Changing the Perceptions of a Culture of Safety for the Patient and the Caregiver: Integrating Improvement Initiatives to Create Sustainable Change.

Evidence indicates that chances for a successful patient mobility program, prevention of pressure injury and falls, and safe patient handling are enhanced when an organization possesses an appropriate culture for safety. Frequently, these improvement initiatives are managed within silos often creating a solution for one and a problem for the others. A model of prevention integrating early patient mobility, preventing pressure injuries and falls while ensuring caregiver safety, is introduced. The journey begins by understanding why early mobility and safe patient handling are critical to improving overall patient outcomes. Measuring current culture and understanding the gaps in practice as well as strategies for overcoming some of the major challenges for success in each of these areas will result in sustainable change.

Developing unit-focused peer coaches for the clinical setting.

In teaching, nursing management, and professional development, the traditional one-to-one approach is used in the peer coach relationship. In clinical environments, the use of peer coaches is a creative way to implement practice change. Tailoring the concept of peer coaching to consider the dynamics and structure of the clinical environment is essential. This article describes the use of a change model in the preparation of peer coaches for safe patient handling in an acute care setting. Unit-focused peer coach preparation includes multiple teaching techniques, such as lecture, hands-on experience, and scripting. Unit-focused peer coaches are a helpful adjunct to nursing staff development.

Effects of a multifaceted minimal-lift environment for nursing staff: pilot results.

Nursing staff are at risk for musculoskeletal injuries because of the physical nature of patient handling. The purpose of this study is to examine the effectiveness of a multifaceted minimal-lift environment on reported equipment use, musculoskeletal injury rates, and workers' compensation costs for patient-handling injuries. The pilot study consists of a mixed measures design, with both descriptive and quasi-experimental design elements. The intervention consists of engineering (minimal-lift equipment), administrative (nursing policy), and behavioral (peer coach program) controls. The comparison nursing unit has received engineering controls only. The convenience sample includes nursing staff employed on two medical-surgical nursing units, who provide direct patient care at least 50% of the time. Nursing staff employed in a multifaceted lift environment report greater lift equipment use and experience less injury, with reduced worker's compensation costs.