Transcript Slide 1

Mad River Community Hospital
Nursing Student Orientation
Topics Presented in this Orientation:
• Our Vision/ Standards of
Excellence
• Services offered at
MRCH
• Parking
• Student Nurse
Responsibilities
• History of MRCH
• Emergency Codes
• Fire Safety & Prevention
• Safety/ Hospital-wide
manuals
• Patient Confidentiality
• Infection Control
• Waste Disposal
• Documentation
• Performance
Improvement
• Cultural Awareness
• Back Care / Lifting
Techniques
** Please complete the attached post-test following your review of this orientation.
Our Vision
• WE ARE Mad River Community Hospital.
• OUR QUEST is to become California’s
leading and most innovative community
health center.
• WE COMMIT to providing excellent care
to patients.
• WE PLEDGE to always respect and care
for those who choose us for wellness
healthcare, employment, or as a place to
practice the art and science of medicine.
Standards of Excellence
~ Mad
River Community Hospital’s mission is “to
provide the highest quality health care to meet the
needs of the people and communities we serve”. All
Mad River Community Hospital team members are
expected to help fulfill this mission.
More Than A Hospital
* Mad River Community Hospital has a full network of health
services:
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Adult Day Health Care of Mad River
Center for Wound Care and Hyperbaric Medicine.
Home Health Services of Mad River
Humboldt Family Medical Care
Mad River Rehab and Sports Medicine
Occupational Health Services of Mad River
Six Rivers Medical Center
Women’s Health Center
Endoscopy/GI Suites
Parking
› Park in the north or south gravel parking lots
› Park to accommodate patients getting into the
hospital
› Do not park in MD, patient, lab, handicapped, or
blocked off areas.
› Do not move cones: may be blocking off areas
for helicopter landing or blood banking
personnel
As a student, what are you
responsible for during clinicals?
• Reporting to the clinical assignment at the designated
time, and receiving your assignment
• Reporting information relative to the patient’s plan of
care to the clinical instructor and staff assigned to the
patient
• Communicating with the appropriate staff in order to
coordinate care
As a student, what are you
responsible for during clinicals?
• Informing the instructor or staff if you feel unable or
unsafe to provide a care measure
• Contributing to the care planning process and
documenting in the appropriate interdisciplinary care
records according to standards
• Document care provided in the appropriate locations
As a student, what are you
responsible for during clinicals?
• Conducting care, treatments, assessments and
documentation according to published standards of the
academic institution and the hospital
• Protecting the rights of the patient according to
standards, including confidentiality, respect and dignity;
and requesting patient’s permission for the student to
participate in her/ his care
Students may NOT perform the following:
• Administer chemotherapeutic agents
• Prepare and/or administer medications in emergent
situations
• Access/administer narcotics independently
• Carry narcotic keys
• Conduct point of care testing
• Urine dipstick
• Nitrazine paper
• Occult blood and whole blood glucose testing*
*Once glucometer competency training complete, student will
be able to perform testing
Students may NOT perform the following:
• Participate in emergency response for cardiac and
respiratory arrest (may observe with instructor
permission)
• Pick up blood from the Lab
• Provide care to the following patient populations:
• Patients who are inmates
• Patients in respiratory isolation requiring individually fitted
masks
• Patients with radiation implants
Students may NOT sign
or complete the following:
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Patient Belonging Sheet
Labor Record
Blood Transfusion Record
Record of Death
Code Blue Record
Leaving Against Medical Advice
TPA Checklist
Transfer Forms
Intra-operative Record
Discharge Instruction Sheet
History of Mad
River Community
Hospital
Our History
The original Trinity Hospital
built on the corner of 13th &
G Streets in Arcata in 1911.
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25 beds
Nursery
Two sun rooms
Operating room on the
top floor for maximum
lighting
• On February 3, 1943, a tragic fire swept through
the hospital causing extensive damage.
