1. Solving the BSO Mystery InVizzen Knowledge Brokers 2015

2. Welcome Solving the BSO Mystery Module  We’ll start in 5 minutes.  Please make sure you have:  Pen  Piece of paper  Checklist sent with the session confirmation

3. Welcome Solving the BSO Mystery Module  Introductions  Name  Role  LTCH

4. Just the Facts  On a piece of paper write FACT or MYTH for each question. 1.BSO is short for Behavioural Supports Ontario. 2.Dealing with responsive behaviours is mainly the job of the BSO staff (e.g. RN, PSW). 3.Managing responsive behaviours takes more time and is more work. 4.Getting better at managing responsive behaviours is better for residents, families and staff.

5. Just the Facts 1.BSO is short for Behavioural Supports Ontario. FACT 2.Dealing with responsive behaviours is mainly the job of the BSO staff (e.g. RN, PSW). MYTH 3.Managing responsive behaviours takes more time and is more work. MYTH 4.Getting better at managing responsive behaviours is better for residents, families and staff. FACT

6. In this session we’ll share 3 clues for keeping yourself safe AND providing good care  1) Know your residents well  2) Use the strategies in the behavioural care plan for your residents.  3) Take part in team huddles

7. What are the common threads in both cases?  Sally is new to this floor – she’s in a hurry to get Mrs. Vanderhayden to breakfast on time.  She’s heard that Mrs. V. likes to pick out her own socks but decides to skip it; she grabs the white ones and when she tries to put them on, Mrs. V. kicks hard and screams that she wants the green ones.  Mrs. V. is very upset, she’s late for breakfast and refuses to eat. Sally’s shoulder is sore for days.

8. What are the common threads in both cases?  Bert prides himself on being efficient. He doesn’t bother to read the behavioural care plan for Mr. Singh – that’s for others to worry about. After all, the BSO PSW works the same shift.  After lunch Bert helps Mr S into bed. Bert is distracted - he had an argument with his son before coming to work.  Bert is using proper lift procedures and adjusting the belt when Mr. S lashes out and punches Bert. For the next 3 days Mr. S is very agitated every time Bert comes close.

9. What did you put your finger on?  What are common threads?  What could have been done differently to prevent:  Responsive behaviours?  Staff injuries?

10. 1) Know your residents well  Here’s more background on Mr. Singh  Served in the RCMP for 30 years  He was attacked and severely wounded when a thief tried to grab his gun  He lived with post traumatic stress syndrome after a school shooting incident  What do you think may have triggered his responsive behaviour – what in his environment was he responding to?

11. 1) Know your residents well  What bright ideas do you have about things you can consistently do to reduce the number of and severity of responsive behaviours?

12. 2) Use the strategies in the behavioural care plan for your residents.  How many of your residents have a behavioural care plan?  A) None  B) All of them  C) I could name them  D) I don’t have any idea

13. 2) Use the strategies in the behavioural care plan for your residents.  What are some of the strategies for your residents?

14. 2) Use the strategies in the behavioural care plan for your residents.  Get input and add here  Screen shot of a care plan

15. 2) Use the strategies in the behavioural care plan for your residents.  If you were Bert and after the incident you looking in the care plan and didn’t see anything for lifts and transfers related to responsive behaviours what would you do?

16. 2) Use the strategies in the behavioural care plan for your residents.  What do you do if:  There’s no behavioural care plan in place but you’ve noticed some responsive behaviours? > Talk to your BSO Nurse or PSW.

17. 3) Take part in team huddles  Team Huddles are short – 5 minute talks about a resident’s responsive behaviours.  Members of the team share what they notice, what works, what doesn’t seem to work and where we go from here.

18. 3) Take part in team huddles  If you were Sally, what would you share about Mrs. V and the case of the wrong coloured socks?  What would you recommend to your team?

19. Clues all add up to ….  Preventing and managing responsive behaviours is everyone’s role.  It’s not more work. It’s about better communication and spending time on strategies that work and stop spending time on things that don’t work.  We need to talk about and act on what works. If nothing changes, nothing changes.

20. Your challenge: 2-3 things you commit to doing?  Ideas:  Remember that I have a role to play in preventing and managing responsive behaviours  Remind myself that by taking short cuts, it will likely waste more time  Watch and listen better so I get to know my residents well  Speak up at team huddles  Read care plans carefully and regularly  Follow care plan strategies  If I’m not sure what to do ask my team and tap into the expertise of the BSO staff