NURSING STUDENTS. Welcome to Children s Health. While you are here, we want you to have an enjoyable and educational experience.

Transcription

1 NURSING STUDENTS Welcome to Children s Health. While you are here, we want you to have an enjoyable and educational experience. Children s Health is the leading pediatric health care system in North Texas, the eighth- largest pediatric health care provider in the nation, and the second - busiest in terms of admissions and emergency department visits. A private, not-for-profit organization, Children s Health is anchored by two full-service hospitals, one specialty hospital and the Children s Medical Research Institute at UT Southwestern, which performs transformative biomedical research. The system also includes multiple specialty centers, 17 Pediatric Group practices, Our Children s House rehabilitation facility and outpatient clinics and a telemedicine network, as well as home health and physician services. For more information, please visit We provide a full spectrum of health care services from daily wellness and primary care to specialty visits and critical care. Holding eight disease-specific care certifications from The Joint Commission, Children s Health has been consistently named one of the nation s top pediatric providers by U.S. News & World Report. As a health care system, the Children s Health mission is to make life better for children, from daily wellness and primary care to specialty visits and critical care, with more than 40 locations, 7,000 team members and 1,000 physicians committed to this mission. Much has changed since 1913, but our mission remains the same: To make life better for children. We re driven to continue to honor the trust parents place in us and work harder each day to expand the knowledge of pediatric illnesses, develop the best possible treatments, and deliver exceptional, compassionate care to the region s children. Please review the information contained in this handbook prior to starting your rotation. It will assist you as you are in our facility and contains valuable information that you will need during your student rotation at Children s. Thank you for choosing our hospital and helping to make life better for Children! Sincerely,

2 NURSING STUDENT HANDBOOK TABLE OF CONTENTS STUDENT REQUIREMENTS 4-6 STUDENT ORIENTATION 7-11 HIPAA HIGHLIGHTS SURVEY READINESS 14 NATIONAL PATIENT SAFET Y GOALS 15 AIDET 16 PATIENT SAFETY TOOLKIT 17 I SHAPED HANDOFF TOOL 18 DALLAS CAMPUS MAP 19 TRAINING CENTER (TRINITY TOWERS) MAP 20 PLANO CAMPUS MAP 21 OUR CHILDREN S HOUSE LOCATIONS 22 CHPG, formerly MYCHILDREN S 23 DALLAS AND PLANO CONTACTS 24 The doctors and staff at Children s Health understand how stressful it can be to have a child who is sick or injured. We treat 70 percent of the high-risk pediatric patients in the Dallas region, so we spend much time with families in the same situation. We focus not only on providing the best medical care, but also on doing everything we can to ease the concerns that come with having a child in the hospital. As we enter our next century, our mission today remains the same as it was in 1913 when Nurse May Smith started the Dallas Baby Camp. We are committed to keeping alive Nurse May Smith s spirit of courage, dedication to excellence and the drive to grow so we can reach as many children as possible with the very best care. 2

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4 STUDENT REQUIREMENTS Your school works with Children s to set up your student rotation, all of your clearance requirements are provided by the school. You instructor may ask you to complete some paperwork. All information & paperwork is sent to NursingStudentPaperwork@childrens.com. IDENTIFICATION BADGES Students will be cleared to receive badges when all required information has been received and verified by the Senior Affiliation Specialist. This applies to both CMC-employed and nonemployed students. Once all the above requirements have been met, the student s instructor will receive an from Student Services clearing them to start clinical. Instructors must take clearance letter with them to the badge office. If you do not have an , you are not clear to start your rotation. Students must pick up the student badge prior to starting the clinical rotation. If a student is also an employee of Children s, they must wear a student badge when they are here for clinical rotations. They may not wear their employee badges when they are here as a student. A government-issued photo ID must be presented for students to receive a badge. Identification badges may be obtained at either Children s Medical Center of Dallas for Dallas based clinical rotations (including Our Children s House) or at Children s Medical Center Plano for Plano based clinical rotations. It is the instructor s responsibility to make sure badges are returned at the end of rotation. The badge office will not issue new badges for the current semester if you did not return badges from previous semester. Dallas Badge Office Identification badges must be obtained from Human Resources, located in the Employee Services Suite (ESS). o Call for an appointment and directions. o Dallas Campus Badge Office Hours: 7:30 a.m. to noon, 1 to 4:30 p.m., Monday, Wednesday, and Friday 7:30 a.m. to noon, 1 to 3 p.m., Tuesday and Thursday The Badge office is closed from 12-1 daily for lunch and closed on Sat & Sun While in the ESS waiting area we ask that cell phone ringers be on silent, and everyone wait quietly, so as not to disturb those in the area working. The Badge Office is scheduled to move in March 2018 and will be located on the 3rd floor of the Bright Building, E3010 more details will be provided once move is finalized. Plano Badge Office The Badge Office is in the Security Office within the Central Plant Building, R1808. (This building is located across from the Emergency Department entrance). Call for an appointment. Plano Campus Badge Office Hours: 6:00 a.m. to 2:00 p.m. on Monday and Friday 7:00 a.m. to 3:00 p.m. on Tuesday, Wednesday, and Thursday The Badge Office is closed from 12-1 daily for lunch and closed on Sat & Sun 4

