P#2 - TIME AND MOTION STUDY: THE IMPACT OF …...P#20 - COMMUNICATING UNIQUENESS Marg Catt. Temiskaming Lodge, Jarlette Health Services, Haileybury, ON. Contact: [email protected]

P#2 - TIME AND MOTION STUDY: THE IMPACT OF EMAR

Sandra Dudziak1, Michael Betel2, Jean Clark1. 1Revera Inc. , Mississauga, ON, 2MediSystem Pharmacy,ON.

Contact: [email protected]

Key Learning Objectives of the Poster:

1) The adoption of an eMAR system allows for better performance on medication quality measures as

well as preventing medication errors.

2) Medication pass time is lower in eMAR homes versus non-eMAR?

3) What happens to the freed up time that becomes available?

What is the Goal of your Poster? Nurses need a way to help ensure that medications are properly

administered and tracked in an efficient and safe manner.

What were the findings/results and conclusion of the Poster? Quantitative Results: Based on the 6

homes, here were the aggregate results: 1. 51% of nursing time was spent on the Medication Pass 2.

14% savings in time in eMars Homes that could potentially be directed to other Resident care activities.

(representing 2.2 hours savings a week). 3. Medication pass – the time required is higher in the non-

eMars homes 4. Processing order – the time required is higher in the eMars homes and this may due to:

a. Forcing compliance to follow correct processes and guidelines b. Forcing compliance with regulations

c. Emphasize the improved safety for Resident and compliance to regulations because of eMAR 5. The

time spent in clinical activities was also significantly higher in the eMar equipped homes.

P#17 - WHERE IS THE OCCUPATIONAL THERAPIST IN LONG TERM CARE?

Margot McWhirter. Shoppers Home Health Care, LTC Division, Toronto, ON.



1) Inform delegates about Occupational Therapy Services in LTC - current and potential roles

2) Stimulate thoughts and discussion around Occupational Therapy Services in LTC

3) Encourage colloboration between Occupational Therapists, administrators, researchers, and policy

makers at efforts to improve quality of life and quality of care for LTC residents.

What is the Goal of your Poster? To engage key stakeholders to advocate for increased access to

Occupational Therapy Services in LTC

What were the findings/results and conclusion of the Poster? Occupational Therapists working in LTC

are deeply committed to this area of practice, and many are willing to become involved in advocating

for a funding model that supports the full scope of OT skills. In doing so, they hope to raise the profile of

their profession while contributing to LTC residents' overal health and quality of life.

Intended Audience - Administrators, Director of Nursing.

P#18 - IMPROVING FUNCTIONAL COGNITION AND ADL PARTICIPATION FOR RESIDENTS IN LONG TERM

CARE THROUGH OCCUPATIONAL THERAPY

Karen Fisher. PT Health, Senior's Wellness Divison. Hamilton, ON.



1) Innovative rehabilitation interventions to improve the quality of life for residents that reside in long

term care facilities.

2) Impact of occupational therapy services on resident's ADL performance and functional cognition.

3) Success stories from the implementation of the pt Health occupational therapy program.

What is the Goal of your Poster? To introduce the breadth of occupational therapy practice in long term

care and the direct impact on quality of life for the residents.

What were the findings/results and conclusion of the Poster? Residents on the occupational therapy

program have demonstrated improvement in ADL performance through MDS outcome measure (ADL

long score) and/or documented evaluations by the occupational therapist. In addition, a number of

residents on the cognitive training program also demonstrated cognitive improvement reflected through

their score on a standardized outcome measure (RUDAS) and/or ability to completed different level of

cognitive tasks

Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors.

P#19 - IMPROVING RESIDENT CARE THROUGH COLLABORATION AND EMPOWERMENT OF STAFF TO

IMPLEMENT BEST PRACTICES IN SKIN CARE

Laurie Yates1, Fran Kleinsteuber2. 1Creek Way Village, Burlington, ON, 23M Canada, Milton, ON.



1) Decribe the implementation of a skin care prevention program.

2) Discuss how implementing the skin care program led to a sense of empowerment for the PSW and an

enhanced team approach, including the registered staff .

3) Describe how a good skin care program can help to decrease cost and enhance resident care

outcomes.

