Transcript Document

Affiliate School
Online Orientation
Message from the CEO
We are delighted that you have chosen Regional One Health as a clinical training site. We hope
that your experience at Regional One Health will be a valuable learning opportunity that will
enhance your career!
Regional One Health is the oldest hospital in Tennessee and is committed to providing quality
healthcare to all in this community. We enjoy a rich and historic 180-year tradition of providing
excellent service and highly specialized care to the citizens of Shelby County and the entire
Mid-South. It is our commitment to continue this tradition.
I am deeply honored and proud to lead this great institution into the next chapter in its history.
It is a privilege to foster and lead a team of healthcare professionals dedicated to excellence
and committed to quality. Through the actions of and communications with our employees, you
will experience a team of highly trained healthcare professionals delivering compassionate and
quality care to you and your family. You will see a healthcare organization that achieves growth
and sustainability by focusing on quality improvement and accountability. You will see a healthy
and sustained Regional One Health.
Sincerely,
Reginald W. Coopwood, MD
President and CEO
Learning Outcomes
At the completion of orientation, participants will be able
to:
1. State the mission of Regional One Health.
2. Identify roles and responsibilities of faculty and
students.
3. Apply safety and infection prevention practices.
4. Discuss the role, expectation, and scope of practice
for students.
5. Identify patients at highest risk for abuse.
6. State the student and faculty responsibility when
abusive behavior occurs.
Orientation Purpose & Goals
Affiliate School online orientation is designed to
inform faculty and students of their role,
expectations and scope of practice while
involved in patient care at Regional One Health.
Goals
 Facilitate communication between affiliate
schools and Regional One Health
 Enhance Patient Safety
Regional One Health Overview
• Since 1829, Regional One Health has been the forefront in
attending to the healthcare needs of it's community.
• Regional One Health, Tennessee's oldest hospital has always
taken pride in it's unwavering dedication to providing patients
with the best possible services.
• Centers of Excellence include Trauma and Burn Centers;
High Risk Obstetrics; and Neonatal Intensive Care Unit.
• Rehabilitation Hospital, Wound Center, Sickle Cell Center,
Adult Special Care and subspecialty outpatient clinics.
• Visit www.regionalonehealth.org for additional information
Mission, Values & Vision
Mission: To improve the health and well being of the people we
serve by providing
compassionate care and excellent services.
Values: We value quality
C.A.R.E.
Compassion
Accountability
Respect
Excellence
Vision: In collaboration with our academic partners, we will be the
premier healthcare system advancing the qualities of life in our
communities.
Instructor Responsibilities
Primary responsibility of instructors are the
Students
The primary responsibility for patient care is
Regional One Health staff assigned to the
patient (regardless of student assignment)
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Instructor Responsibilities
• Communicate with the Training and Development
Coordinator (901-545-7242) to confirm scheduling
needs (including numbers of students and types of
experiences).
• Provide student and faculty documentation of the
required information.
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Fundamentals of Communication
Regional One Health has incorporated Studer principles
referred to as AIDET to enhance customer service to our
patients, family members and staff.
AIDET:
o Acknowledge
o Introduce
o Duration
o Explain
o Thanks
Acknowledge
Greet customer with a smile, maintain appropriate eye contact, and demonstrate a warm,
receptive attitude with everyone you come in contact with.
Introduce
Offer your name, your role in the customer’s care and communicate your ability and desire
to help – this requires your full attention to the other person.
Duration
Explain how long a procedure will take, how long the patient may have to wait, or if you
are walking with someone, how long it will take to reach your destination.
Explanation
Provide detailed information about a test or procedure, such as why it is being performed,
who will perform it, whether there is pain or discomfort, and what will happen afterward.
Be sure to answer the patients’ or family members’ questions.
Thank You
Sincerely thank the patient or visitor for choosing the hospital and for trusting you to
provide care.
Patient Rights
Regional One Health recognizes its role in providing a
foundation for respecting the rights and responsibilities of
patients, their families, physicians, and other caregivers.
