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1 HomeView Personal Care A m o n t h l y s u m m a r y o f a c t i v i t i e s a n d a n n o u n c e m e n t s r e l a t i n g t o p e r s o n a l c a r e i n W i n n i p e g Volume 5, Number 1 February, 2008 Central Care Corporation Region 8 Receives Three Quest for Excellence Awards Central Care Corporation has a Quest for New Dimensions Excellence Awards program, which recognizes excellence within a home, department or program across Canada and celebrates the accomplishments of the staff. Each year, individuals and teams within each home model and redefine excellence by the projects they initiate, by how they approach their work and in the relationships they maintain with Residents and co-workers. The Quest for Excellence program boasts nine awards: Community Service, Leadership, Customer Service, Wishes Come True, Event of the Year, Best Clinical Practices, Business Process Improvements, Healthy Workplace and Partnerships. Three Homes from Winnipeg received awards this past November in a ceremony in Mississauga. Best Clinical Practices: Heritage Lodge High Risk Tracking Team Peggy Klymkiw, Director of Care; Claudia Gildert, Resident Care Coordinator; and Lisa Hoppenheit, Resident Care Coordinator, Heritage Lodge Heritage Lodge is a smaller care centre with only 86 beds. In order to effectively and efficiently monitor and address all of the High Risk areas in their Home, a single High Risk Tracking Team was created. The purpose of this team was to collect and analyze data in the high risk areas of Restraints, Falls, Resident Aggression, Occurrences and Skin Breakdown and make assessments and recommendations for Residents at risk based on best practice guidelines to ensure the safety of their Residents. The goal was to reduce each of these high risk areas in their Home to below the National/Regional thresholds or eliminate them all together. Further, they wanted the staff to develop the mind set that as part of their day to day duties they would look at the surroundings to see what differences could be made to make a safer environment for their Residents, Families and Staff. The specific Objectives of this Team are to: 1. Identify and meet educational needs of staff, Residents and families in regards to these high risk areas with focus on prevention. 2. Ensure that all Residents with High Risk needs are identified and have Care Plans in place to address these needs. 3. Promote Least Restraint Policy and utilize the Restraint Reduction Program. 4. Review and evaluate circumstances surrounding Resident falls including but not limited to environmental issues, physical assessment factors and medication use in order to decrease the number of falls. 5. Examine incidences of Resident aggression, identify potential causes, and make and implement recommendations. 6. Ensure education of all professional nursing staff in Best Practice for skin and wound prevention/care by attendance at Regional Wound Education Sessions offered by CCC Regional Nurse Clinician. Process: The singular High Risk Tracking Team was created to maximize the availability of the line staff. Tracking line listing forms were created and used along with existing CQI data and Occurrence listing to identify areas of need and develop recommendations. Ideas/recommendations that were tried/implemented were monitored for effectiveness. Examples: falls due to trying to sit on a bench in hallway due to the colour of the bench (white) the Residents were having a hard time telling the difference between the floor (white) and the bench. Once seat cushions were put onto the benches with bright colours they have not had a fall of this type. In addition, they instituted the Green Arrow Program: any Resident who is high risk of falls has a green arrow logo attached to their walker/ wheelchair/button that they keep with them at all times. It is also placed on Excellence Awards continued on page 2

