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Employee Newsletter |
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| IMPORTANT EMPLOYEE INFORMATION |
HEALTH AND SAFETY INFORMATION
• JCAHO Behavioral Health National Patient Safety Goals
• Prohibited Abbreviations
• Implementation Tips for Eliminating Dangerous Abbreviations
• Flu Prevention
• Suicide Prevention
• What to do in case of a fire when you are on the job
• Preparing for Severe Heat
• Preparing for Severe Thunderstorms
• Prevention of West Nile Virus
• Have a plan for Tornado's
• Be ready for a Flood
• Speak up for your Health!
• Speak up about your medications!
• Personal Protective Equipment and Removing it Safely!
Letter from the President
The Christmas Dance
Don’t you really love the excitement of this time of year? The sky is lightly overcast. Some trees still have lots of color. Some others have already removed their beautiful multi-colored coats of leaves. The breeze in the air causes the branches to sway and dance in the wind. They move slowly and rhythmically to the beat of the winter tune. There is a nip of cool weather in the air. The happy, yet anxious seeds of Thanksgiving have past and just now the seeds of Christmas time are planted and beginning to bloom.
It brings back such memories of years past and hopes of years to come. I remember a certain season quite a few years ago when my children were very young. It was the season four years past a traumatic car crash that left my daughter, Rebecca and my son, John Kenneth still recovering from injuries sustained in a split second life event. Rebecca had been severely injured by the seatbelt during the crash. It is the seatbelt I am thankful for because it saved her life. John Kenneth wore a seatbelt and shoulder harness also while riding in the back seat of our car. His life was spared also that night; however, the impact and the restraint caused a paralysis that is permanent. . It has never stopped his hopes and dreams.
My wife and I were rearing a mine, yours and ours, family. It took much work to make sure everyone felt like each belonged individually and together as a family. I loved the togetherness and the closeness of sharing these holiday experiences. My friend and colleague, Dr. Brian Gentle was the minister of our Church. The pattern, a ritual, on Christmas Eve had developed that Brian and I both would participate in the 8:00 and 11:00 worship services and communion services. It was because of our friendship and because of a spiritual connection that we did this. Everything was busy at home preparing for Christmas day and it was always hurried to get things as far along at home and then rush to the church to share this task. Even though It had been four years post the car crash that paralyzed my son and severely injured my oldest daughter and me, we were all still making life adjustments and adapting to the changes in the way everyday live was now lived. My heart was still hurting and tender because of the severity of injuries that my daughter and son had sustained.
The 8:00 o’clock service was underway. I was in my black robe and wore a Christmas stole. Brian wore the same. I looked out over the congregation. There in the sanctuary sat Cathy and John Kenneth. Great warmth of love and happiness filled my heart. I did not know that they were going to be there. It was so good to see them. As the service progressed and communion was held, I saw Cathy and John Kenneth standing together to take communion. John Kenneth was wearing his Sunday suit. He and his mom each had a wide smile on their faces. John Kenneth stood tall as he had left his wheelchair and was in his walking braces. It was so difficult to use his walking braces that he had always fought using them. It was such a struggle for him to lift his weight with each step. Tonight he smiled widely. He held his crutches tightly and he used his arm strength to walk. He would lift his body with his arms, as he held the crutches, and he would swing his legs forward, repeatedly until he had reached the chancel rail with his Mother. He pulled the locks from the hip and knee joints. He knelt by the chancel rail, as everyone else knelt. His determination to go the extra mile and kneel as everyone else had both affected and bonded the entire congregation. There was joy and happiness everywhere as people watched his tremendous struggle and determination to walk and kneel like everyone else would kneel to take communion. Eyes throughout the congregation were teary, as were mine. They were tears of support and encouragement that came from their hearts to applaud his success. I was so proud of him and of his Mom, who encouraged his effort. I think he took some pride that night in himself and in his Mom and in me as I served communion. This night, I would not be separated from him because of a ritual. I came down and out of the chancel rail and knelt beside him. I put my arm around his shoulders. His smile looked into my heart and touched me with his strength and courage. I knew I would not have to worry about him again. He had shown the ability to adapt to a new future regardless of how difficult it was going to be. He would use his faith and courage to live a new life moment to moment and day to day. He committed himself to hearing the beautiful music of the future, and he chooses to dance to it and live. He has never complained or voice any regrets.