Patient Safety
Patient Safety is a priority at Regional One Health.
Our Leaders have established specific expectations
that demonstrate our commitment to patient safety.
Our Patient Safety Plan may be found in the
Administrative Manual that is located on the intranet.
Please ask manager/supervisor of unit for
assistance.
Enhance Patient Safety
• Report all Needle Sticks and Injuries
• Use Standard Precautions when dealing with
patient’s bodily secretions.
• The use of Personal Protective Equipment
(PPE) will be provided at no cost. Fit Testing
is the responsibility of the affiliate school.
Restraints
 Regional One Health directs efforts to prevent and reduce the
use of restraint/seclusion. Every patient has the right to be
free from any physical restraint unless their safety or the
safety of others is in jeopardy.
 The use of restraint requires utilization of the least restrictive
measures based on the clinical assessment by the treating
Resident/Licensed Independent Practitioner that
restraint/seclusion is necessary.
 Only trained employees of Regional One Health are allowed
to place a patient in clinical restraints.
 Students are not allowed to place a patient in clinical
restraints!
Restraint Safety
To increase patient safety:
• Remove all sharp objects, cigarette lighters, and matches from the
patient.
• Remove any loose objects from the room that could be harmful to
patient or staff.
• Leave 2 side rails up to prevent the patient from being lodged in split
side rails.
• Leave the bed in the lowest position.
• Make sure that one finger will fit under any restraint used.
• Make sure that rooms are clean in order to protect against nosocomial
infections.
• Patients are not be restrained in the prone position.
• Patients are frequently assessed.
• The head of the bed is elevated to minimize aspiration.
Incident Reporting
Incident is defined as any event which is not consistent
with the desired operation of the facility or care of the
patient. Examples include:
– Physical harm
– Unauthorized leaves by patients
– Patient dissatisfaction
– Mistaken identity
– Hospital acquired infections
– Unexpected and unexplained returns to surgery
Incident Reporting: Faculty & Student’s Role
• Incidents must be immediately reported to:
- Regional One Health House Supervisor.
• Who is included in an Incident?
– Incidents involve healthcare employees,
students, patients, family and/or non-employee.
Prevention and Reporting
of
Patient Abuse
For Faculty and Students
Definition of Abuse
• All patients have the right to be free from abuse.
• Abuse is defined as “the willful infliction of injury,
unreasonable confinement, intimidation or
punishment with resulting physical, emotional or
psychological harm, pain or mental anguish.”
• Abusive conditions can occur between employee
and patient.
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Background & Characteristics of
Challenging Behaviors
• Five percent (5%) of patient abuse cases occur in
hospitals.
• Patients with the highest risk of abuse include those with
mental health disorders, developmental disabilities,
impaired cognition, or physical disabilities.
• Patients that display challenging characteristics such as
combativeness, resistant behaviors, or require large
amounts of attention/monitoring increase the risk of
abuse.
• Patients may be abused by clinicians, other healthcare
workers, students, or family members.
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Policy and Procedure
• The organization has developed and instituted
policies and procedures in regards to the
prevention, identification and reporting of abuse.
• All staff, faculty, and students have a responsibility
to report abuse to their Instructor or House
Supervisor. This includes personal involvement,
knowledge or suspicion of abusive behavior.
• Failure to do so will result in disciplinary action up
to and including dismissal from clinical area.
See Standards of Conduct – Allegations of Abuse
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Types of Abuse
• Physical abuse is any action that causes actual
physical harm to a patient. Examples include
rough handling of a patient, striking, shaking, or
pushing.
• Verbal abuse is the use of words to cause harm.
Examples include using profanity, name
calling,yelling,or cruel teasing of a patient.
• Threats of any kind are not acceptable and may
be interpreted as abuse.
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Types of Abuse
• Mental abuse is any act that makes a patient
fearful, feel belittled or to make fun of a patient by
mocking, imitating, or ridiculing.
• Sexual abuse is touching of a patient in an
intimate or suggestive manner, or making sexual
comments.