2 Excellence Awards continued the nameplate so that staff walking by can see who is at high risk and to do extra spot checks to ensure safety. They also have the logo placed by the room number on the call bell board at the nursing stations to signify which Residents are at high risk. This program is also shared with all families so they to can participate in watching out for those who are in need of assistance. Small changes like these have had huge impact on their falls. The team researches best practices/ ideas, attends conferences and provides inservices to staff and families. The team reports to the Resident Care Team as an adjunct for the Long Term Care Services Accreditation team. Outcome: They have seen all of their High Risk indicators below threshold and in some instances at zero. They have not had any Stage 3, 4, X wounds in over a year and have only had 2 recurrent stage 2 wounds over the past year. Their restraints have been reduced from 4 to 1 chemical restraint and from 8 to 3 physical restraints from last year. As a result, they have seen improvement in the care of their Residents and Families and for their staff. They were acknowledged in the 2006 Winnipeg Regional Health Authority Accreditation for the work that has been done with this team and the benefits this team has been for Residents. They had no recommendations for improvement in their clinical area in the accreditation report. They believe this team can only continue to move forward in improving other components in the Home affecting High Risk areas thus making their Home a safer environment with quality care for their Residents. View Event of the Year Award - Olympics Recreation Managers Stacy Blazina, Dianna Vander Aa, Mike Crosby, Kyla Gard, Shelley Kopeshny, Lois Heinrichs, and Susan Clow (FSM and A/Rec. Mgr.) of the Central Care Family of Homes - Beacon Hill Lodge, Parkview Place, Charleswood Care Centre, Poseidon Care Centre, Kildonan PCH, Maples PCH, and Heritage Lodge Purpose: The Central Care Family of Homes Olympics was held at Charleswood Care Centre on June 12, 2006 with competitors from all seven of the Winnipeg homes. The idea for the games came from two Residents at Heritage Lodge who wanted to be able to compete in the Seniors Games in Manitoba. This not being possible, the feasibility of having their own games was discussed at a meeting of the Regional Recreation Team, and the rest is history. The goals for the event were: 1. To promote healthy competition among peers. 2. To provide opportunities for socialization among Residents from various homes. 3. To provide an opportunity for a community outing and enjoyment of the outdoors. 4. To develop and promote team spirit. 5. To actively participate in sports. 6. To enhance self-esteem. 7. To have FUN! Process: Charleswood Care Centre was chosen as the location due to their accessible grounds and indoor space available in the case of rain. Time frame was set for arrival, opening and closing ceremonies, game stations, refreshments, award presentation, and departure time. Each home would have five Residents on a team, two staff members, and a volunteer to help move the team between game stations and each game station was to be manned by a Recreation Manager. There was a great deal of attention paid to details. The five Games chosen were shuffle bowling, 5-pin bowling, target ball, bean bag toss, and mini golf. Sports were chosen that everyone could participate in and could be adapted if necessary to meet Residents needs and abilities. Some homes held try outs to select team members, other homes invited participants. Team T-shirts were worn by some Home s Residents, and team cheer was developed. Adhering to the Olympic theme, the Opening Ceremonies included flags created by and representing each home, and the lighting of the Olympic flame (Glow stick). Then all participants recited the Athlete s Oath which refers to good sportsmanship and was taken very seriously. The games were declared open. All athletes took turns participating in each sport both indoors and out. While refreshments of an Olympic ring decorated cake and punch were being served, the scores were tabulated. Then Flags were paraded into the room accompanied by much cheering. Trophies had been donated by a staff member and taken to a local trophy shop for refurbishing. The trophy shop donated new tops for all the trophies as well as the plaques for each one. Medallions for each participant were Excellence Awards continued on page 3

