Decatur Memorial Hospital Student Nurse Orientation

Transcription

1 Decatur Memorial Hospital Student Nurse Orientation Welcome to Decatur Memorial Hospital Student Nurse Online Orientation. We have high expectations that your clinical experience will be a positive one and look forward to assisting you. In order to prepare you for your clinical experience, you are required to complete this orientation module, there will be a test you will need to print, complete and return to your instructor prior to your first student visit at the hospital. With every clinical semester you will need to renew your computer access and review the precision blood glucose monitoring with your instructor. The Mission, Values, and Vision of Decatur Memorial Hospital. Mission: To improve the Health of the people of Central Illinois Values: We strive for certain values at DMH, we take into consideration these values when making decisions and actions. CARES: C ompassion A gility R espect E xcellence S ervice Vision: The greatest care delivered by the best people. Relationship Based Care Culture Relationship Based Care connects us as caring people to our patients. It focuses on caring for ourselves; our colleagues and our patients: body, mind, and spirit. We do this by being present and respecting the needs and goals of all involved, keeping the patient at the center.

2 So what is your role? The student nurse will provide care within the framework of the Illinois Nurse Practice Act. The student will be responsible for patient care consistent with their competency level in school and will be held to the same legal expectations as a licensed practitioner. Students are expected to abide by standards and policies set at DMH. Policies should be reviewed prior to initiation of a procedure. Policies are located on the Intranet. Please do not come to the hospital if you are sick. (fever > 100, Rash, please inform your instructor if you come into contact with any contagious condition) All students are asked to appropriately wear their school uniforms. They must display their college identification badge at chest level at all times. Refer to DMH Appearance Policy for all other requirements. A student will never take full responsibility for a patient. They will function under the supervision of an instructor and/or qualified preceptor. Clinical objectives and the student s role will be communicated with staff nurses prior to participation in patient care. Students cannot witness or obtain consents, take orders, or receive critical values. Students will report off to their designated nurse prior to leaving the floor. All errors should honestly be reported to student s instructors and incident reports be completed promptly. Incident reports are located on the Pulse (DMH intranet).

3 DMH Nursing Philosophy Nursing Practice at Decatur Memorial Hospital encompasses a wide variety of specialty practice areas from outpatient ambulatory care to advanced practice anesthesia. In all of these areas, we implement a professional practice model that emphasizes the autonomy and accountability of individual nurses and groups of nurses as they design and deliver care for their diverse patient populations. Nursing leaders are expected to be transformational in their approach to nursing practice, leading us toward innovative solutions to meet the demands of the future. We do this through a council structure at both the hospital wide level and department level where all practicing nurses have the opportunity and accountability to design and improve the practice of nursing in their respective settings. These councils, along with their nursing leaders, focus on measurable positive outcomes in the delivery of nursing care, continually evaluating evidence to design innovative processes for care improvement. We deliver nursing care within a patient care framework developed by nurses across the practice spectrum that places caring relationships with our patients and families as the key driver for innovation and excellence. Each practice specialty is responsible for designing a care delivery model which fits this framework and matches patients needs synergistically with nurses who have the appropriate skills, knowledge and experience to address those needs. These staffing models are evaluated regularly by practicing nurses and leaders to continuously improve our effectiveness in meeting patients needs and in establishing a positive work environment for nursing practice. Linda Fahey RN, DNP Vice President of Nursing We would like to invite you to visit one of our nursing councils, contact one of our professional nurses if you are interested: Results Council Unit Base Council (Specific to each clinical area)

4 Parking You will be required to complete a vehicle registration form if you will be parking at the hospital during your clinical rotation. You will receive a student parking sign to display on the dashboard of your car. This can be completed on your first day. Students must park in the lots indicated for employee parking.

