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©2003 Mercy & Unity Hospitals All Rights Reserved. Student and Instructor Orientation Program Mercy & Unity Hospitals
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Welcome You are the future of healthcare! Mercy & Unity are excited to provide an environment where our professional staff and quality healthcare lends itself to an excellent learning experience for you.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Orientation Toolkit This orientation toolkit is intended for non- employees who are completing academic experiences at our hospitals. This would include: Clinical instructors and students completing clinicals, internships, capstones, synthesis and others as required. Completing this toolkit is part one of your orientation. The second portion is with the specific unit/dept you will be working on. You should meet with the unit/dept representative to obtain orientation specific to your role and department.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 How to Proceed Read each slide and complete any documentation required by your school. This orientation program is the property of Mercy & Unity Hospitals, and is made available for those unable to attend the traditional classroom orientation.. Questions about the information contained in this toolkit should be directed to the Center for Learning and Development, Academic Liaison: 763/236-3030
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Contents Who Are We Mission, Vision & Values Confidentiality/HIPAA Extraordinary Workplace with Extraordinary Employees Safety Awareness Infection Control In Closing...
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Who We Are Mercy & Unity Hospitals are part of Allina Hospitals and Clinics Allina is a not-for-profit healthcare organization serving Minnesota, Wisconsin and the Dakotas. Although we are not-for-profit, it is still necessary to watch the financial bottom line. We need to be here to meet the current and future needs of the communities we serve. We reinvest profits in new equipment and advanced technologies to better care for our patients.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Allina Hospitals & Clinics 13 hospitals 2 nursing homes 42 clinics Medical transportation services serving 70 Minnesota communities Hospice a community service providing health care information and referrals
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Allina Hospitals Metro Hospitals: Mercy Unity Abbott Northwestern United Phillips Eye Institute Regional Hospitals Buffalo Cambridge Owatonna St. Francis River Falls New Ulm
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 What we strive for... Mercy & Unitys Vision We place patients at the center of all we do as we care for and grow with the communities and region we serve. Allina Mission We serve our communities by providing exceptional care, as we prevent illness, restore health and provide comfort to all who entrust us with their care.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Allina Values: Integrity Match our actions with our words. We live our values and mission in all decisions and actions. Respect Treat everyone with honor, dignity and courtesy. Respect values, cultures, beliefs and traditions of others. Value each others talents and contributions. Trust We act in the best interests of out patients, physicians, communities and one another. Compassion Dedicated to creating a healing and caring environment to support the emotional, physical & spiritual well-being of all. Stewardship Use our resources wisely. Commit to being thoughtful stewards of time, energy and talent.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Living the Values Why is it that some patients can have poor outcomes and still say that they wouldnt go anywhere else for their healthcare? The difference is the relationships that we create with our patients. Its the customer service we provide. People come back to our hospitals because we live out our values and walk the talk-not just give them lip service.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Customer Service Basics Creating an excellent experience where patients feel assured, included and appreciated. While much of our work is of a high tech nature, we know the importance of connecting with our customers on a human/emotional level when beginning and ending any interaction.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Who are our customers? External Customers: Patients Families Physicians Internal Customers: Coworkers Other departments
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 The impact of body language, voice, tone and words Are the words we are saying congruent with our body language and our tone of voice? Do we say one thing but project the opposite? When we breakdown communication, we realize that: 55% of the message is our body language 38% of the message is our tone of voice 7% of the message is the actual words we use. (To make the biggest impact, youre actions must match your words)
©2003 Mercy & Unity Hospitals All Rights Reserved. Confidentiality HIPAAs Privacy Law
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Confidentiality Maintaining a patients privacy/confidentiality is not only the ethical thing to do, its the law. We are committed to preserving the confidentiality of patient information. The inappropriate release of information will result in disciplinary action and possible legal action.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 HIPAA? The Health Insurance Portability and Accountability Act (HIPAA). This revised Privacy Law places strict regulations around the privacy and security of patients health information. The law also mandates that we train everyone in the rules and provisions of this law.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Protected Health Information PHI is basically any information that identifies an individual or could reasonably be used to identify an individual. Includes, but not limited to: Name, address, age or SSN Health history and conditions, treatment or meds Hospital or clinic bill or payment record Any identification that an individual is a patient. It can be in any form Verbal, written or electronic Past, present or future medical information
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Minimum Necessary Rule Minimum Necessary Rule: We must only use and disclose the minimum amount of patient information needed to do our jobs. Simply put: You may only ask for, use and disclose patient information as needed for legitimate patient care or business purposes.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Curiosity Killed the Cat- Dont let it get you! Our patients could be your neighbor, friend, classmate or family friend. Sharing with others that you saw someone at the hospital or sharing of their health information may seem harmless to you- but it can be very harmful to the patient-and its illegal! You might be curious to look up information on a family member that is a patient here. Unless you need that information to do your job, you are prohibited from accessing that info. If in doubt, caution on the side of maintaining patient privacy.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Release of Health Information We must have consent from the patient before giving any information to others, including spouse, family members, or friends. The inappropriate release of protected health information is illegal and we must address any harm that occurs because of its inappropriate release. You are held legally accountable to maintain a patients privacy/confidentiality.