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Dealing with Difficult Patients
• Dealing with difficult patients may lead to stress and
cause staff to act on an impulse.
• Signs of stress may include:
Anxiety
Headaches
Muscle tension
Sleep problems
Lack of motivation or focus
Sadness or depression
Irritability or anger
Restlessness
Fatigue
The outcome of your stress may be yelling at staff or
patients, rough handling of patients, being inpatient with
families, etc.
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Ways to Manage Stress
• Remove yourself from the
stressful situation
- take a break
• Exercise
• Use relaxation techniques
• Yoga
• Meditation
• Eat a balanced diet
• Limit excess
caffeine and alcohol
• Avoid tobacco use
• Get plenty of rest
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Physicians and Healthcare Worker
Impairment
Physician Impairment
Impairment
The inability to practice medicine with reasonable
skill and safety to patients due to physical or
mental illnesses or alcoholism or drug
dependency.”
American Medical Association (AMA)
Impaired Healthcare Staff
Impairment is in the form of alcoholism, substance
abuse, chemical dependency, mental/emotional,
instability, or senility.
Warning Sign
Consistently documents the administration of
pain or nerve medications for patients who have
not needed the medications before or after that
nurse has cared for them.
Reporting & Investigation
In the event of a suspected impairment
posing a serious and immediate threat to
a patient, report it immediately to Management.
REPORT IT, REPORT IT, REPORT IT!
Confidentiality
&
Diversity
Confidentiality
• Protecting privacy of our patients is very critical to us because:
– Protect the trust patients have in their healthcare providers
– Code of Ethics
– Required by regulatory and accrediting agencies
• The Health Insurance Portability and Accountability Act (HIPAA) was
enacted to ensure that personal Medical information is protected.
• Therefore, faculty and students are required to submit a signed
confidentiality form to Training and Development prior to clinical
rotations to insure privacy of our patients
Protected Health Information
Definition: Any information that can identify a patient.
It can be transmitted verbally, recorded, on paper or
electronically. Examples include:
 Patient name and address
 Social security number
 Medical records(including diagnosis and treatment)
 Billing information.
Remember:
Faculty and students should only interview or brief
patients or family members in a private area.
Privacy & Students
DO:
– Faculty and students are allowed to make reasonable
notes, including patient identifying data; however all
PHI must be properly destroyed at the end of the
assignment.
– You may discuss patients by name or location only in a
private area.
– Be mindful that there are often patients & family
members on employee elevators, in hallways and in the
cafeteria.
– Prior to sending a fax, check with management.
Privacy & Students, cont’d.
 Do not read records that do not pertain to your assignment.
 Do not leave patient information unattended in public
areas.
 Do not leave material unattended, when using a copier.
 Do not leave computer displays showing confidential
information—log off when finished.
Social Networking
Never take pictures of patients or family members
while in a clinical setting.
Never discuss patients on social media sites.
Bluetooth headsets, cell phone, iPod, and iPad use
are prohibited in the clinical setting.
Cultural Diversity and Sensitivity
Regional One Health is sensitive to cultural,
racial, linguistic, religious, age, gender and
other differences as well as the needs of
persons with disabilities.
Interpreters Services
A Medical Interpreter is a bilingual individual
trained in interpretation skills and medical
terminology. This person facilitates
understanding in communication between
individuals speaking different languages in the
health care setting.
A Medical Interpreter is the voice for the patient
describing symptoms or asking questions.
How to reach an Interpreter?