3 Excellence Awards continued also ordered. Individual silk roses, tied with a ribbon were prepared for presentation to each athlete. Certificates were prepared ahead of time and included the participant s name. They were laminated to enable Residents to easily display them in their rooms. Trophies were awarded in seven categories: Gold, Silver, Bronze, Honorable Mention, Team Spirit, Good Sportsmanship, and Most Enthusiastic. These were received with pride, taken home and proudly displayed. All athletes received flowers, a certificate of participation and a participant s medallion which was hung around each competitor s neck, and worn home. Some are still wearing theirs almost a year later. Outcome: This event was a unique Inter-home sports competition. The expenses were very low due to donations received and the work done in each home to make View items for the event. All charges were divided evenly among each home and paid for through Recreation Supplies budget. There was no charge to Residents other than for transportation. The event was promoted through posters, internal newsletter, discussions with Management Team in each home as well as with each Resident Council, and a trophy and photo display was set up in each home. The continued enthusiasm of the Residents about the event several weeks later spoke volumes to its success. Everyone enjoyed the wonderful warm summer day and outdoor setting for the games. Great team spirit was demonstrated through cheers, pride, and camaraderie. Residents cheered for their team as well as others. In spite of the fast pace to get through all the games, the Residents expressed their enjoyment of the day. Socialization with others occurred during the encounters at the various game stations. All participants participated in all sports. After the reaction that was noted from the Residents there was no doubt that this event had to be repeated. The 2nd Annual Central Care Family of Homes Olympics took place on June 12, 2007 and was again a great success! Wishes Come True Miss E Mosaic Place staff, second floor, Poseidon Care Centre The nursing staff of Mosaic Place rose above their call of duty and gave one special lady the opportunity to live out her final days at Mosaic Place surrounded by those that understand her and hold a special love for her. This story of a Wish of the Heart was featured in an earlier edition of the PCH View. CNS Corner Luana Whitbread and Judy Robertson, Clinical Nurse Specialists, Personal Care Home Program Alzheimer s Awareness Month In recognition of Alzheimer s Awareness month the Personal Care Home (PCH) Program wants to draw your attention to how we can support dementia care through education. Some of the initiatives include Education in a Box, which are kits with a focus on dementia developed in partnership with the Crane library. The kits include videos, evidence based literature and recommended readings on topics such as wandering and are available to the PCHs to support their educational initiatives. The PCH program Educator and Clinical Nurse Specialists are committed to ongoing dementia care education. To date presentations have been provided on such topics as Communicating with People with Dementia; Care Planning; and Understanding Dementia. As well, the PCH program will be participating in the provincial roll out of the P.I.E.C.E.S. dementia care education program in the Spring of P.I.E.C.E.S. is an acronym for six dimensions of health and wellbeing. P: Physical I: Intellectual E: Emotional C: Capabilities E: Environment S: Social self The P.I.E.C.E.S. program originated in Ontario and has been adopted by many provinces across Canada. It provides a practical framework for assessment of and supportive care strategies for residents with dementia. Look for more information coming your way soon!

4 Winter Wonderland in Middlechurch Instead of taking our residents out to see the Christmas lights this year, we wanted to do something that all residents could enjoy. With a donation from The Woman s auxiliary and others, we managed to have Winter Wonderland in our Activity center. It was truly magical and every single resident got to walk through it. We are planning to expand it next year. The display was mainly set up by our Recreation Coordinator, Christina Kowall, with help from anyone who could. It was a tremendous undertaking, but well worth the effort! Betty Bender Director of Nursing Administration Middlechurch Home of Winninpeg Inc.

5 No One Dies Alone Program (NODA) Submitted by: Sarah Brown, Dawn Chaitram, Aubrey Hemminger, and Rosie Sikora The No One Dies Alone Program was adapted from the Sacred Heart Medical Center in Eugene, Oregon and developed for use at Deer Lodge Centre. The purpose of this program is to provide a reassuring presence, through a volunteer compassionate companion, to dying residents who would otherwise be alone. The NODA program is for residents who are on comfort care, are expected to die within hours, and have no family or friends involved and present, or have no family or friends locally. A working group of nurses, allied health, volunteer coordinator, and volunteers developed the program policy, position description, education for volunteers, and the process to activate the program. To activate the program, nurses must phone the spiritual care department during days and the nursing coordinator for evenings, weekends, and nights and then spiritual care or the nursing coordinator will schedule volunteers for a 72 hours period. There is also debriefing for the volunteers, as this experience can be very emotionally involving. There has been an overwhelming response from the community for volunteers who are passionate about end of life care and ensuring that residents will not die alone. The director of volunteers has managed to recruit 30 volunteers. The program is available 24 hours a day, seven days per week and some volunteers are willing to be called overnight in emergency situations. Volunteer shifts are approximately 4 hours during the day and 6-8 hours overnight. At present, the working group is in the process of training the volunteers in both day and evening sessions. The educational component includes physical/comfort care measures and the process of dying, spiritual, cultural, and communication issues (including families), and infection control measures. Some of the challenges of setting up this program involves: ensuring communication of all involved parties, and scheduling and availability of the volunteers. Evaluation forms are available for both volunteers and nursing staff to determine if there are any needs that have not been met, any suggestions for improvement, or if the experience was worthwhile and valuable. To date, nursing staff have appreciated a volunteer compassionate companion at the dying resident s bedside. For more information on the No One Dies Alone program please contact Sarah Brown at or sjbrown@deerlodge. mb.ca.

