Transcript Brookhaven Orientation

NURSING STUDENT ORIENTATION
2009-2010
Welcome……
MISSION STATEMENT
To deliver accessible, high quality health
services in a focused caring environment
while providing health advocacy for the
community and people we serve.
Our hospital…….
321 beds
 Not for profit
 Built in 1956
 Huge ED with over 70,000 patients/year
 2 Health Centers EAST AND WEST
 Hospice, home care, outpatient dialysis
 Is smoke free
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Long Island Health Network (LIHN)
Guidelines
Pathways/clinical maps developed through
evidence based practice for disease
processes that designs the patient’s plan
of care
Identify your patients that are on guidelines
and learn how they are used.
This process improves patient outcomes,
and uses standard best practice
A CULTURE OF PATIENT SAFETY
Patient Identification
2 identifiers: Name and DOB when giving meds,
drawing blood, transporting patients, treatments….etc
Improve Communication
Abbreviations: DO NOT USE LIST
Read back telephone orders, do not accept verbal
orders
Read back of critical lab results
Appropriate ‘hand offs’
A CULTURE OF PATIENT SAFETY
Improve the Safety of Using Meds
Standardize drug concentrations
Watch for look alike/sound alike meds
Label all meds in your work area
Reduce the risk of health care associated infections
Wash your hands!!!
Hand gel available, not effective against C Diff.
A CULTURE OF PATIENT SAFETY
Reconcile meds across the continuum of care
Communicate a list of meds upon admission, at time
of transfer, and upon discharge
Reduce the risk of patient harm from falls
Green armbands
Be vigilant
Use lifting equipment
Report all falls
Be alert to meds that may cause patient falls
A CULTURE OF PATIENT SAFETY
Encourage patients’ involvement in their own care
SPEAK UP Campaign, see posters in the hospital
Identify safety risks, patients at risk for suicide
Special assessment is done on these patients
UNIVERSAL PROTOCOL:
Conduct a pre-operative verification process
Mark operative sites
Conduct ‘TIME OUT’ immediately before starting any
invasive procedure, even at the bedside.
SERVICE EXCELLENCE
Be friendly 
 Wear your ID badge so we can say hello
to you
 Introduce yourselves to your patients
 Keep the environment clean
 Look and act like the professional you
are
PATIENTS ALWAYS COME FIRST!!
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WHO’s WHO??
Mr. Ockers
Mr. Margulis
Dr. Kim Mendez
Mr. Phil Messina
Mrs. Gail Steiger
Mrs. Mary Ellen Lindros
President and CEO
Senior VP of Operations
Chief Nursing Officer
AVP Patient Care Services
Director of Nursing
Director of Nsg Prof. Development
NURSING DEPARTMENT
Kim Mendez/Gail Steiger
Nurse Managers
Nursing Supervisors
Clinical Nursing Supervisors
Clinical Educators (med surg, diabetes, wounds, ICU)
RN’s and LPN’s
Cardiac Monitor Techs
Nursing Assistants
MISSION of the NURSING DEPARTMENT
To
communicate…advocate……
and promote safety and
quality care for our patients,
families, and each other.
UNIT SECRETARIES
On every nursing station
VERY HELPFUL!!
Maintain charts
Enter orders
Facilitate patient care
CASE MANAGERS
Discharge Planners
Coordinators of care
Social Work
Home Care/Hospice Referrals
Transportation
Complicated Cases
Home Care and Hospice
Some of you may rotate to the home care/hospice area…….
INFECTION CONTROL in the HOME
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Nursing Bag Technique
Handwashing is essential, hand cleanser is available
Universal Precautions, discuss with CHN and review policies
Double bag dirty dressings
Dispose of sharps per home policy
Oxygen safety in the home is paramount
Home Care and Hospice
Some of you may rotate to the home care/hospice area……
EMERGENCY PLANS
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Follow HICS as set forth by the hospital
Triage patients according to need and location (most common
events are snow and flooding)
Follow policies for home care and hospice
Home and Hospice participate in pandemic flu planning
Work with Fire Department and/or Police Department as needed
Radio announcements in events of emergency
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WBLI FM 106.1 and WALK 97.5
CULTURAL DIVERSITY
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Be respectful of others - Understand that there is a great
diversity in BMHMC and all patients and staff should be treated with respect as
you would expect to be treated.
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International Nurses – BMHMC staff includes nurses from other
countries including the Philippines and India
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Language – please be sure to speak only English when working at
BMHMC
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Cyra Phone for Interpreters – this phone is used for our
non English speaking patients and a phone is available on each unit.