What is the Goal of your Poster? To demonstrate how implementing best practices in skin care can not

only improve resident care but help to empower the hca and enhance staff collaboration

What were the findings/results and conclusion of the Poster? The key result of implementing this

program was the atmosphere of empowerment for the PSW and a team approach to resident care.

There was a decrease in our pressure ulcers and incontinence related skin breakdown. As a result we

were able to decrease our wound care supply budget with a focus on prevention. The streamlined

product focus decreased confusion for the PSW in relation to product options.

Intended Audience - Administrators, Director of Nursing, Other.

P#20 - COMMUNICATING UNIQUENESS

Marg Catt. Temiskaming Lodge, Jarlette Health Services, Haileybury, ON.



1) Review existing tools used to communicate individualized resident care needs to all direct care staff

and families.

2) Facilitate the communication of care needs by using only one venue for this = best use of existing

technology and documentation program.

3) Reduced human resource time related to updating of information.

What is the Goal of your Poster? To share with other long term care providers the efficient use of our

technology, which has resulted in enhanced communication of resident care needs, less "places" to

enter changes, resulting in reduced HR time to perform updates.

What were the findings/results and conclusion of the Poster? All staff members, families and residents

appreciate enhancement of communication of resident individualized care needs.

Intended Audience - Director of Nursing, Houskeeping/Laundry, Other.

P#21 - TOP 10 BEHAVIOURS OF AN EFFECTIVE VERSUS INEFFECTIVE QUALITY IMPROVEMENT TEAM

Cheryl Ho. The O'Neill Centre Long Term Care Home, Toronto, ON



1) Identify the top 10 behaviors of effective versus ineffective quality improvement teams

2) Provide a self assessment framework which viewers can rank their own team effectiveness.

3) Provide strategies for improving the effectiveness of quality improvement teams.

What is the Goal of your Poster? To provide real life examples of behaviors within teams which are

representative of effective and ineffective functioning and what impact this can have on their quality

improvement initiative. As well, to allow an opportunity to rank their own quality improvement teams

and receive practical strategies for improvement.

What were the findings/results and conclusion of the Poster? Positive quality outcomes need a strong

and effective team as the foundation to support them. Sometimes quality improvement teams need a

little quality improvement themselves. There are objective markers of effective and ineffective teams.

How do you rank your team?

Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors,

Houskeeping/Laundry, Other.

P#22 - BETWEEN THE GENERATIONS: INNOVATIVE INTERGENERATIONAL PROGAMMING IN LTC

Christine Keenan. Revera- Fenelon Court LTCC, Fenelon Falls, ON.



1) 1. Communicate specific ideas and strategies to implement intergenerational programs

2) 1. Promote intergenerational programs and community partnerships that enhance quality of life for

residents, family and staff

3) 2. Showcase the success of the program through visual aides, articles, awards

What is the Goal of your Poster? 1. To demonstrate how Fenelon Court fosters and supports living

human habitats by incorporating children into the daily life of the home following person-centred care,

EDEN and KIN philosophies 2. To demonstrate how Fenelon Court integrates person centered care by

giving residents meaningful roles, sense of purpose and participation in the community. 3. To develop

meaningful and important community partnerships

What were the findings/results and conclusion of the Poster? -Improved Quality of Life -Employee

engagement -Strong partnerships within the community -Children involved in reading program showed

an improvement in conversational skills -Local Service club met their goal of improving literacy in the

community

Intended Audience - Activity Directors.

P#23 - THE BUTTERFLY PROJECT

April Beckett. Community Nursing Home, Port Hope, ON.



1) To have all the residents in the home enjoy and care for the butterflies. Provide residents with

physical and emotional interaction that the program was able to provide.

2) Encourage resident to take care of the garden outside and ensure that the plants are watered daily.

3) Provide resident with other programs surrounding the butterfly’s i.e. Crafts, information sessions,

independent learning.

What is the Goal of your Poster? To create excitement within the home and to provide residents with a

very interactive program. Residents to leave the program with the knowledge of butterflies and their

lifecycle.

