Student and Faculty Core Orientation © Approved 5 23 2011, Revised 4 27 2016 © ©CCEP & NC AHEC Program 2010-2016. All rights reserved. 1 Click on hyperlinks.

Student and Faculty Core Orientation © Approved 5 23 2011, Revised 4 27 2016 © ©CCEP & NC AHEC Program 2010-2016. All rights reserved. 1 Click on hyperlinks at the bottom of the slide to go to previous or next slide Click escape to exit

IntroductionIntroduction Welcome to the Student and Faculty Core Orientation! This presentation includes common orientation information that is required by healthcare agencies for faculty and health science students participating in clinical experiences in North Carolina. The presentation is developed and maintained by the Clinical Consortium for Education and Practice. The NC AHEC Program website is the host for the Core Orientation presentation. If you have trouble accessing the presentation, please contact your school coordinator or agency coordinator. 2

ObjectivesObjectives Upon completion of this orientation the participant will be able to describe the following as related to clinical practice: Standards of Behavior Corporate Compliance- HIPAA, Privacy, Security, EMTALA, Reporting Code of Conduct/Breaches Infection Prevention/Control Policies & Procedures- Pain Management, Falls, Restraints Emergency Alerts Patient Safety Respect for Cultural Diversity General Guidelines 3

To provide the best healthcare possible, everyone must be committed to the healthcare agency’s values and standards of behavior. 4 ExpectationsExpectations

While in Healthcare Agencies, Students & Faculty should demonstrate: 1. Professional Appearance Wear Photo nametag at all times. Comply with dress code policy. * See dress code slides 2. Positive Attitude Acknowledge the presence of patients and visitors. Don’t conduct personal and non-emergent conversations around patients and family members. 5 Standards of Behavior

3. Professional Conduct Respect the rights of others. Be careful not to tell inappropriate jokes. 4. Compassionate and Courteous Communication Address all patients/families by their names, not room numbers. Avoid terms such as “Honey” and “Sweetie.” Acknowledge patient/family complaints and concerns. 6 Standards of Behavior

5. Utilize Health Literacy principles in communication Communicate using plain language; tell patient/family what is the main issue, what action can be taken and why it is important for them to participate. Consider factors such as reading ability, native language and medical terms that may be confusing when speaking with patients, families, and staff. 6. Clean/Safe/Attractive Environment Keep workstations and patient rooms/environment neat and clean. 7 Standards of Behavior

7. Caring for Individuals: Anticipate Needs Be aware of all individuals who may need assistance. Ask “Is there anything else I can do?” before leaving the patient. 8. Maintaining Privacy and Confidentiality When entering a patient room/residence, knock and wait for a response. Identify yourself. State the purpose of your visit. 8 Standards of Behavior

9. Be Aware of Workplace Harassment Harassment – Sexual harassment or any form of physical, mental or emotional abuse will not be tolerated. Notify instructor /supervisor or designated personnel if there are issues which concern you. 9 Standards of Behavior

American Hospital Association Patient Care Partnership Expectations, Rights and Responsibilities:   High Quality Care   Clean & Safe Environment   Involvement in Care   Privacy Protection For more information check out link below: Adapted from: http://www.aha.org/content/00-10/pcp_english_030730.pdfhttp://www.aha.org/content/00-10/pcp_english_030730.pdf 10 Standards of Behavior

Dress Code Picture identification badges must be worn- above the waist- and must be fully visible. Clothing must be clean, neat, pressed and non-tattered. Shoes should be in good repair. No sandals or open toe shoes in patient care areas. Good personal hygiene. Use good grooming habits, regular bathing and shampooing, to avoid obvious and unpleasant odors. No perfumes, fragrances or after-shaves are to be worn in patient-care areas. Hair should be styled as not to interfere with patient care. Beards and mustaches should be short, neat and trimmed. 11 Standards of Behavior

Dress Code Tattoos and body art - see Academic & Healthcare agency policies. Nails must be neat, clean and natural tips less than ¼ inch long without nail enamel or polish. NO artificial nails, nail applications or overlays are allowed for direct bedside caregivers. Underclothing must be worn and not visible. Use discretion for professional attire in the healthcare agency. Wear a lab coat over street clothes. NO tank tops, bare midriff, revealing clothing, sweat pants, leggings, active wear, denim, shorts or flip flops. Jewelry Conservative and safe, based on the area assigned. Keep to a minimum in patient care areas. See healthcare agency’s policy. 12 Standards of Behavior

Multiple Choice: Which information is included in policies related to student identification on the clinical unit? The student identification must include a Photo ID The ID must be approved by the clinical agency An ID is not necessary in some areas The ID is worn only when interacting with patients or clientsThe ID is worn only when interacting with patients or clients 13 Test Your Knowledge

