1. 1 Roles and Resources Peer Leaders:

2. 2 Peer Leaders: Roles and Resources Mary Willa Matz, MSPH VHA Patient Care Ergonomics Program Manager/Consultant Occupational Health Science Researcher Industrial Hygienist VISN 8 Patient Safety Center of Inquiry James A. Haley VA Hospital Tampa, Florida (813) 558-3928 (813) 558-3990 fax mary.matz@va.gov

3. 3 Peer Leaders Peer Leaders are the Key to Program Success… ä Implement Program ä Maintain Program

4. 4 PL Roles/Responsibilities Peer Leaders as Agents of Change

5. 5 “If you want to make enemies, try to change something.” Woodrow Wilson

6. 6 The Realities of being a SPHM PL Change Agent Ultimate Goals/Purposes are broad… ä Responsibility is to assist in implementation of a SPHM Program that.. ä Promotes significant Thought Changes ä Promotes significant Behavior Changes ä Creates an effective ‘Culture of Safety’

7. 7 The Realities of being a SPHM UPL/Change Agent A ‘SPHM UPL/Change Agent’ facilitates… ä staff buy-in ä staff input during SPH Program development and implementation ä maintenance of the SPH Program over time (SPHM Follow-up study) ä attainment of goals of the SPH Program

8. 8 The Realities of being a SPHM UPL/Change Agent To be an effective change agent, a PL needs….  Knowledge of…  Why you’re doing it (Rationale/background)  What it includes (Program elements)  What you’re going to do it with (Program materials/tools)  How you’re going to do it (Action Plan)

9. 9 The Realities of being a SPHM UPL/Change Agent To be an effective change agent, a PL needs….  Communication Skills…  How to listen effectively  How to share & transfer knowledge effectively  How to coach peers

10. 10 Peer Leaders ä Back Injury Resource Nurses (BIRNS) – VA ä ErgoCoaches – Netherlands ä Ergo Rangers – BJC Healthcare ä Back Injury Resource Staff (BIRS) – Select Medical

11. 11 PL Benefits ErgoCoaches ä Take responsibility as ä Problem-owners ä Solution-owners ä 1 – 2 per unit ä Knowledge Transfer mechanisms ä Annual conference ä Newsletter ä Help desk ä Website

12. 12 PL Benefits ErgoCoaches ä Facilities w/ ErgoCoaches had significantly lower sick leave due to Musculoskeletal disorders ä Synergy between ä Work of thousands of ErgoCoaches ä National Support Group ä Governmental working conditions covenants (Knibbe, & Knibbe, n.d.)

13. 13 PL Benefits Co-Worker Benefits ä Employee involvement ä Enhances worker motivation ä Increases job satisfaction ä Leads to greater acceptance of change in workplace (OSHA Ergonomic Guidelines for Nursing Homes, 2003)

14. 14 PL Benefits Co-Worker Benefits ä Staff are empowered ä Channel to voice ideas/suggestions ä Opportunity to have input in making work environment safer ä Increased competence in performing job ä Increased sharing of knowledge/best practices ä Fosters Culture of Safety

15. 15 PL Benefits Example of PL Benefit ä Lifts not being used on night shifts. ä Why? Batteries were being charged on night shifts because no back-up batteries.  Solution: Buy extra battery packs so lifts can be used 24 hours per day.

16. 16 PL Representation Representative from all areas where patient handling occurs Representative from all areas where patient handling occurs Nursing Nursing Radiology Radiology Therapy Therapy Escort Escort Others Others Suggestion: 1 PL per shift per unit/area Suggestion: 1 PL per shift per unit/area

17. 17 PL Selection Eligibility ä Any direct patient care staff (i.e., RN, LPN, CNA, PT, OT, diagnostic tech, etc.) ä Has at least 6 months experience with handling patients ä Employed on unit for at least six months or a PL in another area previously ä Anticipates working on unit at least one year or more

18. 18 PL Selection ä Respected by colleagues & management ä Satisfactory performance evaluation ä Responsible and reliable ä Flexible ä Takes initiative/proactive ä Good time management skills ä Outgoing ä Resourceful ä Assertive (appropriately) ä Interest in SPHM/Safety ä Maintains good relationships w/ management Qualities

19. 19 PL Selection ä Patient handling experience ä Effective oral/written communication skills ä Physically able to perform job duties ä Critical thinking skills (appropriate for duties) ä Ability to teach peers using established training programs ä Informal Leader – credible with & respected by peers ä Computer skills ä Ability to learn, apply, and transfer new knowledge Skills

20. 20 PL Roles/Responsibilities Act as Unit/AREA ‘Change Agent’ Act as UNIT/AREA SPHM Champion Demonstrate Systems Thinking

21. 21 PL Roles/Responsibilities Maintain current knowledge Of… SPHM issues, technology, best practices Through… PL meetings, trainings, Outlook Equipment ‘Super User’

22. 22 PL Roles/Responsibilities Facilitate SPHM “Knowledge Transfer” Safety Huddles Algorithms Policy Coaching

23. 23 PL Roles/Responsibilities Facilitate SPHM “Knowledge Transfer” Training In-services/Small Groups/One-on-one Peers, Managers, Patients/families Topics: Program Elements, Equipment Use, Safety Concerns, Best Practices, etc.

24. 24 PL Roles/Responsibilities Follow unit injuries & close calls Act as Unit liaison w/ Infection Control, Facilities Management, Equipment Manufacturers, etc.