What were the findings/results and conclusion of the Poster? Each session was evaluated to determine

the effectiveness of the program. This was done to ensure that each program met the resident’s needs

as well as providing the same program next year. Each session had various numbers of participants but

each program was very well attended, at times more room was needed with more residents, families

and staff wanting to participate. The Butterfly Release Party had approximately 30 residents attend with

staff and family participation. Families loved the idea and thought it was a great initiative. Residents

thoroughly enjoyed this experience. Some residents even shed a tear when they released the

butterflies; comparing it to their children when they had moved on. Staff also enjoyed this project. They

would walk with residents to the various butterfly homes that were on display and talk about them. You

could often hear conversations on the floors regarding the butterflies.

Intended Audience - Activity Directors.

P#24 - INNOVATION IN FALLS PREVENTION: WE HAVE AN APP FOR THAT!

Janusz Kaleta. Cedarvale Terrace Long Term Care Home, Toronto, ON.



1) To share how a visual representation of falls allows for expedient and effective dissemination of data

to front line staff.

2) To demonstrate how existing technology (Apps/tools) can effectively be used to improve safety in

Long Term Care environment

3) To encourage Proactive rather than Reactive approach to Resident's Safety

What is the Goal of your Poster? Data demystification App is a tool allowing for a visual representation

and mapping the incidence of falls throughout the facility which can point to a specific pattern relative

to exact time, location, shift or particular day when the fall occured.

What were the findings/results and conclusion of the Poster? Because nursing staff in LTC homes

provide care 24/7 it is possible to track falls continuously on a monthly basis. The recorded data SELF-

Arrnages into clusters (colour coded on the tool) and leads to identification of emerging themes i.e.

multiple falls at early morning hours, specific location and / or association with specific risk factor.

Intended Audience - Director of Nursing.

P#25 - MANAGING THE RISK OF POWER MOBILITY IN THE LONG TERM CARE SETTING

Marleen Van Laethem1, Alex Mouret2, Sarah Trenker1. 1St. Joseph's Health Care London, London, ON,

2McKenzie Lake Law Firm, London, ON.



1) To guide other long term care homes in developing the necessary "building blocks" to manage power

mobility (assessment/ identification of less serious to more serious "accidents"/ power mobility

agreement/ monthly team meeting/ ongoing monitoring/ policy

2) To provide other long term care homes with a background around understanding power mobility to

help them face challenges: a) at Mount Hope LTC, we analyzed "accidents" over a six years and

discovered patterns related to diagnoses and high risk driving beh

3) To guide other long term care homes in understanding the legal and ethical implications of power

mobility in the LTC setting.

What is the Goal of your Poster? The goal of the poster is to review Mount Hope’s current process for

managing risks of power mobility devices, provide a summary of the literature related to managing

power mobility and review patterns related to diagnosis and high risk driving behaviors. The poster also

considers ethical and legal questions such as whether the use of a power wheelchair is a right or a

privilege; whether Long Term Care homes might be liable for accidents caused by residents; legal

questions with regard to power mobility devices and driving while impaired, and how best to balance

respect for residents’ autonomy with our desire to ensure a safe environment.

What were the findings/results and conclusion of the Poster? 1. A comprehensive literature review

identified that there is very limited literature on this topic in the English-based literature as this is an

emerging topic. Key articles are summarized. A further list of references can be provided. 2. Residents

with a diagnosis of multiple sclerosis had the greatest number of driving occurrences (accidents),

followed by residents with multiple diagnoses , then CVA's, head injuries and ALS. 3. At Mount Hope

speeding and driving in an aggressive manner are the most common high risk behaviors which occur.

Driving impaired occurs much less frequently.


P#26 - “IMPROVING POTENTIAL FOR POSITIVE OUTCOMES BY UTILIZING INDIVIDUALIZED

CONTINENCE CARE ASSESSMENTS OF RESIDENTS IN CANADA AND THE UNITED STATES”

Kathy Burt, Shelley Gallant, Cara Stone, Diane K. Newman, Angela Douglas. SCA Personal Care, Oakville,

ON.