5 Customer Service At DMH we put our customer first. Listen to your patient s concerns, using HELP? H- Hello my name is E-Explain why you are there. L-Listen to the patient P-Provide accurate information?-ask, Is there anything else you need? In 2008 the CMS (Centers for Medicare/Medicaid) began to require hospital to publicly report patient satisfaction data captured through their HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey instrument. The survey was designed to produce comparable data on the patient s perspective on care that allowed objective and meaningful comparisons between hospitals in areas that are important to consumers. The HCAHPS survey asks how often something was done and asks the patient to evaluate the care with a frequency scale of never, sometimes, usually and always. Results are publicly reported to make hospitals accountable for their actions and improve the quality of care. Cultural Diversity As Health Care Advocates it is our responsibility to provide the best possible care to all of our patients, regardless of age, race, gender, or ethnic origin. We want to create an environment that is respectful to all of our patients. Cultural Diversity is considering the differing views about health and health care. Avoid stereotyping; don t assume an individual patient follows that culture s particular view. It is important to ask your patient open ended questions to assess their views and desires. Effective communication is crucial to provide the best possible care for our patients. DMH has many resources available to assist in communication, ask one of the DMH staff members. Nursing students have a big role in assessing our patient s diversity, and we want to hear your assessment. Suspected Abuse, Neglect, Violence and Exploitation Assessment Working in a healthcare setting we have an opportunity to identify and have an impact on acts of violence. If you suspect one of your patients is a victim of abuse, neglect, violence or exploitation, please inform one of our professional staff members.

6 Confidentiality and Privacy HIPPA (Health Insurance Portability and Accountability Act of 1996) Decatur Memorial Hospital has pledged to our patients to keep their information confidential and to respect their privacy, there is zero tolerance for a breach of confidentiality. Confidentiality means you may not disclose any information you have heard or read about a patient, this includes the patient s name or any identifying factors about that patient. Never discuss confidential information about patients and their families, unless it is with an authorized person in a private area. Privacy is also important with electronic transition, never copy part of a patient s chart, never download patient information (such as to a memory stick), and never put patient information into an . What you learn about your patient here stays here. Students who participate in a clinical rotation here are agreeing to maintain our high level of confidentiality. You are not allowed to electronically access your own personal records as well as family or personal friends while here for your clinical rotations, this is a serious HIPPA violation. The only access into a medical record should be to a patient(s) you are directly caring for. Emergency Preparedness *****Dial 2345 to report an emergency***** Code Red = there is a fire somewhere at the hospital RACE is a national acronym used to help you remember what you must do in case of a fire So if there is a fire remember: RACE: R Rescue: Your first priority is to remove patients from immediate danger. A - Activate: Pull the nearest red fire alarm box and dial 2345 (fire alarms are usually located by the fire exits, Locate the fire alarms during your clinical time. C- Confine: Close all the doors E- Evacuate/Extinguish: Know the location of all fire exits should evacuation become necessary Use the proper fire extinguisher to extinguish or control a fire, only if trained to do so. DMH uses the acronym PASS.

7 Emergency Situation Codes (dial 2345) CODE WORD SITUATION YOUR ROLE CODE BLUE Cardiac arrest in the hospital at the Avoid area. Do not use elevators to area. designated location CODE BLUE EXTERNAL Unresponsive patient or serious patient condition on the campus, but not in the ECC staff, Anesthesia, Respiratory and Security respond. Avoid area hospital CODE GRAY Possible inpatient stroke Rapid Response Team. Stroke Coordinator and Hospitalists respond CODE GREEN Oxygen system outage Patients need to be placed on portable oxygen supply. CODE LEAVE Patient elopement. Designated departments search for the patient. CODE MAJOR Influx of patients that will tax the entire Call back initiated by Director. Perform CODE MINOR hospital. All normal hospital functions cease. ECC is aware of an influx of a number of patients that will affect on ECC and supporting departments (not announced) duties as assigned in External Disaster Plan. Avoid ECC area. CODE ORANGE Bomb threat has been received Do not use any equipment, light switches, elevators. Close doors until area has been cleared. Report all suspicious packages. CODE PINK Pediatric arrest in the hospital at the designated location Avoid area. Do not use elevators in area. CODE RED Fire situation in area designated Avoid area. Do not use elevators to area. If part of fire response team, bring fire extinguisher to location of Code Red. CODE YELLOW Hazardous material spill in area designated Avoid area do not attempt to clean up major spills. CODE SECURE ALL FLOORS CODE SHELTER CODE STORK CODE STRONG AMBER ALERT WATCH CODE WARNING CODE WEATHER CODE A threat of violence to patients or staff with a weapon involved Widespread reduction in air quality (ex. Chemical fume cloud). Denotes an infant abduction in Pediatrics or OB (using the Code Alert system) Activates a team of employees to respond to designated area to assist in controlling a situation/violent patient Denotes an infant abduction in an area not covered by Code Alert system The Weather Service has stated conditions are favorable for severe weather. The Weather Service has stated severe weather has occurred in the area. Weather conditions are such that employees are unable to safely travel to work. Quickly clear hallways of any equipment, patients, and visitors. Run, Hide (and barricade) Fight Follow departmental plans and overhead paged instructions. Be ready to evacuate if necessary. Watch for suspicious persons with children or packages. Designated staff monitor exits. Do not attempt to stop possible abductor Avoid area. Description will be announced. Watch for suspicious persons with children or packages. Don t try to stop abductor. Avoid windows; pull drapes. Patients may be moved to safer locations. Visitors/families go to the South end of Kirkland Lobby. Pull drapes. Avoid elevators. Be prepared to move patients to safety. Staffing may be altered. Employees may be sleeping at the hospital. If you are unable to get to work, call immediately as transportation may be provided.

