Introduction This orientation program is designed to provide you with information about several key aspects of your employment with Allendale County Hospital.

Introduction This orientation program is designed to provide you with information about several key aspects of your employment with Allendale County Hospital and your responsibilities in regards to these different programs, policies and procedures. As a member of the staff it is every important that you know and understand what is expected and/or required in support of and compliance with these programs. This orientation is a brief and general overview of several topics. As a member of the staff, you will be expected to further review more detailed materials available in your department and/or provided as handouts during the orientation sessions. You will also be required to complete this program on an annual basis and participate in other more in-depth inservice and education programs that may be scheduled periodically. Participation in this orientation and other inservice training and education programs, will be monitored and will be reflected in your annual evaluation. Each and every member of our staff fulfills a key role and function in order for the entire organization to achieve its mission of serving our community. You represent yourself and this organization every day while you are on duty and even when you are not on the job. We want you to be proud to be a part of the health care industry and this organization. Being well prepared and well informed to function as a member of this team is the primary objective of this annual orientation. I urge you to do all you can every day to become a more valuable member of our organization through your commitment to learning and self-improvement, as well as your commitment to providing excellent quality service in your respective position. Ken Hiatt Administrator

Allendale County Hospital Policy: Orientation / Annual Update Sessions
Procedures: Human Resources (HR) will be responsible to schedule your initial orientation which must be completed before you can begin work. HR and your supervisor will be responsible to assure that you complete an annual update of the orientation program, normally during the anniversary month of your employment. Objective: To ensure that employees of the Allendale County Hospital and John E. Harter Nursing Center are acquainted with all aspects of their job and informed of the policies and procedures of the hospital and its affiliates, all new employees must complete an Orientation/Annual Update Session immediately following their date of hire and yearly thereafter.

Orientation Policy Procedures (cont)….
Specific topics and areas of orientation will include but not limited to: Human Resources, Confidentiality, Patient/Resident Rights, Infection Control & Bloodborne Pathogens, Back Safety & Body Mechanics, Safety in General & Electrical Safety, Fire Safety, Hazard Communications, and Disaster Plans & Procedures. Material and information will be distributed to each employee as part of an Orientation Packet. Employees will be required to sign and date a statement verifying that they have completed their initial orientation and each annual update. All new employees will be required to attend the first scheduled session immediately following their date of hire. After the initial orientation, employees will be required to complete an update session once a year during the month of their original date of hire. Human Resources will be responsible for ensuring that their employees complete an Orientation / Annual Update Session at least once a year. Employees who fail to complete these sessions or otherwise satisfy this requirement will be subject to disciplinary actions.

Allendale County Hospital Orientation/Annual Update Session
Welcome / Introduction General Information Human Resources Customer Service Confidentiality Patient / Resident Rights Infection Control / Bloodborne Pathogens Back Safety / Body Mechanics Lunch Break Security Policies & Procedures Workplace Violence Hazard Communcation Safety – General & Electrical Lockout / Tagout Policies Confined Spaces Disaster Plans Fire Safety Q&A / Evaluation

Allendale County Hospital FACT SHEET
County Owned and Operated Facility Continuous Operation since 1950 Nine (9) Member Board of Trustees – Appointed by County Council Employs approximately 155 FTE’s 75% of revenues from Medicare and Medicaid patients Hospital Bed Capacity – 25 (designated as a Critical Access Hospital) Nursing Center Bed Capacity – 44 Primary Care Provider Carolina Medical Associates Laffitte & Warren Medical Center Certified Provider S.C. Department of Health & Environmental Control CLIA – Clinical Laboratory Accreditation ACR – American College of Radiology Member: South Carolina Hospital Association American Hospital Association South Carolina Health Care Association Lowcountry Area Health Education Consortium

Allendale County Hospital Board of Trustees
Wyman Wall, Chairman Jay Price, Vice Chairman Arthur Jones, Secretary June Thomas Amy Scott Larry Taylor Willa Jennings Benny Everett Don Sharp

Allendale County Hospital Specialties & Services
Family Medicine Internal Medicine Emergency Medicine Nephrology Radiology Pathology Podiatry Cardiology Hospital Based Services… Acute Care Long Term Care Respite Hospice Care Cardiopulmonary Wellness / Health Screenings Primary Care Physicians Clinical Laboratory Imaging Services: Xray Ultrasound CT Mammography Bone Density

Allendale County Hospital
Name Duties/Responsibilities Ext Ken Hiatt Administrator 226 Tammy Smith Adm Asst / HR 225 Coordinator, IT Services Russell Gibson Purchasing Agent 236 Materials Management Mederia Stanley Director, HIM 331 Coordinator, Utilization Review Becky Rowell, RN Director, Nursing Services 235 Gloria Duncan, R.Ph Director, Pharmacy Services 250 Mildred Scott Director, Laboratory Services 325 Ruth Hiers Director, Radiology Services 287 Patricia Jenkins Director, Cardiopulmonary 245 Services Juanita Hiatt, RN Director, Nursing Center 246 Stevie Grubbs Director, Plant Operations 261 Trina Thomas Director, Food Services 263 Beverly Wilson Director, Financial Services 298 Darlene Jones Director, Physician Practices Key Staff & Managers

Allendale County Hospital
Active Medical Staff 2013 Active Medical Staff Dr. Walter Smith Chief of Staff Dr. Ricky Bair Chief of Emergency Medicine Dr. Milton Arras Chief of Pathology Dr. Alan Armstrong Emergency Medicine Dr. Malcolm Corley Radiology Dr. Gabriel Fornari Emergency Medicine Dr. Charles Grier Radiology Dr. Janet McKissick Family Medicine Dr. Roger Nunn Family Medicine

Human Resources Personnel Policies & Procedures

Code of Conduct As members and associates of Allendale County Hospital and its affiliates, the Board of Trustees, Administration, Management and all personnel who are either employed or privileged to practice and provide services are expected to adhere to certain standards of conduct and behavior. As a healthcare organization, part of our mission is to provide quality care to all those who seek our services regardless of race, creed, sex, national origin or ability to pay. Patients are entitled to treatment that insures and protects their rights to certain privileges as outlined in the Patient’s Bill of Rights, The Resident’s Bill of Rights and the Omnibus Adult Protection Act, as well as other state and federal regulations and laws which govern the provision of services in a healthcare facility. This organization is dedicated to the highest principles of conduct among all of our associated staff. Our relationships with our patients, our business associates, and our community are built upon honesty, integrity, and mutual respect. Violations of these principles will not be tolerated. In addition to the above principles, this organization expects total commitment from all associated staff to the following ideals: 1) Professionalism 2) Courtesy in all matters 3) Loyalty to the organization and each other 4) Confidentiality of all information 5) The avoidance of conflicts of interest This organization has adopted a policy of zero tolerance for any violation of this personal and professional code of conduct. More detailed guidance of related guidelines and other hospital policies and procedures are contained in the employee personnel policies and procedures, department operating guidelines, position descriptions, and other hospital documents. Every associate should become familiar with all guidelines concerning personal conduct and performance. Violations of any of these principles, ideals and/or operating guidelines may result in disciplinary action. Every associate plays a valuable role in the ultimate success of this organization. We are all part of the very honorable endeavor of serving others, often times during very stressful and trying conditions for them and for us. Commitment and dedication to the above principles and code of conduct will provide you with a firm foundation to deliver quality care and service at all times.