1) Assessment tools for incontinence management utilized by healthcare professionals across care

settings generally do not fully define the characteristics to be considered when providing best care,

since they are mostly limited to a collection of numerical

2) This system was validated across over 400 care homes in the long-term care setting with a companion

taxonomy utilizing ADLs and other insights to define the needs for each resident. Over 15,000 residents

were evaluated through the process to formulate a m

3) Across the continuum of care, Individuals who experience incontinence face the risk of being

inaccurately assessed and not receiving the most effective care plan to support greater dignity and

independence. The TENA Portraits™ process provided additional

What is the Goal of your Poster? Across the continuum of care, Individuals who experience

incontinence face the risk of being inaccurately assessed and not receiving the most effective care plan

to support greater dignity and independence. The TENA Portraits™ process provided additional

understanding of the base and contributing factors for this condition, leading to heightened awareness

among care staff. This helped influence staff understanding of how to complete more comprehensive

assessments and care plans for improving the quality of care.

What were the findings/results and conclusion of the Poster? As tested, the TENA Portraits™ process

complemented the MDS assessment process, providing more comprehensive evaluations to improve

understanding of the individualized needs of each resident. This data was then reviewed with staff to

assist in forming recommendations to generate more complete and effective plans for continence care,

promote more appropriate product selection, and identify opportunities for restorative toileting

programs to improve quality of life.

Intended Audience - Administrators, Director of Nursing, Activity Directors, Other.

P#27 - ACCREDITATION AND COMPLIANCE: SYNERGIES AND DIFFERENCES FOR ONTARIO'S LONG-

TERM CARE HOMES

Sandra Pitters, Toby Yan. Accreditation Canada.



1) Identify the similarities and differences between the Accreditation Canada Qmentum program and

the Ontario Long-Term Care Homes' Quality Inspection Program (LQIP).

2) Outline the value that each program brings to improving quality in long-term care homes in Ontario.

3) Outline the future directions of the Qmentum accreditation program based on evaluation results.

What is the Goal of your Poster? Questions have been raised about the differences between the LQIP

process and accreditation process and the value- add of accreditation. The goal of the poster is to clarify

the unique contributions to improving quality in long-term care homes in Ontario made by the

Qmentum accreditation program and the LQIP. The poster will also identify future directions of the

Qmentum program based on evaluation results.

What were the findings/results and conclusion of the Poster? In the summer of 2012, Accreditation

Canada undertook a comparison of the Qmentum accreditation program and the Ontario LQIP program.

The primary role of the LQIP is to assess compliance against legislation. MoHLTC’s inspection process

focuses on regulatory requirements that address potential and actual resident risk. The foundation of

Qmentum is the evaluation of quality and promotion of quality management and safety through the

examination of systems and resulting outcomes.

Intended Audience - Administrators, Director of Nursing, Food Service Supervisors, Activity Directors.

P#28 - LTC MEDICAL DIRECTOR LEARNING NEEDS SURVEY

Evelyn Williams, Sid Feldman, Lila Graham, Andrea Moser. Ontario Long Term Care Physicians, Oshawa,

ON.

Contact: [email protected], [email protected], [email protected]


1) Share results of LTC medical director survey identifying perceived and unperceived learning needs of

physicians working in LTC homes. Survey covered medical administration, quality improvement,

program management, legislative requirements and leadership q

2) Identify key topic areas for focused education for Medical Directors working in LTC

3) Outline education strategy for Medical Director training for Medical Directors in Ontario LTC homes

What is the Goal of your Poster? to engage the sector in discussion regarding the role of Medical

Directors in LTC homes. Review the learning needs of Medical Directors working in LTC homes and how

proposed new educational strategies can support quality medical leadership within LTC homes

What were the findings/results and conclusion of the Poster? Learning needs covered many aspects of

current Medical Director role in LTC homes including quality improvement, program management,

involvement in mandatory programs and legislative requirements.


P#29 - ENHANCED RECREATION DOCUMENTATION: IMPROVED RESIDENT CARE, CUSTOMER SERVICE

AND EFFICIENCIES

Wayne Connelly1, Ron Martyn2. 1The Wexford Residence Inc.,Scarborough, ON, 2Silver Meridian,Whitby,

ON.



1) Create measurable outcomes relative to resident engagement in activity programs, resulting in

program modifications for validated improvements in resident recreation experiences.

2) Improve customer service through the utilization of automated reporting to residents and significant

others of resident engagement successes.

3) Demonstrate professionalism in recreation program documentation when reporting findings and

results with key stakeholders (clients, customers, other care disciplines, surveyors and inspection

teams).

