Bryce Hospital Tuscaloosa, Alabama Staff Development Department

Transcription

1 Bryce Hospital Tuscaloosa, Alabama Staff Development Department

2 The Mission of Bryce Hospital is: To provide effective and efficient psychiatric treatment services to the state s seriously mentally ill citizens, in a safe, secure environment while promoting the individual s quality of life, human worth and dignity. Every employee, regardless of classification or title, has a critical role in promoting this mission. Hospital Goals Provide a safe environment for consumers Maintenance and housekeeping have important roles in this goal. For example, a safe environment must be clean and free of broken or malfunctioning equipment/furniture. Provide and maintain a competent, well-trained work force Hospital workers are required to attend certain classes and complete certain educational requirements in order to work safely in this facility. Ensure the efficient and appropriate utilization of resources Using time and equipment in a responsible manner helps with maintaining efficiency and economy. Provide quality clinical services consistent with evidenced-based practices and national standards The facility ensures that processes and procedures reflect the latest science and requirements 2

3 PATIENT RIGHTS & PROTECTION Because of their serious mental illness, many of our patients are unable to make appropriate and safe decisions for themselves. Hospital workers must remain on alert to ensure that the patients are both physically and psychologically safe. The legal system gives our patients special consideration as Adults in Need of Protection. Staff members have the responsibility to understand what behaviors are considered to be inappropriate in relationship to the patients and to protect the rights of our patients to be free from any kind of harm. Physical Abuse the willful infliction of physical pain or injury upon a patient. Even when injury does not occur, any strike or use of excessive force is Abuse. Verbal Abuse cursing or yelling, at or in front of, patients, using derogatory language, or using a rude, condescending tone. Sexual Abuse any sexual contact with our patients, including verbal communication that is sexual in nature. Neglect the failure to provide basic needs, such as; food, clothing, medical treatment, shelter and supervision. Non-clinical contract workers do not have direct responsibility for any of these functions but should report any problems noted. Exploitation unjust or improper use of another person or another person s resources for one s own profit or advantage. Examples are; to sell or buy anything from patients, to induce a patient to perform any work or other activity for the benefit of the employee, to borrow or steal from patients. Mistreatment teasing, taunting or ridiculing patients or otherwise subjecting them to psychological trauma. Reporting Abuse Always report any suspected abuse to your supervisor, Bryce Police, or the Advocacy Office. The Department of Mental Health includes Ethics Committees, a Bureau of Special Investigations and relationships with outside groups that can address patient care issues. 3

4 WE ARE SENSITIVE TO THE NEEDS OF OUR INDIVIDUAL PATIENTS Bryce Hospital serves the adult mentally ill population of the state. People in other age groups, such as adolescents, are treated at other facilities. Most Bryce patients are under court order for treatment. There are three treatment programs at Bryce; Recovery Program, Phase II Recovery Program and Transitional Care Program. Each program is designed to address the needs of the individual patients. Psychiatrists, Nurses, Social Workers, Psychologists, Recreational Therapists, and other trained staff are assigned to each patient. Some patients are Deaf or Hard-of-Hearing and receive specialized services to meet their needs. In addition to the treatment programs, there are several departments that provide support services; such as Nutritional Services, Dental Clinic, Business Services and Human Resources, among others. Some services, such as Custodial and Food Services are provided by other agencies/institutions under contract to the Department of Mental Health. The safety and well-being of the patients is priority for all workers of the facility. 4

5 HIPAA and Confidentiality One of the most important rights our patients have is for their privacy and confidentiality to be respected. Staff are expected to refrain from discussing/revealing any patient information to anyone that is not authorized. Contract workers, such as maintenance and food service workers, are not authorized to release any patient information to anyone under any circumstances. We must take care to ensure that documents containing information about patients are not left out where unauthorized persons could see them. These items must be disposed of properly as well. For example; lists of patients, tray tickets, snack labels all must be shredded rather than just tossed in a garbage can. HIPAA is a law that carries stiff penalties, such as large fines and even incarceration of workers who violate it. If you are not sure, check with your supervisor. Special Note: Taking photographs or video recordings on campus must be expressly authorized by the Hospital Director or designee to ensure that no patient or hospital information is compromised. 5

