# Presentation: 940810

## VHA TARGETED SAFETY INITIATIVES 2008

## CHARACTER OF INJURY (%)

| 
SPRAIN/STRAIN                     29.1 |  |
| --- | --- |
| CONTUSION/BRUISE             16.8 |  |
| LACERATION/CUT/BITE        12.8                 PUNCTURE |  |

## FREQUENCY OF INCIDENTS  TYPE OF EVENT (%)

| SLIP/TRIP/FALL | 21.5  |  |
| --- | --- | --- |
| BBP | 13.8 |  |
| STRUCK BY/AGAINST | 13.6 |  |
| PATIENT TRANSFER | 11.0 |  |
| MATERIAL HANDLING | 5.9 |  |
| ASSAULT | 5.0 |  |
| TOTAL |    70.7 |  |

## ACTIVE INITIATIVES

**Slips / Trips / Falls**
**National effort with pilot projects and effectiveness evaluation**
**Bloodborne Pathogens**
**Intervention pilots (Brooklyn, Manhattan, Philadelphia, San Diego)**
**Laboratory evaluation (ergonomics lab) in preparation for national standardization**
**Struck by / Against**
**Coding of national injury distributions and causes from 2162 text (Supervisor 1****st**** Report of Injury) to develop program**
**Patient Transfer**
**Executive Decision Memorandum on national roll-out of technology**
**$61,000,000 (of total $205,000,000) distributed in July 2008**

## SLIPS, TRIPS AND FALLS OCCUPATION (%)

|  |  |  |
| --- | --- | --- |
| Nurse | 19.3 |  |
| Practical Nurse | 6.7 |  |
| Nursing Assistant | 6.1 |  |
| Food Service Working | 5.3 |  |
| Custodial Worker | 4.6 |  |
| Medical Support Assistants | 2.9 |  |
| Health Aid and Technician | 2.2 |  |
| Medical Officer | 1.8 |  |
| Social Work | 1.5 |  |
| OTHER | 49.6 |  |

## SLIPS, TRIPS AND FALLS LOCATION OF INCIDENT (%)

|  |        |           | 
 |
| --- | --- | --- | --- |
| Grounds | 14.0 |  |  |
| Parking lot | 8.2 |  |  |
| Sidewalk | 5.6 |  |  |
| Nursing homes | 5.5 |  |  |
| In-patient rooms | 4.5 |  |  |
| OPC | 3.9 |  |  |
| Other patient care | 14.5 |  |  |
| Public waiting | 7.5 |  |  |
| Offices | 7.0 |  |  |

## SLIPS, TRIPS AND FALLS CAUSE OF INCIDENT (%)

**Object ****	****	****       22.9 **
**Slick Surface****	****       19.8**
**Uneven Surface      11.7**
**Liquid                        7.3**
**Stairs ****	****	****          5.7**
**Chairs ****	****	****          4.7 **
**Height                        3.1**
**Other/Undefined      24.8**

## SLIPS, TRIPS AND FALLS Initiatives and Collaborations

- Training CD (EES/PeakTraining)       1998
- Liberty Mutual /NIOSH – 4 VAMC      2002
- NIOSH – Tampa VAMC	                 2003
-  Training CD (EES / VHACO)	        2005
- Web training (EES) 	 	                 2008

## SLIPS, TRIPS AND FALLS CURRENT WORK

**TAG Interventions & Best Practices **
**	****	****	****Facility Safety Assessment / EoC rounds**** **
**	****	****	****Maintenance & Housekeeping policies**
**	****	****	****Footwear & Surface Coefficients**
**Evaluation strategies**
**	****	****	****Rate & Injury Analysis (facility-level)**
**	****	****	****2162 text field assessments**

## STRUCKBY/AGAINST OCCUPATION (%)

|  |  |  | 
 |
| --- | --- | --- | --- |
| Non-clinical | 50.6 |  |  |
| Nursing | 34.6 |  |  |
| Clinical Support | 9.5 |  |  |
| Missing | 4.8 |  |  |
| Physician/Dentist | 1.5 |  |  |
|  |  |  |  |
|  |  |  |  |
|  |  |  |  |
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## STRUCKBY/AGAINST LOCATION OF INCIDENT (%)

|  |  |  | 
 |
| --- | --- | --- | --- |
| In-patient Intense | 26.3 |  |  |
| Out-patient Areas | 15.9 |  |  |
| Non-clinical Areas | 15.1 |  |  |
| General Admin | 13.0 |  |  |
| General Trades | 12.8 |  |  |
| Food Service      | 12.2 |  |  |
|  |  |  |  |
|  |  |  |  |
|  |  |  |  |

## STRUCK BY / AGAINST

**No current knowledge  on true etiology**
**Group to assemble coding and characterization**
**Programs targeted to identified risks**

## SHARPS

-    Sharps performance monitor
- 2005   Brooklyn peer-safety leader project
- 2006   Philadelphia modification
- Inter-facility standardization
- Leadership / modeling problems
- 2007	West Haven modification
- Nursing / new peer-leader model
- Culture issues
- 2008  Operating room interventions / USH Information Letter

## PATIENT ASSAULTS

**2000 ****	****Committee**
**2001 ****	****Quality Forum /management commitment**
**	****	****National survey****	**
**2002****	****National Stand-down (awareness)**
**	****	****Local policy review**
**2003****	****Trainer network**
**	****	****Training plan**
**	****	****NIOSH * VHA facility assessment**
**2004****	****Patient Record Flagging**
**	****	****DBC **
**	****	****Threat assessment skills**
**2005****	****QI Project**
**	****	****Dom assessment project**
**2006 ****	****VISN 7  model assessment**
**2007 ****	****National assessment**
**2008 ****	****Aggressive Behavior Prevention Survey / ****	****Intervention effectiveness assessment**

## Cultural Health