What is the Goal of your Poster? Demonstrate how computerized documentation in a recreation

department resulted in: improvements in recreation programming for residents; expansion of the

overall scope of the recreation department programming; increased customer service; and greater

efficiencies in the utilization of staff time.

What were the findings/results and conclusion of the Poster? Over a period of 18 months the goals of

the project were achieved, and ongoing improvements continue to be realized through the

establishment of new, more challenging benchmarks.

Intended Audience - Administrators, Activity Directors.

P#30 - THE JAVA MUSIC CLUB - REDUCING LONELINESS AND DEPRESSION IN LONG-TERM CARE

Kristine Theurer. Java Music Club, Inc., Surrey, BC.



1) 1. To share research on a new culture within recreation programming that focuses on residents

helping residents and the benefits of implementing a standardized structure within long-term care

homes, assisted living or retirement homes and adult day servic

2) 2. To highlight the use of mutual support groups as a foundation to a mentorship program that equips

residents to seek out and support those that are lonely and isolated.

3) 3. To evaluate the implementation of mutual support groups within the long-term care sector and the

impact on mental, emotional and physical health.

What is the Goal of your Poster? To share the results of a study on the development and evaluation of

mutual support groups within the long term care sector.

What were the findings/results and conclusion of the Poster? Resident reports and observations in the

study indicate positive benefits including a decrease in loneliness and helplessness and increased coping

skills. Participating staff describe how the unique group structure fosters active participation of those

with moderate-severe cognitive impairment.

Intended Audience - Administrators, Director of Nursing, Activity Directors.

P#31 - PILOT PROJECT: ETHICAL ISSUES IN TRANSFER FROM LONG TERM CARE TO OSLER EMERGENCY

DEPARTMENT

Jill Oliver, William Osler. Health System, Brampton, ON.



1) To provide the audience with an example of an ethics-oriented Quality Improvement project that

involves hospital and long term care

2) To identify and describe the methods used by the project to promote change

3) To identify the sorts of ethical issues that can be involved with transfers to hospital that residents

either (1) did not want, or (2) could not benefit from.

What is the Goal of your Poster? The poster provides a summary of an ethics-based Quality

Improvement project that has been undertaken by William Osler Health System in 2012-2013, and

involves partnerships with three Long Term Care Homes that transfer residents to hospital

What were the findings/results and conclusion of the Poster? The poster identifies the ethics-related

issues that can be involved with decision making that precedes a resident's transfer from Long Term

Care to the Emergency Department. The poster also summarizes the methods used to promote change

within that decision making.


P#32 - IMPACT OF QUARTERLY INTERDISCIPLINARY MEDICATION REVIEWS ON RESIDENT CARE IN A

CANADIAN LONG TERM CARE FACILITY

Denis O'Donnell. Medical Pharmacies Group Limited, Pickering, ON.



1) Describe the potential advantages and disadvantages of conducting quarterly medication reviews as a

regularly-scheduled face-to-face meeting involving the primary care physician, the clinical unit nurse and

the clinical consultant pharmacist.

2) List the most common medication issues identified during the interdisciplinary quarterly medication

reviews.

3) Describe the types of interventions resulting from the medication issues identified uring the

interdisciplinary quarterly medication reviews.

What is the Goal of your Poster? To showcase a recently completed clinical research study completed at

the Baycrest Apotex Centre, an Ontario long term care facility, designed to evaluate the impact of

quarterly medication reviews conducted iusing an integrated team approach.

What were the findings/results and conclusion of the Poster? 1821 medication reviews involving 536

residents were analyzed by an independent reviewer. A total of 1952 medication-related issues were

identified during medication reviews. The 3 most common drug-related problems categories were:

unnecessary drug therapy, too high of a dose, and the need for additional drug therapy. 2452

documented interventions occurred during the medication reviews with approximately 95% of residents

having received at least 1 intervention. The 3 most frequent drug-related interventions were:

discontinuation of a medication, decreasing of a dose, and initiation of a new medication. Nearly 450

orders for therapeutic monitoring were generated during the medication reviews. Therapeutic drug

categories commonly targeted during the medication reviews included: proton-pump inhibitors, H2-

antagonists as well as neuroleptics. Approximately 70% of proton-pump inhibitors and H2-antagonists

evaluations resulted in dose reduction or discontinuation of medication. The majority of neuroleptic

evaluations resulted in no change of therapy regimen, but 20% of evaluations resulted in

discontinuation or dose reduction of neuroleptic orders. The results of this study demonstrate that an

interdisciplinary medication review is an effective method to monitor resident’s health status, identify

drug-related problems, and implement drug and non-drug related interventions. The collaborative team

approach may enhance the assessment of residents’ therapeutic outcomes and coordination of

monitoring activities. The interdisciplinary approach used by the Apotex Centre ensures that medication

concerns are addressed immediately during a medication review without a communication delay.