• On March 25, 1943 rebuilding began with the
purchase of a full city block at 14th & C Streets
by the Arcata Chamber of Commerce with
contributions from the community.
Financial Factors for Change
• Humboldt State College (now University)
announced they intended to purchase the Trinity
Hospital site in 1968.
• The Sisters of St. Joseph of Orange announced
closure of Trinity Hospital on June 30, 1969, in
order to consolidate Arcata & Eureka services into
new facility in Eureka.
Community Support for
Arcata Based Hospital
• Arcata Mayor Ward Falor called a town
meeting to discuss the future of Trinity
Hospital.
• Community members formed the Trinity
Hospital Action Committee (THAC).
• National attention was brought into the plight
of Trinity Hospital.
American Hospital
Management Corporation
• The THAC requested help from American
Hospital Management Corporation (AHMC) in
building a new hospital and operating Trinity
Hospital until a new facility could be built.
• Allen Shaw, President of AHMC, was impressed
with the community and physician support.
A New Beginning
• In 1968, AHMC and Trinity Hospital Medical
Staff purchased 47 acres located on the Mad
River.
• Community-wide efforts were underway to
purchase the old Trinity Hospital from the
Sisters.
• On July 1, 1969, with no interruption of services
or employee layoffs, AHMC assumed the
operation of Trinity Hospital.
The Birth of A New Hospital
~ And so began the arduous, political process of
gaining state approval to build a new hospital.
Mad River Community Hospital
• Without the assistance of state or federal funds,
Mad River Community Hospital opened its doors
with patients from Trinity Hospital in October,
1972.
• AHMC has sold its four other hospitals, thus
managing only Mad River Community Hospital
and devoting itself entirely to the people of the
North Coast.
Another New Beginning
• Shaw Pavilion completed in August 2004.
Emergency Hospital Codes
Your Role In Any Code:
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Students can call any code in an emergent
situation, but may not participate past the initial
response.
To Call Any Code:
(Emergency Phone System)
• Dial 3911
- Between the hours of 0700-2300
- State the type of code and
the location. Repeat 3 times.
• Dial 55
- Between 2300-0700
- You will be “live” on the
overhead system.
- Listen for 3 beeps. State type of
code and location. Repeat,
pause, and repeat again.
MRCH Emergency Codes
Code Blue
Cardiac/ Medical Emergency
Code Red
Fire
Code White
Pediatric Medical Emergency
Rapid Response Team
Patient needing emergency assistance
Code Pink
Infant Abduction
Code Purple
Child Abduction
Dr. Strong
Manpower needed
Code Gray
Combative Person
Code Silver
Person with weapon &/or active shooter &/or hostage situation
Code Security
Lock Down
Code Yellow
Bomb Threat
Triage External
Major External Disaster
Triage Internal
Physical Plant Failure (other codes may follow)
Code Orange
Hazardous Material Spill/Release
Code Shelter-In-Place
Sealing of building to outside air
Fire Safety & Prevention
• Goals of Fire Safety
• Your Role in Fire Safety
• Fire Safety (Code Red)
Goals of Fire Safety
• Prevent fires from starting
• Stop the spread of fire
• Protect patients from fire
Your Role in Fire Safety
• Handle all flammables, electrical equipment, and
medical devices correctly and safely
• Never leave trash or supplies laying around in
hallways (potential “kindling”)
• Never block fire doors, exits, fire extinguishers, or
hoses
• Report any equipment problem or hazard
immediately
Fire Safety – Code Red
R
Remove all persons in danger
A
Activate Alarm
- Page by calling 3911 (day) or 55 (night)
- Pull the fire alarm
C
Confine the Fire
- Close doors and windows to help keep fire and
smoke from spreading
E
Extinguish the Fire (if manageable)
- Attempt to put out only if small
- If not, evacuate the area!