We all took communion together that night in celebration of our savior’s birth, Again this year as we celebrate Christmas, remember it is He who was sent to give us hope and strength and courage to overcome the sourness of life so we may hear and seek the music of the future. He gives us the faith and courage to dance to it today and everyday. May you hear the music of Christmas and the New Year and may you have the courage to dance to it today and everyday
I appreciate everyone who is a part of the Alpha Omega family. Thank you for your commitment and dedication to our mission of top quality services to the clients we serve and to the staff who serve them. May you have a merry Christmas and may you always have peace in your heart.
J.K. Horne, Jr.
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JCAHO Behavioral Health National Patient Safety Goals
JCAHO National Patient Safety Goals – How they apply to AOH
For many years JCAHO has worked diligently to educate member organizations and the public about its national patient safety goals. The purpose is to improve the safety of care, treatment and services for individuals receiving services. In addition, the staff who provide services also benefit from increased safety in their working environment.
JCAHO National Patient Safety Goals:
1. Improve the accuracy of client identification
2. Improve effectiveness of communication among caregivers
3. Improve safety of using high-alert medications
4. Not applicable
5. Not applicable
6. Not applicable
7. Reduce the risk of health care acquired infections
8. Accurately and completely reconcile medications across the continuum of care.
9. Not applicable
10.Not applicable
11.Not applicable
12.Not applicable
13. Encourage client's active involvement in their own care as a client safety strategy.
14.Not applicable
15. The organization identifies safety risks inherent in it's client population.
AOH implements these safety goals as follows:
(1) AOH assures accurate client identification by providing individualized care with a one to one staff to client ratio. You can do your part by knowing you client on sight as well as knowing the emergency information specific to your client. In addition you should be competent to provide the client specific needs of the individual you serve. This JCAHO safety goal specifically targets taking blood samples (and confusing two client’s samples), an activity AOH does not do. If you work with a client who checks their blood sugar level you should be doing this on an individual basis so their sample cannot get confused with another client’s sample. The same procedure applies for administering medications. Most of you do not administer medication to individuals you serve but you need to be aware of the need to individually administer medications should the needs of the individual you serve change. In outpatient settings, Alpha Omega asks clients for their full names and is in process of implementing pictures in each chart for identification purposes.
(2) AOH staff in the mountain region are most affected by this goal. Other regions of the state do not take verbal or telephone orders or critical test results therefore not all of you are effected by this potential communication safety issue. However, it is important for all staff to communicate with your supervisor any changes in the condition of the individual you serve. In the mountain region, all staff involved in phone orders will utilize the implementation expection for requirement 2A in which the receiver writes down the complete order, the receiver reads back the order and the receiver receives confirmation from the individual giving the information that everything is correct. In addition, to improve communication, AOH has standardized the abbreviations, acronyms, and symbols used in our notes. Be sure you are familiar with the approved list of abbreviations as well as the list of abbreviations not to use. See your supervisor for a current list if you have any questions. For compliance with standard 2E - Alpha Omega Health, Inc has implemented a new "shift change" form to be completed at each shift change in all Alpha Omega Health, Inc. group homes. The transfer of responsibility and filling out the form gives each individual the chance to ask and respond to questions.
(3) If the individual you serve takes medication during the time you provide services you should be familiar with the way the individual stores and self-administers the medication. The purpose of this is to prevent unauthorized persons from accidentally, or purposely, taking someone else’s medication. You should not be storing any client’s medication. If you have any questions about medication please contact your supervisor. In addition, to further educate our staff, Alpha Omega Health, Inc. distributes a comprehensive list of Look Alike Sound Alike Drugs in order to better assist staff and clients in a proactive approach to preventing errors.
(4) This goal is not applicable to behavioral health services.
(5) This goal is not applicable to behavioral health services.
(6) This goal is not applicable to behavioral health services.
(7) AOH teaches proper hand washing to all employees and contractors. We comply with the Centers for Disease Control (CDC) hand hygiene guidelines when performing physical care. In addition, Alpha Omega utilizes a proactive appoach to infection control through education of staff. We have been diligent in applying our policies and procedures such that we have not had any incidents of cases of unanticipated death or major permanent loss of function associated with a health care acquired infection.
(8) Alpha Omega has several measures in place to ensure medications clients receive are correct, given on time and in the correct dosage. Some examples include: Person Centered Plan and Behavioral Health assessment both have area's for current medications, this is re-evaluated every six months, MAR's are turned in monthly and discharge information includes all medications.