Page Interpreter for a Quicker Response
(901) 790-9189
__________________________________
Call the Telephone Operator at
(901) 545-7100
or
(‘0” from hospital telephone)
Emergencies
&
Workplace Violence
Emergency Codes
Code Red
Report Fire
545-7700
Code Blue
Cardiac Arrest
545-7111
Code Pink
Infant Abduction 545-7700
Code Orange
Hazmat Incident 545-7700
Code Brown
Bomb Threat
Code Black
Floor or building evacuation 545-7111
Code Yellow
Disaster Internal or External 545-7111
Code White
Workplace Violence 545-7700
Code Gray Alert
Severe Weather in Area 545-7111
Code Gray
Relocate to corridors 545-7111
Code Clear
Termination
545-7700
545-5711
Fire Response/Evacuation Information
Race – Fire Response
Pass – Operate Fire Extinguisher
Rescue Anyone in Danger
Pull Pin
Activate Nearest Pull Station
Aim Nozzle At Base Of Fire
Confine Fire By Closing Doors
Squeeze The Handle
Extinguish Fire or Evacuate
Sweep Spray From Side To Side
• Evacuation – Horizontal beyond the next smoke compartment
• (Fire doors) Vertical is down the stairway
• Fire Pull stations – summons Memphis Fire Department, located at every
stairway door and exit door
• Fire extinguisher location – at each nurse station and every 50’ of travel
• Note the wall flags pointing to extinguisher and pull station
Regional One Health is concerned and committed
to safety and health for its’ employees, patients
and visitors.
The Workplace Violence Prevention Program
promote safety and security in the workplace.
Regional One Health Security
Call 911-Emergency
545-7700- Non Emergency
What is Workplace Violence (WPV)?
WPV is any act of physical violence, threats of
physical violence, harassment, intimidation, or
other threatening, disruptive behavior that
occurs at the work site that can affect or involve
affiliate school participants, employees, medical
staff, contract staff, patients, visitors, vendors,
etc.
Regional One Health Policy
 Regional One Health will not tolerate violence in the
workplace.
 Regional One Health will make every effort to prevent violent
incidents from occurring.
 Acts or threats of physical violence, including intimidation,
harassment, or coercion will not be tolerated and must be
reported immediately.
 Affiliate participants as well as staff, guests are required to help
make Regional One Health a safe workplace.
Infection
Prevention
Infection Control
ALWAYS
Wash Hands
Use antimicrobial soap or alcohol
antiseptic handrub before donning
gloves after removing gloves.
Use care to avoid touching
contaminated surfaces in the room
after washing your hands.
Infection Control
Standard Precautions are to be used for the care of
all patients. They are designed to reduce the risk
of transmission of microorganisms (Bloodborne
pathogens and other pathogens) from both
recognized and unrecognized sources of
infections.
Standard Precautions Include:
• Blood and all body fluids, secretions, and
excretions, except sweat
• Non-intact skin
• Mucous membranes
Airborne Precautions:
 Airborne Precautions are designed to reduce the
risk of Airborne transmission of infectious agents
 Airborne transmission occurs by dissemination
of either airborne droplet nuclei or dust particle
containing the infectious agent.
Airborne Precautions
 Patient is to wear a surgical mask if transport or
movement is necessary.
 Notify the area where patient is being taken of
the required isolation precautions and the
reason to expedite the procedure.
 Personal Protective Equipment (PPE): N-95
mask.
 Staff should wear an approved N95 respiratory
device and staff must be fit tested to wear the
respiratory device.
 Wear other PPE as required.
Contact Precautions
 (In addition to Standard Precautions)
Visitors Report to Nurses Station Before
Entering the Patient Room.
 Patient Placement: Private room. When not
available, cohort with patient infected or
colonized with the same microorganism.
 Patient Transport: Patient must remain in room
except for urgent procedures.
Blood-borne Pathogen Transmissions
Blood-borne Pathogen Transmissions in the
Healthcare System are usually caused by:
A cut with a sharp object
Contamination caused by a break in the skin
Contamination of mucous membranes by blood
Needle Sticks
After an Exposure to Blood or Other Body
Fluids:
 Needlestick/Cut-Wash the area.
 Splash/Splatter-Irrigate the area.
 Notify your Instructor.
 Fill out an On The Job Injury (OJI) form
 Call Occupational Health at 57166 M-F 7-4:30 PM.
 After hours/week-ends and holidays report to the Emergency
Department.
 If you have any questions page 790-9697.