Operating a Fire Extinguisher
P
Pull the pin
A
Aim at base of fire
S
Squeeze the handle
S
Sweep from side to side
Safety Manuals/ Hospital-wide Manuals
* When your clinical orientation begins, make sure you
know where these manuals are located in your
department.
* They are also accessible on the Intranet.
* Know what type of information can be found in each.
• Environment of Care manual
• Organization Wide manual
• Nursing Administrative and Clinical manual
• Infection Control manual
Environment of Care Manual
* Contains information on the following:
• Emergency communication plan & call tree
• Phone/power failure procedure
• Staff safety policies/security plan
• Patient emergency response & call system
• Disaster plan
• Hazardous substances
• MSDS location
Patient Confidentiality
• HIPAA Privacy Rule (Health Insurance
Portability and Accountability Act)
• Ensures personal medical information patients
share with doctors, hospitals and others who
provide and pay for healthcare is protected.
The Privacy Rule does the following:
• Imposes restrictions on the use and disclosure of
personal health information
• Gives patients greater access to their medical
records
• Gives patients greater protection of their medical
records
What is Protected Health
Information (PHI)?
• Includes any information (oral, recorded, on paper,
email, etc.) about a person’s physical or mental
health
• Includes any information on services rendered or
payment for those services
Examples:
• Patient’s name or
address
• Social security or
other identification
numbers
• Physician’s personal
notes
• Billing information
Who is covered under the HIPAA
Privacy Rule?
• You are termed a covered entity if you are a:
• Healthcare provider
• Health plan
• Healthcare clearinghouse
• Business associate
What are the rules for use and disclosure of PHI?
• PHI can be used or disclosed for: treatment,
payment, and healthcare operations
• With authorization or agreement from the
individual patient
• For disclosure to the individual patient
• For incidental uses such as physicians talking to
patients in a semi-private room
HIPAA Security Rule
• Second set of federal standards to protect health
information in electronic form
• Protects:
• Confidentiality of electronic PHI (ePHI)
• Integrity of ePHI (once created, can’t be tampered with)
• Availability of ePHI (can’t be accessed without authority)
In general, use/ disclosure of PHI is
limited to the minimum amount of
health information necessary to get
the job done right.
Infection Control
WHAT IS INFECTION
CONTROL?
• Infection Control is the practice of preventing
infection
• Take steps to ensure that patients don’t acquire
an infection while they are here in the hospital
• TERM: Nosocomial (Hospital-Acquired) Infection
FOR MORE INFORMATION,
LOOK IN THE INFECTION CONTROL MANUAL
LOCATED IN YOUR DEPARTMENT
Breaking the Chain of Infection
THE MOST EFFECTIVE INFECTION
CONTROL MEASURE TO PREVENT THE
TRANSMISSION OF INFECTION IS:
** HAND HYGIENE
~ You can isolate a patient and wear your PPE,
but if you DON’T CLEAN YOUR HANDS you will
carry the infection to all the patients you touch
What’s on your hands?
Remember!
Hand hygiene prevents the spread of
infection
Good hand hygiene is the most important
activity you can do to keep your patients
infection free
Hand Hygiene at MRCH
• Hand washing with soap and water:
• Antimicrobial soap
• Non antimicrobial soap
• Hand hygiene with alcohol gel
• Exceptions for use:
• Physical debris on hands
• Protein matter on hands
• Spores
Give Healthcare a HAND
by washing yours!
• Before you start work
• Before patient care
• After patient care
• While providing care when moving
from not clean to clean areas
• Before invasive procedures
• Before sterile procedures
• After you remove gloves
• The opportunities are endless!!!
Personal Protective Equipment
(PPE)
• Wear a barrier to protect against blood and bodily fluids:
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Gloves
Gown
Mask
Eye Protection
STANDARD PRECAUTIONS
• Based on the principle that all
body fluids and excretions may
contain transmissible
infectious agents
• Practiced for all patients, all
the time
• When you find yourself in a
situation that might result in
exposure to bodily fluids,
utilize a barrier
Make a Partnership with Safety
• Use the appropriate personal protective
equipment every time you need it.
