Transcript Confidentiality/Communications

HIPAA/HITECH
 HIPAA-Health Insurance Portability Accountability
Act
 HITECH-Health Information Technology for
Economic and Clinical Health Act
HIPAA
 HIPAA Privacy Rule requires protection of a patient’s
personal health information (PHI) regardless of its
form (electronic, paper or oral)
 Notice of privacy rules must be given to all patients at
the time of admission.
 Copy of privacy rule can be found posted in each
office.
 Notice of Privacy Rule informs patients how agency
may use their information.
HIPAA
 HIPAA rules can not prevent agency from providing
care to a patient.
 Contact Pam Bowman or Jeremy Bailey for any privacy
violations.
 Discipline for HIPAA violations may include verbal or
written warning, probation or termination.
HITECH
 Breach is an unauthorized acquisition , access
use or disclosure of PHI not permitted by the
privacy rule.
 Any suspected or actual breach of unsecured
protected health information is to be reported
to the Privacy Officer.
HITECH
 Breach of PHI (personal health information) may
include:
 Emailing patient information without encryption
 Talking to an unauthorized person regarding patient
information
 Computer stolen or hacked with patient records
 Affected individual would need notified.
 If breach is a large number of patients, HHS and
media would need notified.
Protecting PHI: Texting
 Texting information to another healthcare person
is risky.
 A copy of the text is on your phone, your carrier
data base, and the person’s phone that you sent it
to.
 No identifiable patient information should be
electronically sent without it being secure.
 How secure is a text? Don’t document “texted
Doctor” “texted nurse” ;could be a potential
HIPAA violation because a surveyor make ask
“how was the information secure?”
Protecting PHI: In your home
 Protecting patient identifiable information is not just
for in the office.
 Do you have patient information at home such as;
patient assignment sheets, schedules, face sheets, etc?
 Where are you having patient conversations at while at
home? Is family nearby? Do they have access to
patient information?
Protecting PHI: Patient safety
 A promise to keep information a secret
should not be made, if the information
could impact the safety or comfort of the
patient.
 Example: suicide plan or thoughts of
harming themselves.
Protecting PHI: At the office
 Computers; logging off,
using password
(changing/creating/safeguard
ing)
 Printed patient reports; don’t
leave patient forms face up
where others can see them
(keep in a folder or flip over)
 Discarded patient
information; place into
shredder only.
Policy Against Sexual Abuse
 Agency has a zero-tolerance for any sexual abuse
committed by an employee, volunteer, board
member, or third party.
 Sexual abuse includes:
 Inappropriate sexual contact
 Molestation
 Sexual assault, exploitation or injury
It does not include sexual harassment.
Sexual Harassment
 Sexual Harassment includes:
 Unwelcome physical contact
 Making sexual gestures
 Making or displaying sexual drawings or
photographs
 Sexual propositions, slurs, insults or jokes
No one may subject another to any unwelcome
conduct of a sexual nature.
Compliance Plan
 State of the Heart expects it governing board
members, officers, managers, employees,
physicians, and other agents to maintain
high standards of integrity, business ethics,
and fair dealings and to avoid any actions
that are inconsistent with such standards.
Compliance Plan
 State of the Heart Employee/volunteers
 Will not provide or accept gifts or services of any form to
or from potential patients or referral sources
 Do not participate in activities or business relationships
that might pose a conflict of interest with their
responsibilities to the hospice program
 Will accurately describe hospice program and criteria for
admissions
 Will accurately submit claims for service
Compliance Plan
 Areas at risk for fraud
 Uniformed consent to elect the Hospice Medicare
Benefit
 Admitting patients to hospice that are not terminally ill
 Falsifying records
 Untimely or forged physician certifications
 Inadequate or incomplete services rendered by the IDG
 Hospice incentives to actual or potential referral sources
Compliance Plan
Risk areas cont…
 Billing for inadequate or substandard care
 Providing hospice services in a nursing home before
the written contract is signed
 Hospice Medical Director inappropriately billing for
face to face visits
 Non-response to late hospice referrals by physicians
 Variance between hospice plan of care for nursing
home and home care patients
Workplace Safety
Follow proper lifting
techniques to avoid
injury:
 Get help, if object is too
heavy or oddly shaped.
 Lift with your legs, not
your back.
 Bend your knees and
keep your back straight.
 Don’t twist.
Workplace Safety
 Be aware of
surroundings during
inclement weather.
 Ice or snow covered
paths
 Wet or slippery paths
 Wear proper foot
wear
 Take your time when
walking
Workplace Safety
 WORKPLACE VIOLENCE
 The Receptionist or his/her designee will report any
suspicious behavior of any individual approaching or
entering the buildings.
 He/she will remove themselves from the front desk
area of the office. A staff member will call 911.
 If possible, all external doors will be locked. Staff and
volunteers will remove themselves from the area of the
individual and exit the building as soon as possible.
