Picture this: a home health aide (HHA) visits a patient twice a week for baths and skin care. During one of her visits, she observes that her patient seems more tired than usual and needs more help with moving around during the bath. She learns from the patient’s daughter that her mother is turning down food she enjoyed before. What happens with these observations and information?
The likely answer: it depends on the members of the team, the day, how busy everyone is, the quality of the aide’s documentation, how soon it is read, and a host of other things. Our research team asked ourselves: how can we capitalize on important information, like changes in function or appetite, gathered by front-line staff like HHAs and CNAs in the nursing home? How can we get this information quickly to other team members for further assessment and action? As a result, we developed a new tool, called Stop and Watch, for CNAs in nursing homes. We think the Stop and Watch tool may have great applicability and usefulness to home care teams too. We’ll be interested to learn what you think.
Stop and Watch is a quick and easy tool for nursing aide’s to use to communicate changes in condition. Each letter in Stop and Watch stands for an important change. For instance: “ S” stands for “Seems different than usual” ; “T” stands for “Talks or Communicates less than usual” and so on, all the way through the “H” at the end of Watch” which stands for “Help with walking, transferring, toileting more than usual.”
In our nursing home projects, CNAs carry pads with the Stop and Watch tool in their pockets. They fill the tool out and give a copy of it immediately to the nurses on their unit. The intent is for quick and easy exchange of information between team members. Staff RNs in the nursing homes we work with often incorporate Stop and Watch observations in their reports to primary care providers and emergency room staff. The detail provided by front-line staff can be very useful in putting together SBAR reports that many nursing homes and home health agencies use to facilitate communication across providers and settings.
The complete Stop and Watch tool and instructions are available on our project website, INTERACT2.net. INTERACT – which stands for Interventions to Reduce Acute Care Transfers – is a comprehensive program designed to assist nursing home staff to identify and manage changes in their residents and reduce hospital transfers. In addition to Stop and Watch, take a look at the SBAR communication tools developed for common symptoms in nursing home residents that often lead to hospitalization – let us know if you think these and the other INTERACT tools would be useful in your home care practice.
Gerri Lamb, PhD, RN, FAAN and Laurie Herndon, MSN, GNP
Members of INTERACT Project Team
Florida Atlantic University
CHAMP Note: While the SBAR tool on the INTERACT web site has been formatted to reflect common symptoms in Nursing Home Residents, some of these may be applicable to home care as well. The Stop and Watch tool can also be found in CHAMP’s tool library.