25. 25 PL Roles/Responsibilities Follow Equipment Use/Management Conduct Ergonomic ongoing environmental/ergonomic evaluations Perform walk-throughs to assess equipment use and function - Handout A-1) (Equipment Use Checklist - Handout A-1)

26. 26 PL Roles/Responsibilities Monitor Staff Competency (Staff Skills/Competency Check-off - Handout A-2) Monitor UNIT SPHM Program PL Activity Program Status Program Compliance

27. 27 PL Roles/Responsibilities PL Activity/Status Log (Handout A-3) ä ä UPL’s Perception (weakness) ä ä Complete weekly ä ä Utility ä ä Track PL activities/dose – Justifies need for PL program ä ä Use as indicator for acceptance & effectiveness of SPH program ä ä Champion Use ä ä evaluation tool ä ä determine problem areas ä ä Suggest: Develop web-based data base with reporting capabilities

28. 28 PL Roles/Responsibilities ä Insert facility-specific and unit- specific roles/ responsibilities in Unit SPH Binders

29. 29 Monitoring PL Competency PL Competency Assessment (Handout A-4) PL Activity/Status Log (Handout A-3)

30. 30 Suggested PL Training ä ä Background/History/Patient Handling Injuries/Legislation ä ä Ergonomics and Biomechanics of Patient Handling ä ä Evidence/Research Findings ä ä SPHM Program elements: ä ä Patient Care Ergonomic evaluation process ä ä Patient Handling equipment ä ä PL (job description/duties) ä ä After Action Review ä ä Algorithms ä ä SPHM Policy/Directive

31. 31 Suggested PL Training ä ä Risk analyses ä ä Patient Handling Equipment/Slings ä ä Program implementation/Maintenance Strategies/Facilitators ä ä PL (UPL) Log ä ä Culture of safety Concept ä ä Change theory/strategies ä ä Knowledge transfer concept/theory ä ä Social marketing ä ä Program Facilitators/Barriers

32. 32 Suggested PL Training ä ä Peer Education/Coaching ä ä Conducting competency assessments ä ä Adult education principles ä ä On-the-job (OJT) training principles ä ä Coaching

33. 33 Implementing a PL Program ä Determine PL roles for facility/unit/area. The PL role may differ by clinical area. ä Determine number of UPLs needed for each unit/area. The number of UPLs required may differ by clinical area. ä Review PL Selection Criteria ä Meet w/ nurse managers/supervisors to discuss PL roles, selection, and number required for the clinical unit/area. ä Facilitate selection of UPLs.

34. 34 Implementing a PL Program ä Conduct PL orientation/training. Several training may need to be offered to capture all UPLs. ä Facilitate PL training by equipment manufacturers in order to attain ‘Super User’ status. ä Hold regularly scheduled meetings. Initially, one every two weeks is suggested, then monthly meetings are satisfactory. ä Ensure all UPLs are on Outlook ä Create facility Outlook PL Mail group.

35. 35 PL Resources

36. 36 PL Resources Resources Facility SPHM Champion/Coordinator Facility SPHM Champion/Coordinator SPH Presentations/Materials from this conference SPH Presentations/Materials from this conference Safe Patient Handling & Movement: A Practical Guide for Health Care Professionals, Ch. 7 (A. Nelson, editor) Safe Patient Handling & Movement: A Practical Guide for Health Care Professionals, Ch. 7 (A. Nelson, editor) AORN Ergonomic Guidelines for the PeriOperative Environment (AORN website) AORN Ergonomic Guidelines for the PeriOperative Environment (AORN website) NAON Ergonomic Guidelines for Orthopedics/Rehabilitation NAON Ergonomic Guidelines for Orthopedics/Rehabilitation Tool for Prioritizing High Risk Tasks (Handout A-5) Tool for Prioritizing High Risk Tasks (Handout A-5)

37. 37 PL Resources Resources SPH Unit Binder (Handout A-6 - Table of Contents) SPH Unit Binder (Handout A-6 - Table of Contents) Easily accessible location on each unit Easily accessible location on each unit Install on VAMC Network Install on VAMC Network

38. 38 Peer Leaders Program Facilitators

39. 39 Ways To Assure Success & Sustain Program ä Succession Planning (related to turn-over, change of position, change of unit, etc.) ä Nurse Mgr/Safety Champion responsible for identifying new PL after notification that current PL resigns, transfers etc. ä Open PL course to others to gain Tempo/CEU credits

40. 40 Ways To Assure Success & Sustain Program ä Redundancy ä Have PL Binder accessible on each unit ä Provide one PL per shift per unit ä Peer Leader Back-up (if only 1 UPL/unit) ä From UPL’s unit  From other unit

41. 41 Ways To Assure Success & Sustain Program Hold regular meetingsHold regular meetings ä Patient care responsibilities interfere Stay connected through email helps but not as good as face to faceStay connected through email helps but not as good as face to face Ensure management supports time for meetingsEnsure management supports time for meetings

42. 42 Ways To Assure Success & Sustain Program ä Marketing Unit Peer Leaders (Handout A-7)

43. 43 Safe Patient Handling & Movement Program Peer Leaders are the Key to Program Success… ä Implement Program ä Maintain Program

44. 44 Never underestimate the ability of a small group of committed individuals to change the world. Indeed, it is the only thing that ever has. Never underestimate the ability of a small group of committed individuals to change the world. Indeed, it is the only thing that ever has. Margaret Mead

45. 45

46. 46 Peer Leaders: Roles and Resources QUESTIONS/COMMENTS??