Welcome to UPMC Shadyside!

Transcription

1 Welcome to UPMC Shadyside! Registered Nurse Orientation Getting to know you Tell us your name Where you went to school What unit you will be working on And something about you 1

2 Nurses... the Heartbeat of Shadyside Nursing Education and Research Department Kellie Antinori-Lent MSN, RN, CDE Inpatient and Outpatient Diabetes Educator/Consultant Cindie Archer BSN, RN NA/PCT Educator, BLS Educator Janet Cipkala-Gaffin DrPH, RN Research, Evidence-Based Practice Faith Colen MSN, RN, CEN Emergency Department Karen Henery ~ Administrative Coordinator Nursing Education and Research Linda Lakdawala DNP, RN CPAN 6/7 Pavilion, 3 East, 4 East, 4 Main Wendy Lucas MSN, RN, CCRN MSICU, MICU/CCU, 6 Main Carol Mathews BSN, RN, CWOCN Enterostomal and Wound Care Therapy Bethanne McCabe MSN, RN, CNRN Stroke Coordinator/Stroke Assessment Team 6 West, NSICU Nicolette Mininni MEd, RN, CCRN SICU, CT/ICU, Dialysis, ICU Float Pool, CDU Lois Pizzi MSN, RN-BC Hospital Pain CNS PACU, DAS, ASC, Short Stay Unit Mary Ellen Pritchard MSN, RN, CNL, CEN 2 Pavilion/2 South, 3 Pavilion, 5 West, Med/Surg Float Pool, CDU Lauren Saul MSN, RN MICU/CCU, 4/5 Pavilion, 4 South, 3 Main Anne Sillaman MSN, RN, OCN 5 Main, 7 Main, 7 West Joanne Turka MSN, RN-BC,CCRN Critical Care Nurse Educator, BLS/ACLS Educator Shelley Watters DNP, RN ~ Director - Nursing Education and Research, Professional Development 2

3 Relationship-Based Care Authentic Caring In what ways has your care impacted patients and others? 3

4 Effective Care Happens When We Work as a Team Enjoying your Job and Colleagues! 4

5 Shared Leadership Professional Practice Model Principles of Shared Leadership Promotion of an environment that supports professional nursing practice Identification of nursing excellence in the delivery services to patients Providing mechanisms for the dissemination of best practices Supports autonomy and authority for nurse decision making. Those at the bedside delivering care make the decisions related how best to provide care 5

6 Shared Leadership at UPMC Shadyside 7 Councils o Operations o Professional Practice and Development o Quality and Safety o Evidence Based Practice and Research o Transformational Leadership o Informatics and Technology o Support Services Membership ~ nurses and other clinical staff from inpatient units and all other departments that impact patient care delivery Evaluating Success NDNQI Nursing Satisfaction Survey Evaluation of patient satisfaction scores (Press Ganey) Review of Quality Indicators 6

7 UPMC Shadyside 1 st Magnet Designation ~ March, 2010 Your 1st Year as a Nurse at UPMC Shadyside Resources and Advice for Success! 14 7

8 Changes Some nurses experience separation anxiety during the transition period from: Student Nurse Graduate Nurse Professional Staff Nurse Nurses transferring from other facilities are not immune Personal and professional growth comes from facing challenges Apprehension and Fear Reality of being out in the real world Surrounded by experienced people who know the unwritten rules Now responsible for taking care of patients May be a time of self-doubt did I make the right career choice? 8

9 Overcoming the Challenges Be realistic Immerse yourself in learning Do your homework Seek help and support Deal with mistakes Celebrate small accomplishments Use positive self-talk Trust your instincts! Mama said there would be days like this. 9

10 Head it off at the pass Set boundaries Manage your stress Take care of yourself Take care of each other too Develop support systems Use humor Stay Focused and Positive In your previous nursing experience reflect on a day that you felt that you made a difference what happened that day? Gravitate towards co-workers who are positive 10

11 Practical Tips for a Successful Orientation How to organize your shift At bedside report: o Greet and introduce yourself. o Do a touch and eyeball assessment. o Decide who needs to be assessed first promotes prioritization. o Let them know you will be back after you. 11

12 How to organize your shift If you are having difficulty with getting your meds out on time remember you have one hour before and after for most medications There are some exceptions 24 12

13 How to organize your shift o Experiment now is the time to try out different techniques o May choose to pass all meds first and then assess all patients or the other way around o Find out what works best for you 25 SBAR Communication Situation o Name o Unit o Patient Name and Room # o Do you know this patient? - If you are talking to the patient s attending physician you may be able to abbreviate your Situation and Background. o I am concerned about 13

