Focusing on Employee Safety in Focusing on Employee Safety in Long Term Care - OrientationLong Term Care - Orientation

First!

• Welcome to our Employee Safety Program

• We take our responsibility for our residents’ safety and our employees’ safety VERY seriously (and so should you!)

• The following information is extremely important to your success in our facility

If you are injured on the job…• Employee must notify his/her Supervisor IMMEDIATELY

• First Aid provided by facility nurse

• Employee Incident Report filled out by Supervisor right away

• Can anything be done to prevent further immediate injury?

• Supervisor coordinates with facility Workers’ Comp. Coordinator

• Workers’ Comp. Coord. coordinates medical care if needed

• WC Coordinator makes all medical appointments where possible

• Transitional Duty (Work Status) form given to injured employee to take to the treating physician

• Billing and First Fill form for the employee to present to the medical provider

• Physician provides care – fills out Transitional Duty (Work Status) form

• Injured employee brings Transitional Duty (Work Status) form back to the facility immediately for review and Job Offer Letter creation

Incident Report REQUIRED TO BE FILLED OUT BY THE SUPERVISOR!!!

ONLY SECTIONS FOR EMPLOYEE

For the Administrator

WC Procedure & Paperwork

•Paperwork is extremely important in order to provide approved, timely and accurate care.

What to take with you to the doctor with – on every visit

We provide extensive transitional duty within the restrictions provided by the authorized treating physician.

Always expect to come back to work.

Employee is accountable to have the doctor complete this form.

Employee must bring this form and the doctor’s report back to the WC Coordinator (or designee) immediately after the office visit no matter what time it is.

All employee incidents will be fully investigated in order to find the true Root Cause.

Re-enactment of what happened and why will occur.

Witness statements will be obtained.

Once a Root Cause is found, corrective actions will be taken to make sure the incident does not happen again.

When appropriate, a Workers’ Comp. Claim will be filed.

• Our insurance company fully understands our transitional duty program, our policies and our procedures.

• Injured employee must keep in contact with the WC Coordinator in the facility as well as the insurance company claims adjuster often to assure all laws are complied with.

• No one withholds medical care or withholds loss wage payments from the injured employee but all care and all wage payments from the insurance company must be done by state law, following specific rules & regulations.

Sense of Urgency & Communication

• Supervisors, Managers and Employees must act with a sense of urgency with all employee incidents.

• If medical care is needed, then it will be timely coordinated by the facility WC Coordinator

• Employees must provide a written statement of what happened.

• Employees must promptly bring back all paperwork

Transitional Duty Job Offer•Injured employees released to transitional duty will always be offered work within the facility•This will be done in writing and the employee must sign & date the letter acknowledging the job offer•This letter shall be done the same day the employee is released to transitional duty

Employee Transitional (temporary time period) Return-To-Work

•We are committed to bringing employees back to work to eliminate or limit any sort of wage loss•Work duties will always be well-within the restrictions documented by the treating physician but may be outside the employee’s normal duties•The needs of the building dictate what tasks will be done (and when) and management will select those duties on a case-by-case basis

The Basics: Primary Loss Sources

Typical Workers' Compensation claims:

• Strains / Sprains due to resident transfers & repositioning residents (backs, shoulders)

• Contusions & Strains due to Slips, Trips, Falls (complex & costly)o tripping on bed cords, fall mats, wheelchairso slipping on wet floors

• Contusions, lacerations, strains due to Aggressive Resident Behaviors

Programs Addressing Challenges

Resident Transfer / Reposition

Resident Transfer & Repositioning Program

• Often called “Ergonomics / Back Injury Prevention Pgm"

• Utilize Mechanical Lift Equipment & Slingso Total Lift (Hoyer-type) & Sit-To-Stand (Sara-type)

• Glide Sheets for repositioning residents in bed with minimal caregiver effort (not a "draw sheet")

• 2-person assist with Gait Belts when other solutions are not feasible

• Proper Body Mechanics, posture, techniques, teamwork

We are basically "No Lift" or "Low Lift" facilities

• Whenever possible, we eliminate or minimize manually bearing the weight (lifting) of any resident

• Care Plan documentation must support this program

Resident Transfer / Reposition

• “Falling Residents” – Do not attempt to catch a falling residento Instead: ‘Guide the Fall’ to avoid bearing the

resident’s weighto Use the ‘slide’ technique to gently lower the

resident to the floor

• Lifting Residents from the Flooro NEVER manually lift a resident from the flooro You must ALWAYS use a mechanical lift and

at least two caregivers

Repositioning Residents

• Glide Sheets need to be used whenever the resident cannot provide assistance in moving in bed

• Hands-on training is needed so that staff understand the benefits and limits of this tool

• Proper Body Mechanics, posture & bed height must go hand-in-hand with using this tool otherwise injuries will occur

• An “unbalanced” team (one short caregiver, one tall) will cause issues in this operation

There is NO lifting with a Glide Sheet.Caregivers with proper posture and stance – shift their weight from one leg to another. This moves the resident. There is no pulling. SHIFT, then repeat as needed to get the resident to the desired position.

