August 18, 2014 J2E EDUCATION SESSIONS Attached is a revised agenda for the Aug. 25-26 and Sept. 22-23, J2E Education Sessions. Front Line Staff and All Employees means all MVH employees. The early morning sessions have been changed from previous communications. The 6-7 a.m. session has been changed to 5:30-6:30 a.m. to better accommodate the midnight shift staff. Please post the corrected agendas and request that all staff attend the sessions. WHAT IS POLST? Ray Andrews, Vice President Administration and Support Services Pennsylvania Orders for Life-Sustaining Treatment (POLST) is information added to the Policy for Patient Self Determination (Administrative Policy 2-39) in the most recent revision. POLST is a system developed for improving the quality of patient care and reducing medical errors by identifying, communicating and respecting a patient s wishes with regard to medical treatment through portable medical orders. POLST is not for everyone. Only patients suffering from serious illness or frailty should complete a POLST form. For these patients, their current health status should demonstrate a need for a standing order for emergent or future medical care. Completion of a POLST form can be part of a patient s advance care planning. Advance care planning conversations occur between the physician and patient as well as those close to the patient. In these conversations, patients are informed of their treatment options. Decisions are made, based on personal beliefs and current state of health, as to treatments the patient does/does not want. For a POLST to be considered valid, it must contain the patient s name and signature, resuscitation orders and a physician signature. The form is printed on pulsar pink card stock (65 lb.) paper. For healthy patients, an advance directive is an appropriate tool in making their wishes for end-of-life care known. For Team MVH, the process starts at the time of patient registration. Each adult patient will be asked if he or she has executed an Advance Directive (Living Will, Mental Health Living Will, Durable Power of Attorney for Health care and/or Mental Health Power of Attorney or POLST) and asked to provide a copy for their medical record. Not complying with a patient's advanced directive can lead to more than non-compliance with Center for Medicare and Medicaid Services (CMS) and The Joint Commission. Non-compliance can mean a potential lawsuit with large penalties and fees. Recently, a patient won $16.5 million dollars when a hospital, not MVH, did not follow their advance directive. Please review Administrative Policy 2-39 Patient Self Determination for details of the implementation of advanced directives, including POLST. If you or a patient have additional questions related to advance directives, or would like assistance in creating one, please contact me at ext. 1076. UPDATE FOR MANDATED REPORTERS: CHILD ABUSE EDUCATION AND TRAINING REQUIREMENT Renee Hurley, M.Ed., L.P.C., Director of Patient Relations The Pennsylvania Family Support Alliance will provide three additional sessions to help our staff meet the training requirement necessary for re-licensure, certification and or registration. Staff may register via Net Learning for these classes. There is no guarantee that the Pennsylvania Family Support Alliance will provide additional opportunities for us. It is important that staff take advantage of these available opportunities. Staff members who do not take advantage of the classes offered will have to secure the training on their own at their own expense. Also, we must meet the minimum class enrollment in order to receive a refund on our deposit. Class enrollment also helps us when requesting additional classes. Please do not sign up and then fail to show. This could compromise future programs and refunds. The refunds help us to pay for additional classes. If you find that you cannot attend a session that you have registered for, please find a replacement. Classes will be offered from 9 a.m. to noon in the ECC on Oct. 21, Nov. 14 and Dec. 12. You must stay for the three-hour class in order to receive credit. If you have questions call me at ext. 1275. Paula Bassi, Director of Staff Education Next issue s deadline: Wednesday, August 20, at noon. Send submissions to whurley@monvalleyhospital.com. Remove by Monday, August 25.