(9) This goal is not applicable to behavioral health services.
(10) This goal is not applicable to behavioral health services.
(11) This goal is not applicable to behavioral health services.
(12) This goal is not applicable to behavioral health services.
(13) Alpha Omega Health has added information on client forms regarding who to call and numbers to call to report safety concerns. In addition, each group home has information posted regarding numbers to call to report safety concerns. Alpha Omega also has made "Speak up" information available to all clients and staff.
(14) This goal is not applicable to behavioral health services.
(15) Alpha Omega Health, Inc has modified the assessment we use for clients to assess for suicide risk. Alpha Omega also makes educational information availabe to all staff and clients regarding suicide prevention and hotline numbers for suicide prevention.
Each one of us is responsible for continuing to uphold this good record. These national patient safety
goals help us and the individuals we serve have a safe, more satisfying experience of care, treatment
and services.
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Flu Prevention
FLU PREVENTION!!!
Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
Washing your hands often will help protect you from germs.
Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
Who should get vaccinated this season?
Because of a shortfall in flu vaccine (flu shot) production for this season, CDC is recommending that certain people be given priority for getting the flu shot. People in the following groups should seek vaccination this season:
all children aged 6–23 months;
adults aged 65 years and older;
persons aged 2–64 years with underlying chronic medical conditions;
all women who will be pregnant during the influenza season;
residents of nursing homes and long-term care facilities;
children aged 6 months–18 years on chronic aspirin therapy;
health-care workers involved in direct patient care; and
out-of-home caregivers and household contacts of children aged <6 months.
These are people that are at high risk for serious flu complications or are in contact with people at high risk for serious flu complications.
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Employee of the Month
ALPHA OMEGA HEALTH, INC.
EMPLOYEE OF THE MONTH
Congratulations to our Employees of the Month!!! We appreciate you and all that you do!!!
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Prohibited Abbreviations
PROHIBITED ABBREVIATIONS
U (for unit)
Mistaken as zero, four or cc.
Write "unit"
IU (for international unit)
Mistaken as IV (intravenous) or 10 (ten).
Write "international unit"
Q.D.,
Q.O.D.
(Latin abbreviation for once daily and every other day)
Mistaken for each other. The period after the Q can be mistaken for an "I" and the "O" can be mistaken for "I".
Write "daily" and "every other day"
Trailing zero (X.0 mg) [Note: Prohibited only for medication-related notations];
Lack of leading zero (.X mg)
Decimal point is missed.
Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg)
MS
MSO4
MgSO4
Confused for one another.
Can mean morphine sulfate or magnesium sulfate.
Write "morphine sulfate" or "magnesium sulfate"
mg
(for microgram)
Mistaken for mg (milligrams) resulting in one thousand-fold dosing overdose.
Write "mcg"
H.S.
(for half-strength or Latin abbreviation for bedtime)
Mistaken for either half-strength or hour of sleep (at bedtime). q.H.S. mistaken for every hour. All can result in a dosing error.
Write out "half-strength" or "at bedtime"
T.I.W.(for three times a week)
Mistaken for three times a day or twice weekly resulting in an overdose.
Write "3 times weekly" or "three times weekly"
S.C. or S.Q.
(for subcutaneous)
Mistaken as SL for sublingual, or "5 every".
Write "Sub-Q", "subQ", or "subcutaneously"
D/C
(for discharge)
Interpreted as discontinue whatever medications follow (typically discharge meds).
Write "discharge"
c.c.
(for cubic centimeter)
Mistaken for U (units) when poorly written.
Write "ml" for milliliters
A.S., A.D., A.U.
(Latin abbreviation for left, right, or both ears)
Mistaken for OS, OD, and OU, etc.).
Write: "left ear," "right ear" or "both ears"
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Implementation Tips for Eliminating Dangerous Abbreviations
JCAHO asked accredited organizations how they have implemented the prohibited abbreviations requirement of the 2004 National Patient Safety Goals (Goal 2b). They received more than 100 responses, including lots of good ways to share the list of prohibited abbreviations and to achieve consistent compliance. Here's how some organizations are effectively communicating their prohibited abbreviations list to staff:
Print list on brightly colored paper/post-it notes/posters/stickers/magnets and place in medical records/patient charts, place at/on/near computers, and post in patient care areas.
Provide pocket-sized cards with the list to staff.
Print the list in the margin or bottom of the physician order sheets and/or progress notes.
Attach laminated copies of the list to the back of the physician order divider in the patient chart.