Personnel Policies & Procedures OVERVIEW
Time & Attendance Dress Code Employee Benefits Employee Evaluations Grievances Workplace Injuries & Accidents HIPAA/Security Policies & Procedures Disclaimer

Time and Attendance 40 WORK WEEK Time begins Saturday midnight
Overtime accrues when employee works in excess of 40 hrs in a seven day work week Two (2) weeks in a pay period BREAKS: ½ hour meal break automatically deducted from time If an employee leaves premises for a meal and/or personal business, they must clock out and in All references to meal breaks were eliminated from employee’s handbook PUNCHING THE TIME CLOCK: Do not punch in early Do not punch out late Do not punch another employee’s time card If you miss a punch, let Supervisor & HR know ASAP. PAY DAY: Bi-Weekly payroll, paid every 2 weeks (26x per year) Direct Deposit is mandatory Stubs generally available by Wednesday, 2PM ATTENDANCE: Employees are expected to work their scheduled hours For scheduled time off, employees must submit a leave request to their supervisor for approve BEFORE taking leave. Unscheduled Absence – Supervisor discretion / departmental policy Family Medical Leave Act (FMLA) - Federal law that guarantees 12 weeks unpaid medical leave for employees that meet certain stipulations and requirements; must notify Supervisor if requesting FMLA Time and Attendance

DRESS CODE Adhere to the general dress code of the facility and to the dress code of your department… T-shirts are NOT part of the dress code – except on special occasions as designated by the Administrator… Name tags ARE part of the dress code and must be worn at all times while on duty…

EMPLOYEE BENEFITS ELIGIBILITY:
Full-time, regular employees are eligible the 1st day of the month following a 90-day waiting period. Example – an employee hired on January 15, 2012 would be eligible for benefits on May 1, 2012 BENEFITS: Health Insurance ( BlueChoice – 80% cost paid by ACH) Dental Insurance (PHP of the Carolinas) Term Life Insurance (100% cost paid by ACH) Long-Term Disability (100% cost paid by ACH) Pension / TDA Christmas Club Supplemental Insurances (AFLAC, Colonial, AETNA, etc.) PTO (Paid Time Off) Accrual: - Based on years of service - Accrual begins immediately but not eligible to use PTO until after the 90-day benefits waiting period - Cannot accrue more than 360 hrs - Request to cash in up to 40 hrs between the months of May – August (year-by-year) - All PTO must be approved by Supervisor Holidays: - Five (5) holidays (8 hrs each) - Include New Years Day, July 4th, Labor Day, Thanksgiving Day, Christmas Day - Employees paid time & ½ if they are required to work the holiday DISCOUNTS: Meals / Hospital Services EMPLOYEE BENEFITS

EMPLOYEE EVALUATIONS PROBATIONARY: ANNUAL:
Employees should receive an evaluation after a 6-month probationary period. ANNUAL: Employees should receive an evaluation annually during the month of their original date of hire. The evaluation should be completed by the supervisor, reviewed with Employee and forwarded to Administration.

WORKPLACE INJURIES Report any kind of accident and/or injury IMMEDIATELY Procedures to follow: - Report to Supervisor or employee in charge - See Charge Nurse if injury is questionable - Report to the ER for all severe injuries - The injured worker will be tested for drugs and alcohol immediately after the accident or as soon as possible by lab personnel only. If physically able, the injured worker should report to the lab to have a specimen drawn. If the IW cannot go the lab, then lab personnel will come to them obtain a specimen. ALL injured workers will be tested. - Complete a Supervisor’s Report of Injury (SERO) and submit to Administration within 24 hours - If the ER Physician recommends follow-up, must see whomever the Worker’s Comp company authorizes Failure to report an injury or accident will result in disciplinary action

EMPLOYEE ACCIDENT REPORT
(To Be Completed by the Injured Employee) Employer: ________________________________________________ Employee Name: ________________________________________________ Date of Accident: ________________________________________________ Location of Accident: ________________________________________________ What happened? (please describe accident in your own words)_________________ ____________________________________________________________________ _____________________________________________________________________ How were you injured__________________________________________________ What parts of your body was/were hurt? (Indicate Right or Left) ___________________________________________________________________ Have you ever injured this pat of your body before? (Y/N)______________________ If so, please describe: Who was present when the accident happened? _____________________________ The above report is true and correct. _____________________________________ _________________________ (Signature of Injured Worker) (Date) Accident reports must be handed in to your supervisor or acting supervisor immediately after any incident. Failure to promptly report accidents will result in disciplinary action up to and including discharge. Supervisor’s Report of Employee Occurrence (SERO) (SAMPLE Form to be Completed by Injured Workers)

Designated Worker’s Compensation Physician
The hospital Worker’s Compensation Program requires that a single physician be designated as a Worker’s Compensation Physician. This physician will be the primary referral point for any employee who sustains any type of injury or illness on the job which requires medical treatment. The designated physician practice for Allendale County Hospital is Carolina Medical Associates and its affiliated providers. Any employee sustaining an injury or acquiring all illness on the job shall be referred to Carolina Medical Associates for any type of treatment required beyond emergency first-aid. The initial evaluation of any type of injury occurring on the job should, of course, be referred to the Employee Health Nurse and/or Emergency Room Physician for immediate treatment. Any additional treatment required beyond the initial emergency phase will be referred to CMA. All employees must inform the physician if their accident or illness has been reported to their Supervisor as an on-the-job condition. Authorization should be obtained from your Supervisor or Administrator’s office prior to undergoing further treatment and evaluation. Employees should also be aware that, if you elect to contact some other physician for an on-the-job injury or illness, those expenses may not be covered under the Worker’s Compensation Program. For further information and clarification regarding any type of illness and injury which you may feel is work related, please contact your Supervisor and/or Administrator at any time.

Worker’s Compensation Policy
OBJECTIVE: Provide sure, prompt and reasonable medical attention and income and benefits to employees who receive work-related injuries and/or illnesses, regardless of fault. PROCEDURE: All on-duty injuries and illnesses, which result in the employee being absent from work, will be handled in accordance with the South Carolina Worker’s Compensation Laws and the personnel policies of Allendale County Hospital When an employee is injured on the job, he/she must: 1. Immediately report the injury to the department supervisor 2. A “Supervisor’s Report of Occurrence” (SERO) must be completed and submitted to the Administration Office within 24 hours of occurrence. 3. The injured employee must see the Employee Health Nurse to determine if medical treatment is necessary. If the Employee Health Nurse is unavailable, the injured employee must see the Charge Nurse or report to the Emergency Room for treatment. 4. If additional treatment is necessary, the employee will be referred to ACH’s Worker’s Comp physician(s), ACH will be relieved of all medical expenses as a result of the employee’s injury or illness. 5. Failure to report an injury to the department supervisor or Administration within 24 hours could result in disciplinary action. 6. All medical and indemnity benefits payable to the injured employee will be administered through the facilities workman’s compensation carrier. 7. An injured employee cannot use his accrued PTO/Sick time while receiving worker’s comp benefits for lost work time. 8. If eligible, an employee will be placed on FMLA leave when his/her absence from work is caused by a worker’s comp injury. 9. Every effort will be made to return the injured employee to work as soon as possible – either through light, transitional, or full duty. 10. Employees injured on the job will be tested for drugs and alcohol immediately or as soon as possible.

Employee Drug Screens MEMORANDUM Dated July 2, 2009
The hospital’s worker’s comp policy dictates that ALL injured employees be tested for drugs and alcohol immediately after the accident or as soon as practical. If the injured worker reports to the ER to receive treatment for his/her worker’s comp injury, the following procedures must be followed when drawing the specimen for the drug/alcohol screen: - After the injured worker has been registered in the ER, he/she should present to the lab so lab personnel can draw the specimen(s) needed for the screen and a chain of custody can be established. - If the injured worker is not physically able to report to the lab, lab personnel should be notified that a worker’s comp drug/alcohol screen has been ordered and they (lab personnel) need to come draw the specimen(s). - Nursing personnel should not order the drug/alcohol screen on the computer. Lab personnel will enter all information related to this procedure on their end. If an employee reports a worker’s comp injury but refuses treatment, then he/she should complete a Report of Injury form and report to the Administration Office for an order for the drug/alcohol screen immediately after reporting the injury.