IF YOU WAIT UNTIL YOU GET SPLASHED, SPRAYED
OR EXPOSED TO PUT YOUR PPE ON, IT IS TOO LATE!
• Utilize safety engineered devices the way
they are intended to be used.
THEY ARE INTENDED TO KEEP YOU SAFE!
TRANSMISSION BASED
PRECAUTIONS
• Used in addition to Standard Precautions
• Used when patient has organism that we don’t want to
spread to other patients or acquire ourselves
• Prevent spread by wearing a barrier (Personal
Protective Equipment: PPE) specific to that mode of
transmission
Contact Precautions
Signage
• On the patient room door, you should see these signs:
Contact Precautions
The Details
• Used for organisms that are spread by “contact” – by
body surface to body surface: physical transfer
• Contact transmission is the most important and most
frequent mode of transmission of nosocomial
infections
Contact Precautions
What Should I Wear?
• Wear GLOVES for all patient care – this includes
hand contact with the environment!
• Wear GLOVES and GOWN for patient contact that
could result in your uniform coming into contact with
patient or patient’s environment
Contact Precautions
Used for What Diseases?
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Methicillin Resistant Staphylococcus aureus (MRSA)
Vancomycin Resistant Enterococcus (VRE)
Lice
Scabies
Clostridium difficile
E. coli 0157:H7
Droplet Precautions
Signage
• On the patient room door, you should see these signs:
Droplet Precautions
The Details
• Used for organisms that are spread by
respiratory droplets
• Respiratory droplets are generated by
cough, sneeze, talk, laugh, suction,
bronchoscopy, etc
• Respiratory droplets spread 3 to 5 feet
from the source
• Droplets do not remain suspended in the
air
Droplet Precautions
What Should I Wear?
• Wear a MASK and GLOVES for all patient
contact – this includes hand contact with
the environment!
• If you are providing care that will likely
result in your uniform coming into contact
with the patient or the patient’s
environment, wear a GOWN
• If you are suctioning, intubating, patient
has tracheostomy, etc – wear EYE
PROTECTION
Droplet Precautions
Used for What Diseases?
• MRSA in sputum
• Influenza
• Meningitis
• Measles (Rubella)
Airborne Precautions
Signage
• On the patient room door, you should see these signs:
Airborne Precautions
Used for What Diseases?
• Mycobacterium tuberculosis
• Varicella
• Chicken Pox
Airborne Precautions
The Details
• How Airborne Precautions differ from Droplet
Precautions:
• Used for diseases spread by airborne droplet nuclei
(small particles) or evaporated droplets containing the
microorganism
• The particles can remain suspended in the air for long
periods of time
• The particles can be inhaled by others
Airborne Precautions
What Should I Wear?
• Wear a N-95 MASK and GLOVES for all patient
contact
• Wear the MASK, GLOVES and GOWN when providing
care that may result in exposure to bodily fluids or
your uniform may come into contact with the
environment
Airborne Precautions
Anything Else I Should Know?
• These particles are small and can remain
suspended on air currents for great
distances
• Patients in Airborne Isolation need to be
placed in a room with specific ventilation:
• Negative Pressure
HAI Prevention: Clean Equipment
- All
equipment should be wiped down with
a germicidal wipe (Sani Cloths)
• Between patient use
• When equipment leaves a patient room
(wheelchair, walkers, gurneys)
Disposal of Waste
“Clear Bags”
• Diapers or incontinence pads soiled with
urine or feces can be disposed of in the
“regular” garbage
• Dry, non-confidential waste may be
disposed of in the clear bags
Disposal of Waste
“Biohazard”
• Waste material saturated with blood or
bodily fluids must be discarded in the
biohazard waste container
• Liquid waste material must be solidified
before disposal (Isosorb)
• Be sure to securely tie all biohazard bags
Disposal of Waste
Sharps
• Sharps containers are for all things sharp
• Sharp things include needles, scalpels,
lancets, syringes, ampules
• Sharp things are considered sharp even if
the needle has been removed (syringe)
• Sharp containers are not for tape, cotton
balls or random garbage
What is wrong with this picture?
