PSW NEWS. First Annual PSW Supervisor s Conference. Personal Support Network of Ontario. Inside this issue:

Transcription

1 Personal Support Network of Ontario PSW NEWS Volume 3, Issue 1 January 2009 Inside this issue: Upcoming Conferences in London & Ottawa Support for Personal Support Workers Hand Washing Review New Benefits For Temporary Employees in Ontario Added Protection For Health Care Workers Voices From The Frontline Best Practices in Personal Support: Myth Busting: Wandering PSNO Wants To Hear From YOU! First Annual PSW Supervisor s Conference On November 25th, PSNO hosted a Conference which focused on the needs and development of PSW Supervisors. Over 160 PSW Supervisors gathered at the Westin Prince Hotel in Toronto for the day long event of learning and networking. The morning keynote speaker was Janet Purvis, National Practice Consultant for VON Canada and author of Analysis of Regulation for Continuing Care Assistants in Nova Scotia. Her presentation, Evolution of the Personal Support Opening Plenary: Janet Purvis Worker and the Implications for Professional Nursing, focused on unregulated care providers; whether they should become regulated and if so what the implications might be for Supervisors and how their role would evolve. PSW Supervisor delegates were then invited to choose from a range of small workshops including: I m A Supervisor, Now What? Professional Care Boundaries for Supervising Peers; Developing Leadership Qualities to Inspire and Engage Your Staff; Hush No Rush: The Team Approach to Dementia Care; What PSW Supervisors Can Do to Enhance the Work Experience of Personal Support Workers; Occupational Health and Safety: Everyday Applications for Personal Support Worker Supervisors; and many more! Caledon Community Services Capacity Building in Supportive Housing: The conference closed with a presentation from Yvette Perrault, Director of AIDS Bereavement Project of Ontario. Using humour, she spoke of the challenges in supporting frontline human service workers and managing the continued stress of ongoing loss and transition they face as a direct result of their job. Overall, the 1st Annual PSW Supervisor Conference was a great success! Here is what Conference attendees had to say: Very informative! It gave a much needed voice to the PSW that we as Supervisors sometimes miss ; A very positive approach to PSW leadership and mentoring: Continuing to empower PSW staff ; Terrific opportunity for networking, continuous education and futures planning. The Conference provides renewed energy and goal setting ; Excellent selection of workshops to attend with dynamic speakers and applicable topics and information ; I wish that every PSW Supervisor could attend a conference. It has been a very inspiring experience. Thank you to all who attended for making this first ever Conference a success!

2 Upcoming Conferences in London & Ottawa If you missed our 2nd Annual Provincial PSW Conference, don t worry! PSNO is pleased to inform you that we will be hosting Regional Conferences in London and Ottawa. Registrations are currently being accepted. The London Regional PSW Conference will be held on March 11, 2009 at the Best Western Lamplighter Inn Ottawa s Regional Conference will be held on April 7, 2009 at the RA Center. Both day-long Conferences will include networking opportunities and professional development workshops featured from the 2008 Provincial Conference, which was held in Richmond Hill, Ontario on October 20, Workshops include: Professional Care Boundaries Violence Against PSWs MRSA / C. dificile Trying to Take Over the World Bullying in the Workplace Smooth Transitions This is your opportunity to network with other PSWs and professionals in the industry. Space is filling up quickly, be sure to reserve your place today. Join PSNO and save on Conference fees. For more information, including conference brochures and registration forms, please visit our website at For other inquiries please contact Sarah Blakely at / ext. 244 or via at: sarah.blakely@psno.ca Get the Support You Deserve! Support for Personal Support Workers Community of Practice The Support for Personal Support Workers Community of Practice is funded and supported by the Seniors Health Research Transfer Network and sponsored by the Personal Support Network of Ontario (PSNO) and VHA Home HealthCare. The Support for Personal Support Workers Community of Practice (PSWCoP) is a free knowledge exchanged network for PSWs working with seniors in the community or in long term care in Ontario. The purpose of PSWCoP is to provide PSWs working with seniors in dispersed work settings in the community with support through: access to the support and expertise of their colleagues access to research about best practices in caring for seniors access to the services of a Knowledge Broker and an Information Specialist to answer practice questions and provide information useful to them in the field training in the use of web-based communication tools The PSWCoP is currently recruiting members. Current members are PSWs working with seniors, Researchers, Ethicists, Clinical Practice Specialists and Educators. Members receive notice of all PSWCoP activities; options to participate in dialogues and learning exchange events. There is no fee for membership. To become a PSWCoP member, leave a message with your name and contact information at x4783 or pswcop@vha.ca. Please note this membership is separate from membership in PSNO. Page 2 PSW News