Intended Audience - Administrators, Director of Nursing.

P#33 - LET'S DINE TOGETHER - A DINING PROGRAM FOR LONG TERM CARE

Monica Stanuch, Eatonville Care Centre, Etobicoke, ON.



1) To educate on a holistic approach to reducing responsive behaviours during meal times, and

drastically improving the dining environment and overall quality of life.

2) The relationship between a homelike, social, environment and adequate nutrition.

3) That the program is transferable to different settings and can help diverse populations (i.e. in need of

socializing, responsive behaviours, high nutritional risk).

What is the Goal of your Poster? To educate members of the long term care community on an effective

and cost efficient way to reduce responsive behaviours around meal times, increase food and fluid

intakes, and improve the overall dining experience in long term care homes.

What were the findings/results and conclusion of the Poster? By changing the set up and appearance

of a typical long term care dining room, and adding a staff member to interact with residents on a social

level, the dining experience is transformed into a comfortable, social activity which resulted in positive

changes. Residents that were exhibiting responsive behaviours, mainly leaving the dining room and/or

showing a general disinterest in food, no longer regularly experienced these behaviours. Meals are now

very seldom disrupted due to behaviours, whereas prior to the program, this was a daily occurrence.

Food and fluid intake has increased in residents, which is evident in the 2.42% average weight gain after

6 months participating in the program. Psychosocial improvements have also been noted - residents are

happier at meal times, laughing, smiling and socializing. This is a simple program to implement in order

to improve the quality of life in any long term care home.


Other.

P#34 - SHIFTING THE FOCUS TO SEEING THE POSSIBILITIES: ONE HOME’S JOURNEY IN RESTRAINT

REDUCTION

Juanita Goodhand. Unionville Home Society, Unionville, ON.



1) To share alternate methods and strategies for restraint reduction; policy and procedures; resource

tools.

2) To provide the road map to success to achieve a least restraint model of care.

3) To share lessons learned and provide recommendations to others to establish best practices

What is the Goal of your Poster? To share key learnings and results achieved through the quality

improvement initiative that focused on establishing the best practice of a least restraint model of care.

Discuss the approach followed to achieve the desired results

What were the findings/results and conclusion of the Poster? •Myths and misperceptions for use and

lack of awareness of the risks associated with restraints by staff, resident/families was a barrier to

physical restraint reduction; •Lack of awareness of alternative methods in lieu of restraint by staff and

resident/families i.e. PASDs, side rails for mobility only not safety etc. led to resistance for change;

•Ambiguity of restraint policy led to misinterpretation of its use; •Restraint reduction wasn’t

systematically reviewed as an entire process which led to fragmentation in approach versus a

consolidated effort across the interdisciplinary team; •Staff required additional education and training

to build their skills to support the strategy for restraint reduction; •Families needed support to shift

their personal beliefs through a combination of resource material and 1:1 education that focused on

procedure, benefits, risks and advantages; •Documented evidence of the trial period for restraint

removal for selected residents led to a change in practice and personal belief and management for its

use; •A consolidated systematic team approach created an new system for restraint use; •Established

an accountability framework to measure the outcomes of the changes; •Documented evidence of trial

outcomes, assisted in reducing the skepticism of residents, family and staff who were resistant to a

restraint free model of care. As a result, our physical resident restraint use decreased from July 2012 to

February 2013 decreased from 31.03% to 7.5%.


P#35 - THE INTEGRATION OF STROKE BEST PRACTICE INTO LONG TERM CARE RESIDENT CARE

PLANNING

Gwen Brown, Stroke Network of Southeastern Ontario, ON, Alda Tee, Central East Stroke Network,

Barrie, ON, Donna Cheung, South East Toronto Stroke Network, Toronto, ON, Sharon Trottman, The

West GTA Stroke Network, Etobicoke, ON.