Summary of Employee Benefits
FICA Taxes: ACH pays 7.65% of gross salary for all employees for Social Security and Medicare Taxes Applicable to all employees ACCRUED TIME – PTO: Accrue on actual hours paid each pay period, not to exceed 80 hrs Accrual rates determined by the employee’s length of employment and adjusted on anniversary dates. All PTO must be approved by Supervisor Accrual of PTO begins on the date of employment for eligible employees but will not be available for use until probation is completed. Maximum accumulation is 360 hours. Workman’s Compensation Insurance: All employees are covered under the hospital’s worker’s comp policy Effective immediately Health Insurance (BlueChoice Healthplan): Hospital pays a minimum of $3,700 in health insurance premiums per enrolled employee each year Additional coverage available for spouse and children Full-time employees are eligible Coverage available after a 3-month waiting period HOLIDAYS: Five (5) holidays (New Year’s Day, July 4th, Labor Day, Thanksgiving Day, Christmas Day) Employees will be compensated for time missed from scheduled work due to the holiday provided that the employee works his/her scheduled hours prior to the holiday and on the first day following the holiday unless excused from meeting this requirement. Employees on lay-off, leave of absence or probation are not entitled to holiday pay Holidays must be taken no more than 30 days after the actual date of the holiday. Holidays may not be taken in advance Designated employees who are required by their supervisor to work on the holiday will be paid overtime for the time worked. DENTAL INSURANCE (Self Funded): Single or Family Coverage Full-time employees eligible Coverage available after a 3-month waiting period LIFE INSURANCE: Hospital pays 100% premium Amount of coverage = 1x base salary for year Full-time employees eligible Coverage available after a 3-month waiting period LONG TERM DISABILITY: Hospital pays 100% premium 3-month waiting period; 60% compensation Full-time employees eligible Coverage available after a 3-month waiting period

Summary of Employee Benefits
PENSION: Full-time employees with one year employment Enrollment in December and June Hospital contributes 6% of employee’s gross salary Eligible employees may make voluntary contributions EMPLOYEE DISCOUNTS: Inpatient/Outpatient Services - Full-time employees 25% - Part-time employees 15% Hospital Cafeteria: 25% Payroll Deductions: Hospital offers payroll deduction for the following: Christmas Club Tax Deferred Annunity Hospital Bills (required if balances are not paid after 60 days) Uniform Purchases Supplemental Insurance Policies Education Assistance: Full-time employees eligible Application must be completed and submitted to the Personnel Committee of the Board of Trustees for approval Reimbursement of expenses if “B” or better grade level is maintained Minimum of one year employment requirement at ACH after completion

COMPUTER POLICIES & PROCEDURES
HIPAA – Federal regulations that guarantee the security and privacy of “patient health information” Policies & Procedures for Computer Users: - Computer use is a privilege, not a right - Employees are granted access to the hospital’s information system with supervisor’s approval - DO NOT give our your password - DO NOT access unauthorized information. Access patient information on a “need to know” basis only - DO NOT download unauthorized material - DO NOT conduct personal business on the internet - DO NOT install unauthorized software - DO NOT abuse your access to the internet and/or - DO NOT deactivate anti-virus software or change security settings - DO NOT dismantle, move, take apart or otherwise destroy your computer - Log off the workstation at the end of your shift - Audits on computer use are randomly performed

Confidentiality of Medical Information J
Confidentiality of Medical Information J. Mederia Stanley, RHIT Director, Health Information Management

What is CONFIDENTIALITY?
Confidentiality is about keeping information about the patient’s health care PRIVATE. What is a medical record? A collection of information that includes a patient’s / resident’s PHI – PROTECTED HEALTH INFORMATION.

Patient’s & Resident’s Right to Privacy
SC Law - SC It’s your obligation!!!! The law says… “the hospital is under a duty to maintain a medical record’s security. From Admission to Discharge – - A medical record starts on admission and continues until discharge. - Permanent storage in Unit File or Electronic Medical Record (all patient types) - Records are controlled, access is locked.

Computer System Hear no, See no, Speak no…
You are given a user name and password to log into the hospital’s computer system. DO NOT share your user name and password with anyone – even someone who does the same tasks you do! We can monitor where you have been in the computer system and how long. LOCK your workstation when not in use. Hear no, See no, Speak no… Protected Health Information Think about the 3 little monkeys that hear no, see no and speak no…

Patient Rights / Resident Rights
Patient’s Rights - Swing Bed Resident Rights - Nursing Center Resident Rights Informed Consent for Treatment or Procedure Right to Refuse Medical Treatment or Procedures Advance Directive - Ombudsman ( ) Patient/Resident Informed at time of Admission in Language Patient/Resident Understands Statement of Services Available and Charges Choose Physician Medical Condition Participate in Treatment Refuse Medication and Treatment Transferred or Discharged Rights as Citizens – Civil and Religious Liberties Personal Finances Free from Mental, Physical, Sexual Abuse and Verbal Abuse Free from Chemical and Physical Restraints Security in Storing Personal Possessions

Patient Rights / Resident Rights (cont)
Confidential Treatment of Possessions and Medical Records Treated with Consideration, Respect, Dignity and Individuality Not Required to Perform Services Not in Plan of Care Associate and Communicate Privately - Private Visits with Family, Friends, Clergy, Social Workers Access to the Secretary of the Department of Health and Human Services Resident Care Council Personal Mail Participation in Activities of Social, Religious, and Community Groups of Choice Personal Clothing and Possessions Married Daily Visiting Hours Telephones

Lewis Blackman Hospital Patient Safety Act
Three primary areas in the Lewis Blackman Hospital Patient Safety Act: 1. Name Badges: Name badges must include - Name (first and last) - Department - Job or trainee title Badges must be clearly visible All terms and abbreviations reasonable understood 2. Inform patient who is involved in their care 3. Establish a mechanism to contact the Attending Physician

Daniel’s Law applies to infants up to 30 days old.
Daniel’s Law is a law designed to provide a safe haven for abandoned babies. Daniel’s Law applies to infants up to 30 days old. The person leaving the child does not have to reveal his or her identity. Allendale County Hospital will provide medical care for the baby and contact DSS. DSS will have legal custody of the child and arrange for the final disposition of the child

Advance Directives Plan Ahead with a Living Will or Health Care Power of Attorney What kind of medical care would you want if you were too ill or hurt to express your wishes? Advance Directives are legal documents that allow you to convey your decisions about end-of-life care ahead of time. They provide a way for your to communicate your wishes to family, friends and health care professionals, and to avoid confusion later on. Advance Directive and the Do Not Resuscitate Orders . You have the right to make all decisions that affect your health care. But what if you become unable to make those decisions? Then you will have to rely on others to make the right decisions for you – right? WRONG. You have the right to decide what kinds of treatment you want to be given if you become incapacitated. What is an Advanced Directive? An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions (if you are in a coma, for example). If you are admitted to the hospital, the hospital staff will ask if you have an advance directive. If you have an advance directive, hospital staff will request a copy. If you do not have an advance directive, you will receive information and the hospital staff will assist you in obtaining your advance directive by contacting the South Carolina Ombudsman at A good advance directive describes the kind of treatment you would want depending on how sick you are. For example, the directives would describe what kind of care you want if you have an illness that you are unlikely to recover from, or if you are permanently unconscious. Advance directives usually tell your doctor that you don’t want certain treatment no matter how ill you are. Advance Directives can take many forms. Laws about advance directives are different in each state.