3 Hand Washing Review Tips from the website of the Ministry of Health & Long-Term Care When done properly, hand washing is the single most effective way to prevent the spread of communicable diseases. Good hand washing technique is easy to learn and can significantly reduce the spread of infectious diseases among both children and adults. Follow these 5 simple steps to keeping hands clean: 1. Wet your hands with warm running water. 2. Add soap, and then rub your hands together, making a soapy lather. Do this away from the running water for at least 15 seconds, being careful not to wash the lather away. Wash the front and back of your hands, as well as between your fingers and under your nails. 3. Rinse your hands well under warm running water 4. Pat hands dry with paper towel 5. Turn off water using same paper towel and dispose in a proper receptacle. Other tips to keep in mind: Keep nails short Remove watches, rings and bracelets Do not use artificial nails Avoid chipped nail varnish Wash wrists and forearms if they are likely to have been contaminated Make sure that sleeves are rolled up and do not get wet during washing There is more to hand washing that you think! By rubbing your hands vigorously with soapy water, you pull the dirt and the oily soils free from your skin. The soap lather suspends both the dirt and germs trapped inside and are then quickly washed away. Alcohol rubs / gels / rinses are excellent hand antiseptics, provided they contain more than 60% alcohol. They are widely used in heath care settings, or in situations where running water is not available. They should only be used if no visible dirt is present on the hands. To use alcohol based hand rubs, apply enough antiseptic to make about the size of a quarter onto your hands, enough when you rub your hands together to cover all areas of your hands, including under your nails. Use a rubbing motion to evently distribute the antiseptic product until your hands feel dry. Follow these steps; 1. Remove hand and arm jewellery 2. Ensure hands are visibly clean (if soiled, follow hand washing steps) 3. Apply between 1 to 2 full pumps of product, or squirt a loonie-sized amount, onto one palm 4. Spread product over all surfaces of hand, concentrating on finger tips, between fingers, back of hands and base of thumbs 5. Rub hands until product is dry. This will take a minimum of 15 to 20 seconds if sufficient product is used. Alcohol based hand antiseptics are very safe. The alcohol content of the antiseptic product completely evaporates as it dries. It should not be swallowed, therefore children should be supervised when using it. Some mistakes to avoid regarding hand washing are: DON T use a single damp cloth to wash a group of individual s hands DON T use a standing basin of water to rinse hands DON T use a common hand towel. Always use disposable towels in day care or food preparation settings DON T use sponges or non-disposable cleaning cloths. Remember that germs thrive on moist surfaces Follow these steps and tips and you can significantly reduce the spread of infectious diseases. And be sure to pass this information along! For more information on the importance of hand washing visit Volume 3, Issue 1 Page 3