Correct response. Good job! 14 Feedback

Multiple Choice: Health literacy issues apply to which of the following? Language barriersLanguage barriers Reading abilityReading ability ComprehensionComprehension Medical vocabularyMedical vocabulary All of the above 15 Test Your Knowledge

HIPAA: Health Insurance Portability & Accountability Act   Federal law which protects individuals’ privacy Federal law which protects individuals’ privacy   HIPAA Privacy Rule: HIPAA Privacy Rule:   Identifies permitted uses & disclosures of "individually identifiable health information", known as PHI: Protected Health Information Identifies permitted uses & disclosures of "individually identifiable health information", known as PHI: Protected Health Information   Disciplines workforce for inappropriate access to PHI Disciplines workforce for inappropriate access to PHI   Potentially bars students from clinical rotation & future employment when PHI is intentionally accessed inappropriately or PHI is disclosed & harm occurs Potentially bars students from clinical rotation & future employment when PHI is intentionally accessed inappropriately or PHI is disclosed & harm occurs   Gives patients control of who has access to their PHI, including providers, clergy, agency directories… Gives patients control of who has access to their PHI, including providers, clergy, agency directories…   HIPAA Security Rule: HIPAA Security Rule:   Protects maintenance & transmission of PHI Protects maintenance & transmission of PHI   Requires administrative, physical, & technical safeguards Requires administrative, physical, & technical safeguards   Requires corrective action for failure to comply with security policies. Requires corrective action for failure to comply with security policies..17 Corporate Compliance: HIPAA Privacy and Security

What is Protected Health Information (PHI)?  Information that identifies a person, living or deceased  Any information about a person’s past, present, or future (physical &/or mental) healthcare treatment or payment plan For more information, click on the link below: http://www.hhs.gov/hipaa/for-professionals/privacy/special-topics/de-identification/index.html Ask yourself: Can I identify the patient from the information shown? If the answer is “yes,” then the information must be hidden from public view.

PHI identifiers: Name of patient, relatives/family/employer Mailing & e-mail address, city, county, zip code All elements of dates: birth, service, age >89 Phone & fax number, URL or IP address Insurance & bank account numbers Social security, medical record, serial, device & vehicle identification numbers Face & body photos; Biometric identifiers, i.e.. voice, finger or retinal prints Any unique identifying number, characteristic or code, i.e.. tattoo, unique diagnosis, procedural codes All of this information must be hidden from public view. 19 Corporate Compliance: HIPAA Privacy and Security

How to protect PHI (electronic, written, spoken): Log off before leaving the computer. Place charts, census lists & reports face-down. Place fax machines & printers in an area not visible to the public. Avoid discussing patients in public areas (elevators, cafeteria, hallways). Do not write down, print, copy, or remove patient PHI identifiers, documents containing any patient PHI identifiers or medical information from the healthcare agency. Review healthcare agency’s policy regarding process for copying and/or destroying paperwork. (i.e.. shredding) All hard copy worksheets or report sheets developed during clinical practicums are to be protected from public view and must not leave the healthcare agency. Confidentiality extends to social media electronic communication. It is a HIPAA violation to discuss or post any patient information, including photographs. 20 Corporate Compliance: HIPAA Privacy and Security

Corporate Compliance REASONS TO AVOID USE OF ELECTRONIC DEVICES IN PATIENT CARE AREAS: Use of electronic devices is perceived as being unprofessional & distracting. Devices may transmit microorganisms, causing infections & illness. Patients & families may think you are sharing their PHI. Use of devices may be prohibited by the agency or school. Reminder: No photography, video or audio recordings - by students - are allowed in the clinical facility 21

Multiple Choice: Which is the most appropriate place to discuss Protected Health Information (PHI)? Elevator Cafeteria Private conference room All of the above 22 Test Your Knowledge

In general, HIPAA violations are enforced by the Department of Health & Human Services. Health Information Technology for Economic & Clinical Health (HITECH) Act permits State Attorney Generals to also bring civil actions AND permits monetary awards to be shared with harmed individuals. 24 Civil & Criminal Penalties for Unauthorized Access:  $50,000/violation, with annual maximum of $1.5 million  Agency placed under a Resolution Agreement for compliance reporting & monitoring  Civil Monetary Penalties for agency & perpetrator of privacy breach  Criminal Penalties: up to 10 years in prison  State Attorney General can pursue civil action Corporate Compliance: HIPAA Privacy and Security

Did you know? All activity within electronic medical records is tracked each time a patient’s record is accessed:   Who accesses a record   Which parts are accessed   How long a record is accessed 25 Corporate Compliance: HIPAA Privacy and Security

