Northside Hospital-Atlanta Auxiliary Orientation & In-service

Northside Hospital Auxiliary Is Committed To: Patient and Family Centered Care As a result, we look for ways to demonstrate respect for patients’ values, preferences, and expressed needs. Service Excellence Treating people as individuals with courtesy, dignity, respect and politeness. Providing “Exceptional Service” Mission & Value Statement: Northside Hospital-Atlanta Auxiliary provides compassionate support & quality service to patients, families & visitors, as well as funding for special projects which benefit the hospital.

Northside Hospital-Atlanta Uniform Blue Smock, Apron, Vest, Polo Shirt Plain White Shirt Black Pants or Conservative Length Skirt Black or Neutral Socks or Hose Soft-soled Black Shoes 3 of 56 3

Why Is Cultural Sensitivity Important? “Our culture influences how health care information is received, how rights and protections are exercised, what is considered to be a health problem, how symptoms and concerns about the problem are expressed, who should provide treatment for the problem, and what type of treatment should be given.” (Katz, Michael. Personal Communication, November 1998) What is culture? The thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious or social groups. - (Katz, Michael. Personal Communication, November 1998)

Language/Communication Northside Hospital’s Interpretation Services Department provides 24 hour language services to all patients free of charge. The Interpretation Services Department will help to arrange the following services: Language Interpreters (including sign language) – call ext. 5898 Telecommunication Device for the Deaf Consent Forms and other hospital information, as available, in Braille. The use of qualified Interpreters during a medical encounter improves compliance, understanding, patient safety, clinical outcomes and patient satisfaction.

Language/Communication Family, friends and volunteers should never be used as Interpreters for medical encounters because: They may be more likely to omit, add or change information when interpreting. When communicating information they could violate the patient’s confidentiality. We cannot assume the family member or friend has any knowledge of medical terms. A conflict of interest may exist between the patient and family member related to treatment choices. Undue risk is created for the patient and hospital if there is a misunderstanding or miscommunication about the patient’s wishes. Call Interpretation Services for assistance - #5898

Who needs an interpreter? Interpretation Services Who needs an interpreter? Any patient who requests one. Other patients or family members who are Limited English Proficient (LEP), Deaf or hearing impaired. LEP simply means someone is not completely fluent in English. Are interpreters really necessary? According to Federal Law a patient should receive their care and information in the language or mode they request. This may include foreign languages such as Spanish, Korean, or Arabic as well as languages for the Deaf and hearing impaired such as American Sign Language or lip reading. Joint Commission requires documentation of patient’s language, their interpretation needs & the methods used to meet these needs in every patient’s chart.

How do I get an interpreter? Atlanta hospital campus: Dial ext. 5898 for all services For direct access to the telephone interpreter, dial: 1-800-264-1545 You will be asked for: Your access code (000 + 3 digit dept. #) Your last name Patient's last name Language Note: For needs outside of office hours call the House coordinator by dialing 0.

Anti-Discrimination/Harassment Northside Hospital is committed to creating an environment of courtesy, dignity, respect and politeness. Northside does not tolerate harassment because of race, color, sex, religion, national origin, age, physical ability or citizenship. What is Harassment? Harassment includes but is not limited to slurs, jokes, any other verbal, graphic or physical conduct relating to an individual’s race, color, sex, religion, national origin, age, physical ability or citizenship. If you think you are being harassed you should make your concerns known to the Manager of Volunteer Services, the Auxiliary President, or one of the Vice Presidents.

Attendance As a volunteer it is very important that you report to work your shift on time and when scheduled for work as people rely on you. If you know you will be absent, try to change shifts with another volunteer who works in your same area. Minimally notify your area supervisor of your pending absence. If you are ill, please contact the department where you work to let them know you will not be coming in. You may then call the Auxiliary office to let us know you will be out: 404-851-8707.

Bariatric Sensitivity Bariatric Surgery is a Northside Hospital Specialty. What Are We Asking Of You: Remember the obese patient is a human being and only wants to be treated like one. Understand that obese patients have tried and failed to lose weight many times. Be sensitive with how you phrase your communication. When assisting a patient or visitor, focus on the person, not the task. Make eye contact, introduce yourself and explain what you are going to be doing. Before escorting a patient, ask the requesting nurse the weight of the patient. Do not push more than you can handle – discretely ask them to contact the department for transport.