Trip Hazards

• Bed cord management in resident roomso Cords must be tied or strapped up to the bed frame so that

no caregiver tripso Loops hanging down at the edge of the bed and cords on

the floor are unacceptable, must be managed

• “Bed Cords” are:o Electric cords, call light cords, phone cords, o Air mattress hoses and power cordso Oxygen tubing, electronics cords, bed alarms, cables

• These hazards are spotted very easily and managed very easily. Get guidance from Maintenance Director on exactly how cords will be managed to avoid property damage

Slip Hazards

• Control & Address Spillso Anticipate where possible, where

probableo Pop up signs, spill kitso You See It- You Own It

• Mopping procedureo One side at a time, least amount of

water possible, sufficient warning signs, barriers work best

o Once dry, take up signs

• Footwear

Controlling Slips

• Specifically labeled “Slip Resistant” footwear required for all Dietary staff including manager and dietician

• When “Slip Resistant” footwear is not worn, it is the manager’s responsibility to make sure that staff wear Overshoes

• Overshoes are required when caregivers assist residents in shower rooms

• Overshoes shall be provided by management

Controlling Slips

• Umbrella Bags to be used at main entrances

• Walk-Off mats to be used during inclement weather

• Pop-Up Wet Floor Signs to be installed throughout the building

• Intense awareness to spills and wet floors on an ongoing basis, but changed up often to maintain a fresh messageo High probability areas should be a key focus

Water fountains, hydration carts, dining rooms, soiled utility, food carts, entrances, AC leaks, shower rooms, refrigerators, ice makers, etc.

Solutions - continued

Slips, Trips & Falls Prevention Program

• Bed cord management (elec cords, bed alarms, call light, air hoses, etc.)

• Fall mat procedures (up when resident not in bed)

• Wet floor sign placement, mopping procedure

• Pop-Up wet floor signs in hallways, prompt clean up & removal

• You See It, You Own It - spill clean-up expectation of all staff

• SR Maxx overshoes in Dietary & Shower Roomso or similar "slip-resistant" labeled footwear

• Lighting - a dark room = pathway uncertainty

• Resident Clutter - no room to maneuver, furniture

• Wheelchairs & Wheelchair leg extensions properly stowed

• Awareness - always know your surroundings• Changing employee behavior takes over 2 weeks of repetition – not just training

Aggressive Resident Behaviors

Aggressive / Combative Residents

• Know your residents

• "unpredictable" actually means predictable

• Training is the key – create “specialists”o Proper approach, Understanding warning signso Know when to walk away rather than get hurto Understanding "defensive care"

keep arms away from resident's face keep resident's fingernails short know the triggers of behavior

Other Common Issues

• Closing doors on hands – always use doorknob, don’t take shortcuts, don’t lean in doorways

• Falling off rolling chairs – this is common sense

• Always use proper body mechanics and avoid awkward postures

• Always push carts, never pull them

• Never stand on chairs, always use the right tool for the job (stepstool or ladder)

• Always wear proper personal protective equipment for the task (gloves, goggles, apron). When in doubt – ask.

• Taking short cuts – don’t do it!!

• Using kitchen knives to open packages – don’t do it!!

• Don’t run

• Wear proper clothing & shoes

• Always be aware of what is around you (residents, wheelchairs, cords, spills, mats)

Montly Safety Committee

Safety Committee Meeting 50% staff / 50% management Discuss problems & solutions Raise general safety awareness Conduct inspections & audits Celebrate achievements Bring issues from departments Help identify issues Train & support others Safety cheerleaders Extra training & ownership

Safety Pledge

In order to promote an uncompromising safety environment & to ensure the well-being of all employees working towards continuous improvement in safety excellence, do hereby make the following commitment. I will...

•Work safely as a condition of employment and accept responsibility for my own safety,

•Always put safety first in completing my duties, never taking short-cuts

•Inspect my equipment prior to the start of work, report any unsafe conditions immediately, and never operate unsafe equipment,

•Challenge anyone—at any level—who is not being safe and accept the same challenge from my co-workers,

•Utilize the necessary personal protective equipment for the task every time,

•Report all incidents immediately to my supervisor,

•Know and practice all safety rules, follow all appropriate policies and procedures,

•Use common sense in performing my duties, ask for guidance if I am unsure,

•Be aware of the activities of other team members and residents at all times,

•Insist on a total commitment to safety excellence from myself and all team members,

•Never sacrifice or compromise safety to perform a job quicker or easier,

•Recognize, acknowledge, and encourage safe work habits and behavior that support our Vision and Values.

Finally…

• Please report all hazards to your supervisor

• Report all work incidents immediately to your supervisor

• Take responsibility for your own safety and encourage others to do the same

• Be a part of the Safety Committee

• Work as a Team, offer to help, ask for help

• Ask questions, don’t assume

Thank YouThank You…for your commitment toward helping us maintain

a SAFESAFE workplace for everyone.