1. STUDENT NURSING ORIENTATION
NorthShore University HealthSystem

2. A Message from the Chief Nursing Officer
Nancy T. Semerdjian, RN, BSN, MBA, FACHE

3. Our Vision ~
for Nursing at NorthShore University HealthSystem (NorthShore) is to be recognized nationally and locally for our commitment to providing the very best quality of care and to be a destination for superior nursing care and leadership.   We are committed to embracing the core values of compassion, excellence, collaboration and innovation.

4. Our Goals ~
are to provide a professional environment that promotes superior patient care, shared decision making, and collaborative practice for every nurse at NorthShore.  We are committed to the professional growth of our staff through continuous learning and evidence-based nursing practice.  We hope to establish NorthShore as the destination of choice for professional nurses to embark on a challenging and rewarding career path. The recruitment and retention of knowledgeable, highly skilled, motivated nurses is critical to our success.

5. Our Journey ~
 to Excellence offers the venue for demonstrating our long term commitment to excellence to all of NorthShore and to the surrounding communities we serve. It is a journey that fully supports the NorthShore mission to preserve and improve human life through the provision of superior care, academic excellence and innovative research. 

6. Our Nursing Leadership Team ~
provides the foundation for achieving our goals. Nursing Administration promotes the development of leaders at all levels through continuous learning and knowledge sharing. We create an environment that promotes data-based decision making, participative management, quality, and cost-effective care.

7. Nursing Core Values Excellence Collaborative Practice
Excellence in patient centered care
Collaborative Practice
Shared decision making that fosters accountability, participation, and loyalty
Innovative Technology
Use state of the art technology to enhance innovation

8. Nursing Core Values Education Research
A learning environment that advances nursing clinical and administrative leadership.
Research
Evidence based clinical research that focuses on improved outcomes

9. Color Code Quick Reference Chart
Emergency Codes
Color Code Quick Reference Chart

10. Activating a Code
Activate the Emergency Code System by dialing 3199 and announcing the type of emergency and the location. All codes will be announced through the overhead public address system. Code actions are in effect until an “all clear” is announced overhead.

11. Color Code Quick Reference Chart
Code Red
Fire
Code Yellow
Code Triage Standby
Code Gray
Behavioral Dyscontrol
Code Black
Severe Weather Condition
Code Green
Internal Emergency

12. Color Code Quick Reference Chart
Code Blue
Medical Emergency
Code Pink
Missing Infant/Child
Code White
Bomb Threat
Code Purple
Evacuation

13. Color Code Quick Reference Chart
Code Orange
Hazardous Material
Code Lavender
Facility Lockdown
Code Beige
Chemical/Biological/
Radiological
Code Silver
Incident Command Activated

14. Pain Management
The NorthShore philosopy towards pain and pain management is:
If a patient says he is in pain, we believe him.
Every patient has the right to pain management
Review the policy in Clinical Practice Manual (CP ).
The Clinical Practice Manual is located on the NorthShore intranet, the Pulse, which may be accessed on the clinical unit from any computer.

15. Parking
Evanston Hospital: On your first day, please park in 1000 Central parking garage across the street from the hospital. Each student will be asked to fill out a parking form and take it to the Hospital Parking Office on Girard Street at the entrance to the parking structure. Once a sticker is issued, students should park in the Ryan West lot which is located on Central Street just West of Ryan Stadium, but before the Metra tracks.
Glenbrook Hospital: Park in the Employee/Medical Office Building Staff parking WEST of the new Ambulatory Care Center Building, parking lot sections BLUE 1-12 closest to Landwehr Road

16. Parking
Highland Park Hospital: Parking is available in the areas designated for employees. Please note that parking in spots designated for handicapped, emergency, and patient/visitor parking is strictly prohibited.
Skokie Hospital: Park in the Employee parking lot on the west side of the Kenton building off Knox Ave. Park only in the yellow outlined spaces towards the back. The white outlined spaces are reserved for patients and visitors. Parking is free.

17. Rapid Response Team Purpose Team Members
To improve the quality of patient care, provide support and mentoring for the nursing staff outside of the critical care units in the care of patients with a deteriorating clinical condition.
Team Members
ICU RN
Respiratory Therapist
Nursing Consultant

18. Rapid Response Team
Rapid Response Teams (RRT) reduce incidents of cardiac and respiratory arrests and decrease mortality rates. The RRT may be initiated by any member of the health care team

19. Rapid Response Team When should I call?
Acute change in RR: <8 or >28 breaths per minute
Acute change in O2 sat.: <90% despite 4L/nasal cannula or 50%
Acute change in heart rate: <40 or >130 beats/minute or change in rhythm
Acute change in SBP: <90 mm Hg
Acute change in LOC and/or seizures
Staff concern that “something is wrong” with the patient

20. Rapid Response Team How Do I Call?
Dial “3199” and state, “The Rapid Response Team is needed, (provide the location).”
The operator will page the RRT; there will be no audible announcement.
The RRT team will arrive within 5 minutes, assist the primary nurse in the management of the patient and determine if the patient will remain on the nursing unit or transfer to the ICU

21. Rapid Response Team
What is the responsibility of Primary Nurse before the team arrives?
Remain with the patient
Alert other team members to cover other patients
Take vital signs
Place patient on bedside monitor
Have Jetson brought to the room
Have the 12-Lead EKG brought to outside of the room to have in the event it is needed.

22. Rapid Response Team
What does the Primary Nurse do when the RRT arrives?
Provide the team an “SBAR” report
Remain in the room with the RRT
Continues to function as the Primary Nurse for the patient

23. The SBAR Report Before paging the physician:
1- Assess the patient head to toe
2- Review the chart for appropriate physician & appropriate call
3- Know the admitting diagnosis
4- Read the most recent Progress Notes and the assessment from the nurse of the prior shift
5- Have available when speaking with the physician:
 The Epic chart  Allergies  Meds  IV’s  Labs/results
 Recent VS [you took]  Code Status
6- Text page the physician using the computer. Always include your name and # so the doctor will know who to ask for. Let the concierge know you have placed the call

24. The SBAR Report Situation State your name and clinical unit.
I am calling about: [Name & Room Number]
“The problem I am calling about is: _____________”
I am concerned about: example: BP ≥ 200 ≤100 or a change of 30 mm
Pulse ≥ 140 ≤ Resp. ≤ ≥ Temp ≤ ≥ 104

25. The SBAR Report Background
Be prepared to discuss the following, especially with an on-call/consulting MD
Admission diagnosis and date of admission
Pertinent medical history
Brief synopsis of the treatment to date

26. The SBAR Report Assessment
State what you think the problem is ~ changes in
 BP _______  Pulse ________ Temp._____
 Pain Eval ____  O2 Sats ________ O2 ______
 Mental Status  Respiratory rate/quality
 Heart rhythm  Breathing  Neuro Signs
 BP,  Pulse, rate/quality  Wound drainage
 GI/GU  N&V  Diarrhea  Skin Color

27. The SBAR Report Request/Recommendation
 Pt. seems unstable & may get worse. We need to do something
 I am not sure what the problem is but the patient is deteriorating.
REQUEST:
Transfer to a higher level of care  Come to see the patient
 Ask for a consultant
ASK: Do you need any tests?
 CXR  ABG  EKG  CBC  BMP  BNP  Other
Do you want to change?
 Medication  Treatments
What parameters do you want to be called about?

28. The SBAR Report DOCUMENT The change in patient’s condition, in notes
Orders received
Physician notification: time and report given