1) To show how to access stroke best practice care plans using the RAI MDS assessment tool and Tips

and Tools resource material together.

2) Increase the awarenes of staff working in Long term Care Homes of available stroke best practice

resource materials

3) Stroke-specific resident care plans can support/augment existing care plans and facilitate

individualisation of best practice interventions for stroke residents in Long Term Care.

What is the Goal of your Poster? To enhance awareness and facilitate the uptake of stroke care best

practice in Long Term Care by linking stroke best practice information with the RAI-MDS assessment

tool.

What were the findings/results and conclusion of the Poster? There was an increase in the number of

pilot project participants accessing the Tips and Tools for Everyday Living as a best practice stroke

resource. 95.8% of survey respondents indicated tha the stroke care plans enhanced their ability to care

for stroke residents. More stroke resources were developed related to the best practice Stroke Care

Plans. It was agreed that the new stroke care plans complimented the existing care plans and could be

combined with them to customise resident care planning. Therefore ,further exploration into integrating

stroke care plans into the existing software platform is recommended for all Provincial LTC Homes .


P#36 - LONG TERM CARE SCHEDULING CAUSING LONG TERM HEADACHES?

David Bruzzese. Workforce Management, Mississauga, ON.



1) Manual scheduling causes headaches

2) Different scenarios LTC industry professionals may face on a day to day basis.

3) Synerion provides the solution to manual processes of scheduling. Offering an LTC Scheduler which is

designed to put ease on your day to day operations.

What is the Goal of your Poster? To enlighten long term care professionals on automated scheduling,

schedule compliance, and coverage control.

What were the findings/results and conclusion of the Poster? Contact Synerion for more information

about the Synerion LTC Scheduler.


Houskeeping/Laundry, Maintenance, Other.

P#37 - BEHAVIOUR SUPPORT ONTARIO: BEST PRACTICES IN HELPING MANAGE AND DEAL WITH

RESPONSIVE BEHAVIOURS

Lesley Santos. Shepherd Village Inc., Toronto, ON.



1) Audience will learn about the BSO initiative in the Central East LHIN and the four change ideas that

were spread and sustained at Shepherd Lodge LTC.

2) Audience will learn about the different best practices (PIECES, Montessori, Gentle Persuasive

Approaches) that has led to the decrease in the number of responsive behaviours and increased staff

capacity in managing behaviours at Shepherd Lodge LTC

3) The utilization & application of PIECES, GPA, Montessori + BAT Tool + Visual Board + Behaviour

Rounds are best practices in helping manage or deal with Responsive Behaviours in LTC

What is the Goal of your Poster? To promote best practices in dealing and managing Responsive

Behaviours in Long-Term Care

What were the findings/results and conclusion of the Poster? The # of Montessori programs (Non-

pharmacological interventions) exceeded the # of PRNs given for behaviours -A combination of

pharmacological & non-pharmacological interventions such as Montessori programs aid residents with

responsive behaviours -Overall, SL remains lower than the provincial average in worsened behaviour

symtpoms (6.7 % vs. 13.5%) - (CIHI Q1 2012) - SL has a baseline of 83 responsive behaviours - The # of

residents with responsive behaviours have decreased from 83 in February to 52 in December 2012 -

There has only been two admissions thus far since the implementation of BSO (1 in June, 1 in August) -

Since the incorporation of best practice approaches such as PIECES, GPA & Montessori, the # of hospital

transfers has reduced There has been increased vigilance in monitoring and tracking the number of

responsive behaviours - DOS (Dementia Observation System) has helped our Home obtain a more

accurate # of responsive behaviours - SL's average # of Responsive Behaviours as per DOS is 496 - We

tracked the # of resident admissions into the BSO program and the # of discharges due to successful

interventions by utilizing PIECES, GPA and Montessori frameworks - So far, there have been 43 residents

with responsive behaviours who were seen by the BSO Team, with 31 discharges thus far - The