You CAN access: Information to perform your duties as a student or faculty Records of patients within your care You CANNOT access:   Medical records of friends, family, high-profile patients, employees or yourself   Medical records of former patients, even to see how they are progressing   PHI (Protected Health Information) not needed for your duties 26 Corporate Compliance: HIPAA Privacy and Security

What is Authorization? A patient’s written permission is required for release of any information from the medical record. When can information be given without prior Authorization?   In medical emergencies (life or death) when there is no one available to give consent.   In the case of possible abuse or neglect, reporting must be done - according to legal guidelines.   In the case of communicable disease, reporting to public health agencies is required.   For verifying medical treatment for insurance purposes   By court order If you are asked to share Protected Health Information: Consult your instructor, preceptor, &/or unit leadership 27 Corporate Compliance: HIPAA Privacy and Security

Incidental Uses & Disclosures of PHI:   When PHI is communicated   without intent while performing normal & permitted activities   despite using reasonable measures to protect PHI   in a limited nature   The HIPAA Privacy Rule   is not intended to impede customary & essential communications & practices.   permits certain incidental uses & disclosures of PHI when reasonable safeguards & minimum necessary policies are in place to protect patients’ privacy For more information, click on link below: http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/incidentalusesanddisclosures.html 28 Corporate Compliance: HIPAA Privacy and Security

Corporate Compliance: HIPAA Privacy & Security Confidentiality is more than a legal & regulatory issue.   Patients trust the healthcare agency to maintain the privacy of their medical information.   Maintaining confidentiality shows respect. 29

Multiple Choice: When can patient information be given without prior authorization? If there is a possibility of abuse and neglect; healthcare workers follow legal guidelines for reporting. If there is a communicable disease it must reported to public health agency. If there is a medical emergency and no one is available to give consent. All of the above 30 Test Your Knowledge

How to Say “No” with a Smile “I am not allowed to talk about this with you. You may want to talk with the patient.” “We are required to protect the patient’s privacy.” 32 Corporate Compliance: HIPAA Privacy and Security

Multiple Choice: Reasons to avoid the use of personal electronic devices while on the clinical unit include: Avoid appearance of unprofessional behavior Infection control concerns May be prohibited by academic or clinical agency policy All of the above 33 Test Your Knowledge

True or False: Patients can legally expect to receive high quality care, a clean & safe environment, involvement in care, and privacy protection while in the healthcare environment. True False 35 Test Your Knowledge

Multiple Choice: How do you prevent HIPAA violations? Remove all patient identifying information from clinical assignment sheets/notes before leaving the healthcare agency. Place patient identifying information in a secure container for disposal. Refrain from discussing patients in public or non-clinical areas/settings. All of the above 37 Test Your Knowledge

Corporate Compliance: Safety Management & Reporting Corporate Compliance: Safety Management & Reporting Safety With Medical Equipment & Devices:  Make sure that you have received training prior to use.  Refer to agency policies.  Report unsafe conditions to your instructor, preceptor, or supervisor immediately:  Broken equipment or utility interruptions  Injuries  Spills  Federal law requires reporting of all incidents where there is a reasonable suspicion that a medical device caused or contributed to a patient’s serious injury, illness, or death.  Incidents are reportable if they:  Require surgery or medical intervention  Result in permanent impairment of a body function  Permanently damage a body structure 39

Reporting Malfunctioning Equipment: Safe Medical Devices Act (SMDA) If a patient is injured by a medical device, you should: Take care of the patient’s immediate needs. Remove the device, saving all settings & disposables. Label device “DO NOT USE”, with date & time. Alert your instructor, preceptor, &/or unit leadership. Report unsafe device according to the healthcare agency policy. Medical devices include: Anything- other than drugs- used for patient care or diagnosis: Bandages, Beds, Catheters, Defibrillators, Equipment, IV Infusion Sets & Pumps, Implants, Lab Devices, Lift Equipment, Monitors 40 Corporate Compliance: Reporting Corporate Compliance: Reporting

TermDefinitionSigns Abuseintentional infliction of pain, injury or mental anguish multiple injuries, bruises, inappropriate burns or fractures, repeated ED visits, no opposition to painful procedures Neglectfailure to provide adequate materials, shelter or food necessary for health poor hygiene, hunger, emaciation, delay in reporting injuries, abandonment Exploitationillegal or improper use of a child or a disabled adult or the person’s resources for another’s profit or advantage sudden change in banking practices, unpaid bills when resources are available, previously uninvolved relatives claiming rights to possessions 41 Children, Disabled and Aged are the most vulnerable. If you suspect any of the above, report immediately & seek guidance from your instructor, preceptor, supervisor or patient’s care provider. Corporate Compliance: Required Reporting of Abuse

