Sometimes Change is Hard

As an RNAO Best Practice Spotlight Organization, we take the opportunity to bring together our “Best Practice Champions” to learn and share experiences in working with Best Practice Guidelines. Recently, Irma Jean Bajnok, Director, International Affairs and Best Practice Guidelines Programs, Centre for Professional Nursing Excellence at the Registered Nurses Association of Ontario, spent some time with us sharing a practical and organized framework to address change based on the book, “SWITCH, How to change things when change is hard”. The analogy used in discussing change was an elephant, a rider and a path, a somewhat odd combination but when you think about it, it does make sense.

We are in a state of conflict and contradiction when it comes to change; our hearts and minds often disagree. The logical thinking part of you (The Rider) thinks that you should be able to muscle the heart (The Elephant) into making change against the elephant’s will or preference. The elephant is the emotional, more instinctive part of you. Switch suggests that if you grab their hearts, their minds will follow.

The elephant represents the group who are being asked to change. Elephants are big and very smart, but can be stubborn. Trying to direct them down a path simply because you want them to go that way won’t necessarily make them move. The path is the environment which may need some ‘tweaking’ to rally the group toward the change. The path or environment should have situations, tools, procedures, forms, and so on, that make it easy and intuitive to do the right thing and hard to do the wrong thing. Keep the switch (change) going by encouraging and celebrating steps taken toward the goal.

So the moral of the story is we need to ensure that there is good reason for the change we are making. Change needs to benefit our patients; the nurses and other healthcare providers need a clear understanding of the benefits, that will make the change valuable to them. Then as the rider or manager of the change we can move the elephant down the path.

End of life… What does the patient want?

There are many difficult decisions for families to make in the final stages of a person’s life. Decisions are even tougher if your loved one deteriorates quickly and has not given clear direction of their wishes. Once you add the intensity and stress of an unfamiliar place, unfamiliar medical terminology and updating other family members, even simple decisions can seem extremely tough.

Medical technology has grown considerably over the past 100 years allowing for hospitals to maintain life for a longer period of time. Ventilators, life sustaining medications, procedures and expert staff all play an integral part in ensuring that patients receive the treatments needed to keep them alive. The combination of events, options, and the drive for staff and families in maintaining life can move treatments beyond the wishes of the patient.

It is important for families and healthcare providers to maintain a specific point of view… What are the patient wishes? Some patients want everything done, including invasive procedures and all life sustaining medications. However, as people age and become more comfortable with the thought of death, their wishes often change and Cardiopulmonary Resuscitation (CPR), ventilation, or other procedures may not be wanted. There is also the possibility of organ or tissue donation, and at Chatham-Kent Health Alliance we have increased our processes to ensure that patients can donate their organs if they wish.

It is important to have the discussion with your family members before these difficult decisions have to be made, to ensure that you or your loved ones receive the treatments that fall within your or their planned life’s path. Our goal is to give the care that is best for you, and clear direction in the beginning helps us to ensure that all your wishes are met.

Springtime

You know spring is near when it is time to move the clocks forward. After one of the warmest winters on record, many of us are already embracing springtime and all the advantages that go along with it. So lose your tie and/or dress shoes, grab your favorite t-shirt and running shoes and make the most of springtime in South-Western Ontario!

Most of us look a little pale after being indoors all winter, so heading outdoors should be a priority as the weather warms up. And I don’t mean just laying around sunbathing. Right now, our every day obligations of work and home keep us secured to our chairs and that sedentary lifestyle can be costly for us and our employers. A study published in the American Journal of Epidemiology estimated that the average American (similar for Canadians) spends 55% of their waking time (7.7 hours) in sedentary behaviours such as sitting. A British Journal of Sports medicine article (January, 2010) suggests that people who sit for long periods of time have an increased risk of disease.

The remedy may be as simple as standing a little more each day but being physically active with your partner, your children, grandparents and other relatives is a great idea! All family members can get health benefits by being more active. Plus, the more time you spend with family members, the stronger your family connections become. Now that the weather is so nice, consider going for a walk or hike, play a game of golf or mini-golf, swim, bike, roller-blade, or get involved in organized sports such as soccer, baseball or just a game of catch in the yard.

Regular physical activity benefits both adults and children in the following ways:

1. Building strong bones and muscles;
2. Better posture and balance;
3. Having more energy, plus better physical and mental health;
4. Maintaining a health weight;
5. Improving physical self-esteem; and,
6. Increasing relaxation and improving sleep.

So grab your runners, enjoy the weather and head outside for some fun and exercise!

Chatham-Kent Health Alliance (CKHA) works to improve Medication Administration

From the initial order to the dispensing of medications to the patient, it is the responsibility of all healthcare providers involved to ensure that the most efficient and safe process is done. This requires many health professionals’ contribution to ensure that the right patient receives the right medication at the right time. Physicians, pharmacy, nurses and respiratory therapists all participate to ensure high quality, safe care.

In March, the medicine unit, the intensive care unit (ICU) and progressive care unit (PCU) at CKHA began using a computer generated medication administration record (CMAR). In simple terms, the document that the nurses and respiratory therapists use to guide administration of medications will be generated electronically from the pharmacy database. CMARs reduce the amount of hand written information on the medication record, improving the legibility and decreasing time away from the bedside. It also increases the medication safety checks that care providers do in ensuring the medication is given accurately.