Advance Directives (cont)
What is a Living Will? A living will is one type of advance directive. It is a written, legal document that describes the kind of medical treatment or life-sustaining treatments you would want if you were seriously ill or terminally ill. A living will doesn’t let you select someone to make decisions for you. What is a durable power of attorney for health care? A durable power of attorney (DPA) for health care is another kind of advance directive. A DPA states whom you have chosen to make health care decisions for you if you are unable to make your own health care decisions. It becomes active any time you are unconscious or unable to make medical decisions. You guide the decisionis by including specific rules or limitations in your health care Power of Attorney. What is a do not resuscitate order? A do not resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopoulmonary resuscitation (CPR) if your heart stops or if you stop breathing. You can use an advance directive form or tell your doctor that you don’t want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. Should I have an advance directive? By creating an advance directive, you are making your preferences about medical care known before you’re faced with a serious injury or illness. This will spare your loved one the stress of having to decide what to do in certain life-threatening situations. Any person 18 years or older can prepare an advance directive unless the patient is pregnant. People who are seriously or terminally ill are more likely to have an advance directive. However, even if you are in good health, you might want to consider writing an advance directive. An accident or serious illness can happen suddenly. How Can I write an advance directive? Advance directives and living wills do not have to be complicated legal documents. They can be short, simple statements about what you want done or not done if you can’t speak for yourself. Remember, anything you write by yourself or with a computer software package that should follow your state laws. You may also want to have what you have written reviewed by your doctor and/or lawyer to make sure your directive are understood exactly as you intended. When you are satisfied with your directives, the orders should be notarized if possible, and copies should be given to your family and your doctor. You may change or cancel your advance directive at any time, as long as your are considered of sound mind to do so. Your changes must be made, signed and notarized according to the laws in your state. Make sure that your doctor and any family members who knew about your directives are also aware that you have changed them. Be sure you are clearly understood by everyone you have told.

Identity Theft Allendale County Hospital incorporates medical identity theft prevention into existing training and awareness programs. Allendale County Hospital and its entities strive to: Prevent the intentional or inadvertent misuse of patient names, identifiers, and medical records To report criminal activity relating to identity theft and theft of services to appropriate authorities To take steps to correct and/or prevent further harm to any person whose name or other identifying information is used unlawfully or inappropriately. Under the Red Flags Rules, Allendale County Hospital has developed a written program that identifies and detects the relevant warning signs- or “red flags” – of identity theft. Request Identification at Registration: Each time a patient visits, check whether the identification provided is valid, copy the identification provided each visit and match any photo to the patient/responsible party. During the registration process, if an identity alert flag appears, call the Registration Supervisor to the Privacy Officer for resolution. Emergency Care – NO DELAY: Providing identification is NOT a condition for obtaining emergency care. The process of confirming a patient’s identity must never delay the provision of an appropriate medical screening, examination or necessary stabilizing treatment for emergency medical conditions. Refusal to Provide or Lack of Identification: No one should be refused care because they do not have acceptable identification with them. Patients should be asked to bring appropriate documents to their next visit. Definitions: Identity Theft: Means the act of knowingly obtaining, possessing, buying or using the personal identifying information of another with the intent to commit any unlawful act including, but not limited to, obtaining or attempting to obtain credit, goods, services or medical information in the name of such other person(s); and without the consent of such other person; or with the lawful authority to obtain, possess, buy or use such identify information. Theft of Services: Includes intentionally obtaining services by deception, fraud, coercion, false pretense or any other means to avoid payment for the services; and having control over the disposition of services to others, knowingly diverts those services to the person’s own benefit or to the benefit of another not entitled thereto.

Patient’s Bill of Rights
Allendale County Hospital supports the rights and responsibilities of each patient. Below is our policy on Patient’s Rights and Responsibilities. Please read our policy on Patient Rights and Responsibilities so you are familiar with them. We will be glad to answer any questions. The Patient’s Rights The Patient has the right to have a family member or personal representative of his/her choice notified promptly of admission to the hospital. The patient has the right to choose a physician of his/her choice. The patient has the right to considerate and respectful care free from all forms of abuse or harassment. The patient has the right to receive care in a safe setting. The patient has the right to privacy and confidentiality, both personal and clinical The patient has the right to access information in her/her clinical record within a reasonable time frame. The patient has the right to know the identity of health care providers involved in their care. The patient has the right to give consent for treatment. The patient has the right to refuse treatment. The patient has the right to consultation by health care providers at their request and expense. The patient has the right to have an advance directive and have staff and practitioners comply with these directives The patient has the right to continuity of care and transfer to another facility if needed. The patient has the right to an explanation of hospital charges. The patient has the right to information about rights and hospital rules and regulations. The patient has the right to file a grievance. The patient should contact the administrator at (803) , extension 226. The patient has the right to freedom from restraints used in the provision of acute medical and surgical care unless clinically necessary.

Patient’s Bill of Rights (cont.)
If you contact a member of the facility staff, but no action is taken on your behalf, you have the right to lodge a grievance with the State agency directly, regardless of whether you first use our grievance process. The patient may call South Carolina Department of Health and Environmental Control at or call or write them at South Carolina Department of Health and Environmental Control, Health Licensing, 2600 Bull Street, Columbia, SC The Patient’s Responsibilities The patient is responsible for providing information about past illnesses, hospitalizations, medications and other health related matters. The patient is encouraged to take responsibility for requesting additional information or explanation of condition of health or treatment. The patient is responsible to payment for personal copies of his/her medical record. The patient is responsible for providing hospital with a copy of advance directive on each admission. The patient is responsible for following the recommended treatment plan. The patient is responsible for assuring that any financial obligations are fulfilled. The patient is responsible for following hospital rules and regulations. The patient is responsible for showing respect and consideration to other patients and staff. The patient is responsible for their personal belongings and for taking them when discharged. Valuables should be given to family members and not left at the hospital.

Resident’s Bill of Rights
As a resident of this facility, YOU or your legal guardian has the right to: Medical Treatment Choose you own personal physician Receive from your physician a complete and current description of your medical condition in terms you understand. Participate in planning the care and treatment you receive. Participate in any changes to your care and treatment you receive. Be fully informed in advance of any changes in your care and treatment that may affect your well-being. Refuse to participate in any type of experimental tests or research. Have privacy during treatment. Have your medical records treated with confidentiality. Approve or refuse release of your medical records to anyone outside this facility, unless you are transferred to another health care facility, or it is required by law or by other third party contracts. Personal Possessions: Have security in storing your personal possessions. Approve or refuse release of your personal records to anyone outside this facility, unless as provided by law. Keep and use personal clothing and possessions as long as they do not affect other resident’s rights. Manage your personal finances. If the facility has been delegated in writing to manage your finances for you, it must provide you with a quarterly report of your finances.

Resident’s Bill of Rights (cont.)
Personal Treatment Be treated with respect and dignity Be free from mental or physical abuse Be free from being restrained either physically or with drugs, unless your doctor has ordered them. Be free from working or performing services for the facility unless they are part of your plan of care. Be discharged or transferred to another facility against your wishes only for: your welfare, the welfare of the other residents; medical reasons, or for nonpayment. You must be given written notice of at least 30 days prior to discharge or transfer unless your discharge or transfer is for your welfare or the welfare of other residents. In that case, the facility must provide you with written notice within a reasonable time under the circumstances. Communication: Have your legal guardian, family members, and other relatives see you when they visit. Refuse to see your legal guardian, family members and other relatives Send and receive mail with freedom and privacy Associate and communicate privately with persons of your choice. Meet with your legal guardian, family members or other resident’s family members to discuss this facility. Meet with and participate in social, religious, and community group activities, unless a written medical order prohibits such activity.