Workplace Safety in the Home
 Potential home hazards:
 loose carpeting
 throw rugs
 exposed cords
 pets and clutter
 Enforce No Smoking when oxygen is in use
Workplace Safety in the Home
 Lift and move patients using safe transfer
techniques
 adjust the bed up
 use a draw sheet
 use your arms and legs to lift (not your
back)
 ask for help
Driving Safety
Avoid distractions
 talking on cell phone
 eating
 texting
 reading
 You are 4 times
more likely to be
involved in a
collision when
talking on a cell
phone.
Driver Safety
Slow down
Pay attention
Emergency Preparedness
Designated Area: Evacuating building
 Darke: South employee parking lot >
 Jay: North employee parking lot>
 Mercer: Across the street>
Fire Safety
 R– Rescue (persons from fire/smoke)
 A– Alarm (call 911)
 C– Contain (Close all doors to rooms)
 E- Extinguish (fire, if safe to do so)
Fire Safety
 In case of fire in the building:
 Notify staff of fire in building and location. Call 911
 Turn off electrical equipment
 Exit building by determining nearest exit away from the
fire.
 Everyone in the building should gather in designated
area.
 Greenville-south parking lot
 Portland-front parking lot
 Coldwater-across the street
Fire Safety
Tornado
 If a tornado warning is announced, go to the
designated area marked in blue on the fire escape
plan posted in each office.
 Darke: Men and women’s restroom
 Mercer: Interior hallway or chart room
 Jay: Men and women’s restrooms
Tornado
 If you are driving and you see a tornado,
seek shelter immediately
 Do not try to outrun a tornado (Weatherchannel.com)
Flash Flood
 Office- move to higher ground-evacuate if able.
 Driving-avoid high water, do not drive through.
Earthquake
 Get under a desk or table, if able.
 If standing in the hallway, go stand in a
doorway.
 Once the tremor has stopped, staff will leave
the building and go to their designated
parking lots.
Bomb Threat
 If a bomb threat is made to any employee,
the employee will immediately announce to
staff and everyone evacuate the building.
 Staff will meet in their designated areas and
wait until authorities have cleared the
building.
Hazardous Material Spill
 Employees will
follow evacuation
procedures from
local authorities.
 If in a patient’s
home, call the office
for further
instructions
Hazardous Material Exposure
 Any staff or volunteer involved in a hazardous material
incident report incident to supervisor.
 MSDS (Material Safety Data Sheet) information found
online @
www.msdsonline.com
Hospice Care Center Safety
CODE BROWN-Missing adult
 When an employee, volunteer, or family members is unable to locate an
adult patient, the person will immediately notify the Director of
Inpatient/Palliative Care and the hospital operator.
 A description of the missing person will be given to the operator with
the following information: Name, gender, age, description, and
location from where person is missing.
 The hospital operator will:
 Announce one time, “Attention hospital personnel: Code Brown is now in
effect.”
Hospice Care Center Safety
CODE RED-Fire
 Rescue persons in immediate danger; close doors,
place wet blankets at bottom of doors
 Alarm must be sounded
 Contain the fire by closing all doors in the fire area
 Extinguish small fires by the following methods:
 Smothering the fire
 Use of fire extinguisher
 CODE RED cont…
 Evacuate area following Wayne HealthCare Evacuation
Protocol
 Care Center staff will close doors and windows in the
unit.
 Lights in corridors and rooms will remain on.
 Care Center staff/visitors will not use the elevators
Hospice Care Center Safety
CODE VIOLET-Violent person
 Any staff person or volunteer may initiate a Code
Violet if confronted with or witnessing a potential
violent situation. This can be either verbal or physical.
 The Director of Inpatient/Palliative Care or designee
will be notified immediately of the situation. He/she
will contact the Director of Operations/Risk
Management and the Director of Social Services.
CODE VIOLET cont…
 The hospital operator will be notified of a Code Violet.
 The Greenville Police Department will be called by the
Director of Inpatient/Palliative Care, designee, or the
Director Operations/Risk Management.
 If the hospital operator announces a Code Violet for a
location outside of the inpatient unit, the Care Center
staff will shut the doors and not reopen the doors until
the Code Violet is clear.
Hospice Care Center Safety
CODE GRAY-Severe Weather/Tornado
 The hospital operator will announce “Attention
hospital personnel Code Gray, Code Gray, Code Gray.”
This will be repeated throughout the storm.
 All Care Center staff will stay in their designated area.
 Patients/families will be moved to inner windowless
areas of the unit.
CODE GRAY cont…
 Patients who are able should sit on the floor, back to the
wall with a pillow and blanket to protect their face and
head. Patients who are unable to be moved will be covered
by blankets. Care Center staff will stay with these patients.
 Elevators will not be used.
 Care Center staff will stay in designated areas until warning
is lifted.
 If evacuation to ground level is required, all staff,
volunteers, patients, and families will go to the center of
the building in windowless areas.
How are infections spread?
 Germ-virus, fungus, parasite or bacterium
 A place for the germ to live-person, food, water or
animal
 A susceptible host- a person with low resistance to
the germ
Let’s go
 A way for the germ to enter
boys! We
have a way
in now.