Remember:
 Good hand hygiene is the single most effective way
to prevent the spread of infections.
 Use the correct PPE when handling contaminated
instruments.
 Use safety devices.
 Do not recap needles.
 Practice good hand hygiene.
Expectations
Faculty & Students
Expectations of Students
• Students should be on their assigned units at
the start of the shift.
• If the student must be late, every attempt
should be made not to disrupt the work of the
unit/department.
General Expectations
Students are expected to follow the dress code policy.
 Reflect business-like and professional atmosphere.
 Hair and nails shall not obstruct work with patients,
or interfere with performance when working with
machinery of any type.
 Wear PPE’s (personal protective equipment) in the
environment of care according to guidelines.
General Expectations
Students are expected to follow the dress code
policy.
 Adhere to departmental uniform policy.
 Student ID badges must be worn at all times
while on duty with picture and name visible.
 Avoid excess make-up, perfume, shaving lotion,
jewelry, and nail polish.
General Expectations
 Students should answer the phone by identifying
the unit , self, and stating “How may I help you?”
 Students may answer any call light.
 Students are expected to maintain the
confidentiality of all patients.
 Students must not have loud and boisterous
conversations in the organization.
Specifics: Treatments & Procedures
Students are not allowed to perform the following
procedures:
- Any point of care testing, i.e. accu-chek
- 12-lead EKG acquisition
- Unit specific procedures requiring certification, additional
classroom or skills lab preparation. i.e. Hemodynamic
monitoring devices, ICP monitoring devices, ICP
monitoring, subcutaneous access ports, dialysis
Specifics: Treatments/Procedures
• Phlebotomy may be performed following
institution provided instructions
• Students are expected to perform the
treatment/procedure under the direct
supervision of the instructor.
Specifics: Medications
Students may prepare and administer
medications to meet their educational goal
EXCEPT:
– Intrathecal and epidural medications
– Chemotherapy
– Drug trial medications or those with research
protocols
– Narcotic waste or witnessing of narcotic
waste/disposal
Specifics: Blood/Blood Products
• Students may monitor blood/blood product
infusion and response.
• Students are NOT allowed to
– Obtain blood/blood products from the blood bank
– Perform bedside identification/verification of
blood/blood products
Specifics: IV Therapy
• Students may perform IV therapy skills only
under the direct bedside supervision of the
nursing instructor.
• IV insertion may be performed following
institution provided instruction.
Evaluations
Students and faculty complete an evaluation
of the clinical site at the end of the rotation.
Affiliate school shares evaluation results with
Training and Development at end of each
semester.
Authentication
• I have successfully completed Regional One Health
Affiliate School online orientation.
• I agree to abide by the rules and regulations set forth in
the policies presented during the online orientation.
• Additional information will be obtained during orientation to
assigned clinical unit.
Student Signature:_________________________
Instructor Signature:________________________
Date:______________
NOTE: Print this page, sign and submit to Training and Development along with
other required documents as listed on the affiliate school checklist.
Affiliate School Checklist
The purpose of this checklist is to ensure each affiliate school has satisfied the following criteria/guidelines to conduct
clinical rotation at Regional One Health.
School:_________________________________________Program Director: ______________________
Telephone Number:______________Fax number:
____________________________
Instructor Name:____________________________Telephone Number___________________
Mobile Number:____________________________
YES
NO
•
Contract signed and dated by both parties
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Copy of current Liability Insurance Certificate
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List of Students
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Statement of Immunizations
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Statement of Faculty and Student CPR
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Clinical Objectives
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Signed confidentiality forms for Faculty and students
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Statement regarding criminal background check
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Statement regarding drug screening
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Statement of attestation regarding online orientations
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Statement regarding FIT testing
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Statement of instructor’s credentials and attestation of online orientations
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If the instructor is a current or past Regional One Health employee, please print name used during employment:
_________________________________
Evidence of the above criteria and a copy of this checklist must be returned to Regional One Health Department of
Training and Development two (2) weeks prior to clinical rotation.