Report on the Pulse Patient Safety Education Fund, December 2019

The objective of this project is to help our program participants to better understand and become more actively involved in their personal health care. Over the course of a year, the goal is to teach adults recovering from serious mental illness who also have chronic health conditions to use basic medical equipment to check their vital signs.

Education is Vital: A Client-Centered Approach

Under the auspices of the New York State Office of Mental Health, Options for Community Living, Inc. provides safe, affordable housing and supportive services to Nassau and Suffolk County residents who are recovering from serious mental illness. With assistance, residents learn to manage their medication, develop skills to care for themselves; perform cooking and household chores; and access community resources. Options counselors, case managers, peer workers, vocational specialists, and health care facilitators provide support and help program participants on their path to more independent living.

In December of 2018, Options Health Care Facilitators (HCF) began a new health education program in our Mental Health Licensed Residential Programs, Supportive Housing (SH), and Mobile Residential Support Team (MRST) programs. Options HCF are Licensed Practical Nurses that focus on mental and physical health and wellness, medication management, nutrition, fitness and support systems.  Services provided by Options HCF are designed to improve physical and mental health, improve housing stability, and prevent, where possible, emergency room usage and inpatient hospitalization. The goal of the new program was to teach program participants recovering from serious mental illness and chronic health conditions how to monitor their own vital signs using basic medical equipment. To date, ninety (90) adults have been instructed by an Options HCF on the proper use of a blood pressure monitor, thermometer, and pulse oximeter. Funding provided by the Pulse Center for Patient Safety Education & Advocacy supported the purchase of four blood pressure monitors, four thermometers, and four pulse oximeters used in this new program.

At initiation of the program, the HCF used an evaluation form with each client to understand their basic knowledge of taking and tracking their own vital signs. The HFC determined which pieces of equipment would benefit the client the most, demonstrated how to use the equipment properly with each client, and provided written instructions for taking vital signs as well as education on each client’s medical condition/needs. To ensure program success and longevity, we determined that a six-month commitment with a once monthly check-in was more beneficial than the weekly check-in suggested in the original proposal. Our QI Department created an outcome tracking form that the HCF edited monthly in our Foothold database, tracking individual client progress. This gave our HCF more flexibility with education and monitoring throughout the year. Once a demonstrated skill level had been achieved, the HCF helped our program participants apply for support through their physician/insurance company to receive equipment of their own. The support provided through this effort allowed our program participants to be more involved in their care and have informed conversations with their HCF and health care providers.

Feedback from participating clients included:

During a visit with the HCF, the client asked if they could check his blood pressure together.  Client stated, “I just thought it would be a good idea to know what my blood pressure is.”  After they took his blood pressure, the HCF educated him on his readings and the importance of monitoring his blood pressure regularly, to which he responded, “Yes, I would like that. Could you teach me how to do it myself?”

During a routine visit, a client reported, “My sugars have been pretty good, and my blood pressure is good lately too.”  After explaining this to the HCF, the client took out his blood pressure machine to test and show her how well he’s been doing.

After providing a pulse oximeter to a client, HCF educated him on the guidelines of what his oxygen levels should be, and what would require him using his oxygen.  She asked him to test independently during his visit and he was able to do so and report, “Its 86% right now.”  He also was able to report, “My oxygen goes up and down during the day depending on what activities I'm doing.”

By learning to accurately monitor their blood pressure, body temperature, oxygen level, and pulse, program participants were able to see how changes in their care impacted their vital signs and their health. Data recorded from tracking vital signs over the extended period was used to re-evaluate program participants’ care plan and overall wellness goals.

The daily tracking of vitals allowed the program participants to see how changes in their medication, routines, and self-care directly impacted their vital signs and overall wellbeing. This knowledge will help program participants to make informed decisions about the use of emergency services and contact with their health care practitioners outside of their regularly scheduled appointments in the future.

Learn more about Options for Community Living Here:

Learn more about Pulse Center for Patient Safety Education & Advocacy Here 

Learn more about the Pulse Patient Safety Education Fund Here:

Learn more about the 2018 Pulse Patient Safety Symposium Here