Infection Transmission
 Germs can enter through:
 Direct Contact-touching
 Indirect Contact-food, water or bandage
 Droplet-sneeze or cough
 Air
Standard Precautions
 The bodily fluids that you are
most likely to encounter in the
healthcare are blood, saliva,
vomit, or urine.
 Sometimes the blood may be
present, but difficult to see
with the naked eye.
 To be safe, you must assume
that all bodily fluids are
contaminated with infectious
blood. This is called standard
precautions.
Barriers
 PPE-Personal
Protective Equipment
 Gown/apron
 Gloves
 Mask
 Goggles
All patient care staff
and volunteers should
carry their PPE with
them to patient visits.
Barriers
 Wear gloves any time contact with blood,
body fluid, or mucus membrane is likely.
 Wear eye protection and a gown, if splashes
or spray is likely.
 Use a mask for protection from infection
that can be carried in the air. Example:
Tuberculosis or Flu.
Hand washing
 Before:
 Handling food
 Patient care
 Entering nursing
bag
 Handling
medications
After:
•Patient care
•Performing wound
care
•Sneezing/coughing
•Touching mouth, nose
or eyes
•Touching
contaminated items
When in doubt-Wash
Hands
Hand washing: Hand Sanitizer
Biohazard Spill Kit
 Biohazard spill kits are
provided to patient care
employees in the event
body fluids need to be
cleaned up. (ex:
blood/emesis on a floor)
Transmission Based Precautions
 Contact
precautions are
used for infections
spread by body
secretions. They are
commonly found on
the skin and urine.
 Examples: MRSA,
WHERE ARE THE GLOVES??? Staph, Pink Eye
Transmission Based Precautions
 Droplet precautions are
used for diseases that are
spread by sneezing,
coughing, and talking.
 Example: Pneumonia, flu,
whooping cough, rubella,
and mumps
COVER THAT SNEEZE OR COUGH!
Transmission Based Precautions
 Airborne based precautions are used with
patients that have infections with
microorganisms that can be transmitted by
air for long periods.
Examples:
 TB
 Measles
 Chicken pox (also requires contact)
BloodBorne Pathogens
 BloodBorne pathogens are carried in a
person’s blood stream and other body
substances such as:
 saliva or mucus
 stomach and chest fluids
 fluids surrounding the brain, heart and
joints
BloodBorne Pathogens
Some bloodborne pathogens are deadly or can
make you very ill.
 HIV
 Hepatitis B & C
 Malaria
How do they spread?
 Needle stick injuries
 Cuts, scrapes, any break
in the skin
 Splashes into the
mouth, nose or eyes
 Sexual contact
 Infected needles
Hepatitis B (HBV)
 Symptoms include:
 May lead to chronic
jaundice, fatigue,
liver disease, liver
abdominal pain,
cancer, and death
loss of appetite,
 Vaccination
intermittent nausea,
available
vomiting
Hepatitis B
 Very infectious. Virus can survive for
approximately 1 week EVEN IN DRIED
BLOOD.
 Prevent getting Hepatitis B by:
 Getting vaccine
 Not sharing toothbrushes or razors
 Not getting tattoos or body piercing
Hepatitis C
 Also attacks the liver
 Symptoms are milder than Hepatitis B
 A person can be a chronic carrier.
 There is no vaccine for Hepatitis C.
 Both Hepatitis B & C can cause cirrhosis
and lead to liver cancer.
HIV
 Virus that causes AIDS.
 Virus attacks the immune system
 A person may be HIV positive and have no
symptoms.
 HIV is not spread through casual contact
such as: hugging or touching
 Does not survive well outside the body
Protect Yourself
 Never recap used needles
 Cover cuts, hangnails
or rashes.
 Keep any non
intact skin covered.
Protect Yourself
 Wear gloves when coming into contact with
non-intact skin or body fluids
 Wash skin immediately after any contact
with body fluids.
 Wear gown and/or gloves, if splashing or
spraying may be expected.
Exposure Control Plan
 All patient care employees and volunteers are to
practice Standard(Universal) Precautions.
 All patient care employees and volunteers are to
use Personal Protective Equipment.
 Hepatitis B vaccine is available to all employees
and volunteers who are at risk.
 TB screening is completed at hire and yearly.
Exposure Control Plan
If you are exposed
to any blood or
body fluid, notify
your supervisor
immediately.
Tuberculosis (TB)
 TB germs can live in your body without
making you sick. This is called latent TB
 A mantoux skin test or chest x-ray can tell if
you have TB infection.
 Mantoux test is given under the skin and
then “read” in 48-72 hours.
Tuberculosis
 Active TB disease can cause weakness, fever, wt
loss. If TB is in the lungs, it can cause coughing
and bloody sputum
 Sometimes TB is found in other body parts such
as the spine, kidneys or brain.
 A special mask is worn when taking care of a
patient with TB.
THE END
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