Disposal of Waste
Pharmaceutical Waste
• Pharmaceutical waste containers are for
pharmaceutical waste
• Pharmaceutical waste includes all
medications and additives that have any
ingredient other than sugar, salt or
water
• Do not dispose of pharmaceutical waste
down the sink (Exception: IV fluid bags
with electrolytes)
Documentation
Improving Your Charting
The chart remains as the only
evidence of the nursing care
you have given!!!
If it was not charted it was
not done!!!
But I swear it did it!!
There are many factors required to be
assessed for each and every patient:
• Patient needs
• Care necessary to meet those needs
• What needs to be done in respect to continuing
care after patient is discharged
Nursing charting must
contain:
• Physical/psychosocial assessment to
determine the need of care and the frequency
for additional assessments
• Assessment of patient nutritional assessment
• Assessment of functional abilities/status to
determine the need for post-discharge
planning and rehabilitation
The charting must reflect:
• Age specific and appropriate assessment and
interventions
• On-going assessment of educational needs
• Involvement of family and/or significant
others when appropriate
• Adjustments in the plan of care with changes
in condition or diagnosis
• Continual assessment of discharge planning
needs
All entries should reflect:
• The care you have given
• Adherence to MD orders or plan of care (Problem List)
• Care should be consistent with standards of care (“Best
Practice”)
e.g. Your charting will be measured against what any
other educated and prudent nurse would have delivered
to the same patient in the same care situation
Finding Time to Chart
• Flowcharts help minimize the time required to
document “routine” care, however,
Charting must also be individualized
So, how do you find the time to do this??
Multi-task !
• While assisting a patient to the BR who needs help
getting back to bed….
• Combine care delivery with history taking, teaching,
assessment (Bed Bath)
• While giving medications you can teach your patient
about what they are receiving.
• What other ideas do you have??
Your Initial Assessment
Examples:
Identify pressure ulcers in detail when
admitting a patient:
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Location, size, depth, drainage characteristics,
integrity of tissue margins.
If this is not done, it must be assumed that the
ulcer developed during the course of this hospital
visit!!
Patient at risk for Falls:
• If a patient was to fall and fracture a hip, you
have no evidence that steps were taken for the
patient’s safety to prevent falls if you don’t
document that you:
• Instructed the patient NOT to get up to the bathroom
without using the call light (and the call light was at
the bedside)
• Ensured that the bed was left in the lowest position
Patient refusing medications:
• Document the exact reason why the patient refused
medication or treatment:
Example: Mr. Dysphasia states, “I cannot swallow pills.”
You chart: “Instructed patient regarding importance of taking
potassium replacement, with understanding
verbalized. Call to Dr. Jones to notify of patients
refusal and request liquid alternative.”
NOT “Patient refused.”
A complete chart contains:
• Identification of patient (stamp/sticker)
• Date and time of assessment or intervention
• Assessment of problem, knowledge deficit
requiring teaching, patient concern etc.
• Assessment contains subjective and
objective information
A complete chart contains:
• Statement of problem or knowledge deficit
• Measurable goals: outcomes
• Implementation measures: interventions taken
to correct the problem or knowledge deficit
• Evaluation of patients response to interventions
What about flowcharts??
* Excellent for recording repetitive data:
Vital signs, I/Os, routine care
Don’t forget to chart patient’s
response to interventions:
If pain is rated as 8/10, and you
give a pain medication, be sure to:
• Document their pain level or response (e.g.
asleep) 30min - 1 hour afterward.
