3. Credo
“Patients should not be
harmed by the care that is
intended to help them, nor
should harm come to those
who work in health care”
Crossing the Quality Chasm, 2001
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4. Agenda
Safe Patient Handling Law BackgroundSafe Patient Handling Law Background
Safe Patient Handling WebsiteSafe Patient Handling Website
Law TimelinesLaw Timelines
Equipment requirements and fundingEquipment requirements and funding
QuestionsQuestions
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5. Safe Patient Handling Legislation
Governor Gregoire signed EngrossedGovernor Gregoire signed Engrossed
Substitute House bill 1672 on March 22,Substitute House bill 1672 on March 22,
20062006
Bill became law on June 21, 2006Bill became law on June 21, 2006
Legislation makes safe patient handlingLegislation makes safe patient handling
part of how hospitals provide care bypart of how hospitals provide care by
adding this requirement to DOH hospitaladding this requirement to DOH hospital
licensing requirementslicensing requirements
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6. Background
The law was supported by:The law was supported by:
Service Employees International UnionService Employees International Union
Local 1199NWLocal 1199NW
United Food & Commercial Workers’United Food & Commercial Workers’
UnionUnion
Washington State Hospital AssociationWashington State Hospital Association
Washington State Nurses AssociationWashington State Nurses Association
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7. Why was the law enacted?
To improve the safety of healthcareTo improve the safety of healthcare
employees and patientsemployees and patients
Provide funding to hospitals implementingProvide funding to hospitals implementing
safe patient handling programssafe patient handling programs
To improve nurse retentionTo improve nurse retention
To reduce costs to hospitalsTo reduce costs to hospitals
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8. Nurses lift an estimated 2
tons per shift
Do the math:
Number of patients/day
Number of lifts/patient
Average weight/patient
4 X 6 X 170 = 4,080lbs/day
We Know…
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9. We know…
38% of nurses suffer work-related back38% of nurses suffer work-related back
injuries requiring time away from workinjuries requiring time away from work
12% of nurses consider leaving nursing due12% of nurses consider leaving nursing due
to low back pain at average age 39to low back pain at average age 39
Nurse aides have also experiencedNurse aides have also experienced
significant injurysignificant injury
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10. “Zero-Lift” Program
Lifting programs have been proven to beLifting programs have been proven to be
effective. WHS’s Workers’ Compensationeffective. WHS’s Workers’ Compensation
“Zero Lift Program” has experienced“Zero Lift Program” has experienced
remarkable success:remarkable success:
Patient Handling injuries had decreased by 43%Patient Handling injuries had decreased by 43%
Time loss frequency rates had decreased by 50%Time loss frequency rates had decreased by 50%
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11. Safe Patient Handling
Steering Committee
Collaboration developed to provideCollaboration developed to provide tools andtools and
modelsmodels that will help hospitals implement safethat will help hospitals implement safe
patient handling programs.patient handling programs.
Healthcare UnionsHealthcare Unions
Department of Labor & IndustriesDepartment of Labor & Industries
Physical and Occupational TherapistsPhysical and Occupational Therapists
Employee Health ManagersEmployee Health Managers
Urban and Rural Hospital AdministratorsUrban and Rural Hospital Administrators
Washington State Hospital AssociationWashington State Hospital Association
Washington Hospital Services’ Workers’Washington Hospital Services’ Workers’
Compensation ProgramCompensation Program
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12. Law Timelines
February 1, 2007February 1, 2007 – establish safe patient– establish safe patient
handling committeehandling committee
December 1, 2007December 1, 2007 – implement safe patient– implement safe patient
handling programhandling program
January 30, 2010January 30, 2010 – acquire lifting– acquire lifting
equipmentequipment
Enforced by the Department of HealthEnforced by the Department of Health
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22. February 1, 2007
Establish a safe patient handlingEstablish a safe patient handling
committee with at least half of thecommittee with at least half of the
committee being direct care staffcommittee being direct care staff
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23. Establishing a Committee
Recruit Participants (50% direct careRecruit Participants (50% direct care
staff)staff)
Elect committee chair and co-chairElect committee chair and co-chair
Develop meeting schedule andDevelop meeting schedule and
protocolsprotocols
The primary responsibility of the committee is toThe primary responsibility of the committee is to
establish, implement and monitor the Safe Patientestablish, implement and monitor the Safe Patient
Handling Program.Handling Program.