5 During Rotation at Children s Children s picture ID must be worn at all times Children s Dress Code policy should be followed at all times Students must pick up your student badge prior to starting your rotation Personal cell phones are not allowed on the units End of Rotation Badges must be returned to the Badge Office at the end of your rotation Students should complete end of rotation surveys - Hosting departments will provide students information on how to complete survey ONLINE TRAINING Precepted Students will be assigned online training. This training will be completed with your instructor during Epic training. While completing this training, if you have any trouble, please contact Ginger Nelson at or the service desk at Login information for Children s learning management system is a follows: Non-employee that has not attended Children s ever before as a student: 1. Go to a. Username: CMCDXXXXX XXXXX= On the clearance letter from Student Services, find your Lawson ID number found under your name at the top of page (no spaces) b. Password: Success45 You will be required to change your password to something you will need to remember 2. Once logged in to Cornerstone a. click on Action Items and complete the online course(s) listed in the queue: CH - EPIC Inpatient- Precepted Student Nurse Curriculum (possibly Children s Annual Required Training CART will be on your Action Items) Either an employee or someone that attended Children s before as a student: 1. Go to a. Username: <first 3letters of first name and first 3 letters of last name>. John Brown would be JohBro b. Password: you will need to call the service desk to have your password re-set ( ) 2. Once logged in to Cornerstone a. click on Action Items and complete the online course(s) listed in the queue: CH - EPIC Inpatient- Precepted Student Nurse Curriculum Student that is also an Employee: 1. Use your network ID and password to access Cornerstone 2. Once logged in to Cornerstone a. click on Action Items and complete the online course(s) listed in the queue: i. CH - EPIC Inpatient- Precepted Student Nurse Curriculum 5

6 When you have completed all online training Send an to and so that your file can be completed. Your should include your Lawson ID number (from your clearance letter) & the date you completed training 6

7 STUDENT ORIENTATION Information must be reviewed prior to first clinical shift GENERAL INFORMATION PATIENT RIGHTS AND ORGANIZATIONAL ETHICS o Student must know if patient has an Advance Directive o Patient Bill of Rights is available in all patient care units and admitting o Questions or concerns about unethical or illegal activities at Children s may be called anonymously to the Compliance Hotline at o Parent requests to not have a student will be honored HAZARDOUS MATERIALS AND WASTE o Material Safety Data Sheets (MSDS) Provide access to information concerning the use of hazardous materials in the hospital Phone for information For an exposure to hazardous material: call o Utility Systems Electrical Outlets plug all critical patient care equipment into RED outlets in patient s room EMERGENCY NOTIFICATION o 7