Common reasons for lawsuits
involving nursing care :
• Failure to question inappropriate physician’s
orders
• Failure to adequately monitor a patient
• Failure to protect the patient from an avoidable
injury
• Failure to document care that was given in an
adequate manner
• Failure to properly administer medications
• Failure to take a complete and appropriate
nursing history
Common reasons for lawsuits
involving nursing care :
• Failure to follow orders correctly and timely
• Failure to perform procedures properly
• Failure to protect patient confidentiality
• Failure to assess an emergency situation
properly and initiate appropriate resuscitative
measures
• Functioning outside the scope of nursing
practice
• Failure to request help when the nurse is unable
to meet the needs of a patient
Common reasons for lawsuits
involving nursing care :
• Failure to notify the physician of test results
• Failure to follow hospital policy and procedure
when restraining patients
Why make such a big deal??
• Charting is a professional responsibility
• Medical record may be scrutinized by insurance companies
or Medicare or Medical and evaluated for errors
• Length of stay justification
• Quality of care assessment through chart review by
accreditation organizations
• Risk management reviews chart to evaluate safety concerns
• To protect hospitals/nurses in the event of a lawsuit.
What about handwriting??
•How you write is as important
as what you write!
Up to 25% of medication errors are
related to illegible handwriting!
What about typing??
• Type in clear, concise
statements.
• Use flowchart pre-filled answers
but elaborate as appropriate
• PRINT PRINT PRINT
• SLOW DOWN
• NUMBERS MUST BE
WRITTEN CLEARLY
2 not 2.0
0.2 not .2
You Should Never…
• Never leave blank spaces for others to “catch up”
• Never destroy or change any part of the medical
record after it has been created
• Never chart in advance!
You Should Never..
• Chart for others
• Chart the observations that others have made.
Ex.
“Patient fell on the floor” (NO)
“Patient found on the floor next to bed” (YES)
• Never chart in a way that could be determined as a
negative assault on the patient’s character.
i.e. “Patient was a drunk and obnoxious jerk”
• Instead chart specific behaviors:
i.e. “The patient refuses to have x-rays performed,
refused assessment, was observed to have a
very unsteady gait while ambulating in the
waiting room and urinated in the trash can in
the waiting room.”
Dangerous Abbreviations
* Know where the list is located
on your unit and in the
Org. Wide manual.
DO NOT USE THEM!
* There is also a list of Acceptable
Abbreviations in the Org Wide Manual.
Performance
Improvement
Regulatory Agencies, Occurrence Reports,
Risk Management
Performance Improvement
• All nursing departments have a planned, systematic and
ongoing monitoring and evaluation program to assess the
quality of care delivered to patients
• The Performance Improvement Coordinator as well as the
unit managers, are responsible and accountable for assuring
this process is in place and that consistent standards are used
to monitor and evaluate patient care
Performance Improvement
• Performance Improvement data is presented to the staff
during their staff meetings.
• This is an opportunity for all to review the data, analyze the
scores, and provide ideas for how improvements can be
achieved.
• The findings from the Performance Improvement
activities are used to formulate continuing education
programs for the staff.
Regulatory Agency Umbrella
CMS
AOA
Joint
Commission
CDPH
CMS
• Centers for Medicare & Medicaid Systems
• Reimbursement for Medi-Cal and Medicare
patients
• Reimbursements effected by performance
• Improved Performance = Increased
Reimbursement
What does CMS do with info about our
performance?
• We are mandated to submit our
performance
• CMS publicly reports our performance
compared with other hospitals
• CMS pro-rates our reimbursement based on
our performance and “grades” us on a scale
with other hospitals
• Rewards for being in top 10%
CDPH Evaluation
• California Department of Public
Health
• For State of California licensure
• Investigates complaints and
deficiencies
• Deficiencies can incur fines
OSHA: Occupational Safety & Health
Administration
• Federal and State
• Primary concern: YOU
• Safe work place
How do Regulatory Agencies decide on
what to focus on?