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24. Labor Management
The Steering Committee recommendsThe Steering Committee recommends
union involvement in committeeunion involvement in committee
development and decision makingdevelopment and decision making
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26. December 1, 2007
Establish a safeEstablish a safe
patient handling programpatient handling program
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27. Safe Patient Handling
Program
Safe patient handling program shall include andSafe patient handling program shall include and
hospitals must:hospitals must:
1.1. Implement a safe patient handling policyImplement a safe patient handling policy
2.2. Conduct a safe patient handling hazardConduct a safe patient handling hazard
assessmentassessment
3.3. Develop a process to identify the appropriate useDevelop a process to identify the appropriate use
of the safe patient handling policy based onof the safe patient handling policy based on
patient needs and availability of equipmentpatient needs and availability of equipment
4.4. Conduct an annual performance evaluationConduct an annual performance evaluation
5.5. Consider the feasibility of incorporatingConsider the feasibility of incorporating
equipment when constructing or remodeling aequipment when constructing or remodeling a
hospitalhospital Brought to you by
28. Establishing a Safe
Patient Handling Program
1.1. Implement a safe patient handling policy forImplement a safe patient handling policy for
all shifts and units of the hospitalall shifts and units of the hospital
It is recommended your safe patient handlingIt is recommended your safe patient handling
committee draft a policy togethercommittee draft a policy together
2.2. Conduct patient handling hazard assessment.Conduct patient handling hazard assessment.
Include variables such as patient handlingInclude variables such as patient handling
tasks, types of nursing units, patienttasks, types of nursing units, patient
populations, and the physical environmentpopulations, and the physical environment
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29. Establishing a Safe
Patient Handling Program
3.3. Facilitate the development of standardsFacilitate the development of standards
for assessing each patient and theirfor assessing each patient and their
activitiesactivities
A.A. Get input for department staffGet input for department staff
B.B. Include how to document and shareInclude how to document and share
information across shifts and departmentsinformation across shifts and departments
C.C. Consider using algorithmsConsider using algorithms
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30. Establishing a Safe
Patient Handling Program
4.4. Conduct an annual performanceConduct an annual performance
evaluation of the program to determine itsevaluation of the program to determine its
effectiveness-report results to your safeeffectiveness-report results to your safe
patient handling committeepatient handling committee
5.5. When developing architectural plans,When developing architectural plans,
consider the feasibility of incorporatingconsider the feasibility of incorporating
patient handling equipment into thepatient handling equipment into the
designdesign
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31. What Makes a Successful Program?
Analyze what works already in your hospital:Analyze what works already in your hospital:
Existing practicesExisting practices
Attitudes about changeAttitudes about change
Administration’s supportAdministration’s support
Organizational cultureOrganizational culture
Barriers to changeBarriers to change
Current patient flowCurrent patient flow
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32. Know Current Practices
Department practices and techniquesDepartment practices and techniques
already used for handling their patientalready used for handling their patient
populationpopulation
Who is influential in each departmentWho is influential in each department
the leaders of co-workersthe leaders of co-workers
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33. Educate Your Hospital
Committee members to their role on theCommittee members to their role on the
team, empower them to do their workteam, empower them to do their work
Management - for staffing, so teamManagement - for staffing, so team
members can attend meetings and do theirmembers can attend meetings and do their
workwork
Keep the committee informed of theirKeep the committee informed of their
accomplishments so they feel successfulaccomplishments so they feel successful
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34. Campaign – Build Momentum
Use every modality possible to share whatUse every modality possible to share what
is being planned and implemented:is being planned and implemented:
Recruit an Administration sponsor who willRecruit an Administration sponsor who will
speak directly to the care giversspeak directly to the care givers
Design in accountability of managers,Design in accountability of managers,
supervisors, charge nurses, house supervisorssupervisors, charge nurses, house supervisors
and direct care givers; to know when the teamand direct care givers; to know when the team
meetings occur, who the members are,meetings occur, who the members are,
department’s need for equipment, whatdepartment’s need for equipment, what
systems and techniques will change, processessystems and techniques will change, processes
for acquiring what they need, etc.for acquiring what they need, etc.