A G E N D A J2E Education Session August 25, 2014 Anthony M. Lombardi Education Conference Center LEADER S BACK TO BASICS Beverly Begovich - Presentor 10 a.m. 11:30 a.m. LEADERSHIP SESSION Focus is on the Leader s Role with RELATE, Words that Work, Hourly Rounding, and Discharge Telephone Calls 1:30 p.m. to 2:30 p.m. ALL EMPLOYEES 3 p.m. to 4 p.m. ALL EMPLOYEES 4:30 p.m. to 5:30 p.m. ALL EMPLOYEES 6 p.m. to 7 p.m. HOSPITALIST GROUP MD Communication (HCAHPS Domain)
A G E N D A J2E Education Session August 26, 2014 Anthony M. Lombardi Education Conference Center LEADER S BACK TO BASICS Beverly Begovich - Presentor 5:30 a.m. to 6:30 a.m. ALL EMPLOYEES 7:30 a.m. to 8:30 a.m. ALL EMPLOYEES 9 a.m. to 10 a.m. ALL EMPLOYEES 10:30 a.m. to 11:30 a.m. ALL EMPLOYEES 2 p.m. to 3 p.m. ALL EMPLOYEES
A G E N D A J2E Education Session September 22, 2014 Anthony M. Lombardi Education Conference Center Jesus Ramirez - Presentor 7:30 a.m. to 8:30 a.m. ALL EMPLOYEES 9 a.m. to 10 a.m. ALL EMPLOYEES 3 p.m. to 4 p.m. ALL EMPLOYEES 4:30 p.m. to 5:30 p.m. ALL EMPLOYEES 6 p.m. to 7 p.m. ALL EMPLOYEES
A G E N D A J2E Education Session September 23, 2014 Anthony M. Lombardi Education Conference Center Jesus Ramirez - Presentor 5:30 a.m. to 6:30 a.m. ALL EMPLOYEES 7:30 a.m. to 8:30 a.m. ALL EMPLOYEES 9 a.m. to 10 a.m. ALL EMPLOYEES 10:30 a.m. to 11:30 a.m. ALL EMPLOYEES 2 p.m. to 3 p.m. ALL EMPLOYEES
SEND FORM WITH PERSON WHENEVER TRANSFERRED OR DISCHARGED To follow these orders, an EMS provider must have an order from his/her medical command physician as, ame pennsylvania DEPARTMENT OF HEALTH Pennsylvania Orders for Life-Sustaining Treatment (POLST) First/Middle Initial Date of Birth FIRST follow these orders, THEN contact physician, certified registered nurse practitioner or physician assistant. This is an Order Sheet based on the person's medical condition and wishes at the time the orders were issued. Everyone shall be treated with dignity and respect. A CARDIOPULMONARY RESUSCITATION (CPR): Person has no pulse and is not breathing. CPR/Attempt Resuscitation 7 DNR/Do Not Attempt Resuscitation When not in cardiopulmonary arrest, follow orders in B, C and D. (Allow Natural Death) MEDICAL INTERVENTIONS: Person has pulse and/or is breathing. COMFORT MEASURES ONLY Use medication by any route, positioning, wound care and other measures to relieve pain and suffering. Use oxygen, oral suction and manual treatment of airway obstruction as needed for comfort. Do not transfer to hospital for life-sustaining treatment. Transfer if comfort needs cannot be met in current location. B LIMITED ADDITIONAL INTERVENTIONS Includes care described above. Use medical treatment, IV fluids and cardiac monitor as indicated. Do not use intubation, advanced airway interventions, or mechanical ventilation. Transfer to hospital if indicated. Avoid intensive care if possible. Li FULL TREATMENT Includes care described ventilation, and cardioversion as indicated. Transfer to hospital if indicated. Includes intensive care. above. Use intubation, advanced airway interventions, mechanical Additional Orders C ANTIBIOTICS: No antibiotics. Use other measures to relieve symptoms. Determine use or limitation of antibiotics when infection occurs, with comfort as goal Use antibiotics if life can be prolonged D ARTIFICIALLY ADMINISTERED HYDRATION / NUTRITION: Always offer food and liquids by mouth if feasible No hydration and artificial nutrition by tube. Trial period of artificial hydration and nutrition by tube. Long-term artificial hydration and nutrition by tube. Additional Orders Additional Orders E SUMMARY OF GOALS, MEDICAL CONDITION AND SIGNATURES: Patient Goals/Medical Condition: Discussed with Patient Parent of Minor Health Care Agent Health Care Representative Court-Appointed Guardian Other: By signing this form, I acknowledge that this request regarding resuscitative measures is consistent with the known desires of, and in the best interest of, the individual who is the subject of the form. Physician IPA/L.RNP Printed Name: Physician /PA/C.KNP Phone Number Physician/PA/LI-MP Signature (Required): DATE Signature of Patient or Surrogate Signature (required) Name (print) Relationship (write "sear it patient) PaDON version 10-14-1U 1 of 2