‘The Voice of the Patient’ Customer Relations We stress the Patient Bill of Rights We emphasize the importance of personal interactions We encourage partnering with patients/families regarding their care

Some Important Patient Rights: Patients have the right to considerate and respectful care that recognizes their personal dignity, values, and beliefs. Patients have the right to complete and current information concerning their diagnosis, treatment and any known prognosis. Patients have the right to participate in their care, including the management of their pain.

Domestic Violence What is Domestic Violence? The use of physical, sexual, and/or psychological coercion to establish and maintain control over an individual. If you suspect that someone experienced Domestic Violence, speak confidentially with your department supervisor, the Manager of Volunteer Services or an Auxiliary leader. Domestic Violence brochures are available on the units and in public restrooms.

Seven Elements of the Environment of Care Safety Management Fire Safety Management Security Management Emergency Management Utilities Management Medical Equipment Hazardous Materials Emergency & Security Numbers Atlanta Campus: Emergency Number: 8911 or (404) 851-8911 Security Number: 8797 or (404) 851-8797 Personal Safety Number: 404-851-6100

Safety Management All volunteers should consider themselves as members of the Hospital Safety Team. Report any safety concern to Security or the Manager of Volunteer Services. Report all on the job injuries or job-related illnesses to the Manager of Volunteer Services and Employee Health. If Employee Health is not open report to the House Coordinator located in Main Admissions. If a visitor in your area is injured, you should: render assistance – ask someone to notify Security and stay with the injured person notify Security (8911-if life threatening, 8797-if non-life threatening) complete an On-line Incident Report Help prevent slips and falls – Immediately clean up small spills of coffee, sodas and etc. For large spills place a Wet Floor sign in area and contact Environmental Services.

Security Management There is 24 hour Security at each campus. Escorts and Vehicle Assists are available by calling Security (8797). Work Place Violence - Report all Verbal or Physical Abuse to Security and your supervisor. Report all suspicious persons and events to Security Code One - Security is needed immediately for a Combative Person or Patient Restraint Assist. On each computer there is a Code One icon that will call Security immediately. Only use in case of emergency.

Security Management Deck Safety – each year employees, visitors and patients are involved in motor vehicle accidents in our parking decks, so we advise all personnel and volunteers to exercise caution. The maximum speed limit in the parking decks is 10 mph. For the safety of pedestrians the maximum speed limit on Hollis Cobb Drive is 15 mph. 18 of 56 18

Code Red is the code for Fire or Smoke. Fire Safety Code Red is the code for Fire or Smoke. In the event of a fire the following will occur: You will hear “Code Red” and the location announced All doors will close All wheeled objects will be removed from patient corridors in the designated area 19 of 56 19

Fire Safety Code Red is the code for Fire or Smoke. Use R-A-C-E if you discover a fire or smoke condition. Rescue: Your Patient and Yourself Activate: Pull the nearest Alarm, Dial Campus Emergency Number & Give Location Contain: Close all Doors Extinguish: Use a Fire Extinguisher

Fire Safety Use P-A-S-S with Fire Extinguishers. P- Pull the pin. A- Aim at the base of the fire. S- Squeeze the handle. S- Sweep the fire. Report all Smoke Smells to Security & Alert your Charge Person. Smoking Policy –Smoking is not allowed “inside” any building owned or operated by Northside Hospital. There are three visitor smoking areas: Outside by Cardiology on the 1st floor of the Main Hospital On the circle, by the trash can across from the Main Entrance Outside Labor & Delivery down the walkway on the right side

Emergency Management Code Blue Is someone who may be having a Cardiac or Respiratory Arrest. Dial campus emergency 8911 for help. Code Orange Is for Bomb Threats. Report suspicious items to Security. Do Not Touch or Move Suspicious Items. Code Green Is for External Mass Casualty. Continue in your present role and follow the instructions of your Charge Person. Code Grey Is for Tornadoes. Close and latch all windows and help relocate patients to inner hallways if requested. Code White Is for Snow and Ice Plan. Code Yellow Is for Radioactive (HazMat)/ Spill Decontamination Plan. Code Brown Is for Relocation/Evacuation Plan. Code Purple Missing /Wandering Adult Patient Code Silver Active Shooter If asked about a code, what do you say? “There is an internal issue and we have it under control.”

