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Safety Counts June/July 2014 - Download entire PDF by clicking
HHEWS comes to OB
Last year, Hallmark Health System (HHS) developed the Hallmark Health Early Warning System (HHEWS), which provides an objective analysis of inpatients at risk so appropriate action can be taken before a patient’s condition worsens. The tool tracks vital signs and the total score can guide clinical decision-making.
This spring, the tool was rolled out on the obstetrical unit (called MATHHEWS – MAT for maternity) at Melrose-Wakefield Hospital, though with a few tweaks. The OB team included additional “vital signs” such as bleeding and contractions. “We also added physician actions, such as when the physician needs to be at the hospital or review the fetal monitor strip,” said Carol Downes, MSN-MBA, RNC, BC-NEA, patient care director for maternal and newborn services.
In OB, MATHHEWS is a combined score (mother and baby). “Recently, we had a patient in labor who started to run a temperature and her baby’s heart rate increased,” said Downes. “Together, their score required action. We created and executed a plan and both mom and baby did fine.”
Currently, the MATHHEWS tool is applied to every patient – not just those considered to be at high risk – who is admitted to labor and delivery. “We opted to include everyone so we could maximize staff training during our pilot phase,” said Kati Roe, BSN, RNC, clinical practice leader for labor and delivery.
During the pilot, the tool has been tweaked further, incorporating feedback from physicians and nurses. One enhancement involves streamlining the documentation form; another includes an alert to postpone any scheduled procedure, such as an elective induction or C-section, when there are patients on the unit with a high MATHHEWS score. As a result, the tool “offers clearly defined data for medical and nursing staff,” said Roe. “No debate, no surprises.”
Safety drill protects infants
In the past 30 years there have been 132 infant abductions from health care facilities (none in Massachusetts), according to the National Center for Missing and Exploited Children. To protect infants from abduction, Hallmark Health System (HHS) conducts annual emergency drills through the AlliedBarton Security Service at HHS. “We hold the surprise drills in maternity and elsewhere to test our procedures and reinforce awareness among the staff of the need to be vigilant,” said Security Director Chris Nowak.
The most recent “Code Pink” drill in maternity was a fictional scenario developed by Nowak and a nurse educator. The plot involved an estranged father (played by one of the HHS security staff) trying to steal his newborn baby (played by an infant CPR manikin) from the mother while they were still in the hospital. Once the “Code Pink” is called and the drill is “live,” every unit in the hospital activates its response plan. “Each unit has specific responsibilities,”said Nowak, “such as monitoring stairwells, hallways, elevators and exits near the unit. We have camera systems to help, but we really need staff to be observant – things such as distinguishing features of the abductor or the direction of travel should there be a getaway car,” he added.
Each drill is followed through to its conclusion and a debriefing held afterward to assess performance and pinpoint any vulnerabilities. “We learn something every time,” said Nowak. “From this one, it’s to expect the unexpected. We most often think of a stranger abducting a baby from a hospital, rather than a parent. A threat can come from anyone at any time, so we can’t let our guard down.”
Moms learn home safety for their babies, at home
Each year, staff of the Hallmark Health VNA and Hospice make more than 160 home visits to new mothers and their babies. Besides checking up on the health of both, a key goal of these visits is safety teaching. Safety teaching covers two main areas. One is general newborn care, “including safety practices like never leaving the baby unattended on a changing table to go answer the phone,” said Hallmark Health VNA Maternal and Child Health Coordinator Michelle Bradford, RN, BSN. The other is education on Sudden Infant Death Syndrome (SIDS) and safe sleep. “This is particularly important because of cultural and generational differences,” she added. “A generation ago moms were taught to put babies down on their stomachs. We now know that’s not safe but many grandparents, for example, might think that’s still the thing to do.” In addition to in-home education, staff distribute brochures about safe sleep (available in English and Spanish) to help spread the word among family members plus any other caregivers for the newborn.
Part of the post-partum home visiting program involves a safety check of the home – everything from crib slats and bedding to the presence of lead paint to the appropriate installation of a car seat. “If we see problems, we notify the pediatrician of our findings and also can refer the family to other resources as needed – for lead paint abatement, for example,” she added.
Community services for children and families emphasize safety
Caring for families and their children along a continuum is a trademark of Hallmark Health System (HHS). “This is among the most integrated service lines within our system,” said Eileen Dern, RN, CES, director of Community Services. “While mom and baby perinatal stays at Melrose-Wakefield Hospital are relatively short, our relationships with families are long-term, promoting child safety and much more.”
Among the largest family support programs are the North Suburban Women, Infants and Children (WIC) Nutrition Program, Healthy Families and the North Suburban Child and Family Resource Network, all of which include safety-focused programming. “Helping parents and caregivers know how to care for their child can include teaching about safe sleep, infant and child CPR, immunizations, and strategies to prevent child abuse and neglect,” said Dern. “The biggest safety feature we offer, however, is an open door for parents,” she added, “answering their questions, directing them to needed resources and helping them to be the best parents possible.”
Vol 2, No. 6, June/July 2014
Vol 2, No. 5, May 2014
News & Events
Tuesday, June 17 2014 15:38