©2003 Mercy & Unity Hospitals All Rights Reserved. An Extraordinary Workplace with Extraordinary Employees A Culture of Caring
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 An Environment for Healing When patients see how well we treat one another, they will know this is a good place for healing. We cannot provide to patients what we are unable or unwilling to provide each other. If they see or hear uncaring behaviors, they will not find the healthy, healing environment they need.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Where You Would Want to Give and Receive Care Create a Respectful and Professional Workplace
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Diversity Defined as all the differences and similarities that exist among people - including race, gender, age, sexual orientation, job status, physical differences, etc.. We value the differing points of view, varied experiences and the talents of each and every person.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Harassment Free Workplace We have a zero tolerance policy for harassment in all of its forms. Including, but not limited to, harassment based on: Sex Race Age Disability National Origin Religion Sexual Orientation
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Key Points on Harassment Its the impact, not the intent. Whether or not you intended harm doesnt change the fact that someone was impacted by your actions or behavior. Direct or indirect, subtle or obvious We must own the culture in which we work. Is this a place you want to come and work or is someone else's behavior causing a hostile or intimidating environment. At the workplace or off duty related activities such as social gatherings or calls to your home. Act early-talk to the accused and ask them to stop the behavior. If no resolve, escalate by discussing with your instructor who will report to the hospitals academic liaison, unit manager or HR dept.
©2003 Mercy & Unity Hospitals All Rights Reserved. Safety Vision To make Mercy & Unity Hospitals a safer place to give and receive care
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Minnesota Employee Right to Know Act (ERTK) 1983 The law was passed to make sure employees are told about the dangers associated in working with hazardous substances and harmful physical or infectious agents. The law outlines both employer and employee responsibilities for safety from work related injury or illness.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 What does exposed to mean? You are considered routinely exposed to a substance or agent if there is a reasonable possibility youll be in contact with one of the items during the normal course of your assigned work.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Employer Requirements Education of staff and new employees on: The types of hazardous materials, agents and equipment in your work area. How to properly handle and work safely with the products. Where information about hazardous materials is located. Education specific to the materials/agents in your work areas will need to be covered during unit specific orientation.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Employee Requirements The law gives you the right to: Refuse to work under imminent danger conditions or if information or training about how to safely proceed with your job is not provided. If you feel that this applies to a situation, then discuss with your instructor or unit leadership.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 What if Im asked to work in an unsafe situation? Tell your instructor or the unit leadership if you feel a work situation may be dangerous Tell your instructor or the unit leadership if you dont know how to use or handle hazardous materials and/or equipment you are assigned to work with. Report faulty equipment so it can be repaired or replaced. Dont put yourself in any situation where you could be injured or harmed. You have the right to refuse to work under dangerous conditions.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 What Happens Next? The unit leadership will: Evaluate the situation for safety and the presence of hazards. Teach you how to safely use the product, direct you to the appropriate resource, provide you with learning materials, give you the appropriate Personal Protective Equipment. Reassign you to an alternate job until a hazardous condition can be corrected or eliminated.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Chemical Spills/Release Each department maintains procedures for the safe handling and spill clean-up of the hazardous products used in their areas. You need to receive unit specific orientation on the hazards found in your area. With any chemical spill, you should notify the supervisor and maintenance.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Locating information on Hazardous Substances & Chemicals. Material Safety Data Sheets (MSDS) provide information on the effects and properties of hazardous substances. These can be accessed from the Allina Knowledge Network (AKN). Ask the unit educator/designee to access these sheets.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Emergency Codes You might hear these emergency codes paged overhead, so it is important to know their meanings. Dr. RedFire Alarm Code BlueAdult Cardiac and/or Resp. Arrest Code PinkNeonate Cardiac and/ Resp. Arrest RPRRestraint Personnel Requested RPR AlertCalls the RPR team in less severe situations. Dr. ShieldSecurity help needed Orange AlertDisaster Plan in effect Code APediatric or Infant Abduction