8 PATIENT CARE Preceptors must remain with the student for all assessments and interventions with the patient. If a student has been validated on routine tasks such as taking vital signs & collecting I/O then the student may complete those tasks independently within the comfort level of the preceptor. Unit Staff o Student should be familiar with roles on the unit: RN, LVN Resident, Hospitalist, Nurse Practitioner HUC (Health Unit Coordinator) PCT (Patient Care Technician) PCA (Patient Care Assistant) Infection Prevention o Hand hygiene is the single most important intervention to prevent the spread of infection. Practice hand hygiene prior to and following all contact with patients and the patient environment. Alcohol hand gels are located at the exit of all patient rooms and throughout the hospital. o Standard precautions should be observed at all times on all patients. In addition to Standard precautions, the patient may require transmission based precautions. They include: Contact Droplet Airborne o Isolation signs are located outside the rooms of applicable patients. Strict compliance is expected. o Personal protective equipment including gloves, impervious gowns, mask, and masks with shields are available for your use. o Eating and drinking are not allowed in patient care areas or nurse s station. o Isolation policies available via policy tracker. Change of Shift Report o Where, how, and when is it done for designated area? o Bedside report o Role of family during report Vital Signs o Temperature Thermometer types Routes and contraindications Temp > 38.5 o usually treated, rechecked every hour until normal o Pulse - Take apical for 1 minute o o o Respirations use stethoscope to assess breath sounds and quality of respirations Blood Pressure Selecting Cuff size appropriate to weight/age Pain Assessment FACES Scale FLACC Scale Numeric Scale (0-5) 8

9 Neuro Checks o Include pupils, motor strength, sensation, level of consciousness, verbal responses Weights o Accuracy essential for correct medication dosing o Recorded under Measurement on Vital Signs Flowsheet o Time of day varies by unit Cardiac/Apnea Monitors o Implications for care Beds/Baths o Unit routine Patient summary Contains important patient information. View only. Student Documentation o As the student logs in, they will assign the preceptor for the shift as a co-signer on their documentation o The student can chart on all flowsheets. o The preceptor must co-sign the documentation by the end of the clinical shift. Patient Education o All patient education must be done in collaboration with the patient s nurse Dietary o Formula Obtaining special formula Selecting Volu-feeders/nipples (different types) Time limit for nippling = minutes notify nurse of prolonged feed times Consult parent or nurse for helpful hints Older children call room service for all meal requests Calorie Count o Record exact amount and type of P.O. intake Intake and Output o Routine vs. Strict - discuss differences in output recording o Weighing diapers - discuss technique o Flowsheet - discuss procedure for charting o Parent I & O sheet at bedside - must transcribe information to patient care flow chart and document prior to patient s discharge Miscellaneous o Treatment Room (TR) For all invasive procedures (IV s, LP s, bone marrows) Discharge o Discharge meds - check with nurse for procedure o Nursing student may reinforce discharge teaching 9

10 SPECIAL CONSIDERATIONS Intravenous Lines (Students are to work with PERIPHERAL LINES ONLY. CENTRAL VENOUS CATHETERS INCLUDING PICCs should be managed by the preceptor with the student observing) Basic considerations o Clinical Practice Policy #4.41 Peripheral Intravenous Management o Emphasize necessity of IV site assessment and documentation every hour and prior to IV medication administration o Infusion pumps (Alaris) IV Solutions o Non-compounded fluids expire in 96 hours; 24 hours if compounded (medication added to solution). o Check IV solutions with initial assessment of patient o Most IV medications arrive RTA Ready to Administer do not require dilution o Refer to online formulary for additional information IV Tubing o Consult Attachment C in the PIV Management policy. o Document tubing change in EPIC, including date and time. o Label tubing Rates o KVO orders not accepted; rate must be specified Troubleshooting o Ensure site is visible o Tape change when soiled o Review signs of infiltration and phlebitis if infiltration occurs or is suspected, notify patient s nurse immediately; an incident (eset) report is required. Medications Instructors or bedside nurse must be present when students assist with medication administration. Basic considerations o Medication Management Policy # Medication Administration o Implications of medication administration in the infant and child o Accessing Children s Drug Formulary o Verify patient identification via ID band o RTA drugs (Ready To Administer) pharmacy will provide o Mobile Meds checked against provider orders to verify accuracy o Students may not be a second verification for any high alert medications. Any dosages of insulin, digoxin, schedule II narcotics, neuromuscular blocking agents, heparin (therapeutic), or cyclosporine must be checked by 2 staff nurses before giving. 10

