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"In the development of the HAPU Prevention Program, the caring science was used as the theoretical framework. Three Caritas Processes were selected to build a strong infrastructure: Teaching and Learning; Holistic Care; Creating a Healing Environment. "
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Kaiser Permanente, Northern California
Caritas in ActionHow Caring Science informs and inspires KP caregivers and affirms our commitment to provide our
patients and their families exceptional care
Caritas Consortium 2013
Caring Science as a Lens to Reframe & Revitalize HAPU Prevention
Intent to Contribute Statement:KP Santa Clara was identified as having the highest hospital acquired pressure ulcer rate in the entire company in 2012.
The Data: Metrics prior to development of caring infrastructure: CalNoc, HAPU Data by volume, and 1K/patient days. In the development of the HAPU Prevention Program, the caring science was used as the theoretical framework. Three Caritas Processes were selected to build a strong infrastructure:
First caritas: Teaching and Learning focused on several areas: Failure Modes Effect Analysis, Onsite Visit to KP Sacramento's best practices; understanding the etiology of pressure versus non pressure; bringing a variety of educational offerings to the multidisciplinary team including frontline staff.
Second caritas process: Holistic Care with early identification of pressure ulcers on admission; total head to toe assessment including the skin; performing root cause investigations on all HAPUs to uncover both psychosocial and physiological activities.
The third caritas process is creating a Healing Environment which focuses on the environment to promote sustainability with gains with this HAPU Prevention Program, such as moving from a reactionary to a proactive mode of care delivery and auditing 2 RN Verification for all patients on admission and transfer and those patients with a Braden Score of 16 or less during shift.
This Caring Approach has improved the quality of patient care in the area of HAPU Prevention by having improved CalNoc Prevalence and Incidence Study in Quarter 3 and 4 of 2012 and Quarter 1 in 2013 with dramatic reduction of HAPUs in Quarter 4 2012 and Quarter 1 2013.
Caring Science as a Lens to Reframe & Revitalize HAPU Prevention
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Keyword TAGs: Identifier
Consortium2013-July, Santa Clara, Podium, Poster, Patient Care Services
Education & Staff Dev, Hospital Initiatives, Healing Environments, Patients/Families
Descriptor HEROES, Research and Metrics
Inspired Contributor(s) 1 : Kathy Ricossa
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Service Area: Santa Clara
Medical Center: SCL
Affiliation: PCS
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Year Shared: 2013
Venue: Caritas Consortium
Format: Art, PowerPoint
ID #: 15
Caring Science as a Lens to Reframe & Revitalize HAPU Prevention
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Story: Respecting Patient/ Family Choice Through Authentic Presence
Caring Science as a Lens to Reframe & Revitalize HAPU Prevention
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Welcome to Kaiser Permanente in Santa Clara!Our Story…
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Cal Noc Prevalence and Incidence Studies
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HAPU Rates by Year
2009 2010 2011 20120
20
40
60
80
100
120
140
160
180
200
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2012 HAPU Monthly Volume Report
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HAPU Prevention Examining the Caritas Processes
• Building a Strong Infrastructure Teaching and Learning Holistic Care Healing Environment
Reference DiNapoli, P., Turkel, M., Nelson, J., & Watson, J. (2010).
Measuring the Caritas Processes: Caring Factor Survey. International Journal for Human Caring, 14(3), 15-20.
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Teaching and Learning
• 2011-2013 Failures Mode Effects Analysis
• Learning from others Learning from KP Sacramento Best Practices
• Bringing these best practices back to our facility
• Understanding the difference between pressure and non pressure
• Bringing Wound Care educational offerings to the facility Distinguished Speakers; Vendor Days; Webinars
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Holistic Care
• Identification of pressure ulcers on admission
• Examining the entire patient from “hair to toe” assessment
• Involving all health care workers in a multidisciplinary approach
• Performing Root Cause Investigations for all pressure related skin alterations Uncover all aspects of the patient
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Healing Environment
• Moving from reactionary mode to proactive approach to identify patients who are high risk
• Focus on the environment which promotes keen assessments and prompt interventions 2 RN Verification
— Admission, Transfer, During Shift
Turning Every 2 Hours
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Is the Caring Science Model affecting our patient care outcomes?
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HAPU Rates by Year
2009 2010 2011 2012 20130
20
40
60
80
100
120
140
160
180
200
184
145
97
132
12
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Cal Noc P&I Study Update
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Most Recent HAPU Data by Volume
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2 RN Verification Admission
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2 RN Verification on Transfer
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2 RN Verification During Shift with Braden Score 16<
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Kaiser Santa Clara CaresAbout HAPU Prevention
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The Magic of KP Santa Clara Continues…
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Thank you for allowing me to share our story
• Contact Information
• Kathy.Ricossa@kp.org 408.851.7804
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