• Focus on QUALITY
• Focus on PATIENT SAFETY
• Focus on BEST PRACTICE
• Focus on PATIENT SATISFACTION
• Input from:
• Institute for Healthcare Improvement
• National Quality Forum
Why Participate?
• Because QUALITY, BEST PRACTICES & Patient
Safety are IMPORTANT!
nd because we are rewarded for good practice
What do we focus on here?
• Best Practices around
patients with:
• Pneumonia
• Heart Failure
• Heart Attack (Acute
Myocardial Infarction)
• Surgical Infection
• Stroke
• Deep Vein Thrombosis
• Immunizations
• Smoking Cessation
• Quality in all the services
we provide:
• from food to diagnostic
tests
• Patient Satisfaction
• All inpatients and
outpatients are surveyed
What do we focus on here?
• Patient Safety
• Culture of Safety
• Recognition of unsafe conditions and environments
• Recognition of situations that could result in a problem or undesired
outcome
• Talking about what we can do to make our workplace safer
• Communication!
Core Measures
• What is it?
• Best Practices identified by CMS as contributors to better
outcomes, decreased length of stay and decreased
occurrence of readmission
• The diagnoses include:
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Heart Failure
Pneumonia
Acute Myocardial Infarction
Surgical Care Improvement Project
Immunizations
Occurrence Report
• Used for reporting
unanticipated events such
as:
• Equipment failures
• Patients leaving AMA
• Falls
• If you notice a potential
problem:
• Isolate the problem (the
piece of equipment, etc)
• Report the problem to
your supervisor or the
department that can fix
the problem
Risk Management
• Uses Occurrence Report information
• Patient/Family complaints
• If you hear a family or patient complaining, address the complaint if
you can
• If you can not address the complaint, report it to someone who can
• “ABUSE”
• “HARRASSMENT”
• RED FLAGS!
Cultural
Awareness
Cultural Awareness
• Why learn about cultural awareness?
Cultural Awareness
• Help patients receive more effective care.
• Improve your job performance and your job
satisfaction.
• Meet expectations of regulatory agencies.
Cultural Awareness
• What is Cultural
Awareness?
Cultural Awareness
• Considering every patient’s culture when giving care.
• Treating every patient, family member, visitor and co-worker as an
individual.
BACK CARE
BODY MECHANICS and
LIFTING TECHNIQUES
A Healthy Back
• Composed of 24 movable bones called vertebrae
• Disks act like cushions
• Muscles and ligaments
support the back
• Injury or disease = PAIN
A Balanced Back
• Cervical, Thoracic, and Lumbar curves must be aligned
• Ears shoulders and hips stacked
• A healthy back is also protected and supported by well
conditioned muscles
Preventive Back Care
• Always warm up
• Exercise the muscles that support your back
• Stretch to improve flexibility
• Posture is important
TASK ANALYSIS
• Fancy name for “PLANNING AHEAD”
• Break task into steps
• Think it through
PLANNING AHEAD.....
• Can I do the task by myself in a safe manner?
• If not, determine the number of people it will take.
• What equipment or materials are needed to do the job?
Use Your
POWER ZONE!
• Floor to shoulders,
directly in front of the body
• The maximum Power Zone is from the knees to
the waist
• You have 5-7 times the load capacity when using
the Power Zone
Keep it “Locked In”
• Keep your back muscles “Locked In” while lifting
• 10x disk pressure when
“Bowed Out”
• Head and shoulders up
BACK SAVING TIPS
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Always lift with your legs
Support lower back
“Nose between the toes!”
Be aware of trip or slip hazards
Push, don’t pull
Exercise
Thank you for reviewing the MRCH
Student Nurse Orientation
We welcome you to our hospital team!
Please complete the post test, and bring it with
you on the first day of your hospital orientation.