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Deaf Talk - is used for hearing impaired ( ask your nurse if the patient
needs this equipment)
FIRE SAFETY
R
A
C
E
Remove patient from danger
Activate the alarm
Contain the fire and close doors
Extinguish the fire if you can
THE CODE IS CALLED DR. PEPPER
Dial 3040 and state your location
CODE 64
This is the code for cardiac arrest
If it happens to your patient:
1.
Call for help
2.
Call or have someone call 7333 and
state your location
3.
Start CPR
DR. HEAVY
This is the code for violence!!
Call 7911 and state your location
Your responsibility is to get out of harm’s
way and allow security to do their job
OTHER CODES…
CODE PINK: Infant Abduction, LOCKDOWN!!
Babies have HUGS tags
CODE GREEN: Oxygen Alarm
CODE DECON: Biohazard coming to ED
HICS: Hospital Incident Command Center. Mobilized in crisis events.
Report to your instructor and wait for direction.
CODE RAPID RESPONSE: Team called to assess sudden acute
changes in patient condition
HIPAA and PATIENT CONFIDENTIALITY
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Any information learned in the hospital should be contained here
and not discussed with anyone not associated with the patient (
this includes family and friends)
The computer should only be used for patients that have been
assigned to you. Unauthorized use of the computer will result in
your removal from the organization
Patient status should not be discussed in public
Comply with all security and privacy regulations
Report any concerns to your instructor
Any documents with patient identification used during your shift
should be placed in the shredder box before leaving
The confidentiality statement must be signed prior to starting your
hospital rotation
INFECTION CONTROL
WASH YOUR HANDS before and
after caring for each patient and
after removing gloves!!!
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Infection Control Manuals on each unit
Watch for ISOLATION SIGNS and follow
instructions
Use gloves when you need to
Put sharps in appropriate containers
Red Bag Waste is in Dirty Utility Rooms
Patient Bill of Rights
See Handout and competency.
 Competency should be completed prior
to starting your rotation.
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INCIDENT REPORTS/ERRORS
Do not be afraid to report an error!!!
Errors are usually due to process issues and
must be reported. This information is used for
performance improvement and can result in
changing process to prevent future errors.
Reports are computerized and should be filled
out prior to the end of the shift. All incidents
must be reported to the Nurse Manager or
Nursing Administrative Supervisor through
your instructor.
MEDICATIONS
Be sure to check the patient’s identification with
order, patient and screen of computer prior to
any procedure
MAK System: Medication Administration Check System
Bar Coding scanner
Pharmacists on the Floors during the day
Patient Education for medications ongoing.
Hand outs available for printing on the Intranet
PROHIBITED ABBREVIATIONS
Do not use
U
QD
QOD
SC, SQ
TIW
CC
OD
MS
Must use
units
Daily
Every other day
Subq or subcutaneous
Three times a week
ML
once daily or right eye
Morphine Sulfate
Do not use Zeros after a decimal point
Write 1 mg, not 1.0 mg
Always use a Zero before a decimal point
Write 0.5 mg, not .5 mg
MILITARY TIME
Based on a 24 hour clock, no am or pm
 Used for all documentation
 2400 is Midnight
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CHARTING
Interdisciplinary Database and Plan of Care
Action Flow Records
Vital signs and Intake and Output
Restraint documentation for compliance
Initial FOCUS Notes
Patient Education Sheets
All on computer in Soarian Documentation
LIHN Guidelines continue to be paper
ID BAND COLORS
White:
Pink:
Green:
Red:
Orange:
Blue:
Yellow:
Standard band, name & DOB
Arm or side affected, no blood
draws or BP’s
Patient at risk for falls
Allergy, read it for specifics
Latex Allergy
On anticoagulation therapy
used for non admitted patient(should
changed immediately on arrival to floor)
be
Your practice…..
BE SAFE!!!
 Do not give medications without your
instructor
 You are beginning a very honorable
career, act professionally at all times.
 Any issues or concerns should be
reported immediately to your instructor
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FINAL WORDS
Provide quality nursing care and be proud of
your profession
Offer compassion to all patients
Maintain your integrity
Respect the dignity and privacy of your patients
Be responsible for your actions
Take accountability for yourself
WELCOME TO BROOKHAVEN MEMORIAL
HOSPITAL MEDICAL CENTER
BE PROUD TO BE A
NURSE