Resident’s Bill of Rights (cont.)
Personal Privacy Have privacy when receiving personal care. Have privacy when visiting with your husband or wife Share a room with your husband or wife, unless your doctor forbids this in your medical Have your personal records treated confidentially Employ a sitter from outside this facility to come and provide you with sitter services, unless you have already agreed in writing with this facility not to hire a private sitter. You must choose a sitter from an approved agency or list and that sitter must be approved by the facility. The sitter must also abide by the policies and procedures of this facility. You must agree not to hold the facility liable for any matters involving your private sitter. All rights and responsibilities specified above as they pertain to a resident adjudicated incompetent in accordance with state law, or a resident who is found by his/her physician, to be medically incapable of understanding these rights, or a resident who exhibits a communication barrier, shall devolve to such resident’s guardian, next of kin, personal representative, sponsoring agency(ies) or representative payee (except when the facility itself is representative payee) selected pursuant to the Social Security Act. You have a right to file a grievance. The resident of his/her guardian, next of kin, personal representative, sponsoring agency(ies) or representative payee should contact the administrator at (803) , extension 226. If you contact a member of the facility staff, but no action is taken on your behalf, you have the right to lodge a grievance with the State agency directly, regardless of whether you first use our grievance process. The resident may call South Carolina Department of Health and Environmental Control at or call or write them at South Carolina Department of Health and Environmental Control, Health Licensing, 2600 Bull Street, Columbia, SC By the time you the resident was admitted to this facility, a representative of this facility must have explained to you or your guardian, next of kin, personal representative, sponsoring agency(ies) or representative payee: YOUR RIGHTS: You must have been told and given a written explanation of your rights, what to do if you believe your rights have been violated, and how to enforce your rights under state law. You must have acknowledged that you received these explanations in writing, and they must be part of your file. SERVICES: You must have been told and given a written list of the services that are available to you and the cost. If the services or their costs change, you must be notified of those changes in writing. REFUND POLICY: This facility must have a policy on giving refunds to residents. The policy must be based on the actual number of days you were in the facility or a bed was held there for you. You must have been given a copy of this policy in writing and you must be notified in writing again of any changes that are made to this policy.

Infection Control

Infection Control Infections put everyone at risk
Infections can spread from and to: - Staff - Patients - Visitors Infections have a human cost. They can be painful and cause complications. Nosocomial infections can even cause death… A nosocomial infection is one that - develops while a patient is staying at a health-care facility - was not present when the patient was admitted to the facility Nosocomial infections can develop at any health-care facility. They are expensive and may lead to the following: - Longer hospital stays for patients - Lost work time for patients - Increased health care costs - Legal action, if the facility did not adequately follow infection control procedures - Lost work time for you or other heatlh-care workers who get sick. The number one way to prevent the spread of infections is by washing your hands for at least 20 seconds

HANDWASHING PURPOSE: To remove transient microbial contamination that has recently been acquired during contact with infectious or colonized patients or environmental sources. POLICY: Handwashing is the SINGLE most important procedure for preventing the spread of infection. Personnel should practice good handwashing techniques even when gloves are used. PROCEDURES: Turn on faucets so that water is of comfortable force and temperature Wet hands first; leave water running; obtain a small amount of soap, approximately a quarter-size drop Vigorously rub together all surfaces of lathered hands for at least 20 seconds Rinse well under running water using friction Dry hands with paper towels Use paper towels to turn faucets off SPECIAL EMPHASIS – HANDS ARE WASHED: On arrival to work After using the restroom, eating, smoking, sneezing and coughing Before and after each patient contact Before and after donning gloves Hand Sanitizers can be used but does NOT replace hand washing…

Infection Control & Transmission Based Precautions
Use transmission-based precautions in addition to standard precautions when a patient is know or suspected to have certain infections. There are 3 types of transmission-based precautions… Type #1… AIRBORNE PRECAUTIONS… Airborne precautions prevent the transmission of infectious agents that remain infectious over long distances when suspended in the air (e.g. rubeola virus (measles), varicella virus (chickenpox, Mycobacterium tuberculosis, possibly SARS.) Patients will be placed in a private room that is equipped with special air handling and ventilation capacity called Negative Pressure Rooms. The hospital has 2 rooms designated as Negative Pressure Rooms – ER Room #3 and Room #55. Patients must be maintained in these private rooms. Healthcare personnel caring for patients on Airborne Precautions must wear a special N-95 mask to care for these patients and the mask is donned upon entering the room. Whenever possible non-immune HCW’s should not care for patients with vaccine-preventable airborne diseases (e.g. measles, chickenpox, and smallpox). Patients who must be transported outside of the room should wear a mask and follow the Respiratory / Hygiene Cough Etiquette. Patients who are on airborne precautions will have signs on the door to inform staff and visitors of what precautions are needed There will also be a pink/red colored isolation cart that is maintained outside the door for supplies needed to care for the patients and also visual reminders. **You must see Patricia Jenkins or a Cardiopulmonary department member to be fitted for a N-95 mask. This mask must be fitted to the individual wearing the mask for the seal to be an effective seal to offer protection.

Infection Control & Transmission Based Precautions
Type #2… DROPLET PRECAUTIONS… are intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions. Special air handling and ventilation are not required to prevent droplet transmission. Infectious agents for which Droplet Precautions are indicated are: B pertussis, influenza virus, adenovirus, rhinovirus, N meningitides and group A streptococcus (for the first 24 hours of antimicrobial therapy). Single private room is required. Healthcare personnel wear a mask (a respirator is not necessary). For close contact with infectious patient, mask is donned upon room entry. Patients on Droplet Precautions who must be transported outside of the room should wear a mask and follow Respiratory/Hygiene Etiquette. Patients who are on Droplet Precautions will have signs on the door to inform staff and visitors of what precautions are needed. There will also be a pink/red colored isolation cart that is maintained outside the door for supplies needed to care for the patients and also as visual reminders. Type #3… CONTACT PRECAUTIONS… prevent the spread of infections by skin-to-skin contact or by contact with a contaminated object. You must wear gloves and gowns when entering the room of a patient who is on contact precautions/contact isolation. Each patient will have their own disposable stethoscopes, thermometer, and blood pressure cuff. Patients on Contact Precautions will have signs on the door to inform staff and visitors of what precautions are needed. There will also be a pink/red colored isolation cart that is maintained outside the door for supplies needed to care for the patients and also as visual reminders. There are 3 germs that require you to put a patient in Contact Isolation: MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistent enterococcus), and TB (tuberculosis) C-difficile.

Infection Control & Clostridium difficile (C. difficle)
What is Clostridium difficile - C. difficile? It is a spore-forming, gram positive anaerobic bacillus that produces 2 exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea. Symptoms include: watery diarrhea, fever, loss of appetite, nausea, and abdominal pain How is Clostridium difficile transmitted? It is shed in the feces. Any surface, device or material that comes contaminated with feces may serve as a reservoir for the Clostridium difficile spores. These spores are transmitted to patients mainly via the hands and contaminated objects of healthcare personnel who have touched a contaminated surface or item. Patients who have C-difficile will be in a private room, will be on contact isolations/precautions, and staff and visitors must wear gown and gloves upon entering the room. Patients who have C-difficile will be on Modified Contact Precautions. Alcohol does not kill Clostridium difficile spores. Therefore, hand gel cannot be used when caring for patients who have C-diff. Handwashing with soap and water is the only effective source to use for decontamination of hands. Bleach/Clorox is the only cleaning/disinfectant agent that will decontaminate surfaces

Infection Control & MRSA (Methicillin Resistant Staphylococcus aureus
Patients with MRSA must be on Contact Isolation… Care givers must wear gowns and gloves upon entering room and caring for patients Private room for patients with MRSA MRSA is found on the skin, nose, blood and urine. MRSA is high spreadable… When patients present to the registration area and have flu-like symptoms, they will be asked to place a mask on to ensure they are not spreading the flu virus. Registration clerks are able to ask the patient to don a mask.