8 Rapid Response Team DMH has a Rapid Response Team (RRT) - The purpose of the Rapid Response Team (RRT) is to improve inpatient outcomes by providing a means for rapid and timely intervention of a declining patient through activation of a trained team of caregivers. Any person providing care can initiate the Rapid Response by calling #5555 with the room location they should respond to. For additional information you may access this policy on the DMH intranet site The Pulse. Equipment Safety It is everyone s responsibility to identify equipment in need of repair and removing it from the department. A work order is then filled out and it is sent to engineering. Be aware of tags indicating equipment is not working properly. Tagged equipment should not be left in a patient care area. Any piece of electrical equipment, regardless who brings it in to DMH, is required to be inspected the engineering department. The Safe Medical Devices Act requires us to report serious injures or deaths of patients or employees related to medical devices to the Food and Drug Administration (FDA) Personal Safety Tips Use proper lift equipment when transferring your patient. Ask for help when needed Do not leave your valuables unattended. Report any suspicious person or unauthorized persons to Security immediately. When leaving or entering the hospital after dark, or anytime you do not feel safe, call security at 2020 for an escort to and from your car. Hazardous Materials Hazardous Materials is waste capable of producing infectious disease. It includes blood and body fluids, sharps, surgical waste, isolation waste, microbiological waste and pathological waste. Materials that should be placed in red bag waste include: Any Personal Protective Equipment saturated with blood or body fluids Dressings saturated with blood or body fluids Any disposable item that is saturated with blood or body fluids IV Bags and tubing with blood in them. Hemovacs and drains Suction canisters Chest drainage units Hemodialysis products Wet Vent circuits Disposable items that are contaminated with infectious waste. Saturated is defined as contents that may drip or release when held vertical, squeezed or compacted.

9 Items that go into the general waste include: Diapers (absorbent and hold/absorb urine and stool) Empty syringes without needles Emesis basins (after flushing/emptying out contents) Foley catheters after emptying Sanitary napkins (absorbent and hold blood) Dry vent circuits Wrappers, plastic, and paper items that do not have confidential information on them. PPE and dressings that are not saturated with blood or body fluids Empty Primary solution bags and empty medicated IV bags are to be placed in the general waste. If the bag has a patient label on it you must do one of the following prior to placing in general waste to comply with HIPPA: Remove name portion of the label and place in recycle bin. Using a black sharpie mark out the patient name so it is no longer recognizable. Place bag in the blue non-hazardous RX waste container. Sharps - include needles, scalpel blades, broken ampoules; anything in a hospital or clinic which that may be contaminated with infectious material or a risk to injury if handled. Such objects should be disposed in the red sharps container. A material safety data sheet (MSDS) for each hazardous material is available upon request. Infection Control It is DMH s goal to create an environment for zero hospital acquired infections. Please contact our Infection Prevention Nurse with any questions: Shannon Comer RN, Hand washing is the single most effective way to prevent the spread of infection. Wash hands for at least 15 seconds with soap and friction. There are hand sanitizers conveniently located on the units Remember to clean your stethoscope, or any equipment between patients Strict adherence to Universal/Standard precautions Recognize the types of isolation precautions used for specific communicable disease. Follow the directions on the isolation signs. PERSONAL PROTECTIVE EQUIPMENT is available in each patient care area Artificial nails are not permitted to be worn by employees or students with direct patient care responsibilities.