Behaviour Assessment Tool (BAT) enables us to track the number of behaviours by month - BAT enables

us to identify the types of responsive behaviours such as wandering, agitation, verbal and physical

responsive behaviour, suspiciousness, agitation, etc and allows us to determine an intervention for each

identified behaviour Success Story using PIECES framework – D.H. -One of resident's behaviours:

opening all residents' windows and removing a window screen. -Resident stated that she opens the

window to "get some fresh air" -BSO RPN checked resident's MAR and saw that she had a PRN puffer -

Staff gave puffer and behaviour ceased. -Information was written on the Visual Board and

communicated to all shifts : If resident is stating she wants fresh air or begins to open windows, staff are

to give PRN puffer -Resident no longer opens windows Success story using GPA and Montessori

Programming – S.T. -Resident’s behaviours: Resistive to care, physical responsive behaviour when staff

render care. Two staff provide care due to resident’s behaviours. -Interventions: BSO staff had one to

one visits with resident, engages him in Montessori programming such as reading newspaper and

listening to Hindu music. -Through effective communication, his needs were met. I.e. Staff introduce self

with a soft tone of voice, with a smile. Staff explain procedures to resident clearly and slowly and staff

listen to his responses. BSO staff found that this worked well with resident as his resistance to care and

physical responsive behaviour ceased. BSO staff then educated and taught unit PSWs how to care for

this resident. -Outcome: Resident is now receiving care from one staff member, he cooperates and

participates in his ADLs. Cheerful demeanor when approached with a smile. Staff implementing and

following suggestions from BSO Team. Resident no longer displays behaviours and attends activities on

the unit and exercises with Physiotherapist Resident/Family Responses to BSO Initiative -“Since [the BSO

Team] is coming to see my husband, I have noticed a change in him and his interaction with the staff. His

behaviour has changed towards me and the staff. He is pleasant and happy to see me when I visit with

him. Thank you so much for everything , I really do appreciate all of you.” -“The BSO Team would listen

and help me as we spoke. There were those who helped me regain my cognitive power with special

word games. There were others who took me for walks and conversed with me about interesting news.

Lesley, the BSO Lead, would have me write a journal and talk me through my emotional issues. All in all I

would like to praise of them for helping me to regain a new start on life again. I am so grateful for their

caring help. I can live out my life happy, content and I feel useful again. Thank you for funding them.” -“I

have seen the benefits of the BSO program and appreciate the overall improvement in my mom’s

quality of life.” Change Idea #1: Visual Board -Visual board contains: Resident's name, list of identified

resident's Responsive Behaviours, Behaviour Triggers, Interventions and Risks in table format -Provides a

snapshot or ‘cheat sheet’ of resident’s responsive behaviours, triggers & interventions that is accessible

for all shifts -Posted on 6 floors (Room behind Nursing station) in a private area to maintain

confidentiality -All staff provide input -Includes Montessori activities for identified residents Change Idea

#2: Behaviour Assessment Tool -Consists of Crisis Care Plan, Behaviour Rating Scales, and enables all

staff to apply P.I.E.C.E.S. approach -Currently being completed by BSO Team in collaboration with Unit

RPN and PSW -Reviewed and discussed at BSO Team Rounds -Inserted into resident’s chart under “BSO”

tab -Resident focused -Resident’s capabilities (strengths) Change Idea #3: BSO Rounds -Behaviour

Rounds held once a week with Interdisciplinary Team, including Pharmacist -BSO Team leads Rounds List

of identified resident's responsive behaviours, behaviour triggers, interventions, risks and medication

review discussed during Rounds -Behaviour peak times are identified Interdisciplinary team determines

pharmacological and non pharmacological interventions (i.e. Montessori programs) for the identified

resident -Behaviour triggers and Interventions communicated to all shifts Change Idea #4: Montessori

Programming -BSO Team completes a Life History Assessment for each resident -Interviews resident

and/or family member re: hobbies, interests, daily routines. -Montessori Kit containing a collection of

what resident likes to do i.e. Crossword puzzles, Bible, Books, CDs is devised by the BSO Team for each

resident, which promotes resident-focussed care Montessori programming is scheduled for each

identified resident during behaviour peak times -All staff participate in Montessori Programming


P#2 - TIME AND MOTION STUDY: THE IMPACT OF …...P#20 - COMMUNICATING UNIQUENESS Marg Catt. Temiskaming Lodge, Jarlette Health Services, Haileybury, ON. Contact: [email protected]

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