Bloodborne Pathogens Course Objectives:
Inform employees of the hazards due to occupational exposure to bloodborne pathogens Discuss and provide overview of OSHA’s Bloodborne Pathogens Standard Inform participants of the Exposure Control Program Routes of Entry: Accidental injury by a sharp (needles, scalpels, broken glass) contaminated with infectious material Open cuts, nicks and skin-abrasions, as well as the mucous membranes of your mouth, eyes or nose Indirect transmission, such as touching a contaminated object or surface and transferring the infectious material to your mouth, eyes, nose or open skin. Exposure on the Job: It is important to become aware of the hazards you face when dealing with blood and other body fluids Remember that when you become comfortable in your routine, you may have a tendency to let your guard down and expose yourself to dangerous situations With effective training and safe work practices, you can protect yourself and your co-workers from deadly bloodborne pathogens “Bloodborne Pathogens” are… Pathogenic (disease-eating) micro-organisms present in human blood which can cause disease in humans. These diseases include but are not limited to: 1. Human Immunodeficiency Virus (HIV) 2. Hepatitis B Virus 3. Hepatitis C Virus

Bloodborne Pathogens HBV HCV HIV Hepatitis B (HBV):
Human Immunodeficiency Virus (HIV): HIV is the pathogen responsible for “Acquired Immunodeficiency Syndrome” (AIDS) HIV is spread through blood-to-blood or sexual contact with someone who is infected with the virus It is not spread through casual contact The incubation period is from 2 to 15 years Many people infected with HIV can be asymptomatic for years During the symptomatic period, people may experience fever, significant weight loss, swollen lymph glands, thrush, night sweats, fatigue, diarrhea and loss of appetite. HIV attacks the body’s immune system rendering it susceptible to opportunistic Infections and certain cancers There is no “cure” or vaccine. There are drugs available to treat infections and cancers associated with AIDS Hepatitis B (HBV): Hepatitis means “inflammation of the liver” It is more common and more infectious than HIV Symptoms of infection include tiredness, loss of appetite, fever, vomiting, jaundice and dark urine Infection damages liver function Chronic infection may lead to chronic liver disease and increased risk of liver cancer Chronic infection can result in death HBV HCV HIV Bloodborne Pathogen # HCW’s Infected Per Year 1000 2200 10-12 Risk of HCW Infection After Single Needlesitck 3-10% .3% Progression to Chronic Infection 5% 85% 100% Vaccine Awailable Yes No Hepatitis C: 85% of HCV-infected persons become chronically infected Symptoms may not be present until many years after infection and when advanced liver disease has developed Symptoms include flu-like symptoms and jaundice Chronic infection may lead to cirrhosis and/or increased risk of liver cancer

Bloodborne Pathogens “Other Potentially Infectious Materials”
(OPIM) Include: Body fluids visibly contaminated with blood Semen Vaginal secretions Peritoneal fluid Pleural fluid Cerebrospinal fluid Synovial fluid Amniotic fluid Unfixed/unattached tissue or organ from human (living or dead ) All body fluids which are difficult to differentiate OSHA’s Bloodborne Pathogen Standard – Key Provisions: Exposure control plan Methods of compliance to reduce risk Hepatitis B vaccination Post exposure follow-up and evaluation Hazard Communication Information and training Recordkeeping requirements The Employer’s “Exposure Control Plan” Must… Identify in writing job classifications, tasks and procedures where occupational exposure occurs Include schedule for implementing provisions of standard Include procedure for evaluating circumstances of exposure incidents Must be accessible to employees Must be reviewed and updated annually

Bloodborne Pathogens Methods of Compliance to Reduce Risks:
“Standard Precautions” – treat all body fluids/OPIM as infectious Engineering Controls Work Practice Controls Use of PPE Housekeeping Hepatitis B Vaccine Work Practice Controls: Work practice controls are specific procedures you must follow to protect yourself from exposure to infectious materials. Some Work Practice Controls: - Never bend, recap or break contaminated needles or sharps and dispose of them in puncture-resistant containers immediately after use - Do not eat, drink or apply cosmetics when you may be exposed to blood or other infectious materials - Don’t keep food or drinks in the refrigerator, freezers or cabinets, or on shelves, countertops where blood or other infectious material may be present - The most important work practice is handwashing. Wash hands 1) every time you remove gloves or other PPE; 2) If skin comes in contact with blood or body fluids; and 3) after working on or around an environmental surface that may be contaminated Engineering Controls: Engineering controls are physical or mechanical systems your employer provides to help eliminate hazards Some examples are: safety needle devices, sharps disposal containers, biohazardous waste bags, biosafety cabinets and autoclaves.

Bloodborne Pathogens Use of PPE:
Gloves (disposable, single use) – wear gloves any time there’s a possibility of contact with potentially infectious materials, contaminated items or surfaces, mucous membranes and non-intact skin; change gloves and wash hands between patients Protective Eyewear: use for splashes, sprays, splatters or droplets of blood or OPIM Face Masks: use with goggles where blood or OPIM can be splashed into eyes, nose or mouth Protective Clothing: gowns, aprons or lab coats Housekeeping: Clean contaminated surfaces and equipment that is exposed to blood or OPIM with an antiseptic cleaner followed by soap and water Place contaminated sharps and infectious material in designated containers Handle contaminated laundry as little as possible and with minimal agitation

Bloodborne Pathogens Post Exposure Follow-Up and Evaluation Of Exposure Incidents: Confidential medical evaluation which includes: 1. Circumstances of exposure 2. Testing of source individual & exposed employee 3. Counseling 4. Evaluation of reported illnesses 5. HCP must be provided specified information to make evaluation 6. Provide employee written opinion 7. Prophylaxis 8. Diagnoses must remain confidential Hepatitis B Vaccination: Must be made available to exposed employees within 10 working days of assignment Provided at no cost to employee and at a reasonable time and place Under supervision of licensed physician/licensed health care professional As recommended by USPHS No “pre-screening” Employee must sign declination form if chooses not to be vaccinated HBV vaccination provides immunity in approximately 95% of people Administered in three-separate intramuscular injections over a period of six months Antibody test is performed to confirm immunity (2 months after series is complete) Must receive all injections to be protected Vaccine is generally well tolerated Non-immunized employees who are exposed to HBV should receive immune globin within 7 days along with the HBV vaccine.

Bloodborne Pathogens for Healthcare Workers
QUIZ True/False: There is a vaccine available for Hepatitis C Virus (HCV). True / False Standard Precautions means that you must treat all body fluids/blood as infectious True / False A body fluid splash to the eyes is considered an exposure incident. True / False A safety needle device is an example of an engineering control. True / False A work practice control that you must follow to protect yourself and/or others from an exposure is to dispose of sharps in a puncture-resistant container immediately after use. True / False Blood on the outside of a glove is considered an exposure incident True / False HIV can be spread through casual contact. True / False If you wear gloves, you do not need to wash your hands. True / False Eye goggles, lab coats, and facemasks are some example of PPE. True / False A person who is infected with HIV or HVC can look and feel healthy for many years before having signs/symptoms of an infection. True / False HIV is more common and infectious than HCV and HBV. True / False OSHA requires employees to offer (free of charge) the hepatitis B vaccine to potentially exposed employees within 10 working days of assignment. True / False

BACK SAFETY & BODY MECHANICS

Preventing Back Injuries
Pre-Quiz True / False: It is safe to lift with your back bent and your legs straight. Pull loads rather than push (you can pull twice as much as you can push without strain) Ergonomics is the practice of adapting the workplace to the worker’s needs. When performing repetitive motion tasks, twist only with your upper body. When transferring a patient, communicate the procedure to the patient.