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Severe Weather Codes Severe Thunderstorm Warning- conditions are favorable for severe weather Tornado Warning (phase 1) - a tornado has been sighted. Close windows, blinds and curtains. Keep corridors clear. Tornado Warning (phase 2) - hospital is in the path of the tornado. Move patients and visitors away from windows to interior corridors closing all doors. Visitors should stay with the patients and staff should move the the best shelter in the department.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Fire Safety Essentials in Your Department You will need to locate this information in the areas you work. Location of the fire alarm pull boxes Location and type(s) of extinguishers Emergency phone number x63333 The stations main oxygen shutoff valve(s) Evacuation plans and routes
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 R.A.C.E. Fire Procedure R escue A lert C onfine E xtinguish
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 R.A.C.E. Rescue: Move anyone in danger to a safe area. Alert: Pull fire alarm box and call x63333 to report the fires location. Confine: Close doors & windows in area, clear corridors and fire exit areas. Extinguish: Fight the fire only if it will not place you in danger. Blankets can be used to smother the flames of small fires or waste basket fires as well as using extinguishers. R escue A lert C onfine E xtinguish
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 How to Use Extinguishers Know the types of extinguisher in your work area. Choose the appropriate extinguisher for the type of fire. Then: PPull-the pin AAim-the extinguisher SSqueeze-the handle SSweep-the extinguisher hose at the base of the fire.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Patient Safety Initiatives To provide our patients with a safe healing environment we have initiated safety goals around the care of the patient. Some of the goals you should become familiar with include: 2 Patient Identifiers Unacceptable abbreviations Clinical Alarms Pause for the Cause & Surgical Site Marking
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Matching the right patient to the right treatment or service: When obtaining blood samples or administering medication or blood products or applying the patients armband, two patient identifiers will be used to compare to the same two printed identifiers on the lab request, medication record, blood product label or patients medical record. Patient Identifiers Include: Patients stated name and date of birth are compared against the printed name and DOB on the medication record, blood product label, specimen label, or medical record. Alternative to stated name and DOB included SSN, medical record number, patients phone number or address. These must be compared against the same two printed identifiers. Patients unable to state their name and DOB: Verification by a family member Verification by carefully matching the name and DOB on the wristband with the same info on the medical record, blood product label, specimen label. A patient room number will never be used as a method of patient identification or verification.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Unacceptable Abbreviations We have developed a list of abbreviations that are not approved for use within the medical record (documentation, notes or orders). Orders written for an unacceptable abbreviation/practice will not be accepted or executed. Unacceptable orders will be clarified by the nurse and documented as a verbal order before executing.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Abbreviation/Practice: U ug (microgram) Eliminate trailing Zeros after a decimal (2.0 mg) Require leading zero before a decimal (0.5 mg) AZT (Zidovudine) AZA (Azathioprine) HCT (Hydrocortisone) MSO4 (Morphine) MgSO4 (Magnesium Sulfate) Nitro & NTP (Nitroglycerine or Nitroprusside) 6MP (6-Mercaptopurine) Chemotherapy Abbreviations QD, QOD, AS/AD/AU/OS/OD/OU Correct Practice: Write the word units Use mcg Never use a zero after a decimal point (2 mg) Always use a zero before a decimal (0.5 mg) Write the full drug name for each example Write the full words Unacceptable Abbreviations
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Clinical Alarms Goal: Improve the effectiveness of clinical alarms. Examples of clinical alarms are : cardiac monitor alarms, fetal monitor alarms, apnea alarms, door alarms in behavioral health, elopement/abduction alarms, infusion pump alarms, bed alarms, bathroom alarms or respirator alarms.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Alarm Considerations Clinical alarms are basically all patient care equipment containing alarm functions Alarm functions should be managed/adjusted by the assigned staff RN or other hospital designee. Students/instructors should collaborate with assigned staff RN when setting/adjusting alarm parameters. Staff/Students must be trained in the use of alarms: How parameters are set Who sets parameters Who responds to the alarm In the case of critical alarms, are they deactivated at the central desk or does a qualified staff member enter the room and assess the patient. Alarm policies are practiced If an alarms fails, a Patient/Visitor Safety Report is completed, Risk Management is notified, and the equipment is immediately sent to Clinical Equipment Services (CES) for evaluation.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Pause for the Cause Goal: Eliminate wrong site, wrong patient, wrong procedure/surgery. Done prior to local injection/incision/start of procedure. Surgical Site Marking: The surgical site is marked for correct site and laterality, per policy. Pause for the Cause: The circulating RN reads the patients full name and procedure including site/side, from the consent form. All members of the surgical team listen and confirm the correct procedure, patient, surgical site and side (laterality).