Delete prohibited abbreviations from preprinted order sheets and other forms.
Create clipboard cover that provides the list.
Provide the list on the front page of the intranet.
Provide a card with the list that can be attached to the back of the identification badge.
Place tent cards with the list where physicians write orders and dictate.
Have the list printed on pens.
Send monthly reminders of the list to staff via computer.
Educate and monitor staff who document in the medical record.
Create an educational display for use during Patient Safety Awareness Week.
Educate affiliated health care professional education programs about the list.
Place articles in employee and physician newsletters.
Provide mouse pads with the list.
Convene regional/community meeting to develop consistent list for physicians who maintain privileges at two or more facilities.
Direct pharmacy not to accept any of the prohibited abbreviations. Orders with dangerous abbreviations or illegible handwriting must be corrected before being dispensed.
Conduct a mock survey and question staff to test their knowledge.
Work with software vendor to ensure changes are made to be consistent with the list.
At every medical staff meeting, give patient safety updates, including information about the prohibited abbreviations.
Identify and promote "Physician Champions" who support accreditation-related activities and advocate for full compliance with the NPSGs.
Ask every staff person to sign a statement that he/she has received the list and agrees not to use the abbreviations.
Create a catchy name or theme: Do the "Write" Thing; Dirty Dozen; Outlaw Abbreviations—Join the Patient Safety Posse; "Operation BANEM" (Banned Items); Uncle Sam-style poster saying "You can prevent a fatal error;" P.S. It's all about Patient Safety.
Promote a "Do not use abbreviation of the month" campaign.
Create a song incorporating the "do not use" list.
Create a slide show/presentation illustrating poor handwriting and dangerous abbreviations. Include actual examples from your organization.
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Inclemate Weather
VI.16 INCLEMENT WEATHER/DISASTER
Policy: In the event the National Disaster Weather Services issues a severe weather watch or warning, the designated staff on duty in the residential programs or the Director/Coordinator of an office will initiate the inclement weather procedures. Inclement weather includes tornado, hurricane, snow, ice storms and any other disaster condition.
Procedures:
If the National Disaster Weather Service issues a severe weather watch for the local area a radio or television will remain on at all times for updates.
All residential programs are to keep a disaster supply kit comprised of food and items necessary for an emergency. When a watch is issued disaster items will be stocked, medications ordered, having at least a 10 day supply, outside items secure, gas tanks filled, and the generator prepared for emergency use.
All individuals receiving periodic services will have a Disaster Plan completed at admission, which identifies potential disasters in his/her location and plans for the disaster if it occurs. At admission the supervisor, using the supply disaster list, will verify the presence or absence of each item on the list and document its location. This information will be reviewed with the employee and a copy kept in the home chart.
Emergency phone numbers will be posted in each residential program listing internal supervisor’s pager numbers, the 24-hour answering service phone number and external community resources. In homes where periodic services are provided, emergency numbers will be located in the home chart.
In the event of a power shortage in a group home, a cellular phone is available and will be utilized to obtain internal and external assistance.
Each supervisor will have a call down list which will be utilized to notify staff of instructions in the threat of a disaster. Supervisors will coordinate staffing.
For individuals receiving services in the home or community, the supervisor will contact all individuals and his/her families to assure they are prepared for inclement weather.
Staff in the residential programs will keep in contact with the Residential Coordinator to discuss the possibility of going to a shelter or hotel. Staff will keep in constant contact with the coordinator.
If a severe weather watch is upgraded to a warning, staff will implement the safety procedures specific to the type of weather emergency.
Education in disaster planning will be provided to families and individuals receiving our service.
Snow/Ice
Staff in the residential programs who are on duty must remain on duty. Efforts will be made to relieve staff at normal shift changes if able. In the periodic program, staff will remain with the client if the legal guardian is not present. In the Regional Offices, the Regional Directors/Coordinators will close the office if they feel it is necessary for the safety of staff.
In the event of loss of power or heat, in residential programs, the residents will assemble in a central location and be encouraged to dress warmly. The Residential Coordinator will be contacted for direction to possibly relocate to another home, hotel or shelter, or to obtain a generator for extended loss of power.
The Residential Coordinator must be contacted before anyone leaves the residential program in a snow or ice emergency.
During the winter months, Residential programs will maintain a supply of sand, salt and have a snow shovel readily available. Additionally, the staff will assure that there is a full tank of gas in the vehicle.
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