Multiple Choice: According to the Safe Medical Devices Act (SMDA) a report is required of all incidents where there is a reasonable suspicion that a medical device caused or contributed to a patient’s serious injury, serious illness, or death. When a reportable incident with failed equipment occurs, what should you do? Remove the equipment from service.Remove the equipment from service Label the equipment with "DO NOT USE”, date and time.Label the equipment with "DO NOT USE”, date and time. Notify the faculty/instructor or preceptorNotify the faculty/instructor or preceptor. All of the above 42 Test Your Knowledge

Corporate Compliance in the Emergency Dept. What is EMTALA?   Federal Emergency Medical Treatment & Active Labor Act   Also known as COBRA or the Patient Antidumping Act   Regardless of insurance coverage or ability to pay- when a patient presents to an emergency room for attention to an emergency medical condition- requires hospitals to provide:   Evaluation by a qualified healthcare provider   Needed stabilizing treatment   Transfer to another agency, as needed, for specialized care 44

Multiple Choice: EMTALA, also known as the Emergency Medical Treatment and Active Labor Act, includes all of the following except: Patient presents to the ED and requests emergency medical treatment. Patient presents at radiology for an outpatient procedure. Patient is evaluated by a qualified health care providerPatient is evaluated by a qualified health care provider. Patient receives care regardless of ability to pay. 45 Test Your Knowledge

Laws Related to Compliance Issues Federal Anti-Kickback Law: o Prohibits paying for patient referrals o Prohibits staff or students from accepting gifts, tips, money or other gratuities from patients & their families. Federal False Claims Act (FFCA) o Fraud: intentional filing of a false medical claim- for payment o Prohibits providing &/or billing for services such as drugs, oxygen, x-rays- without a documented provider order o It is a crime for a person or organization to knowingly make a false record or file a false claim with the government- for payment. o No proof of specific intent to commit fraud is required. Stark Law: o Applied to providers who refer Medicare patients for laboratory, radiology, home- health, outpatient or inpatient services or prescription drugs. o There cannot be any relationship between the provider & the referred service. o Known or suspected violations must be reported. 47 Corporate Compliance: Code of Conduct

Consequences of Non-compliance   Fines &/or imprisonment for: Fines &/or imprisonment for:   Agency staff Agency staff   Students & faculty Students & faculty   Loss of Medicare & Medicaid funding for the Healthcare Agency, affecting its ability to treat patients. Loss of Medicare & Medicaid funding for the Healthcare Agency, affecting its ability to treat patients.   Loss of clinical privileges at the Agency for Students & Faculty Loss of clinical privileges at the Agency for Students & Faculty   Loss of future hiring potential at the Agency for Students & Faculty. Loss of future hiring potential at the Agency for Students & Faculty. 48

Multiple Choice: Which of the following are consequences if a student or faculty member does not comply with the code of conduct? Student/faculty/academic institution could lose clinical privileges and/or ability to work in the healthcare agencyStudent/faculty/academic institution could lose clinical privileges and/or ability to work in the healthcare agency. Fines and/or imprisonment for student/faculty/academic institution/healthcare agencyFines and/or imprisonment for student/faculty/academic institution/healthcare agency. Healthcare agency could lose its Medicare and Medicaid funding and ability to treat patients. All of the above 49 Test Your Knowledge

True or False: It is okay to accept gifts from patients so they can show appreciation for their care. True False 51 Test Your Knowledge

Hand Hygiene The expectation is that healthcare workers and students will perform proper hand hygiene whether wearing gloves or not: Before touching a patient or his/her environment. After touching a patient or his/her environment. After removing gloves and other Personal Protective Equipment Before documentation After documentation Infection Prevention/Control 53 http://www.cdc.gov/handwashing/pdf/wash-your-hands-fact-sheet.pdf for more information on when and how to wash your hands

Hand Hygiene Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. GI issues such as C-diff and Norovirus require handwashing with soap and water. Hand sanitizers are ineffective. Infection Prevention/Control What if I fail to perform proper hand hygiene? If a student is observed failing to perform proper hand hygiene, the instructor will be notified.If a student is observed failing to perform proper hand hygiene, the instructor will be notified. Repeated failings would jeopardize a student’s clinical rotation.Repeated failings would jeopardize a student’s clinical rotation. 54

Bloodborne Pathogens The healthcare agency’s Bloodborne Pathogen (BBP) Exposure Control Plan provides information on: Hepatitis B Vaccinations. Jobs and tasks that are risky. How to choose Personal Protective Equipment (PPE). If you have questions about BBP: Contact appropriate agency department or refer to the agency’s policy manual/resource. After hours, contact the house supervisor or equivalent. To review the BBP Exposure Control Plan, access the healthcare agency’s resource/policy manual. Infection Prevention/Control 55