Protecting the Health Care Worker (Preventing Back Injuries in the Health Care Industry)
Purpose of this Program: To create a comprehensive back injury plan to minimize back injury incident rates Objectives: Identify risk factors Discuss causes Identify means of prevention Know the Risks: Reaching, lifting a heavy load, suboptimal lifting postures, and carrying a load a significant distance are all risks Back sprains and strains occur due to: 1. Faulty body mechanics 2. Poor planning 3. Failure to ask for help 4. Poor physical condition 5. Stressful living and work positions Health Care Industry Back Injury Facts: Health care workers are ranked in the top ten occupations for highest frequency of back injuries This trend has been consistent for the last twenty years Back problems are seldom caused by a single injury During 24% of total work time, a nurse’s back is in a bent and /or twisted position Back Injury Trends: 64% of strains and sprains were to the back 50% of sprains and strains occurred in nursing personnel 7% occurred in other patient handling positions Costs of Back Strains and Sprains: Back injuries account for 55-65% of the cost of all claims 1.7 out of 10 of these claims are indemnity claims The medical and worker’s compensation costs are estimated to exceed $10 billion annually

Facts to Know: The incidence of back injury is generally proportional to the extent of the hazard Load + frequency = incident rate The average individual cannot lift more than 40% of their weight Strength and lifting capacity decreases with age How Do We Reduce the Hazard: Management commitment Employee involvement Know the tricks of the trade: 1. Transfer belts 2. Sliding boards and sheets 3. DME 4. Mechanical lifting devices 5. Lumbar support belts Basic Lifting Rules: Wear appropriate clothing that allows you freedom of movement Always stabilize wheel chairs, beds and lifts Remove foot rests and arm rests to make the transfer less stressful Transfer belts will save your back Non-slip footwear is essential for ambulating an individual Explain the lift or transfer to the individual to assure them Encourage those who need assistance to help you if they are able Aggressive individuals require more staff, time and patience Mechanical lifting devices will save your back Hemiplegic individuals should be moved with the strong side towards the direction you are going Always raise and lower beds to the appropriate height Remove obstacles Engineering Methods: Mechanical Lifting Devices DME Gail Belts Lumbar Support Belts Slide Boards Draw Sheets

Work Practices: Adapting the workplace to the worker’s needs Applying ergonomics has been shown to improve the quality of work life and reduce occupational injuries for health care workers. The method that workers use to perform lifts or transfers should be the most comfortable and safe for patients or residents OSHA has passed an ergonomics standard that require back injury prevention/ergonomics programs Common Mistakes: Lifting with the back bent and legs straight Using fast jerking motions Bending and twisting at the same time Load too far away Poor planning Poor communication Insufficient strength To summarize… The key principle of lifting “Lifting with your mind instead of your back”

BACK SAFETY PREVENTING BACK INJURIES – QUIZ HEALTHCARE WORKERS
TRUE / FALSE: When lifting heavy loads, hold the load close to your body. Two causes of back sprains and strains are due to faulty body mechanics and poor physical condition Back problems are seldom caused by a single injury It is safe to lift with your back bent and legs straight Transfer belts and mechanical lifting devices will save your back When a patient begins to fall, don’t try to prevent the fall; guide the patient easily and safely to the floor Pull loads rather than push (you can pull twice as much as you can push without strain) Ergonomics is the practice of adapting the workplace to the worker’s need When performing repetitive motion tasks, twist only with your upper body When transferring a patient, communicate the procedure to the patient.

Moving the RIGHT Way WHY should I learn the RIGHT WAY To move and lift things ? Moving things the wrong way can make your back ache! Back injuries are all too common on – and off the job. People who are out of shape or overweight are especially at risk. Because you’ll help reduce the risk of accidents… MEET YOUR BACK It’s composed of vertebrae, discs, a spinal cord, nerves and muscles. All of these work together when you lift or move something. Here’s how: THE VERTEBRAE: or bones of the spine are separated and cushioned by spongy discs that allow your back to move smoothly. MUSCLES AND LIGAMENTS hold the vertebrae in a delicate balance, even as you move your back IF YOU MOVE OR LIFT SOMETHING IMPROPERLY, you can disturb this balance – often with painful results. Don’t take chances with: WOUNDS: Handling sharp, rough surfaces can cut and bruise skin STRAINS and SPRAINS Muscles and joints can be injured by overexertion HERNIAS The strain of lifting can cause painful ruptures in the abdominal wall. FRACTURES Dropping a heavy load can break bones

Preventing Pain, Injuries & Damage
Plan the Job Plan a route that’s free from tripping and slipping hazards. Know where the object will be unloaded and plan “rest stops” along the way. Get Help: Ask for help (or use a mechanical aid) if you have any doubt about moving the object by yourself. Lift With Your Legs: Assume a comfortable stance. Lift smoothly, keeping the load close to the body. Avoid twisting your body as you lift. KEEP HANDS IN THE “CLEAR” Be careful not to crush fingers when unloading. Examine the Object: Determine its weight, and look for sharp edges. Check to see if the load is stable and equally distributed. Decide how to hold the object. Get A Good Grip: Use palms and fingers to make carrying easier and to protect hands and feet. If you wear gloves to prevent cuts or burns, make sure they fit properly. Wear Safety Shoes: Reinforced toes and nonslip soles may prevent injuries due to dropped objects or slippery surfaces.

Lifting ALTERNATIVE LIFT LIFTING
Practice these methods whether lifting a grocery bag or moving freight One Person Lift (“squat lift”) STAND as close to the load as possible, feet spread apart (slide the load close to you if it’s on a shelf) BEND at the knees, keeping your back straight and stomach tucked in. (You’ll reduce the risk of pinching a disc). GRASP the load firmly LIFT smoothly with your legs HOLD the load close to the center of your body ALTERNATIVE LIFT (When it’s not possible to bend your knees or get close to the object…) STAND close to the object (or person) to be lifted. BEND at the knees if you can – or brace yourself by putting your knees against a solid object. BEND at the hips, keeping your head and back in a straight line LIFT gradually, using legs, buttocks and stomach muscles The discs in your spine are like sponges – they absorb liquid while at rest and lose fluid if “warmed up” with exercise. Discs which are warmed up are less likely to rupture from the strain of lifting something.

LIFTING CARRYING UNLOADING
You can help prevent injuries when carrying objects, too! Here’s how: UNLOADING Be as careful unloading as you are when lifting. Repeat the same procedure in reverse. DON’T BLOCK YOUR VISION by carrying too large a load – get help if you need it. KEEP THE LOAD CLOSE to take full advantage of the mechanical leverage of your body BEND YOUR KNEES to lower the load. Keep your back straight and the weight close to your body. BE CAREFUL WITH FINGERS and toes. Allow enough room for them when the load is set down. SLIDE THE LOAD into tight spaces – it’s much easier and safer than trying to lift it. PLACE THE LOAD on a bench or table by resting it on the edge and pushing it forward with your arms and body FACE THE SPOT the load will rest on by turning your feet and whole body in that direction DON’T CHANGE YOUR GRIP on the load unless its weight is supported AVOID TWISTING YOUR BODY if you must change direction. Move your feet instead. Be sure the load is secure Wherever you place it. Make certain it won’t fall, tip over, roll or block someone’s way.

SHAPE UP SOO… IT’S UP TO YOU TO HANDLE OBJECTS SAFELY SHAPE UP!
Strengthen muscles in your back, legs and abdomen with exercise, to make moving things easier and safer SOO… IT’S UP TO YOU TO HANDLE OBJECTS SAFELY PELVIC TILT - Lie on your back, knees bent, feet flat on the floor - Tense your stomach so that the small of your back presses against the floor. Squeeze your buttocks together and lift your hips slightly off floor BENT LEG SIT-UPS Lie flat on floor, knees bent feet flat on the floor - Arms may be at your sides or folded across your chest - Raise your head, chest and shoulders off the floor - Relax. Repeat KNOW YOURSELF and your limits KNOW HOW to move materials KNEE-TO-CHEST Lie flat on your back, legs straight Grasp one knee and bring it as close to your chest as possible Relax. Repeat - For a more difficult exercise, draw both legs up at once HAMSTRING STRETCH Lie flat on your back, knees bent, feet flat on floor - Slowly raise one leg, straightening your knee - Hold for 5 seconds then lower the straightened leg to the floor - Relax. Switch legs KNOW WHEN to get help CHECK WITH YOUR PHYSICIAN Before starting an exercise program. Always start slowly and increase the length and intensity of workouts gradually. Repeat exercises only as comfort allows