10 Public Health Pest Public health pests are a nuisance that pose a problem for our patients and staff. These pests include such things as bed bugs, lice, and scabies. We have a pro-active approach to prevent infestation that includes: Immediate response by staff when these pests are identified or suspected Routine inspections and treatment of the hospital done by a pest management company with experience in treating bed bugs. We cannot prevent these pests such as bed bugs from coming into our facility BUT what we can do is: work together to quickly identify them and take appropriate actions to prevent an infestation. Bed bugs can enter on patients, visitors, staff and even students. Bed bugs are successful hitchhikers. They travel from place to place in furniture, bedding, luggage, boxes, and clothing. They can go for months without feeding. If a patient is suspected of bedbugs: Place patient in Contact isolation with booties Have the patient shower or give a bed bath Double bag personal belongings and seal bag with tape send them home if possible Notify Environment Services (EVS) CAPTURE AND CALL (any bugs you find place in a specimen container so Pest Management can identify the bug) Provide Patient Education on Bed Bugs to patient and families found on The Pulse under the clinical tab then patient education If a student lives in an area that is at risk for bed bugs or they think they may have them at home, we ask that they do the following: Do not bring items from home into work If they have a dryer at home, dry your work clothes on high heat for 30 minutes right before coming to work (high heat kills all stages). Act early, the longer you wait the harder it is to treat. Contact a local pest company to confirm the identity of the bugs. Contact your landlord if you rent. There are several methods to kill bed bugs including heat methods and pesticides. It may take more than one method and one type of treatment to be successful. The presence of bedbugs may prevent the student from attending the hospital until the problem is resolved and approval obtained from Infection Prevention personnel. Patient safety Utilize patient lifts.only use with a staff member who has had specific training in the use of the lift. Prevent falls by identifying patients who are at high risk and take extra precautions. The Fall Risk Assessment Protocol is located in our computerized documentation system. DMH uses

11 red footies to identify our highest fall risk patients. Patient identification requires the use of two identifiers whenever caring for patients. This might be visually looking for patients name on the patient s bracelet scanning the bracelet, asking the patient, Can you tell me your name. All Patients must have an ID bracelet. All Patients must have an ID bracelet. a. Should it be necessary to remove the identification bracelet, a new bracelet will be completed and placed on the patient. b. Types of bracelets 1. WHITE: Normal identification bracelet used for patients unless otherwise specified. 2. GREEN: Indicates patient is allergic to latex. 3. BLUE: Indicates patient is a NO CODE (has a Do Not Resuscitate order). 4. RED: Indicates venipuncture, arterial puncture and blood pressures on a particular extremity is contraindicated. a. This is NOT an identification bracelet but serves as an additional band on the patient. It should be placed on the affected extremity when required by a patient s condition (i.e. history of mastectomy, AV shunt, Subclavian Stenosis). b. For patients undergoing surgery that restricts use of an extremity for blood pressures, arterial or venous punctures (i.e. mastectomy), the red identification bracelet will be applied in PACU following surgery. c. Red identification bracelets will be labeled DO NOT USE (specified extremity). This is NOT an identification bracelet but serves as an additional band on the patient. It should be placed on the affected extremity when required by a patient s condition (i.e. history of mastectomy, AV shunt, Subclavian Stenosis). d. For patients undergoing surgery that restricts use of an extremity for blood pressures, arterial or venous punctures (i.e. mastectomy), the red identification bracelet will be applied in PACU following surgery. e. Red identification bracelets will be labeled DO NOT USE (specified extremity). All patients will be scanned for identification for medication administration every time. DMH has a List of Do Not Use Abbreviations located on the Pulse (DMH intranet) Communication is the key for success for our patient s well being and continuity of care. Make sure to communicate any pertinent information to the Nurse in charge of the patient s care. Most importantly if you are not sure or don t know ASK, anyone of our staff members will be happy to help. Restraints A restraint maybe used to protect the patient from harm to self, when an alternate intervention has failed. Some examples of restraint alternatives are low beds, controlling a patient s pain, moving a patient close to the nurse s station. If the alternatives do not work, an order for the application of a restraint is obtained from the physician. The order is only effective for 24 hours. The use of restraints will be documented in the patient s EMR.