Blood, OPIM and PPE When handling blood or “Other Potentially Infectious Materials” (OPIM) and anytime there is a risk of a splash, you MUST use Personal Protective Equipment (PPE): Gloves – When handling blood, OPIM or touching non-intact skin. Gowns, Mask & Goggles or Face Shields – When there is a risk of splash of blood or OPIM Make sure you know where to find and use PPE. If it is wet or dripping and isn’t yours: use PPE! Infection Prevention/Control 56

Blood or Body Fluids: Spills and Exposures 1. 1.IMMEDIATELY wash the exposed skin with soap and water or flush mucous membranes with water or saline. 2. 2.Report the spill or exposure to the instructor, preceptor or agency liaison. 3. 3.Report to infection prevention/control department or specialist/department per agency policy. 4. 4.Complete an appropriate report per agency policy. Infection Prevention/Control 57

Sharps Safety Sharps Safety Devices are for your protection and, by law, you MUST use them. Examples of Sharps Safety devices: Needles and syringes used for intramuscular or subcutaneous injections. Needle-less IV tubing sets. Safety needles and lancets. Phlebotomy devices. IV safety catheters Sharps should be thrown away in a Sharps disposal box or use an approved alternative method for home use. For More Information: www.fda.gov/safesharpsdisposalwww.fda.gov/safesharpsdisposal http://www.safeneedledisposal.org/wp-content/uploads/2015/07/sharps_dos-and-donts.pdf Infection Prevention/Control 58

Standard Precautions In addition to hand hygiene, PPE and safe injection practices, other elements of standard precautions include: Care and cleanliness of the work area. Cough etiquette and respiratory hygiene. Safe handling of laundry. Use of proper bag technique – More information click on link http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Bag_Technique__Preventing_a nd_Controlling.6.aspxhttp://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Bag_Technique__Preventing_a nd_Controlling.6.aspx Patient isolation and transportation. Handling of dirty patient-care equipment, instruments and devices. Guidelines for Isolation Precautions: Refer to healthcare agency policies and procedures. Infection Prevention/Control 59

Tuberculosis (TB) Precautions To prevent the spread of TB, patients suspected of having TB must: Wear a surgical mask until they are placed in a negative pressure, private room. Be placed on “Airborne Precautions.” Wear a surgical mask anytime they are outside the negative pressure room. Any one entering the room of a patient on Airborne Precautions must wear an N-95 mask or Powered Air Purifying Respirator (PAPR). Fit-testing is required for N-95 mask wear. Students/faculty NOT fit-tested for N-95 masks should NOT be caring for patients with Airborne Precautions. Infection Prevention/Control 60

Infection prevention requirements: No food or drink in clinical areas.No food or drink in clinical areas. Linen Clean linen must be covered.Clean linen must be covered. Never place bags of linen on the floor. Portable patient care equipment Must be cleaned between patients Must be identified as “CLEAN” per agency policy.Must be identified as “CLEAN” per agency policy. Infection Prevention/Control 61

True or False: Gloves and other appropriate personal protective equipment (PPE) are required when dealing with blood and other potentially infectious material. True False 62 Test Your Knowledge

True or False: Sharps safety devices such as safety lancets and needleless IV sets are for your protection and use is required by law. True False 64 Test Your Knowledge

True or False: Students cannot care for patients on Airborne Precautions unless they are fit-tested for an N-95 mask or wear a Powered Air-purifying Respirator (PAPR). True False 66 Test Your Knowledge

Multiple Choice: When working with a client with suspected C-diff or Norovirus, health care workers must: Use soap and water for hand hygiene Use hand sanitizer for hand hygiene Use either soap and water or hand sanitizer 68 Test Your Knowledge

It is important to be familiar with your assigned agency’s Policies and Procedures. Contact the healthcare agency to find out how to access Policies and Procedures. Policies and Procedures 70

Policies and Procedures Patients have a Right to Pain Management Pain is the 5th Vital Sign Pain Management includes: Medications Emotional Support Comfort measures Alternative therapies Refer to Healthcare Agency’s Pain Assessment & Reassessment Policy. 71

Policies and Procedures FALLS PREVENTION Is Everyone’s Business An accidental fall can change a short hospital stay- for a minor problem- into a prolonged stay. o o Identify “At Risk” Patients o o Keep bed in low position o o Keep call device within reach o o Eliminate clutter, remove throw rugs o o Assess pain- and medicate as needed o o Perform routine checks o o Maintain adequate lighting o o Provide non-skid footwear o o Assist with routine toileting; use of bedside commode as needed o o Utilize bed or chair alarms o o Follow healthcare agency policy for falls prevention 72

MEDICAL OR BEHAVIORAL RESTRAINTS *Requires Provider Order *Requires Training Attempt alternative measures first Maintain patient safety & dignity Periodic release and offer of food, water & toileting Provider orders are time-limited Refer to healthcare agency Restraint Policy & Procedure Policies and Procedures 73