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35. Inform Your Patients, Families, and Visitors
Advertise in brochures, newsletters,Advertise in brochures, newsletters,
hospital bulletin boardshospital bulletin boards
Create expectationsCreate expectations
Make the work of the committee public,Make the work of the committee public,
positive and rewardingpositive and rewarding
Please visit website to view a sample marketing materialsPlease visit website to view a sample marketing materials
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37. Risk & Needs Assessment
Measures to eliminate or reduceMeasures to eliminate or reduce
patient handling risks must bepatient handling risks must be
identifiedidentified
Conduct an analysis of injuriesConduct an analysis of injuries
Identify and prioritize patient handlingIdentify and prioritize patient handling
risksrisks
Assess patient mobility needsAssess patient mobility needs
Conduct an inventory of patient handlingConduct an inventory of patient handling
equipmentequipment
Identify environmental and system barriersIdentify environmental and system barriers
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38. Learn From Your Mistakes
Conduct annual performance evaluationsConduct annual performance evaluations
of the:of the:
System’s policySystem’s policy
Committee’s workCommittee’s work
Program effect on injuries & fallsProgram effect on injuries & falls
Equipment UseEquipment Use
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40. Change Can Be Hard
Have activities with rewards for individualHave activities with rewards for individual
care givers and departments:care givers and departments:
Informal brown-bag lunchesInformal brown-bag lunches
Departments can compete against eachDepartments can compete against each
otherother
RodeosRodeos
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41. A Successful Program
Adheres to the requirements of the lawAdheres to the requirements of the law
Meets all deadlinesMeets all deadlines
Uses the available toolsUses the available tools
Involves your safe patient handling team inInvolves your safe patient handling team in
decision makingdecision making
Shares experiences, ask questionsShares experiences, ask questions
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42. Washington Regulatory Requirements1
When developing architectural plans forWhen developing architectural plans for
constructing or remodeling a hospital orconstructing or remodeling a hospital or
unit, the hospital must consider theunit, the hospital must consider the
feasibility of incorporating patient handlingfeasibility of incorporating patient handling
equipment or design needed to incorporateequipment or design needed to incorporate
equipment later.equipment later.
11
RCW 70.41.390RCW 70.41.390
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43. Before The Blue Prints
Get all levels of staffGet all levels of staff
involvedinvolved
Think about all possibleThink about all possible
scenariosscenarios
Place real users in a mockPlace real users in a mock
up of the design conceptup of the design concept
and simulate simulationand simulate simulation
Full scale simulation withFull scale simulation with
props or3-D computerprops or3-D computer
simulationssimulations
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44. Working Space Transfer to Bed
(Add 12” all around the bed for bariatric patient)
Transfer bed /wheelTransfer bed /wheel
chair or bed tochair or bed to
stretcher: 1500 mm 5’stretcher: 1500 mm 5’
Transfer with floor liftTransfer with floor lift
or bed/geriatric chairor bed/geriatric chair
1800 mm 6’ (ceiling1800 mm 6’ (ceiling
lift saves 12”)lift saves 12”)
Space for care giverSpace for care giver
and rest chair 100 mmand rest chair 100 mm
39”39”
Door room widthDoor room width
1220 mm (48”) for1220 mm (48”) for
bariatric patientbariatric patient
*Adapted from Jocelyn
Villeneuve, Design for Safe Brought to you by
45. Single Bed/Bath Room Layout
Total Space ~180 sq ftTotal Space ~180 sq ft
Side nearest the door 6’Side nearest the door 6’
for a transfer involvingfor a transfer involving
floor device add 12” forfloor device add 12” for
bariatricbariatric
Window side 47”Window side 47”
Foot of Bed 47”Foot of Bed 47”
Bed faces the doorBed faces the door
privacy maintainedprivacy maintained
with curtain, betterwith curtain, better
observation and transferobservation and transfer
(working) space(working) space
Door width 1220 mmDoor width 1220 mm
(48”) for bariatric patient(48”) for bariatric patientBrought to you by
46. Bathroom Space
Make sure equipment,Make sure equipment,
staff and patient can fit instaff and patient can fit in
space.space.