Other Contact Information SEND FORM WITH PERSON WHENEVER TRANSFERRED OR DISCHARGED Surrogate Kelatonstip Hbone Number Health Gare Hrotessional Prepanng Form Hreparer I tie Phone Number Date Freparea Directions for Healthcare Professionals Any individual for whom a Pennsylvania Order for Life-Sustaining Treatment form is completed should ideally have an advance health care directive that provides instructions for the individual's health care and appoints an agent to make medical decisions whenever the patient is unable to make or communicate a healthcare decision. If the patient wants a DNR Order issued in section "A", the physician/pa/crnp should discuss the issuance of an Out-of-Hospital DNR order, if the individual is eligible, to assure that an EMS provider can honor his/her wishes. Contact the Pennsylvania Department of Aging for information about sample forms for advance health care directives. Contact the Pennsylvania Department of Health, Bureau of EMS, for information about Out-of Hospital Do-Not-Resuscitate orders, bracelets and necklaces. POLST forms may be obtained online from the Pennsylvania Department of Health. www.health.state.pa.us Completing POLST Must be completed by a health care professional based on patient preferences and medical indications or decisions by the patient or a surrogate. This document refers to the person for whom the orders are issued as the "individual" or "patient" and refers to any other person authorized to make healthcare decisions for the patient covered by this document as the "surrogate." At the time a POLST is completed, any current advance directive, if available, must be reviewed. Must be signed by a physician/pa/crnp and patient/surrogate to be valid. Verbal orders are acceptable with followup signature by physician/pa/crnp in accordance with facility/community policy. A person designated by the patient or surrogate may document the patient's or surrogate's agreement. Use of original form is strongly encouraged. Photocopies and Faxes of signed POLST forms should be respected where necessary Using POLST Review If a person's condition changes and POLST is updated as appropriate. If any section is not completed, then treatment. An automated external defibrillator Resuscitation" Oral fluids and nutrition must always time permits, the patient or surrogate the healthcare provider should follow other appropriate methods to determine (AED) should not be used on a person who has chosen "Do Not Attempt be offered if medically feasible. must be contacted to assure that the When comfort cannot be achieved in the current setting, the person, including someone with "comfort measures only," should be transferred to a setting able to provide comfort (e.g., treatment of a hip fracture). A person who chooses either "comfort measures only" or "limited additional interventions" may not require transfer or referral to a facility with a higher level of care. An IV medication to enhance comfort may be appropriate for a person who has chosen "Comfort Measures Only." Treatment of dehydration is a measure which may prolong life. A person who desires IV fluids should indicate "Limited Additional Interventions" or "Full Treatment. A patient with or without capacity or the surrogate who gave consent to this order or who is otherwise specifically authorized to do so, can revoke consent to any part of this order providing for the withholding or withdrawal of lifesustaining treatment, at any time, and request alternative treatment. This form should be reviewed periodically (consider at least annually) and a new form completed if necessary when: (1) The person is transferred from one care setting or care level to another, or (2) There is a substantial change in the person's health status, or (3) The person's treatment preferences change. Revoking POLST If the POLST becomes invalid or is replaced by an updated version, draw a line through sections A through E of the invalid POLST, write "VOID" in large letters across the form, and sign and date the form. version 2 of 2
Department of Education Attendance Record Class Topic: At The Helm Class Date: August 18, 2014 Instructor/Presenter: Department: Coordinated by: Date sent to Education: 1 2 3 4 5 6 7 8 9 10 11 12 Last Name Start Time: First Name Location of class: End time: Educational Format: (please select all that apply) Live program On-line Webinar Video Magazine Article Demonstration Other: ***Attendees must sign in to receive proper credit for this activity*** Signature Department Job Title 13 Please send supporting documentation: copies of program materials, certificates of completion, handouts, etc. along with attendance record(s) to the Education Dept. - Thank you! THIS AREA TO BE COMPLETED BY NETLEARNING ADMINISTRATORS ONLY Curriculum: Course Group: Class ID: Notes: C Format required: Yes or No C Format completed: Yes or No Date & Initial Recorded into NLA: Date Received :