6 Incident Management Copies of the Bryce Hospital Incident Management Plan can be found on each of the treatment programs. If you have any questions, you can consult the Risk Manager. The purpose of the plan is to promote a safe environment. If you are witness to, or involved in any situation where: harm comes to someone (patient, staff or visitor), or harm could have resulted, or any situation that is out of the ordinary routine, an Incident Report will be completed. You should contact your supervisor or the Program/ Department Director for instructions. Any problems that you experience in the facility or if you have questions or concerns about any of the patients or their treatment, please contact your supervisor or BHPD. We encourage staff, visitors, and patients to report any activity or statements made by anyone that might indicate an intent to hurt themselves or anyone else (suicidal or homicidal threats, or acts such as hoarding medicines.) 6

7 CULTURE OF PATIENT SAFETY Bryce Hospital makes Patient Safety a priority. Some of the measures taken by Bryce to improve Patient Safety are: Emergency Code drills (if you are on campus during a code, real or a drill, you are expected to participate fully. Our readiness for emergencies depends on these rehearsals. Fall Prevention program: Many of our patients are at high risk for falling. For example; we are careful not to leave items on the floor where they might become tripping hazards and we quickly wipe up spills. Wiping up spills is so critical that we are expected to wipe them up even if we did not cause them. In case of a fire, staff are to move anyone in the smoke filled area to a non-smoke filled area. If building evacuation become necessary, the Safety Director or BHPD will make the announcement. Fire extinguishers are very clearly marked and placed strategically throughout the building. In patient care areas, they are in locked cabinets which can be opened with the Common Key. Fire extinguishers should only be used on small fires and the user should always be sure that an escape route is open. Choking Protocols: Many of our patients are at high risk for choking so the hospital has instituted a number of measures to reduce the risk, such as, special diets, supervision during meals and snacks, staff training to recognize and respond to the choking victim, etc. Please refrain from sharing food items with patients or leaving food items accessible to potentially vulnerable patients. Some patients must be monitored even more closely because they tend to engage in placing inedible items in their mouths. Many Bryce patients are in treatment for suicidal ideas and behaviors. Any staff member who sees or hears anything that might indicate a patient is in danger of engaging in self-endangerment should immediately report it to the nurse or other member of the treatment team. The hospital maintains a list of prohibited items. All staff members must be aware of what is prohibited at the facility and abide by these guidelines. 7

8 Infection Control Bryce Hospital adheres to Standard Precaution protocols and makes sure that staff have access to barrier devices, such as disposable gloves, and to hygiene products such as alcohol-based hand rubs. As in any other healthcare setting, proper Hand Washing is the most highly recommended strategy for breaking the chain of infection. Wash your hands frequently and thoroughly (minimum of 20 seconds of friction.) Hospital policy requires that all workers have hand sanitizer on their person at all times while on duty. Remove gloves when exiting service area; gloves should not be worn routinely but only for specific tasks Make arrangements to miss work if you are ill. If you enter an area marked with Special Precautions sign, ask the nurse on the Living Area for special instructions. Use barrier devices, such as gloves, when appropriate, and dispose of them in the designated receptacle in your area, always in areas locked off to the patients Cover your cough/sneeze. Use a tissue or your sleeve, never your hand. Cover open cuts or wounds with bandages as appropriate. The Flu Vaccine is available, free of charge, to all workers in the facility. 8