• 36” door36” door
• 24” minimum clearance on24” minimum clearance on
each side of toileteach side of toilet
• Retractable bars attachedRetractable bars attached
to wall for client transfersto wall for client transfers
assisted by 1-2 care giversassisted by 1-2 care givers
• Wheel Chair rotation 5’Wheel Chair rotation 5’
diameterdiameter
• Toilet weight toleranceToilet weight tolerance
needs to be 600+ lbsneeds to be 600+ lbs
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47. January 1, 2008
A hospital shall develop procedures for hospitalA hospital shall develop procedures for hospital
employees to refuse to perform or be involved inemployees to refuse to perform or be involved in
patient handling or movement that the hospitalpatient handling or movement that the hospital
employee believes in good faith will expose aemployee believes in good faith will expose a
patient or a hospital employee to an unacceptablepatient or a hospital employee to an unacceptable
risk of injury.risk of injury.
A hospital employee who in good faith followsA hospital employee who in good faith follows
the procedure developed by the hospital inthe procedure developed by the hospital in
accordance with this subsection shall not be theaccordance with this subsection shall not be the
subject of disciplinary action by the hospital forsubject of disciplinary action by the hospital for
the refusal to perform or be involved in thethe refusal to perform or be involved in the
patient handling or movement.patient handling or movement.
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48. Employee Rights
Hospitals MUST develop procedures forHospitals MUST develop procedures for
employees to refuse to perform or be involvedemployees to refuse to perform or be involved
in patient handling or movement task that thein patient handling or movement task that the
employee believes “in good faith” will exposeemployee believes “in good faith” will expose
a patient or employee to an unacceptable riska patient or employee to an unacceptable risk
of injuryof injury
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49. January 30, 2010
Each hospital must complete, at aEach hospital must complete, at a
minimum, acquisition of their choice of:minimum, acquisition of their choice of:
One readily available lift per acute care unit onOne readily available lift per acute care unit on
the same floor unless the safe patient handlingthe same floor unless the safe patient handling
committee determines a lift is unnecessary incommittee determines a lift is unnecessary in
the unit;the unit;
One lift for every ten acute care availableOne lift for every ten acute care available
inpatient beds; orinpatient beds; or
Equipment for use by lift teamsEquipment for use by lift teams
Hospitals must train staff on policies,Hospitals must train staff on policies,
equipment, and devices at least annuallyequipment, and devices at least annually
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50. January 30, 2010
Acquire equipment using your hazardAcquire equipment using your hazard
assessment, injury data and with the inputassessment, injury data and with the input
of the hospital’s safe patient handlingof the hospital’s safe patient handling
committeecommittee
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51. Acquire Equipment
Step 1:Step 1: Establish a safe patient handlingEstablish a safe patient handling
committee (50% direct care staff) committee (50% direct care staff)
Step 2:Step 2: Train the safe patient handlingTrain the safe patient handling
committee committee
Step 3:Step 3: Write your Safe Patient HandlingWrite your Safe Patient Handling
Policy Policy
Step 4:Step 4: Assess the risks and needs for eachAssess the risks and needs for each
unit in your hospital unit in your hospital
Step 5: Plan for the purchase of equipmentStep 5: Plan for the purchase of equipment
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52. Our “Challenge” Is:
Getting the Equipment & Changing Practice…
Getting from manualGetting from manual
handling…handling…
To safe patientTo safe patient
handling…handling…
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53. Where is High Injury Risk Exposure?
