Are you striving to make your nursing home an even better place to live and work? Join the Advancing Excellence campaign today Across the country, nursing homes and stakeholders are coming together to form a dynamic, two-year campaign entitled Advancing Excellence in America’s Nursing Homes. The campaign is designed to recognize the work nursing homes have already done, establish a forum for creating even more improvement, and celebrate the successes gained during the new initiative. The campaign builds on Quality First, the Nursing Home Quality Initiative, and the culture change movement. Goals include developing a culture of person-centered, individualized care and creating a more empowered workforce. “These aren’t new ideas,” Dr. Bruce Smith, Medical Director of Group Health Nursing Home Services, said, “but the campaign gives us a new way to energize and organize our continuing efforts. It provides focus and a means to measure progress.” Participating nursing homes will receive resources and technical assistance to meet the campaign targets. “In our state, the campaign organizers are putting a special emphasis on helping nursing homes make improvements related to pressure ulcer prevention, pain management, and staff retention,” Susan Hausmann, nursing home quality improvement director at Qualis Health, said. “Thanks to the collaboration of the local sponsors (see below), I’m confident that nursing homes will benefit from participating in this campaign.” To learn more about the campaign targets—and for helpful hints regarding choosing your campaign goals—please see the local campaign's website. Downloadable resources and a local events calendar will be available soon. Registration is available online; if you would prefer a paper form instead, please e-mail Susan Hausmann or call her at (206) 364-9700, ext. 2890. Advancing Excellence unites stakeholders Local support for the Advancing Excellence campaign is strong. The following organizations have already committed to sponsoring the Washington state campaign: American College of Health Care Administrators, Northwest Chapter American Medical Directors Association, Washington Chapter Long Term Care Health Information Managers (LTCHIM) Long Term Care Ombudsman Program Qualis Health Resident Councils of Washington Residential Care Services / Department of Social and Health Services Washington Association of Housing & Services for the Aging (WAHSA) Washington Health Care Association (WHCA) Washington State Board of Nursing Home Administrators

NAC input, simplified processes key to pressure ulcer prevention Regency at Puyallup Rehabilitation Center significantly reduced their high-risk pressure ulcer rates: from an average of 18.1 in 2003-2005 down to 5.2 for the second quarter of 2006. How did they achieve such a substantial change? The Regency team approached this challenge from several angles, trying one method at a time and working out the kinks before instituting house-wide changes. Here’s a sampling of challenges that they identified, along with the steps they took to resolve them. Complex, multi-page protocols  They updated and simplified the protocols. Whenever possible, they are now printed on a single page, in a chart or flow-sheet format. Care plans not implemented promptly Further simplifying their systems, the Regency team used the Braden Scale pressure ulcer risk categories to develop four corresponding “shopping list” care plans. These care plans serve as cues for busy nurses, are quick to initiate, and allow NACs to perform many of the prevention steps. Failure to promptly identify changing risk factors While the licensed nursing staff can readily identify a resident’s pressure ulcer risk level, the Regency team realized that NACs, who are in closer daily contact with the residents, were better positioned to identify subtle changes. They decided to train the NACs on the use and purpose of the Braden Scale. The NACs are now better able to recognize and report changes, and care plans are initiated more quickly. Training the NACs about the Braden Scale “has been a tremendous help,” Lisa Briley, RN, said. “Instead of us telling the NACs to do something, they are letting us know that they’ve already done it.” For more about Regency’s successful NAC training, please see the related article below. Find helpful pressure ulcer tools, including details about the Regency Puyallup effort, at the Qualis Health website.

Register for Eden Alternative training If you are interested in becoming a certified Eden Associate, you won’t want to miss a three-day training session to be held April 9–11 in Yakima. Learn about the Eden Alternative’s unique patient-centered approach, such as how to fight against the “three plagues” of loneliness, helplessness, and boredom. The registration fee is $400. For information and registration, please contact Jesse Rogers via e-mail or phone (512) 847-6061. Sunnyside’s Hillcrest Manor, the sponsor of the April session, has just joined Riverview Lutheran Care Center in Spokane as one of two Washington facilities approved to provide Eden Alternative training.

Plan ahead to make in-services more powerful When your nursing home plans its next in-service, follow the lead of Regency at Puyallup Rehabilitation Center—which took the time to answer the following questions—to fine-tune your efforts and maximize the results. Is training the answer? The team identified many obstacles to improving high-risk pressure ulcer rates; education was not always the best solution. For example, their existing protocols were too complex to be effective even with a great deal of training. Who should receive the training? Regency had good pressure ulcer training for the licensed nurses. Yet, it did not create the kind of results they were expecting. They realized that the NACs, with their closer daily contact with the residents, could be the key. How can the information be conveyed best?  Linda Whitman, RN, took an innovative approach to personalize the training. As a result, the NACs not only absorbed the training more readily, but have become empowered by their enhanced role. Tracy Backman, NAC, described several changes she’s made to help prevent pressure ulcers. “We come up with some ideas and pass them onto the nurses,” she reported.

Did your organization make significant, measurable improvements in 2006?
Apply for the Washington Award of Excellence in Healthcare Quality and be recognized for your achievements!

The nomination deadline is February 28, 2007. Get more info.