6 If you would like to find out what s being newly published in the journal literature, the J. W. Crane Memorial Library offers a special Table of Contents service to all staff working in Winnipeg Personal Care Homes. Sign up to receive the most recent Tables of Contents of a huge selection of journals in nursing, allied health, geriatrics, health, or health care management. Tables of Contents are delivered electronically directly to your in View Keeping Up-to-Date with the Journal Literature: Table of Contents Service J. W. Crane Memorial Library, University of Manitoba Health Sciences Libraries ; dlclibrary@umanitoba.ca; Fax: Providing Library and Information Services to all staff at Winnipeg Personal Care Homes box, or if you don t have access to e- mail, you may choose to receive them by regular mail. When you receive your Table of Contents by , you can click directly on the U of M Links button and go directly to the article. If you receive your Table of Contents by mail, simply fax or mail it back to the J. W. Crane Memorial Library and we will send the article directly to you. Another option is to subscribe to a subject alert of your choosing. When new articles on this subject are published, you will receive an notification. If you have access to the Internet, another way to keep up with the journal literature is to visit the Info Long Term Care Blog at blogspot.com. Written by Laurie Blanchard, Outreach Librarian Long Term Care, this blog is designed to pull together new resources and literature in long-term care. The section of the blog below lists the latest new articles. Please contact Laurie Blanchard by at laurie_blanchard@umanitoba.ca or by phone: to arrange your personalized Table of Contents or subject alert service.

7 The first laboratory confirmed influenza A outbreak in one of the facilities within the Personal Care Home Program has now been confirmed. Four other influenza like illness (ILI) outbreaks have been reported in personal care homes thus far this season. The definition of an influenza like illness outbreak is the occurrence of cases of influenza-like illness in excess of the expected number of cases in the personal care home/long term care facility. Two or more cases of influenza-like illness that occur within seven days is an outbreak and is to be reported. Influenza is an acute onset of a respiratory illness characterized by cough and one or more of the following symptoms; fever > 38 C sore throat arthralgia myalgia prostration To manage an influenza like illness outbreak refer to the Personal Care Home/Long Term Care Facility Influenza Outbreak Management Protocol (2007). Steps for managing an outbreak include: Continually assessing residents for signs and symptoms of influenza like illness. Reporting any residents with signs and symptoms of influenza like illness to the nurse in charge/designate and the Infection Prevention & Control practitioner for your facility. Initiating appropriate infection prevention & control precautions including: Reinforcing good hand hygiene Enhancing environmental cleaning Notifying the appropriate persons of the suspected outbreak. Obtaining an outbreak code. Obtaining appropriate specimens. There is still time to get the flu shot InfluenzaVaccine is still available. For further information contact the Infection Prevention & Control Practitioner/designate for your Personal Care Home/Long Term Care Facility or Betty Taylor btaylor@wrha.mb.ca. Influenza Information can also be found on the WRHA web site at

8 Information Sheet for: Dancing with Dementia Effective Behavioural Care Strategies and It s All About You! Celebrating Staff and Refreshing Commitment! with Jayne Harvey, FCS International See Poster on Page 1 for registration information & seminar details Dancing with Dementia Understanding Dementia and Behavioural Care Defining the uniqueness of disease, experience & vulnerability Symptoms & related care strategies Behavioural response and care requirements The Concepts of Supportive Therapy Foundation for effective Behavioural Care Strategies to manage challenging behaviours Reading behavioural cues Environmental and care requirements Utilizing effective communication It s All About You! Consider how you feel about resident care Remember why you chose this vocation Explore your mission in life Come and be inspired! Jayne Harvey travels across Canada and internationally as a consultant and educator in behavioural care and management issues. She provides practical strategies and tools that apply to long-term care facilities and organizations regardless of existing expertise or resources. Jayne s dynamic style is as motivational and practical as it is energetic and entertaining. Participants walk away equipped to meet many of the challenges that face them. For more information contact: or Page 2

9 WRHA PCH Visit Schedule February 14, June19, 2008