Security Management Code Pink is the code for a Missing Infant. The elevators will shut down, stop what you are doing, go into the hallway and assist with search for the missing infant. Code Amber is the code for a missing child. Assist with the search for a missing child. Code Purple is the code for a missing or wandering patient. Patient identified with a purple armband on wrist. Follow similar procedure as Code Pink or Code Amber. Report to Security if found. Report all suspicious persons and events to Security 23 of 56 23

Security Management Code Blue is the code for any type of medical emergency such as Cardiac or Respiratory Arrest. Stay with the person and have someone dial 8911 for help. Code Silver is the code for an active shooter. Protect yourself, patients and visitors. Try to move to an interior room with no glass or in a protected area. Take directions from hospital staff in protecting patients. Don’t be a hero! A Star on the patient’s door or a Yellow armband indicates that the patient is a “risk to fall”. 24 of 56 24

Code Green/Teams Activated or Code Green Event Is for External Mass Casualty. Northside is expecting a large influx of patients. If in key areas remain there, otherwise take direction from your area supervisor. Bio-Terrorism or Pandemic Event - Infection Control Protocols will assist in protecting employees, patients and visitors. If in close proximity to hospital and you would like to assist, report as soon as possible. Wear badge & uniform if possible. Report to Labor Pool in Cafeteria. Receive assignment, follow staff instructions.

What do you say if a code is called? “We have an internal issue and we have it under control.” 26 of 56 26

Infection Control Everyone responsible for understanding the risk of exposure to blood or other potentially infectious materials in the hospital. The Infection Control program works only if you are committed to following the guidelines described in this course. Standard Precautions is to treat all patients as if they are infectious. If a patient has a CONTACT PRECAUTIONS metal box on the door – check with the nurse before entering the room. You may need to put on a mask, gloves and/or gown.

Hand Hygiene Hand Hygiene is the single most important thing you can do to prevent infection. Frequent hand hygiene is the foundation of infection control. This single action lowers the risk of transmitting microorganisms from one person or site to another. Wearing gloves does not replace hand washing. Gel must be used after gloves are removed. Alcohol based hand rub: gel is used between all patient contacts before and after “crossing the threshold”; it is more effective than hand washing. Use the gel when entering / exiting the patient room. Wash hands after 5-7 times of gel usage or when hands become “sticky.” Hand washing: Use hand hygiene before entering patient room or contact with patient or equipment. Wash your hands with soap and water when you have completed an activity such as a assisting with diapering, using the restroom, eating, any contact with blood and body fluids and if hands are visibly soiled. 28 of 56 28

Hand Washing Guidelines Use our approved soap and wash for at least 10- 15 seconds. Friction is the most important step in hand washing. Don’t forget to scrub your fingernails. Dry your hands with the paper towel and turn off the faucet with the paper towel. Use foam going to or out of all patient rooms. Artificial Nail Guidelines Note: For infection control, artificial nails may not be worn if in direct contact with patients. In addition, volunteers should not have chipped nail polish when working with patients.

Volunteer Responsibilities Volunteers should not come to work when feeling ill, congested or have a rash or fever. If exposed to an infectious disease, contact Employee Health for evaluation. Those with an infectious disease need to be cleared by Employee Health before returning to duty. Protect yourself and patients – get a flu shot: Vaccine is available free of charge Myth busters about flu vaccine: Injectable influenza cannot cause influenza Side effects do include a sore arm the next day Help yourself and others to have a healthy winter!

Incident Risk Management Report If you are injured during your service, do not go directly to the Emergency Department! Report to Employee Health or House Coordinator (after hours or on the weekend) Fill out an on-line Incident Report with the Manager of Volunteer Services Report the incident on-line as soon as possible – do not wait! Keep all paperwork for your records 31 of 56 31

Biohazard Symbol The biohazard symbol is a universal symbol placed on any container or area that may contain regulated waste. Biohazard signs are always red or orange and have the biohazard symbol.