11 STUDENTS MAY NOT: o Provide care to, or document on, patients that are undergoing procedural sedation (moderate sedation for a specific procedure that requires specific monitoring & documentation). Student may assist nurse with care of sedated patients. o Delegate to unlicensed assistive personnel (MA s techs, etc.) o Start IVs o Administer chemotherapeutic drugs o Transcribe orders o Count narcotics o Initiate administration of blood or blood products o Monitor patients receiving blood or blood products o Witness informed consents o Participate in Advanced Life Support o Be assigned to any patients in airborne isolation as they are not fitted for respirator masks o Take verbal orders o Access Central Line Venous Catheters (CVCs) or change CVC dressing (including PICC lines) o Administer breast milk independently. In addition, breast milk must be obtained and logged in by staff RN only Nursing Units may have specific patient diagnoses that students may not care for. Obtain this information from the unit educator. Procedures not included on this list (e.g. suctioning, tracheostomy care, urinary catheter insertion) may be performed by students only with the assistance of their preceptor. 11

12 HIPAA Highlights for Students (The Health Probability & Accountability Act) All Students are responsible for ensuring they understand HIPAA and how it applies to them as a student during their rotation o Students completed CART training as part of their rotation requirement o Information in this document was pulled from CH CART: HIPAA Privacy v8.0 and is not meant to replace CBT o If you anything containing patient information (PHI) it must be sent securely. Do not place PHI in the subject: line of an 12

13 Information in this document was pulled from CH CART: HIPAA Privacy v8.0 A breach of HIPAA is grounds for immediate termination of rotation If you have any questions, please discuss with your Hosting Department 13

14 SURVEY READINESS The Joint Commission regulations must be adhered to at all times. With tracer methodology, any staff member or student could be asked questions related to the care of their patients. In an effort to be ready at all times for the possibility of a survey and to maintain patient safety, the following questions and answers should be reviewed by Instructor and students. Q. What is the orientation process for Instructor and students? A. Prior to rotation, students must review a standard hospital orientation that includes information on HIPPA, Compliance, Safety, and Infection Control. Instructor then completes 8 hours of orientation/re- orientation to their assigned units each year. This includes time with the educator and staff reviewing unit routines, documentation, and equipment. Hosting department s employee(s) are responsible for orienting the students to their department and hospital. Q. Where are policies located? A. Policies can be found in Policy Tracker, accessed from the Childnet homepage under Quick Links Q. What do you do in case of fire? A. Rescue rescue anyone in immediate danger Alert report a Code Red by pulling the closest fire alarm or by dialing Confine confine the fire Extinguish extinguish the fire To operate the fire extinguishers, remember: P pull the pin A aim at the base of the fire S squeeze the trigger S sweep Q. What is your responsibility in the event of a code? (excluding Code Blue) A. Always report to the charge nurse for instructions. If off the unit, immediately return. Q. Where can the Patient s Bill of Rights be found? A. In all patient care areas and Admitting Q. What do you do in the event of an unusual incident? A. Inform the patient s nurse and charge nurse. Consult with charge nurse on whether to complete an eset (incident report) and how to document the event in the patient s chart. Q. What do I do with malfunctioning equipment? A. Always notify the charge nurse. Equipment such as catheters, NGTs, etc. should be saved and placed in a bag and sent to Risk Management along with the eset report. For pumps, monitors etc., complete a Healthcare Technology Management (HTM) repair tag (found in the dirty utility room) and attach to the piece of equipment, then call HTM for pick-up. 14

15 National Patient Safety Goals 15

16 AIDET AIDET is a framework for staff and students to communicate with patients and their families as well as with each other. It is a simple acronym that represents a very powerful way to communicate with people who are often nervous, anxious and feeling vulnerable. AIDET is not applied in the same way every time you encounter a patient or family member. Customize AIDET to achieve the desired outcomes of reduced anxiety, improved trust, enhanced understanding, and improved overall customer satisfaction. Acknowledge to reduce anxiety and build a good working relationship Knock, asking permission to enter Smile, make eye contact, greet pleasantly Introduce to reduce anxiety and help them feel that they are in good hands State name and role at Children s Highlight skill and expertise (certs, years) of self / others the customer will encounter Duration to ease tension and stress caused by wait times Share wait times, procedure time expectations Explanation to increase compliance in following instructions and guidelines Explain all processes and procedures Provide clear expectations Thank you to foster an environment of gratitude and to identify additional needs Express appreciation for their cooperation, time, and/or entrustment of care Ask what else you can do ALWAYS: Listen to what the customer is saying Ensure body language is relaxed, calm, open and non-threatening (don t seem rushed) Use appropriate emotions such as empathy, enthusiasm, positive attitude, and warmth 16