4 New Benefits For Temporary Employees In Ontario The Ontario Government has passed new regulations for elect-to work employees. These benefits, which came into effect January 2, 2009 are: Rights to public holiday entitlements Rights to notification of termination; and Rights to severance pay. Labour Minister Peter Fonseca is quoted as stating: The McGuinty government is committed to protecting the rights of all employees. We want to ensure that Ontario s employment legislation reflects the realities of today s workplace and labour market in a balanced way, and that employees working through temporary help agencies are properly protected under the law. According to Children and Youth Services Minister Deb Matthews, By eliminating barriers to permanent employment and strengthening employment rights for many vulnerable workers, we re creating opportunities for them to achieve their potential. According to the Ministry of Labour, there are more than 700,000 people in Ontario working in temporary jobs. As a result of this new legislation, these changes will ensure that temporary home care workers are given the same respect as all other health care workers. These new regulations are part of the Ontario Government s Poverty Reduction Strategy. To find out more about this Strategy please visit: english/strategy.asp Added Protection For Health Care Workers The Ontario Government has announced that it is creating a team of 17 specialists devoted to help improve workplace safety for health care workers in Ontario. The goal of these health care specialists is to improve enforcement of occupational health and safety regulations in health care workplaces, which employs over 480,000 individuals. We are pleased to support an increased focus on improving occupational health and workplace safety conditions in health care workplaces. Health care workers face many hazards that are unique to this sector, said David Caplan, Minister of Health and Long-Term Care. This team of specialists will: Help enforce compliance with health and safety legislation in health care sector workplaces Ensure health care providers are better prepared for emergencies, including outbreaks of infectious diseases Support a committee of sector representatives who advise the Minister on occupational health and safety matters, and Assist employers and employees in health care and all other sector to prevent occupational diseases. To learn more about the Ministry of Labour health care sector plan visit: english/hs/sawo/ sectorplans/ healthcare1.html Page 4 PSW News

5 Voices From the Frontline This edition of Voices From the Frontline focuses on Lorna Sackaney, a PSW with Constance Lake First Nation, within the Sunrise Elder s Complex. She lives in Calstock, Ontario. How long have you been working as a PSW? I started my career as a PSW with Constance Lake First Nation in 2003, and have been working at the Sunrise Elder s Complex since it was opened 2 years ago. Why did you want to become a PSW? While living in London I saw an ad about becoming a PSW. I was taking care of my elderly parents at that time, and I have a lot of patience. It sounded interesting and I thought it was something I could do. What is the profile of your clients? Most are able, but there are people with arthritis who have a hard time cooking for themselves and doing things on their own. Some are people who have suffered from a stroke, others with mental illness. As a PSW, what kind of services do you provide? The Sunrise Elder s Complex is a building with 10 apartments and one unit which services 6 clients. PSWs who work in the building assist with meals, take vital signs, test blood sugar, bathe, meal prep, clean, do laundry, and spend time with and talk with clients. I also work as a manager s assistant, so I help with staffing, scheduling, reporting, work on care plans, time sheets and do reassessments after the nurse has done her assessment. My job has a lot of variety, I can be in front of the computer and then out pushing a mop. What is your greatest strength as a PSW? I have a lot of patience with people and can tolerate if people become upset. What is the most difficult part of your job? For me, it is confrontation. If things go wrong or I m having a hard time with a client. Also, sometimes there is a communication barrier, for example if someone suffers from a stroke. This can frustrate both the client and the staff. We do our best to use our knowledge and experience to communicate with them. Are there any additional challenges you face as a result of working in a northern Ontario city? There is a shortage of nurses. RNs work from Monday to Friday, so there are no nurses on-site on weekends, which can be challenging. If someone gets sick, the PSWs can t report to a nurse and have to make their own decision to either call an ambulance or they may make a call to Telehealth. We also use each other (PSWs) as resources. Also, because we are so far up north, education can be hard to access. Often there are opportunities in Toronto and Hamilton, but these can be difficult for us to access because they are so far away. We do attend video conferences, but they are not the same as face to face. What do you do to relieve work-related stress? I like to walk, read a book or watch a movie to get my mind off things. Sometimes when it gets too stressful, PSWs will talk to each other and support one another. We are a small group of staff and we work well together as a team. Talking about it releases some of the stress we carry. What advice would you have for anyone considering a career as a PSW? There is so much shortage in the health care field, and PSWs are needed. It is a rewarding career. It feels good to help people. Voices from the Front Line is a regular feature of PSW News. If you think you have an interesting story like Lorna s that you would like to share with others, please contact Sarah Blakely at PSNO at My job has a lot of variety I can be in front of the computer and then out pushing a mop. Volume 3, Issue 1 Page 5