Policies and Procedures RRT: Rapid Response Team For Deterioration in a Patient’s Condition Purpose: to provide early and rapid interventions to promote positive outcomes Identify Early Warning Signs & Report Refer to healthcare agency’s process for managing unstable patient situations 74

Organ Donation Only trained personnel from an Organ Procurement Organization (OPO) are permitted to offer families the option to donate, recover donated organs, and distribute in an equitable manner. Refer questions to your instructor, preceptor, unit leadership and/or agency organ donation liaison. See Healthcare Agency’s Policy and Procedure regarding Organ Donation Policies and Procedures 75

Policies and Procedures Safety Reporting Systems (SRS) Goal: Improve Quality & Safety   Reportable Events:   Inconsistent with Standards of Care   Near Misses   Serious & Non-Serious   Sentinel Events   Refer to agency reporting policy/procedure 76

True or False: The purpose of the rapid response team is to provide early and rapid interventions to promote positive outcomes for the patient. True False 77 Test Your Knowledge

True or False: Anyone can offer the option of organ donation to families. True False 79 Test Your Knowledge

Multiple Choice: You should report adverse events to your faculty/instructor & per healthcare agency policy when: There is no event but a possibility was recognizedThere is no event but a possibility was recognized. Serious harm occurred to the patient. Non-serious harm occurred to the patient. All of the above 81 Test Your Knowledge

Multiple Choice: Use of restraints requires which of the following: Training Physician order Periodic release and offer of food, water, and toileting All of the above 83 Test Your Knowledge

Hazardous Materials On product labels. On Safety Data Sheets (SDS) compliant with the Globally Harmonized System of Classification and Labeling of Chemicals (GHS). In safety policies. Every chemical container must include: *Chemical Name *Guidelines for Use * Warnings * Manufacturer If a product is transferred into a new container, ALL the above information must be on the new container. For the protection of staff and students, safety information about chemicals used within the healthcare agency is available: 85 Policies and Procedures

A Safety Data Sheet (SDS) tells how to: Use Store Protect Yourself (PPE) Clean up a spill Offer first aid Dispose of a chemical SDS information is available online. Know how to access the SDS information in the area you are assigned. For emergencies: Follow healthcare agency policy. 86 Policies and Procedures

Managing Chemical Hazards Use only if you are qualified and knowledgeable. Use only properly labeled containers. Use Personal Protective Equipment (PPE). Know what to do in an emergency. Ask for help if you don't understand label information. Immediately report spills, leaks, or accidents to instructor, preceptor or unit leadership. Never use unidentified chemicals. Store chemicals in approved areas. Properly dispose of used chemicals/containers. 87 Policies and Procedures

Hazardous Material (Haz Mat) Incident: Significant Chemical Spill Avoid the area until “all clear” is announced. Trained health agency personnel will respond Nearby departments should prepare to receive re-routed traffic and be ready for possible evacuation. Other departments are on stand-by to assist if needed. Staff should be trained to clean spills of chemicals used regularly. Depending on the healthcare agency’s policy, an announcement may be optional for spills that are manageable within the department. 88 Policies and Procedures

External Haz Mat Incident If a chemical spill/exposure occurs in the community, and the agency is expecting to decontaminate and treat victims in the Emergency Department, external haz mat precautions will be initiated. In response: Members of the HazMat response team should respond to the Emergency Department. Contaminated patients should not be allowed into hospitals without decontamination. Directions will be given per healthcare agency procedures. Students should report to the instructor, preceptor, or unit leader. 89 Policies and Procedures

Biohazardous Waste Regulated Medical Waste: Blood or body fluids > 20 ml Microbiologic waste Pathologic waste (specimens, tissues, organs) Bloody dressings, gauze Blood transfusion bags and tubing Materials used for cleaning blood spills if > 20 ml Discarded per agency policy & containers Sharps Boxes: Used syringes/needles. 90 Policies and Procedures

91 Policies and Procedures Unregulated Waste: o o Plain IVs (No Medications Instilled): o o Can be emptied down the drain o o Examples: Saline, D5, Lactated Ringers, Potassium, Electrolytes o o Empty IVs, vials, wrappers, and syringes will continue to be disposed of according to healthcare agency’s procedures. An item is empty if it contains 3% or less of it’s original volume. o o Refer to healthcare agency policy and procedure. “ Plain down the drain” NARCOTICS and other C ontrolled Substances

92 Policies and Procedures Pharmaceutical Waste:   Medication: partially administered in vials/ampules, leftover or unused, not given, or refused, such as:   IV bags and tubing with medication remaining   Oral medications   Ointments and creams   Physician samples   Disposal:   Per healthcare agency policy   As indicated on the pharmacy medication label   As indicated in the medication dispensing system