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19 Children s Medical Center Dallas 1935 Medical District Drive, Dallas Located off I-35 (Stemmons Freeway), Exit Medical District Dr. DALLAS CAMPUS Parking DALLAS CAMPUS During construction students will follow the signage and park in the visitor lot construction is scheduled to end in March 2018 but the end date is subject to change o Students and instructors do NOT have access to use the employee parking or visitor parking garages. o You will park in the flat lot located at the corner of Medical District Drive and the I-35 access road for Contractors. (Next to the Purple Parking garage for employees). Students must badge in and out of this this parking area. o On the first day students may park in the flat Visitor Parking area in front of the Pavilion and the badge office will give them a voucher to get out. The vouchers we have only work on the Visitor Lot shown below, anywhere else you will pay. 19

20 The Learning Center at Trinity Towers 2777 Stemmons Freeway (I-35E) in Dallas The Learning Center is on the 6 th floor refer to monitor in reception for classroom info 20

21 Children s Medical Center Plano 7601 Preston Rd, Plano PLANO CAMPUS Park here for your clinicals. Plano Campus Parking Students can park in the Northeast employee lot or at the back of any lot on campus. 21

22 Our Children s House 9 locations We are proud that Our Children s House is now part of Children s Health. Our Children s House offers an array of coordinated, comprehensive services for children with special health care needs. The program brings together a licensed pediatric hospital together with nine outpatient clinics. Our Children s House clinics can help coordinate care, and offer developmental screenings and assessments, parent education and support, and physical, occupational and speech/language therapy. Families can also access outpatient feeding therapy, developmental therapy, rehabilitation, and the special needs day care. In addition, there are physician based physical medicine and rehabilitation, pulmonary and headache clinics. *Students must pick up badges at CMCD Dallas prior to first shift **Preceptor will provide info on where to park on first day Our Children's House Allen 8 Prestige Circle, Ste. 101 Allen, Texas, Phone: Our Children's House Dallas 1340 Empire Central Dallas, Texas, Phone: Our Children's House Frisco 7010 Preston Road, Ste. 240 Frisco, Texas, Phone: Our Children's House Las Colinas 7453 Las Colinas Blvd. Irving, Texas, Phone: Our Children's House Plano 7000 West Plano Pkwy., Ste. 210 Plano, Texas, Phone: Our Children's House Rockwall 2455 Ridge Rd., Ste. 255 Rockwall, Texas, Phone: Our Children's House Grapevine 1643 Lancaster Drive, Ste. 300 Grapevine, Texas, Phone: Our Children's House Waxahachie 1540 N. Hwy 77, Bldg C, Ste. 10 Waxahachie, Texas, Phone: Our Children's House Irving 3337 Stovall St. Irving, Texas, Phone: Our Children's House Inpatient Center 1340 Empire Central Dallas, TX Phone:

23 Children's Health Pediatric Group Formerly MyChildren s At Children s Health Pediatric Group offices, formally MyChildren's, we specialize in health care for newborns, infants, and children through age 18. Children s Health Pediatric Group is staffed by pediatric physicians and nurse practitioners, and we have locations serving communities throughout the Dallas-Fort Worth Metroplex. We accept most forms of insurance, including Medicaid and CHIP, and offer resources to help you see if you qualify for coverage. *Students must pick up badges at CMCD Dallas prior to first shirt **Preceptor will provide info on where to park on first day CHPG- Bachman Lake 2750 W. Northwest Hwy, Suite 170 Dallas, TX Phone: CHPG Carrollton 3044 Old Denton Road, Suite 138 Carrollton, TX Phone: CHPG- Cedar Hill 294 Uptown Blvd., Suite 120 Cedar Hill, TX Phone Number: CHPG Celina 1060 S. Preston Road, Suite 106 Celina, TX Phone: CHPG Cockrell Hill 4350 DFW Turnpike #150 Dallas, TX Phone: CHPG Desoto 534 E. Pleasant Run Road Desoto, TX Phone CHPG East Plano 2520 K Avenue, Suite 100 Plano, TX Phone: CHPG Garland 455 N. Garland Road Garland, TX Phone: CHPG Grapevine 2805 E. Grapevine Mills Circle, Suite 120 Grapevine, TX Phone: CHGP Irving 1111 W. Airport Fwy, #143 Irving, TX Phone: CHPG- Lake Highlands 8330 Abrams, Suite 112 Dallas, TX Phone: CHPG- Lancaster Kiest 3200 S. Lancaster, #181 Dallas, TX Phone: CHPG- McKinney 1720 N. Central Expressway, Suite 150 McKinney, TX Phone: CHPG- Medical District 2350 Stemmons Freeway Dallas, TX Phone: CHPG- Mill City 4922 Spring Avenue Dallas, TX Phone: CHPG- Oak Cliff 3434 W. Illinois Avenue, Suite Dallas, TX Phone: CHPG Prosper 321 Preston Road, Suite C Prosper, TX Phone: CHPG- Pleasant Grove 1401 S. Buckner, Suite #139 Dallas, TX Phone: CHPG- St. Phillip s 1600 Pennsylvania Avenue Dallas, TX Phone: CHPG- West Plano 7800 Preston Road, Suite 300 Plano, TX Phone:

24 DALLAS CAMPUS UNIT CONTACTS Unit UNIT Name Type of Services Manager Phone Educator Phone B4 C4 Gen Surgery/Ortho Trauma/Gen Peds General Surgery/ Ortho/Trauma General Peds Natalie Denson Jordan Schools Post-Surgical/Trauma Natalie Denson Jordan Schools C5 Renal/ General Peds Renal/Renal transplants General Peds Amy Taylor Jennie Yoo C8 Cardiology Medical/surgical cardiology, Telemetry Elysia Harshman Jenny Felber C9 Center for Pulmonology Difficult ENT, Asthma, Overflow CF, Overflow Pulmonology, Endocrine D9 Center for Pulmonology Pulmonology, Complex Trach, Vent Dependent, CF, Asthma, Difficult ENT Marshall Stephenson Marshall Stephenson Angie Chelf Angie Chelf C10 D10 Center for Neurosciences Center for Neurosciences EMU/Neurology Geneva Burnap Diana Montoya Neurosurgery/Plastics/Gen Peds Geneva Burnap Diana Montoya C6/D6 CCBD Cancer, Blood Disorders Stem Cell Transplant Unit Susan McCollom Sarah Kennedy Virginia Koepsell D8 GI Inflammatory Bowel Dx/ Short Gut Liver/Intestinal Transplants Amy Taylor Jennie Yoo B1 ES Emergency Services Justin Rankin Chelsey Rixon Mary Baker Leslie Sanchez B2 OR Surgical Procedures Lori Strohla Kim Bell Laurie Ham B5 Psych Pediatric Behavioral Unit Jane LeVieux Jennifer Brown D2 PACU Pre-Procedural/ Post-Procedural Care Leslie Whitefield Shannon Williams C12 PICU Medical/Surgical Critical Care Sara Runyan Sondra Bell Kendel Richards C11 TICU Neuro/Trauma Critical Care Sara Runyan Sondra Bell Kendel Richards D3 CICU Cardiac Intensive Care Marilee Owens Kim Schuettner D7 NICU Neonatal Intensive Care Kerrie Huval Angie Barnett Kristen Malone Plano and OCH Campus Unit Contacts UNIT NAME TYPE OF SERVICE MANAGER PHONE EDUCATOR PHONE 1 & 2 North & South General Peds/Surgery Rachael Burris Kat Cooney ED Emergency Services Astrid Sobotka PICU Intensive Care Adrianne Strait Our Children s House Mary Baker Leslie Sanchez Kendel Richards Kristen Malone Transitional Care/Rehab Melissa Rueck Martha Shaw **UNITS SUBJECT TO CHANGE AT ANY TIME Return to Table of Contents 24