Potentially Infective Material Potentially infective material is bagged at point of use to prevent contamination to patients, personnel, and visitors. Red biohazard bags are used for disposable items that have visible blood (that would drip blood if they squeezed). Sharps must be placed in puncture-resistant containers at point of use. No volunteer should dispose of sharps! Never change the needle box container! Soiled linen is placed in the blue soiled linen bag. Even bloody linen is placed in the blue bag for cleaning.

Workplace Practices In work areas where exposure is likely, do not eat, drink, or put objects in your mouth apply cosmetics, lip balm, or contact lenses

Minimize Risks Environmental Service is to be contacted to contain, remove and disinfect all blood and body fluid spills. Wear gloves and other appropriate personal protective equipment if there is the potential of coming in contact with blood or other body fluids. Put on and remove gloves correctly, being careful not to contaminate your hands. Don’t wear large rings and be careful not to poke nails through fingertips. To remove – begin pulling one glove off but before completion, begin pulling the other glove off with the still gloved first hand. Gloves should almost be inside of one another.

Standard Precautions Standard Precautions are used for all patients, even if you don’t know their diagnosis. Standard Precautions means wearing gloves, gowns, mask, goggles or other equipment when you anticipate contact with the patients blood or body fluids, secretions and excretions, non-intact skin and mucous membranes. Standard Precautions helps to protect both patients and hospital personnel from disease causing germs. Respiratory Hygiene- people should cover their mouth when coughing or sneezing.

For Any Blood/Body Fluid Exposure: Wash affected area Notify your Supervisor and Employee Health Notify the House Coordinator on weekends Complete an online incident report as soon as possible 37 of 56 37

Transmission-Based Precautions Transmission-Based Precautions apply to patients with documented or suspected infection or colonization (germs are on skin) that are highly transmissible. Signs and/or beige boxes will be placed on all doors of patients in isolation. They are available in English and Spanish. Contact the nursing staff/supervisor for help if you don’t know what to do before entering the room. Transmission-Based Precautions include Airborne Precautions Droplet Precautions Contact Precautions They are used in addition to Standard Precautions. “If it’s wet and doesn’t belong to you, don’t touch it!”

Personal Protective Equipment Always use the required Personal Protective Equipment (95% of infections can be prevented by using protective clothing.) This specialized clothing and equipment provides protection against contact with blood or other potentially infectious materials. Hands – wear gloves Face – wear mask or goggles Body – wear gowns Please note, for most volunteer jobs Personal Protective Equipment is very rarely used. When in doubt, talk to the Charge Nurse or your Service Chair.

Emergency Infection Control Concerns-Bioterrorism or Pandemic Influenza Northside Hospital has a plan in place in the event of a bioterrorism event or pandemic flu. These plans are integrated with the emergency preparedness system at the hospital, county, state and federal levels. Guidelines In the event of an emergency, supervisors will be given explicit information to protect our employees, volunteers and our patients and visitors.

Summary Be familiar with key elements of the Infection Control Program. Wash your hands frequently. Understand hospital environmental control issues. Use good workplace practices and follow standard precautions. Wear protective clothing and use respiratory protection as indicated. Contact your supervisor immediately if you are exposed to blood or other potentially infectious materials. For more information, talk to the Manager of Volunteer Services.

Patient Safety is a part of lay literature…

National Patient Safety Goals These goals were created to keep patients, staff and visitors safe. There are many Patient Safety Goals but the one’s most pertinent to volunteers include the following: Goal I: Improve the accuracy of patient identification Checking names, records and armbands. Goal VII: Reduce the risk of health care-associated infections Hand washing is the key! Goal IX: Reduce the risk of health of patient harm resulting from falls Vigilance is the key! It is everyone’s responsibility to identify and report any potential risks in the environment: torn carpets, faulty wiring, wet floors, etc.

Wheelchair Safety Place wheelchair close to patient. Make sure brakes are locked and foot pedals up when the patient is either sitting down or getting up from the wheelchair. Stand along side of wheelchair to better assist patients and make certain the patients feet are securely positioned on the foot pedals. Move slowly! Back into elevators. Push wheelchair up inclines and go down inclines backwards with you leading the way. Push only to your comfort level.