Test Your Knowledge True or False: Hazardous waste such as: blood or body fluids, pathologic waste - tissue samples, microbial waste, bloody saturated dressings, blood transfusions bags, and material used to clean up blood spills, etc. may be placed in any plastic trash can as long as it has a lid. True False 93

Feedback Correct response. Good job! 94

Signs must be posted in rooms where radioactive materials are stored or used. Do not enter without proper supervision. Only properly trained individuals may handle or administer radioactive materials. When unattended, materials must be secured. You may not eat or store food in these areas. Radiation Safety Policies and Procedures 95

Policies and Procedures Oxygen tanks and other compressed gas cylinders can explode. They must be handled with extreme care – it’s federal law!   Secure with a chain or in a rack when stored   Use only an approved carrier during transport – an approved carrier is designed for this purpose.   Store in limited quantities   Full, ready to use, and empty tanks must be stored separately and clearly labeled for easy identification 96 Gas Cylinder Safety

All North Carolina healthcare agencies are converting to a plain language alert system. Refer to each healthcare agency’s emergency management guide for codes, alerts, and emergency telephone numbers. Emergency Alerts 97

Type of AlertExampleAnnouncementCode NameEmergencyFire / Alarm Facility Alert + Fire/Smoke Alarm + Descriptor + Location Code Red SecurityMissing Infant/Child Security Alert + Missing Person + Descriptor (Infant/Child) + Location Code Pink MedicalMedical Emergency Medical Alert + (Type of Emergency- Incident) + Descriptor + Location Code Blue Emergency Alert Matrix 98

Fire Emergency Alerts ctivate the alarm and call the emergency number. 4 steps to respond to a fire: escue anyone in immediate danger. lose doors and windows. xtinguish if possible. E vacuate if necessary. R C E 4 steps for using an extinguisher--“PASS” A 1 23 4 99

Bomb Threat Emergency Alerts In response to a bomb threat announcement, students should report to the instructor/preceptor/unit leader: Immediately check your department or area for any items that don’t belong. (backpacks, computer cases, boxes, etc.) Call Security to report anything found that could be related to the threat. Refer to healthcare agency policy /ask your supervisor for instructions. Prepare to evacuate if directed. 100

Disaster: Emergency Alerts An occurrence that changes the way the healthcare agency will deliver services, and may mean a large number of casualties. For example: Infectious disease outbreak Large plane crash Weather-related disaster.   Remain in your location – you will be contacted if needed.   Review your healthcare agency’s disaster plan. 101

Security Alert: Emergency Alerts Response to an incident of civil or emotional upset that threatens the safety of patients, visitors and staff. Potential reasons to activate security alert include, but are not limited to: – –Heightened emotional or behavioral response, even after de-escalation attempts. – –Hostile/aggressive verbal communication – –Active shooter or visible weapons. – –Physical altercations. – –Hostage situations. – –Communication of threats. 102

Active Shooter Guidelines When an active shooter is in your vicinity:  Run – escape if possible  Hide – if you can’t escape  Fight – if you are confronted by the shooter Department of Homeland Security. (2015, November 30). How to Respond to An Active Shooter. Retrieved from http://www.dhs.gov/active-shooter-preparednesshttp://www.dhs.gov/active-shooter-preparedness  Follow the healthcare agency’s procedure  Follow instructions by law enforcement officers Emergency Alerts 103

Missing Infant or Child Emergency Alerts   The first few minutes are critical.   Unless you are involved in a life-saving activity, search the area immediately.   Report suspicious individuals carrying bags, bundles, infants or children – to the agency’s security department.   Quick, decisive action may result in finding the infant or child.   Be familiar with agency policy if you are working with infants and children. 104

Test Your Knowledge Multiple Choice : The most important thing to remember about fire response is the safety of the people in the immediate area. When you see or smell smoke or fire in your department, what should you do FIRST? Remove anyone in immediate danger Grab the nearest fire extinguisher Contain the fire by closing doors and windows Yell, “Fire!” 105

Test Your Knowledge Multiple Choice : What is the FIRST thing you do when preparing to use a fire extinguisher? PULL the pin AIM at the fire SQUEEZE the trigger SWEEP at the base of the fire 107

Many healthcare agencies are participating in a North Carolina statewide program to implement standardized armband colors for improved safety. Check each agency’s orientation material for participation and use of the colored bands or other method of risk identification. Banding Together for Patient Safety 109

Patient Safety Accrediting bodies - such as The Joint Commission (TJC) & the Accreditation Commission for Health Care (ACHC) establish annual patient safety goals for healthcare agencies. Healthcare providers are responsible for knowing and implementing these for patient care. Click on the link below and read about required patient safety goals for assigned clinical area(s): http://www.jointcommission.org/standards_information/npsgs.aspx 110

