healthy & happy living leadership program

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  • TitleStudents Name, Faculty

    Name of Affiliated Department, Division, or Theme1 ; Department Name2, University of Alabama at Birmingham

    GoalCreating Culture Change.

    The biggest goal of the program is creating a culture change

    within the facility. It is critical that all facility staff move toward

    having a patient-centered point of view when making

    decisions about how to handle behaviors and depression

    symptoms.

    For example, some residents are at risk of falling and they

    continuously try to get up and walk. Instead of giving the

    resident a pill for anxiety or behavior, staff should problem

    solve and ask the question, what do the behaviors mean? Is

    the resident hungry? Tired? Has to use the restroom?

    Bored? Behaviors almost always are some form of

    communication from the resident.

    Conclusion You can plan too much. Sometimes it is best to just start

    the project and continuously improve along the way.

    Waiting until the plan is perfect is unrealistic.

    Culture change happens very slowly. Change is always

    hard, but when staff can see the benefit and reason behind

    the change, change will happen.

    Acknowledgements: Executive Director Chad Ketcham, Director of Nursing Rhonda Lewis, Social Worker/Project Manager Joan Gonzalez, UW Eau Claire Printing Services

    Timeline1. Purchase Non-Pharm Interventions

    Blanket Warmers, Essential Oils, Busy Kits,

    ____Therapy (Animal, Music and Art), Games, etc.

    2. Education for Floor Staff, Department Managers,

    Doctors, Nurse Practitioners, and Pharmacy Consultant.

    3. Create progress logs on what interventions are being used

    on who. What works? What doesnt?

    4. Continue to use feedback to improve program

    PDSA Cycle

    RecommendationsIf I could redo this program, I would initially involve more staff

    members, such as CNAs and Nurses who would be utilizing

    this program the most. Input from floor staff is critical and

    valuable to the success of any program. I think this would

    also help with employee engagement. If employees have a

    voice, they are more likely to participate and support the

    program.

    BackgroundGolden LivingCenter-Greeley has had a recent increase in

    antipsychotic use, depression symptoms and behaviors

    occurring in the third Quarter of 2015. The facility received a

    grant funded by the state aimed at reducing antipsychotic

    medications, depression and behaviors. This program is a

    Nursing Facility Performance Based Incentive Payment

    Program, but I will refer to as Healthy and Happy Living

    Program.

    8.3 8.2

    6.7

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    3.6 3.5 3.6 3.6

    NOV-15 DEC-15 JAN-16 FEB-16

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    GLC - Greeley Depression (LS)232% Reduction

    GLC - Greeley PR National Benchmark

    15.216.7

    13.6

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    17.6 17.8 17.5 17.3

    NOV-15 DEC-15 JAN-16 FEB-16

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    GLC - GREELEY BEHAVIOR (LS)117% Reduction

    GLC - Greeley PR National Benchmark

    Healthy and Happy Living ProgramReducing Antipsychotic Medications, Depression & Behaviors

    Leah Ripp Golden LivingCenter - Greeley

    23.721.8 21.9

    20.6

    17.8 17.4 17.2 17

    NOV-15 DEC-15 JAN-16 FEB-16% o

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    GLC - Greeley Antipsychotic (LT & SS)15% Reduction

    GLC - Greely PR National Benchmark

    Good

    IntroductionA large number of the individuals in skilled nursing centers are living with some type of dementia. For these individuals and as illness progresses, behavior often becomes a key form of

    communication. This can be challenging to families and staff, and too often, antipsychotic medication is used in an attempt to modify behavior.

    Good

    Good

    Results Continued Depression.

    Depression has decreased in our Long Term Care residents

    by 232%! This has been the biggest indicator of success, as

    staff can tell residents are generally more happy as they have

    more activities to indulge in. Using a resident-centered point

    of view allows each resident to participate in activities and

    therapies that are of interest to them and their care needs.

    Behavior.

    Behaviors have also decreased by 117%. As depression and

    antipsychotic medications decreased, behaviors started to

    decline as well. When residents become happier with their

    care and life at GLC-Greeley, we see less behaviors.

    Furthermore, eliminating antipsychotic medication for some

    residents has created more alertness and decreased

    behaviors. Overall, I am very pleased with the results knowing

    there is still room for improvement.

    Essential oils have been a key

    element of success for the

    Happy and Healthy Program.

    Lemon scents are used in

    morning activities to promote

    alertness and participation.

    On the other hand, when

    residents have insomnia or

    anxiety, utilizing lavender

    spray on resident pillows or

    drinking Chamomile Tea

    promotes relaxation and

    sleep. Essential oils can be a

    great option for almost any

    behavior!

    Utilizing different therapies

    has decreased use of

    antipsychotic medications,

    depression and behaviors.

    As seen in the picture

    above, this bunny gave our

    resident's a big smile on

    Easter Sunday.

    ResultsAlthough we are only 6 months through a 2 year program, we

    have already seen amazing results

    Antipsychotic Medications.

    GLC Greeley had an initial percentage of residents on

    Antipsychotic Medications of 23.7%, compared to the national

    benchmark of 17.8%. The Heathy and Happy Living Program

    has dropped this antipsychotic use by 15% through the use of

    non-pharm interventions, education and engaging our staff.

    (Seen on graph to the left).

    Examples