12 DHM Computer Systems Students experiencing clinical for the first time at DMH will attend a computer training class on how to use the electronic medical record (EMR). For returning students, this class is available upon request check with your instructor. If you experience difficulty signing onto a DMH computer call the help desk at DMH intranet The Pulse : You will receive a specific log on where you will find: Policies and Procedures Standing Orders Ovid database And much more Precision PCX Annual competency on the blood glucose monitoring equipment is required. Arrangements with your instructor will be made on the first day of clinical to complete this requirement. Social Media Decatur Memorial Hospital (DMH) encourages employees and students to use caution when publishing online comments that may reflect upon DMH, the employee, our patients and families, and other employees or partners of DMH. Therefore, employees are asked to carefully consider what is stated in social media forums and how those statements may impact others. This includes all Internet-based communications and electronic media, including without limitation personal blogs, message boards, microblogging sites such as Twitter or Tumbler; social networking sites such as Facebook, and LinkedIn; and other websites. The use of digital cameras (including cameras on cell phones) is strongly discouraged on DMH premises. Under no circumstances should cameras be used in patient areas, research areas, restrooms, and shower facilities. If you have questions regarding social media, please refer to the Social Media policy located on the Pulse. Electronic Medical Record DMH utilizes an electronic medical record for all nursing documentation.

13 General information Log on You will receive a log on specifically for you as a nursing student at DMH. If you are also employed at DMH you be assigned a different log-on specific for that job. Patient care/documentation Pain Management o Margo McCaffery defines pain as: Pain is whatever the experiencing person says it is, existing whenever he/she says it does. DMH utilizes different pain scales to meet the needs of the individual patient. o Numerical rating 0 10 Zero indicating the patient is not experiencing any pain. Ten indicated the worst pain the patient has experienced. o Wong Baker Faces Scale o Flacc scale - is a behavior pain assessment scale used in non-verbal patients unable to provide reports of pain. Face, legs, activity, cry, consolability. The pain assessment and reassessment is documented in the patients EMR. Smoking Policy Decatur Memorial Hospital is committed to improving the health of the people of Central Illinois. As part of that mission, we provide a smoke-free and tobacco-free environment for all patients, visitors, and employees (including students). No smoking of cigarettes, cigars, e- cigarettes, vapor, or related products is permitted within the Hospital or within any DMH owned/managed buildings and grounds. Welcome to Decatur Memorial Hospital Once you have read this through this orientation, complete the student nurse post-test found on the last page. Once you have completed the form, print it out, sign it and give to your clinical instructor or bring it with you the first day of hospital orientation. If you have questions regarding any of the content of this orientation please contact any of the persons on the contact list.

14 Contact Information Michelle Senger RN, BSN Clinical Nurse Educator (217) Stacey Taylor RN, BSN Education Manager (217) Tracy Newlin RN, BSN Education Department (217) Education Office: Abbey Britton (217) Nicole O Brien (217) Education Department Fax: (217) Revised 4/11, 9/14, 3/15, 9/17, 11/17

15 Decatur Memorial Hospital Student Nurse Orientation Post-Test Please fill out and return this form to your instructor prior to your fist clinical experience. You will not be able to start clinical at DMH without completing this form. 1. I have read, understand, and agree to follow the Decatur Memorial Hospital Student Nurse Orientation. Yes No 2. Dial to page an Emergency situation. Student Signature / Date (including year) Print Name Clearly Address Phone Number Department Interning with School Name (From): (To): Dates of clinical rotation Lic plate #