6 BP Blogger: Myth Busting: The Wandering Issue By: Mary-Lou van der Horst Mary-Lou van der Horst is currently working with the Regional Geriatric Programs of Ontario- Central area as a a Geriatric Nursing / Knowledge Translation Consultant and the Ontario Osteoporosis Strategy for Long- Term care as Project Manager / LTC Nursing Consultant. Previously, she was the Regional Best Practice Coordinator in Lon Term Care for Central South Ontario with the Ontario Ministry of Health and Long- Term care assisting the long-term care sector to implement evidence-based / best practices care improvements. Myth 1: Wandering Isn t Common: The need to keep on the move that looks to others as aimless wandering is a common behaviour for persons with Alzeimer s disease or dementia. It s a direct result of physical changes in the brain. Overall estimates in LTC are between 11% to 50% of residents wander and as high as 60% for those with dementia. Staff consider wandering behaviours as one of In the literature, the typical person who wanders is usually an older man, is 74 years of age, for different reasons, anytime of the day, in dif- the most difficult to manage. Residents wander more cognitively (MMSE 13) and functionally ferent ways and with different results, some impaired in their ADLs, has sleep problems, is beneficial, some placing them at risk. Residents using more psychotropic medications, may be identified as those who wander are more likely to more spatially disoriented with an inability to experience adverse events, such as falls, hip fractures, use of restraints, use of psychotropic medications, and omitted treatments. Wandering is not a single simple behaviour, but rather a multitude of behaviours. Residents who wander may have some of the following behaviours: Repeatedly shadowing or seeking the whereabouts of a caregiver Going to unauthorized or private spaces Inability to locate landmarks or getting lost in a familiar setting Haphazard, fretful or continuous moving, walking or pacing Walking without an apparent destination or purpose Searching for missing or unreachable people / places Walking that cannot be easily dissuaded or redirected. Myth 2: Wandering Is Aimless: Wandering behaviour may appear to be aimless or confused but researchers believe there are reasons for wandering. There has been a recent shift from using the term wandering and replacing it with walking and increasing recognition that wandering may be beneficial and adaptive for people with dementia. Unfortunately, the reasons for wandering remain an unsolved riddle. Researchers speculate 3 main reasons for wandering: 1)Biomedical: There is an increased drive to walk (hyperactivity) as a direct result of brain damage - Cognitive impairment 2)Psychosocial: It s need-driven: searching for people or places associated with security; to ease loneliness and separation; to find social contact or companionship; to deal with boredom and isolation, to cope with depression, stresses and anxiety; to recreate a situation from their past such as going to work, doing previous roles or catching a bus, to find something that is lost, to do exercise; and trying to communicate need. 3)Behavioural: A person with impaired cognition is susceptible to influence from and interaction with the environment such as: Discomfort or unsettled state (e.g. hunger, pain, thirst, urinary urgency, constipation) Medication side effects Too much or irritating stimulation (e.g. sound, visual) Unfamiliar surroundings Change in routine or usual caregivers Distressing medical or emotional conditions Temperature: too hot or too cold Desire for more physical stimulation (desire fresh air, see or touch plants, feel sunlight, or simple desire to move) Page 6 PSW News