14 SBAR Communication Background o The patient is in the hospital because o Vital signs are Assessment o My assessment of the situation is o Tell physician if problem is life-threatening Recommendation o Do you want to order? 14

15 Patient Bill of Rights: Nursing Responsibilities Patients have the right to: Participate in their plan of care Make informed decisions Use understandable language Health status, diagnosis and prognosis Anticipated outcomes of treatment and services Have provided services without discrimination Privacy, Respect, Dignity and Comfort Quality, Support, Advocacy Ethical Standards All UPMC employees have the utmost duty and obligation to: o exercise a set of values o exhibit right intentions and virtues o provide quality healthcare We consistently exercise honesty and integrity while adhering to all compliance and ethical standards governing our industry 15

16 Ethical Case Study As an employee of UPMC, you have access to clinical systems to perform your job. You know your neighbor is in the hospital, but you don t know why. You are concerned about your neighbor and decide to look up her records to see what the problem is. You are not involved in your neighbor s care. Was this access permissible? Ethical Case Study You have done an excellent job caring for Mrs. Plumb and the family wants to thank you. Can you accept? A $100 gift card to your favorite store A Daisy nomination An above and beyond recommendation A pizza to share with the staff and they ask what kind they should order A box of candy for the staff 32 16

17 About patient privacy UPMC SHY s Personal Information Number (PIN) o PIN is the first 2 and last 2 numbers of the patient s medical record number (although patient can request a number of his or her own choosing) o Example: MR # is What is this patient s PIN number? o o Assigned to every admitted patient Improves communication between staff and patient s family and friends Personal Information Number (PIN) Process Initiated based on patient s entry point into the hospital o Admission Team, ICU nurses, nurses in the DAS/ASC and SSU PIN documented in electronic health record and on a canary yellow form kept in the patient s paper chart When family or friends call or presents on the unit asking for information on the patient we must request the PIN number prior to sharing information 17

18 Progression of Assignments A simple way to remember this At the beginning Preceptor will help a great deal Then the preceptor helps, but pulls away somewhat to allow for growth And finally the preceptor will allow independence Preceptor knows You can let them tread water but NEVER LET THEM SINK. Your Supporters Preceptor is your guide o May choose to have you shadow first day or do part of a one-patient assignment - Based on your experience o Will be a role model and introduce you to other staff and clinicians o Listens to your report and reviews your documentation Advanced Clinical Education Specialist meets periodically with you and your Preceptor o Support o Unit Director along with Preceptor and Clinical Educator monitors your orientation 18

19 Green Book Documentation Used for Unit-Based Orientation Keep the green book available when caring for patients so Preceptor can fill in observations Only sign evaluation page after the Preceptor reviews what he/she has written DO NOT take your green book home or put it in your locker! o Nurse Manager or APN will want to review Ensure that the SHY and Unit-Based Orientation Competencies are being completed and signed by your Preceptor Items with asterisks (***) must be completed during the clinical orientation.others during Annual Competencies preferably within 6 months

20 ulearn Modules Component Completed Component Completed Age-related care/ abuse Quality of Care Infection Prevention (Advanced) Quality Improvement and Measures of Quality Healthcare Associated Infections (HAI) Clostridium difficile Infection (C. diff) Partnering for Life: Core Measures Device-related Infections Falls Best Practices Surgical Site Infection Prevention The Joint Commission s National Patient Safety Goals Restraints Pain Management Ketamine Controlled Substances Kangaroo (Coviden Pump) Alaris Pump Module CMS 30 minute rule Stroke Education (search and select in catalogue then select item below from list to enroll) CD Bedside Dysphagia Blood Bank Label Change (collection mgr.) Improving Line Safety Central Line Care (toolkit) SKIN module Bedside Dysphagia testing (neuro, resource, ED) Some other thoughts for support Build in 15 minutes of reflective time as often as possible at the end of the shift o Ask your Preceptors any questions to clarify what occurred during the shift Once your are off of Orientation, your UD will try to have you follow your preceptor s schedule to continue those mentoring benefits 20

21 Questions Bibliography: Anthony, G. (2004) Shared governance models: the theory, practice, and evidence. Online J Issues Nursing Available at: Accessed November 8, 2007 Hess, R. (1994) Shared governance: innovation or imitation? Nursing Economics Pierson, P., Miller, J. & Moore, K. (2007) Engaging staff in the Magnet journey: The key is communication. MEDSURG Nursing, 16 (1), Porter-O Grady, T. (2003) Research shared governance: a futility of focus. Journal of Nursing Administration Porter-O Grady, T., Alexander, D., Blaylock, J., Minkara, N. & Surel, D. (2006) Constructing a team model: creating a foundation for evidenced-based teams. Nursing Administration Quarterly. 30(3),