Patient Safety REFLECTION: According to the National Patient Safety Goals, how many patient identifiers are required prior to administering medication: 11 oneone 22 twotwo 33 threethree 44 fourfour 111 http://www.jointcommission.org/standards_information/npsgs.aspx

Good attempt! This is incorrect. Please try again: Click hereClick here 113 Feedback

True or False: Some healthcare agencies are working together to standardize the use of colored arm bands to alert staff of patients who are on special safety precautions such as allergies, falls, etc. True False 114 Test Your Knowledge

Respect for Cultural Diversity Respect for cultural diversity is the demonstration of a caring spirit and honoring individual differences by treating everyone with esteem, courtesy and sensitivity to their unique needs, concerns or beliefs. The values of outstanding customer service and integrity are also evident. 116

Why is respect for cultural diversity important in healthcare organizations?  Improves quality of care  Helps to decrease health disparities among minorities  Contributes to patient-centered care and communication  Supports National Standards for Culturally and Linguistically Appropriate Services in Health For more information click on the link below: http://www.hdassoc.org/wp-content/uploads/2013/03/CLAS_handout-pdf_april-24.pdf 117 Respect for Cultural Diversity

Patients from Different Cultures   It is possible to tailor your speaking style to the needs of the patient.   The more you know about your patient’s culture and values, the more likely you are to get your point across.   Interpreters are available at most agencies. 118

Respect for Cultural Diversity Communication   Remember: 90% of communication is non-verbal Includes tone of voice Includes body language: posture, eye contact   Personal space: Some cultures prefer closeness and touching Some cultures are uncomfortable with closeness   Some cultures value eye contact; some do not.   Smile, speak in a friendly tone of voice.   Treat others fairly and with respect.   If you accidentally offend someone, apologize. 119

Multiple Choice: Why is cultural respect for diversity important in healthcare? It improves quality of care. It contributes to patient-centered care and communication. It supports the National Standards for Culturally and Linguistically Appropriate Services (CLAS). All of the above 120 Test Your Knowledge

Chain of Command If you have concerns, questions, or issues First- speak with your Instructor, Preceptor or Unit Leader. As needed- your Instructor, Preceptor or Unit Leader will communicate with other leadership or experts. General Information 122

Test Your Knowledge Multiple Choice : For any unit concerns, questions or issues, the student should first speak to the _____________. Department Director Healthcare Provider Faculty/Instructor/Preceptor Law enforcement officer on duty 123

Palliative Care The comprehensive care and management of the physical, psychological, emotional, and spiritual needs of patients (all ages) with chronic, debilitating, life threatening illness and their families. Palliative Care Focus Pain management Symptom management Hydration / Nutrition Holistic approach & support General Information 125

General Information Meals?Libraries? Parking? Many agencies encourage carpooling. There may be specific parking areas for students. 126 See specific healthcare agency guidelines for details.

General Information 103 Theft Prevention Reduce your risk of becoming the victim of a theft. Your best defense is prevention. Do not bring valuables into the healthcare agency. Parking Lots   Always lock your car.   Keep valuables out of sight: place money, wallets, purses, GPS devices, computers, packages and shopping bags in the trunk.   Park in well-lighted areas.   When it’s dark outside, walk to your car with staff or fellow students. At some facilities you may request an escort- by calling Security.   Secure bikes, motorcycles and mopeds.

General Information 128 E-Cigarettes are also prohibited.

Core Orientation Attestation By printing the certificate of completion for the Core Orientation: I attest that I have read and reviewed the Student/Faculty Core Orientation Power Point presentation and understand the information as presented. I agree to maintain the confidentiality of the patients I care for I agree to abide by the policies of the healthcare agency’ to which I am assigned, and will seek assistance with and/or clarification of the information presented if needed. 129

Core Orientation Completion Certificate of Completion Click on the link below to access the CCEP’s Certificate of Completion. This document will open in MS Word. Fill in the certificate with your name and date, print, and submit to the academic coordinator. http://www.wakeahec.org/certificates/Core Orientation Certificate.docx Once you’ve completed the certificate, click your esc key to exit this course.

Student and Faculty Core Orientation © Approved 5 23 2011, Revised 4 27 2016 © ©CCEP & NC AHEC Program 2010-2016. All rights reserved. 1 Click on hyperlinks.

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Student and Faculty Core Orientation © Approved 5 23 2011, Revised 4 27 2016 © ©CCEP & NC AHEC Program 2010-2016. All rights reserved. 1 Click on hyperlinks.

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Presentation on theme: "Student and Faculty Core Orientation © Approved 5 23 2011, Revised 4 27 2016 © ©CCEP & NC AHEC Program 2010-2016. All rights reserved. 1 Click on hyperlinks."— Presentation transcript:

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