Because it is an electronic record, CMAR allows nursing, respiratory, pharmacy and physicians to see the same information at all times, either in the paper file or in the patient’s electronic health record, reducing the risk for miscommunication between providers.

The momentum is continuing into the in-patient surgery department and the expected integration of CMARs across all in-patient care areas throughout CKHA is scheduled by the end of May.

I would like to thank Ruth LeClair and Janice McCready from Medicine, and Doreen Windsor from ICU, the pharmacy department and the rest of the CMAR task force for their hard work in improving the care we provide to our patients. This project continues to reflect CKHA’s vision of “An Exceptional Community Hospital, Setting Standards - Exceeding Expectations”.

Ruth LeClair (left) and Janice McCready (right) showing CMAR to Stephanie Bond, RN.

Doreen Windsor (right) with Nicole Leclerc, Ward Clerk and Phil Taylor, Professional Practice Nurse.

April is Daffodil Month: Cancer Awareness

Eager gardeners know that after a long winter, nothing is more welcoming than the sight of the yellow daffodil to mark the arrival of spring. To the Canadian Cancer Society, the daffodil is more than just a flower. It is a symbol of strength and courage, a symbol of life.

Cancer prevention starts with healthy living. By making healthy lifestyle choices you can reduce or “cut down” your risk of getting cancer. There is no single cause of cancer but some factors appear to increase the risk of developing it.

There are some risk factors that you cannot change. For example:

• Age


• Family history of cancer (heredity)
  

There are some risk factors related to everyday choices, you can choose to:

• Be a non-smoker and avoid tobacco smoke


• Eat a healthy diet


• Be physically active every day


• Stay at a healthy weight


• Limit alcohol use


• Reduce your exposure to UV (ultraviolet) rays from the sun or indoor tanning equipment, like tanning beds


• Know your body and report any changes to your doctor or dentist


• Follow health and safety instructions when using hazardous materials at home and at work.
  

If you know your body you can find possible health problems early, including cancer. Know what is normal for you and don’t ignore any changes. If you notice any unusual changes, tell your healthcare provider about them.

Here are some warning signs you should not ignore:

• A new or unusual lump or swelling in the breast, testicles or any other part of the body


• Any sore which does not heal anywhere on your body or in your mouth


• Obvious change in the shape, size or colour of a mole or wart


• A nagging cough, hoarseness or a croaky voice


• Difficulty swallowing


• Blood in the urine, stool or phlegm


• Unusual bleeding or discharge of any sort from the nipple, or vagina


• Any change in bladder habits, such as pain or difficulty urinating


• Any change in bowel habits (constipation or diarrhea) that last more than a few weeks


• Persistent indigestion


• Unexplained weight loss, fever or fatigue


• Unexplained aches and pains


• Any new growths on the skin, or patches of skin that bleed, itch or become red
  

Remember, having any of these signs does not mean that you have cancer. Only your healthcare provider can tell for sure.

Kudos to our Housekeeping Staff!!!

Recently we had a patient come to Chatham-Kent Health Alliance (CKHA) who had some kind words for our Housekeeping Staff, and I wanted to share them with you.

Upon arriving, this person was immediately impressed with how wonderfully kept up and clean our hospital was. He commented that our hospital was absolutely spotless and sparkling clean. What great praise to hear from one of our patients!

Thank you to our Housekeeping Staff for your excellent work!!!

Easter with Something Extra

Just like Christmas, Easter has its own customs, such as the Easter Bunny, which has its origin in folklore. A tradition of the Easter Bunny leaving a basket of treats such as Easter eggs and chocolates on Easter Day is common in North America. Sometimes children leave out carrots for the Easter Bunny, often eggs are hidden in the garden for children to find. The idea of an egg-laying rabbit came to America in the 1700s through immigrants arriving from Germany. They told their children to make ‘nests’ before Easter with their caps and bonnets and if they were good the Easter Bunny would leave them coloured eggs. The custom of giving eggs at Easter celebrates new life. Eggs were always thought to be special because although they do not seem alive, they have life within them especially at springtime when chicks are hatched.

If you are looking for a great way to enjoy Easter with your children, try putting together a gift basket with a difference. Here are five tips to help you build a fabulous Easter gift basket:

1. We all deserve the odd sweet treat, but it is easy to overdo things at Easter. Portion control is one way to help keep treat intake in check.


2. Include a toy or game that encourages your kids to get outside and get active. A skipping rope, ball or frisbee is a simple way to encourage exercise for any child.


3. Easter is about new life. Why not include some flower or vegetable seeds in your gift basket? You can plant them in small pots or even make a start on a veggie garden.


4. Painted eggs are a great way to continue the Easter theme. You can nurture your children’s creativity and enjoy spending time together.


5. Take advantage of the Easter tradition of egg hunts to get kids up and moving.
   

Happy Easter!

Language of Caring – What’s it all about?

The Language of Caring is a strategy to improve the patient experience at Chatham-Kent Health Alliance (CKHA). You may wonder why we are doing this now.

We are doing this because we are Caring People, Caring for People, and we want to be able to communicate that caring to our patients and their families each and every time. At CKHA, we take service excellence seriously and this will build on the strengths we already have in place.

Being able physically care for people as well as articulate our caring will, we believe, improve outcomes for our patients.
For more on this, please take a few minutes and take a look at the video below. Thank you