9 Emergency Codes Severe Weather Alerts: Patients must be kept safe during severe weather. Staff and patients will be required to report to the Safe area designated for the building during Tornado Warnings. Please ask your supervisor or Unit staff if you are unsure of expectations during severe weather alerts. Code Green= Psychiatric Emergency: You are expected to ensure your safety by allowing the staff trained in approved intervention techniques to respond. Move out of the way of responders and remove any of your tools or equipment that could present safety hazards. Code Red= Fire: Evacuate if ordered to do so. Become familiar with where evacuation routes are posted in your area. Code Blue= Medical Emergency: Medical staff respond to assist the person in distress. Other staff assist by holding doors open for emergency personnel or helping with crowd control. Code D= Disaster: Follow the instructions of your supervisor or the Program Director Code 4= Lock Down: Lock door to room you are in and keep away from windows. Wait for all-clear. Code 2= Bomb threat; listen for & follow instructions of BHPD or the safety director Active Shooter: Lock down in your area, stay quiet and listen for & follow instructions from BHPD or the safety director. Code 10= Is called when a Bryce patient seems to be in need of his/her medical team but is not a dire emergency. Medical Assistance needed STAT= Can be called anytime anyone at the facility (including a contract worker) is in need of immediate medical attention, such as suffering an injury from a fall. 9

10 Bryce Hospital Facility Security Locks, keys and keypads It is crucial that all staff members take measures to safeguard keys & maintain keys in working order (turn in bent or worn keys) Because many of our patients are too ill to adequately care for themselves, it is of utmost importance that staff ensure their safety and security by making sure all doors are always locked Lost keys and access cards must be reported to your supervisor & BHPD immediately upon detection. You will have to pay to replace them. Process for replacing keys: obtain a signed key card from your supervisor Do not let anyone else in. Anyone coming to the facility & asking to be let in at a locked door should be directed to BHPD. Keypad codes must not be shared with anyone else. People needing access must go through the proper procedure. Patient Safety/ Elopement Prevention In order to prevent patients from leaving buildings without authorization or wandering off from those supervising them, it is important to: Check doors behind you to ensure that the lock catches securely Make sure that your work areas are locked so that patients cannot get in where chemicals, supplies or other items could result in injury Stay out of hallways during mealtime periods when patients are being escorted from living areas to dining rooms Be respectful when staff are escorting patients from one area to another so that they can maintain the group together for accountability Non-official visits to campus: if you must come on campus while not on duty, check in with BHPD to obtain a Visitor s Pass Police authority: Bryce Police are fully endowed with authority to give citations and make arrests and staff are expected to respect all directives from Bryce police. 10

11 Workers in any kind of healthcare facility are in high risk categories for non-fatal workplace assaults. You should defer to the clinical staff on the Program to intervene with any agitated patient. The best practice is to be aware of the environment and the behavior of those around you so that you can take measures to keep yourself safe. The following are some Tips for Responding to Agitated People What to LOOK for: Signs that someone is nervous, anxious or angry, such as: Pacing Yelling Asking lots of questions Cursing Fidgeting Demanding Sweating Invading your personal space Talking fast and/or loudly Threatening Wringing Hands Asking challenging questions Body language (making a fist, pointing at you, banging fist on desk, etc.) Things to DO: Relax and Downplay, smile if appropriate Remain calm Breathe Listen as they talk Try to understand their point of view Nod your head Ask co-workers for help (if necessary) Don t make promises you can t keep Try to help or get someone who can help the person. STRIKES: A weapon hitting a target, or the damage done on impact (punch, slap, kick, shove, spit, thrown objects, etc.) BLOCK Shield yourself Deflect force of blow away MOVE Move out of line of fire Move out of range (Duck and Dodge, etc.) GRABS: An attempt to control or hurt a part of your body (bite, choke, tackle, grabbing hair, wrist, clothes, etc.) NOTE: Until person makes contact, treat an attempt to grab as a strike Block and Move!) Stay calm, have a plan, and use a diversion or distraction A relaxed attitude on your part can help to calm the person Identify the weak point of the grab Be sure to practice different scenarios, so you will know how to deal with and feel more comfortable responding to various kinds of assaults. Apply leverage against the weak point (step close to the person, or away, as necessary) Use total momentum to get away from your attacker 11