7 Myth 3: Same Care For All: Wandering is a complex behaviour with each resident having unique wandering behaviours. As of yet, researchers have not identified causes or cures for wandering. We have limited knowledge on why it occurs and how to manage it. For residents with dementia, we should think of wandering as a health behaviour and see it as being appropriate and adaptive. No connection has been found between wandering and getting lost; not between enhancing the environment and decreasing wandering. However, there are several non-pharmacological strategies researchers believe can help you manage wandering and that they must be resident-centered to meet each resident s needs: 1. Allow for Safe Wandering: Create a safe space for wandering. Remove clutter and obstacles 2. Look at the Immediate Environmental / Specific Cause(s): Identify triggers that the resident consistently reacts to and eliminate, reduce or modify stressors/cues that trigger wandering, use music to calm, offer food/fluids if hungry/thirsty; address toileting needs, provide social interaction 3. Develop Meaningful Activities to encourage the resident s participation considering their past skills. Change activities when they become bored. Provide distraction such as something to do with their hands. Take them outside for walks, ensure they enjoy fresh air regularly, provide interaction activities. 4. Exercise. Have them attend a regular exercise program to burn extra energy and help them sleep. 5. Provide Visual Cues of familiar objects, furniture and pictures to give the person a sense of comfort and belonging. Leave a nightlight on to reduce confusion. Provide a visually appealing environment. 6. Document the Wandering especially the times, patterns and cues that trigger wandering. Ensure the resident has identification on them at all times. 7. Install Technological Devices such as motion detectors and alarm systems, create a safe area 8. Communicate with the resident. Be supportive, reassuring and work with their needs. Any of these non-pharmacological strategies and others are best used in combination. Myth 4: Stop The Wandering: For many people, the term wandering suggests that it should be stopped. It s better to support a resident s movement and exploring, as it provides stimulation, social contact, helps maintain mobility and strength, prevents skin breakdown and constipation, and enhances mood. It s normal. Wandering or walking should not be stopped. However, wandering may be detrimental when it results in the resident leaving the LTC home, entering unsafe or other resident spaces or results in injuries, weight loss, dehydration, falls, excessive fatigue agitation or even death. Physical restraints haven t been shown to reduce wandering, successful exiting or enhance safety in residents who wonder. Rather, it s linked with an increased risk of injury, pressure ulcers, infection, falls, sedation, agitation, anxiety and violence. There are different types of wandering associated with Alzheimer s disease: Aimless wandering or non-focused walking with little or no direction or destination, puttering around Purposeful wandering goal-oriented Night-time wandering with broken sleep pattern, restlessness, disorientation Industrious wandering repetitive or excessive/busy behaviour, continue habits, recreate past For more information on this and other best practices Contact your Regional Best Practices Coordinator Seniors Health Research Network Hamilton Long Term Care Resource Centre Original blog can also be found in the Members Only section of the PSNO website Describe Wandering pattern as: Direct pattern straight forward to a destination Lapping roundabout movement and revisiting points Pacing back and forth between two points, restless (akathisiacs) Random Haphazard movement, repeating movements Modelers tag, shadow others, checking whereabouts of others Self-stimulators do activities in addition to continuous pacing e.g. turning doorknobs continuously Exit seekers attempt to leave Residents who wander persistently are the source of 80% of successful exiting. 45% of exiting occurs within the first 48h of admission to a new LTC home. Successful exiting occurs when a resident who needs supervision leaves the LTC home without staff awareness or supervision. Wandering and elopement are not the same! Elopement or successful exiting is a serious consequence of wandering. It can result from a desire to return to a secure place, home or workplace, trying to reconnect with family members or may be following habits, such as leaving for work. They may be drawn by a sunshine or a desire for fresh air or daily walk. Volume 3, Issue 1 Page 7

8 PSNO Wants to Hear from YOU! Do you have story ideas you d like to see in an upcoming Newsletter? An article you would like to submit? Know someone who should be featured in Voices From the Frontline? Then we want to hear from you! PSW News is YOUR Newsletter. We want to make sure that we are covering news that matters to you and the PSW community. At PSNO we re always looking for more stories to share with our members. If you have something to share, please contact Sarah Blakely at: x244 or toll free at x244 or via at sarah.blakely@psno.ca Personal Support Network of Ontario Lawrence Avenue West Toronto, ON M6A 3B6 Phone: / Ext. 0 Fax: sarah.blakely@psno.ca We re on the Web The Personal Support Network of Ontario was established to help personal support service professionals carry out their work more effectively by offering access to information, resources and tools as well as providing opportunities to connect with a network of professionals in their field. Helping PSWs carry out their work more effectively