Inpatient Rooms*Inpatient Rooms*
(+ OR, PACU, Rehab)(+ OR, PACU, Rehab)
RepositioningRepositioning
Move up, roll, cleanMove up, roll, clean
TransferringTransferring
Bathroom/CommodeBathroom/Commode
WalkingWalking
Bed to GurneyBed to Gurney
Bed to ChairBed to Chair
Example of continuous track
from patient room to bathroom
*Biomechanical Evidence… William Marras,
PhD, CPE Brought to you by
54. Where to put track…
Committee Decision – Need/Data DrivenCommittee Decision – Need/Data Driven
CCU-Tele-Neuro-Med/Renal-RehabCCU-Tele-Neuro-Med/Renal-Rehab
Remodel DrivenRemodel Driven
Or combo data/remodel, needs to be clearedOr combo data/remodel, needs to be cleared
w/committeew/committee
““Track” As Many Rooms As Possible*Track” As Many Rooms As Possible*
Fixed Lifts – view rooms, plus as follows…Fixed Lifts – view rooms, plus as follows…
Isolation RoomsIsolation Rooms
CCUCCU
Known heavy low mobile patient care areasKnown heavy low mobile patient care areas
Portables (475 lb capacity) 1 per 5 roomsPortables (475 lb capacity) 1 per 5 rooms
Use until you have budget for fixed liftsUse until you have budget for fixed lifts
*Tampa General Model
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55. Patient Transfer Devices
Floor lifts/Bariatric Room Set-upFloor lifts/Bariatric Room Set-up
From floor, chair, bed, also sit to stand & walkingFrom floor, chair, bed, also sit to stand & walking
Slider Transfer SheetsSlider Transfer Sheets
Lateral and horizontal transferLateral and horizontal transfer
Ceiling LiftsCeiling Lifts
Repositioning, floor to bed, bed to chairRepositioning, floor to bed, bed to chair
BedsBeds
Chair posit., flexi-foot, TrendelenburgChair posit., flexi-foot, Trendelenburg
Transport devicesTransport devices
Zoom stretcher, bariatric stretcher, “Ergo-tug”Zoom stretcher, bariatric stretcher, “Ergo-tug”
This is a cut out of our transfer device locatorThis is a cut out of our transfer device locator
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56. Ceiling Lifts
Portable lift on gantryPortable lift on gantry
(xy) configuration(xy) configuration
Repositioning is easyRepositioning is easy
Full bodyFull body
repositioning slingrepositioning sling
Seated universalSeated universal
slingsling
Pam workingPam working
with trainingwith training
dummy anddummy and
ceiling lift.ceiling lift.
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57. December 30, 2010
A hospital may take a credit for the costA hospital may take a credit for the cost
of purchasing mechanical liftingof purchasing mechanical lifting
devices and other equipment that aredevices and other equipment that are
primarily used to minimize patientprimarily used to minimize patient
handling by health care providers,handling by health care providers,
consistent with a safe patient handlingconsistent with a safe patient handling
program developed and implementedprogram developed and implemented
by the hospitalby the hospital
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58. B&O Tax Credit
All hospitals qualify for the B&O TaxAll hospitals qualify for the B&O Tax
CreditCredit
Hospitals can receive up to $1000 per acuteHospitals can receive up to $1000 per acute
care available inpatient bedcare available inpatient bed
The number of acute care availableThe number of acute care available
inpatient beds in each hospital is based oninpatient beds in each hospital is based on
the year-end financial reports submitted tothe year-end financial reports submitted to
the Department of Healththe Department of Health
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61. In Summary
Use hazard assessment, injury data andUse hazard assessment, injury data and
committee to make equipmentcommittee to make equipment
acquisitionsacquisitions
Equipment: key pointsEquipment: key points
Engage your facilities staff & giveEngage your facilities staff & give
ergonomic input for construction remodelergonomic input for construction remodel
designdesign
Think BIG and spend lots!Think BIG and spend lots!
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62. Thank you
Service EmployeesService Employees
International Union LocalInternational Union Local
1199NW1199NW
Washington State NursesWashington State Nurses
AssociationAssociation
Regional HospitalRegional Hospital
Regional Hospital forRegional Hospital for
Respiratory and ComplexRespiratory and Complex
CareCare
Valley Medical CenterValley Medical Center MulticareMulticare
St. Mary Medical CenterSt. Mary Medical Center Valley General HospitalValley General Hospital United Food & CommercialUnited Food & Commercial
Workers Union Local 21Workers Union Local 21
Harrison Medical CenterHarrison Medical Center Kittitas Valley HospitalKittitas Valley Hospital United Food & CommercialUnited Food & Commercial
Workers Union Local 141Workers Union Local 141
Providence St. PeterProvidence St. Peter
HospitalHospital
Empire Health ServicesEmpire Health Services Department of Labor &Department of Labor &
IndustriesIndustries
Washington State HospitalWashington State Hospital
AssociationAssociation
Swedish Medical CenterSwedish Medical Center WHS Workers’WHS Workers’
Compensation ProgramCompensation Program
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65. Thank you for participating!
Please fill out the evaluation.Please fill out the evaluation.
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66. This platform has been started by
Parveen Kumar Chadha with the
vision that nobody should suffer the
way he has suffered because of
lack and improper healthcare
facilities in India. We need lots of
funds manpower etc. to make this
vision a reality please contact us.
Join us as a member for a noble
cause.
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67. Our views have increased the mark of the
10,000
Thank you viewersThank you viewers
Looking forward for franchise,Looking forward for franchise,
collaboration, partners.collaboration, partners.
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