Enhancing Care for Seniors: Implementing Evidence-Based Tools in Lutheran Senior Services

1. Lutheran Senior Services Why we choose Interact II Tools

2. Where we started… • Data poor • Health Care Reform • Growth of short stay rehab program • Move to Evidence Based Practice

3. Tools We Are Using • Resident Transfer Form • Change in condition cards • Care Maps • SBAR

4. T R A N S F E R E N V E L O P E

5. Change in Condition Cards

6. C A R E M A P S

7. 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

8. 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

9. Staff Education

10. 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

11. Challenges and Successes

12. Data Findings Re-Hospitalization Rates

13. The Next Step… Partnering with Hospitals