Lutheran Senior ServicesWhy we choose Interact II Tools

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Where we started…

Data poor

Health Care Reform

Growth of short stay rehab program

Move to Evidence Based Practice

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Tools We Are Using

Resident Transfer Form

Change in condition cards

Care Maps

SBAR

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TRANSFER

ENVELOPE

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Change in Condition Cards

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CARE

MAPS

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Define a Process

Clinical Guidelines for Management of LRI

Assessment / Observation standards• Review Broncho-pulmonary assessment in Optimus• Define guidelines for staff

Communication• Build Profile order set “Management of URI”

– Nursing orders Assess Bronchopulmonary status BID and prn Provide additional fluids Encourage coughing and deep breathing Encourage mobility Monitor VS and O2 Sat BID and prn

– Physician orders IV fluids Antibiotic therapy Oxygen therapy Nebulizer treatments Portable CXR CBC BMP

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Process (cont.)

• CARE PATH: Symptoms of Lower Respiratory Infection (INTERACTII)– SBAR Communication as a guide to communication with physician

Education• Develop powerpoint education tool covering the steps defines in

Assessment and Communication• Skills training

– Completing a respiratory assessment Equipment: Lung sound recordings, Double ear stethoscope

– Understanding the findings of the assessment

Monitoring• Track hospitalizations and review using Quality Improvement Tool

(INTERACTII)• Report quarterly and include in quality Dashboard

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Staff Education

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Assessing Lung Sounds

http://www.easyauscultation.com/lung-sounds.aspx

 

http://www.wilkes.med.ucla.edu/lungintro.htm

 

http://www.cvmbs.colostate.edu/clinsci/callan/breath_sounds.htm

 

http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html

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Challenges and Successes

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Data FindingsRe-Hospitalization Rates

Dec Jan Feb March April ytd0%

5%

10%

15%

20%

25%

30%

The Next Step…

Partnering with Hospitals