Personal Safety – Body Mechanics Get close to object before lifting! Lift with your legs, not your back! Don’t push objects! Use your biceps to pull the object! Do not twist with a load! Change your positioning. Balance is vital! Spread your feet for support.

Safeguarding Patient Information A federal law, HIPAA, contains privacy and security rules that govern the use of protected health information (PHI) Northside is committed to maintaining the integrity and security of PHI and has developed policies and procedures governing the use of PHI Northside strongly encourages you to report any issues or concerns you have about the security or integrity of patient information. If you observe or suspect any inappropriate or suspicious activity, it is your responsibility to report it to your supervisor, the Manager of Volunteer Services, an Auxiliary officer, or the HIPAA Hotline 404-845-5534. Failure to comply with privacy and security rules could result in: Loss of job Fines Imprisonment

What is PHI? Protected Health Information (PHI) consists of patient identifiable information delivered via paper, verbal communications or electronic means. Examples include: Patient name Address Date of birth SS# Medical record # Email address Identifiable health information may be shared among caregivers for the purposes of: Treatment, Payment or Healthcare Operations (TPO). This is misuse: Looking up your own personal information without a formal request to the HIS Department Looking up test results, birthdates, addresses, financial information, etc. of friends & relatives Reviewing a patient’s records out of curiosity Discussing any patient information when it is not related to your job

Using PHI Use or disclosure of PHI should be on a “need to know basis”. Access to a system does not imply that it is appropriate to search any patient information at will. In other words, never look at patient information unless it is necessary to do your job. Only use the absolute minimum necessary patient information All employees must read and sign a “Confidentiality of Information & Computer Access Code Agreement,” which explains your responsibility to keep information confidential and secure

PHI Security Never leave any PHI data displayed on your monitor or unprotected at your workstation when you are away Always log out of an application before leaving your workstation Always place monitors in a location that prevents others from viewing information on the screen Use screen savers to help ensure confidentiality Make sure laptops and PCs are monitored and secure NEVER send PHI via email or the Internet without using encryption that is approved by the IS department Talk to your supervisor if you suspect a PC is infected with a virus or under any other sort of electronic attack

Confidentiality Never discuss patient information with anyone (e.g. name, diagnosis, employment status, financial status, etc). Absolutely no information concerning the patient may be discussed outside the hospital to a friend, relative, neighbor or member of the clergy unless the patient gives you permission. Volunteers are bound by law to observe a patient’s rights to confidentiality!

Confidentiality Conversations with patients should be limited to cheerful subjects Be compassionate and understanding Never offer an opinion on personal affairs or medical diagnoses Violation of confidentiality is grounds for dismissal

Respect and Confidentiality The dove indicates the loss of an infant. The heart indicates the adoption of an infant. These symbols may be seen posted outside a new mother’s door.

Risk Management and Legal Issues If an attorney contacts you about a patient or other event at Northside Hospital you should not speak to them. Please refer them to the Risk Management office. Risk Management handles all significant complaints, attorney inquiries, lawsuits, and other legal matters. If you have any questions please call ext. 8890. Legal Northside Hospital is a Drug Free Workplace.

Corporate Integrity Northside has a Corporate Compliance Program Any ethical concerns should be addressed to the Corporate Integrity Line, 404-845-5907 (this number is posted in the office on the bulletin board on the left side as you walk in the office) Calls may be made anonymously, 24 hours a day

Impaired Provider - Physician or Affiliated Professional who: Has altered ability or clinical judgment due to a medical condition or use of alcohol or drugs. May pose an immediate threat to the health and safety of patients. May be unable to provide appropriate patient care. What to do: Immediately report the problem to any Manager, House Coordinator, Medical Staff Leadership, Manager of Volunteer Services or Auxiliary officer. HOSPITAL POLICY IS: Non punitive approach. Works as advocate for impaired individual. Seeks to protect patients from harm.

The end Congratulations! You have completed the Northside Auxiliary-Atlanta Orientation & In-service. To complete this course you must complete the Orientation/In-service Test and bring it with you to your scheduled Orientation or turn it in during the annual in-service drive.