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Safety & Ethical Situations If you encounter a potential hazard or unsafe situation in our hospital or if you have an ethical concern regarding our practices or a patient care situation, you should discuss this with the staff co- assigned with you and/or your instructor. We encourage reporting of safety concerns, incidents, hazards and ethical concerns. We have committees and processes in place to address these issues and make changes when appropriate. Concerns reported to your instructor or co- assigned staff will be escalated to the unit leadership. You may be asked to complete a Patient/Safety Visitor Report or Area of Concern Form to document the events.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Safety Phone Numbers Dallas Anderson, Security Manager: 763/236-4306 Deb Andrews, Employee Safety Director: 763/236-4712 Shari Bakker, Patient Safety Director: 763/236-8084 763/236-SAFE
©2003 Mercy & Unity Hospitals All Rights Reserved. Infection Control
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Where do germs come from? Environment surfaces floors gardens People skin intestines Equipment Water Flowers/plants
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Chain of Infection All links must be complete for an organism to spread from one place to another. Our goal is to break the chain in one or more links.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Risk of Transmission Intact skin is a good barrier to organisms organisms can enter through non-intact skin (cuts, scrapes, eczema) Mucous membranes allow transmission, such as through: eyes nose mouth
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Risk of Transmission Most transmission occurs through contact: Direct contact- touching patient Indirect contact - touching a contaminated surface Spray/splashes: Fluids, sputum, etc Most contact is with our hands
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Hand Washing Hand washing is the single most effective way you can break the chain of infection.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Hand Washing Basics Soap Use only hospital approved soaps, lotions & foam products. Warm running water 10-15 seconds Use friction Turn off faucet with paper towel.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Waterless Hand Washing (Quik-Care Alcohol foam) Can be used instead of soap and water if hands are not visibly soiled or contaminated with blood or body fluids. Dispense a walnut size amount and rub hands and under nails until dry. Use before and after every patient contact or contact with contaminated equipment. Contains emollients, therefore is better for your hands and is less drying to hands than soap and water. The emollients can build up on the hands after repeated use, so, wash with soap and water occasionally.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Artificial Nail Restriction This restriction must be followed by everyone who has direct patient contact, cleans rooms, handles patient supplies, prepares or serves food/drinks, handles medications or blood products. Artificial nails including tips, wraps, overlays, acrylics, gels, any appliques, nail piercing, nail jewelry or any other artificial nail enhancements of any kind are not allowed in our facility. Natural nails must be kept 1/4 inch or less.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Standard Precautions Standard Precautions considers all patients as potentially infectious. Prevent exposure to infectious organisms by wearing Personal Protective Equipment (PPE) when contact with the following is anticipated: blood body fluids, secretions and excretions non-intact or broken skin mucous membranes
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Personal Protective Equipment (PPE) PPE is located in all patient care areas. Exact location should be sought out during unit specific orientation. Gloves - to keep hands clean Gowns - to protect uniform from getting splashed or wet Facial protection - to protect mucous membranes from getting splashed or sprayed
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Blood Spills Potential exposure to blood or body fluids could occur at any work site There is a plan in place for each work site Guiding principles of each plan: Avoid direct contact with body fluid. Clean up spill and then disinfect area. Wash hands.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Location of Exposure Control Plan and Infection Control Policies The Allina Knowledge Network (AKN)
©2003 Mercy & Unity Hospitals All Rights Reserved. In Closing...
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Documentation of Orientation You have now completed general orientation to Mercy & Unity Hospitals. The 2nd part of your orientation will be obtained in your specific dept/unit, based on your specific role. Either your instructor or the unit leadership will provide this information. It is our expectation that orientation is completed prior to an experience at our hospitals. However, verification and tracking of its completion is the responsibility of the school.
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 Department Specific Orientation Checklist Minimally, your department specific orientation should include the following items: Location of: Crash Cart Emergency Equipment Personal Protective Equipment Evacuation Map Orientation to: Documentation process and related technology Medication administration and related technology Accessing policies, procedures and other resources Hospital and unit care & quality improvement initiatives Demonstration of quick release tie and application of locking restraints (required for anyone working with patients).
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03 How to access policies on the Allina Knowledge Network (AKN) All policies are located on the AKN, an intranet site which can be accessed using our network computers.
©2003 Mercy & Unity Hospitals All Rights Reserved. You Are Finished!!!
©2003 Mercy & Unity Hospitals All Rights Reserved. Revised 10/03
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