introduce self
with a soft tone of voice, with a smile. Staff explain procedures to resident clearly and slowly and staff
listen to his responses. BSO staff found that this worked well with resident as his resistance to care and
physical responsive behaviour ceased. BSO staff then educated and taught unit PSWs how to care for
this resident. -Outcome: Resident is now receiving care from one staff member, he cooperates and
participates in his ADLs. Cheerful demeanor when approached with a smile. Staff implementing and
following suggestions from BSO Team. Resident no longer displays behaviours and attends activities on
the unit and exercises with Physiotherapist Resident/Family Responses to BSO Initiative -“Since [the BSO
Team] is coming to see my husband, I have noticed a change in him and his interaction with the staff. His
behaviour has changed towards me and the staff. He is pleasant and happy to see me when I visit with
him. Thank you so much for everything , I really do appreciate all of you.” -“The BSO Team would listen
and help me as we spoke. There were those who helped me regain my cognitive power with special
word games. There were others who took me for walks and conversed with me about interesting news.
Lesley, the BSO Lead, would have me write a journal and talk me through my emotional issues. All in all I
would like to praise of them for helping me to regain a new start on life again. I am so grateful for their
caring help. I can live out my life happy, content and I feel useful again. Thank you for funding them.” -“I
have seen the benefits of the BSO program and appreciate the overall improvement in my mom’s
quality of life.” Change Idea #1: Visual Board -Visual board contains: Resident's name, list of identified
resident's Responsive Behaviours, Behaviour Triggers, Interventions and Risks in table format -Provides a
snapshot or ‘cheat sheet’ of resident’s responsive behaviours, triggers & interventions that is accessible
for all shifts -Posted on 6 floors (Room behind Nursing station) in a private area to maintain
confidentiality -All staff provide input -Includes Montessori activities for identified residents Change Idea
#2: Behaviour Assessment Tool -Consists of Crisis Care Plan, Behaviour Rating Scales, and enables all
staff to apply P.I.E.C.E.S. approach -Currently being completed by BSO Team in collaboration with Unit
RPN and PSW -Reviewed and discussed at BSO Team Rounds -Inserted into resident’s chart under “BSO”
tab -Resident focused -Resident’s capabilities (strengths) Change Idea #3: BSO Rounds -Behaviour
Rounds held once a week with Interdisciplinary Team, including Pharmacist -BSO Team leads Rounds List
of identified resident's responsive behaviours, behaviour triggers, interventions, risks and medication
review discussed during Rounds -Behaviour peak times are identified Interdisciplinary team determines
pharmacological and non pharmacological interventions (i.e. Montessori programs) for the identified
resident -Behaviour triggers and Interventions communicated to all shifts Change Idea #4: Montessori
Programming -BSO Team completes a Life History Assessment for each resident -Interviews resident
and/or family member re: hobbies, interests, daily routines. -Montessori Kit containing a collection of
what resident likes to do i.e. Crossword puzzles, Bible, Books, CDs is devised by the BSO Team for each
resident, which promotes resident-focussed care Montessori programming is scheduled for each
identified resident during behaviour peak times -All staff participate in Montessori Programming
Intended Audience - Administrators, Director of Nursing, Activity Directors, Other.