GENERAL SAFETY

General Safety Rules Overview:
Protect Yourself, Patients, Visitors and Other Employees Know Your Job – Practice Safe Habits – Job Specific Practices and Policies Recognize Hazards – Report them to Supervisor – Recommend Improvements Participate in Training General Safety Rules: PERSONAL HYGIENE: To assure fitness for the job, practice good health habits, enjoy proper meals, get sufficient rest and keep yourself clean KNOW YOUR JOB AND RESPONSIBILITIES: You learn the right way by asking, not by trail and error. Communicate your suggestions on better and safer methods to your department head. Always be conscious of the safety of others, as well as your own. CLOTHING: Wear proper, accepted clothing for the job PROTECTIVE CLOTHING OR EQUIPMENT: Wear proper protective clothing when specified, such as rubber gloves, aprons, masks, hairnets, conductive footwear, etc. HOUSEKEEPING: A place for everything and everything in its place. Keep equipment, tools, materials and work areas clean and orderly MOVEMENT: Walk to the right, never run. Use handrails on stairs. Be cautious when approaching corners and congested areas. “HORSEPLAY”: An act in jest can end in disaster. Horseplay is prohibited FIRE AND EMERGENCY PROCEDURES: Know what to do, what action to take, where to go

Electrical Safety Do’s and Don’ts:
Report any malfunctions of equipment, appliances, fixtures, etc. to the Maintenance Department immediately. Do not continue using any electrical device that sparks or trips switches, blow fuses, etc. – report it to Maintenance Report any electrical devices that have frayed cords, cracked/broken plugs, exposed wires to Maintenance Never use extension cords or cheater plugs Never pull or yank on cords and wires – always unplug at the receptacle before attempting to move an electrical device Do not handle or use electrical devices if your hands are wet or if you are standing in wet substances or if your clothing is wet Do not push or pull heavy equipment across wires that are connected to electrical devices Do not bring electrical devices into hospital without inspection and approval by the Maintenance Supervisor Always unplug any electrical device before trying to repair or adjust the device. Ask for help – call Maintenance. Do no attempt to repair or adjust electrical devices with fingers, knives, or other metal objects – ask for help. Call Maintenance.

This is a SMOKE-FREE and TOBACCO-FREE Facility.
Fire Safety KEY PRINCIPLES: Don’t Panic RACE Remove Patients from Immediate Danger Activate Alarm Contain Fire – Close Doors Extinguish / Evacuate Code RED – (Location) Keep fire door closed Do not re-enter secured areas Make sure help (Fire Dept) is on the way Fire Extinguishers: - Type A: Large Silver Cylinder - Pressured Water Use only on wood/paper, never on electrical or grease fires - Type B/C: Red Cylinder – Dry Chemical May be used on any type fire; most effective on electrical fires and burning liquids Written Plan: Available in Department/Administration Outlines Actions of Each Department RESPONSIBILITIES: Prevention / Safety - Report Hazards Participate in Drills – Drills Required Monthly Use of Equipment – Fire Extinguishers Rescue / Evacuation Procedures This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan INTRODUCTION: The greatest danger in a fire in a hospital is PANIC. It is the duty of every employee to prevent patients from being unnecessarily alarmed in any emergency. If there is a fire in the hospital, every effort must be made to confine it to the immediate area in which it started . If the fire can be easily contained it may not be necessary to alarm patients in areas away from the fire. KNOW YOUR HOSPITAL … It is the duty of every employee to know the exact location of fire alarm stations, fire extinguishers and how to use them. You must know the location of all exits in your work area and in those areas which you frequently must go to. PREVENT FIRES… The best protection against fires is prevention. Good housekeeping and policing of potential hazardous areas is important. Be fire conscious by being constantly alert for fire hazards. REMAIN CALM… Do not panic, never yell FIRE!!! Report the facts calmly and correctly. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan FIRE IN YOUR DEPARTMENT
Remove from danger any patient or person in the immediate vicinity of fire or smoke Pull the nearest fire alarm and notify switchboard operator giving the exact location and type of fire NOTE: The alarm will be given over the public address system by the operator announcing “CODE RED, Room 52, Laboratory, etc.” Upon hearing the alarm, all employees will report to their own department and await further instructions. Close all doors. Turn off all oxygen equipment in the immediate area first. It may not be necessary to turn off oxygen in adjoining areas if they are not in immediate danger. Keep ambulatory patients with you to prevent re-entry into the fire areas. Do not remove patients in adjoining areas until ordered to do so by the person in charge. NOTE: Only the Administrator, Director of Nursing, Nursing in Charge or Fire Department may order the evacuation of patients. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan FIRE IN OTHER DEPARTMENTS
All departments and the nursing station will place a person at the nearest telephone to take messages and relay instructions. Incoming and outgoing calls will be kept to a minimum. If patients are aware of the fire, assure them that there is plenty of help to assist them, if necessary. All nursing personnel will remain on the nursing floor unless instructed otherwise. Personnel in non-patient areas will report to the conference room for central dispatching if evacuation is necessary. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan NURSING PERSONNEL See that all corridor and room doors are closed. Put wet blankets, towels or sheets under doors to keep out smoke if necessary. Keep someone stationed at the telephone for transmittal of instructions Nurse in charge should maintain the daily census and account for each patient should evacuation be ordered. Remove patients when ordered as follows: 1. Those in immediate danger 2. Ambulatory patients – wrap in blanket, escort to designated exit 3. Wheel Chair patients – wrap in blanket and wheel to designated exit 4. Helpless patients – use stretcher, if available. If not, roll bed covers, ease patient onto floor and pull patient with help to safe location. Do not move patient on bed unless absolutely necessary. E. Notify switchboard if additional personnel are needed to assist with evacuation This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan SWITCHBOARD OPERATOR When an alarm comes in, immediately contact the Administrator and Plant Maintenance Contact Allendale Dispatch – 911 – when instructed to by the Administrator, Plant Maintenance or Nurse in Charge. Announce fire alert over public address by using code words: “CODE RED, Room #52, Laboratory, etc.” Keep a line open on the switchboard at all times to the area where the fire is located E. Should the switchboard be out of operation, use the nearest available operative phone or cell phone. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan FIRE FIGHTING PARTY The plant maintenance supervisor will report to the scene of the fire and assume control until fire department personnel arrive. All maintenance personnel and housekeeping personnel will report to the scene of the fire. The plant maintenance supervisor or nurse in charge will designate one person to meet the fire department upon arrival at the scene. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan OPERATING ROOM AND POST ANESTHESIA CARE UNIT If fire or smoke is away from the operating room and post anesthesia care unit (PACU), personnel shall close all doors and remain in surgical suite unless instructions are received to do otherwise. If fire or smoke is in the operating room suite, follow “Rules in Case of Fire in Your Department” as it applies to the situation. In the event of a fire in the operating room the evacuation plan (Operating Room Fire Evacuation Plan) would be implemented by the circulating nurse. If surgery is in progress, the surgeon and/or anesthetist will determine when the patient can be moved. The circulating nurse or his or her representative will be responsible for: The movement of patient(s) Shutting off all electrical appliances and lights Turning off oxygen. Shut-off values are located: (1) Outside operating room door (2) Outside PACU on wall in corridor leading to outpatient procedure rm Calling for emergency equipment Securing adequate assistance to accompany patient(s) Calling plant maintenance and giving permission to shut down ventilating system and fans as soon as possible The PACU nurse and/or representative would be responsible for moving any patient(s) from the post anesthesia care unit and alerting the circulating nurse of any assistance needed. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan ER AND OTHER TREATMENT AREAS
The nursing in charge will assign personnel to report to the Emergency Room to treat any emergency cases that may be necessary If fire or smoke is away from the ER and other treatment areas, personnel shall close all doors and remain in area unless instructions are received to do otherwise. If fire or smoke is in the ER or other treatment areas, follow “Rules in Case of Fire in Your Department” as it applies to the situation. If a procedure is in progress, the physician will determine when the patient can be moved In the event of a fire in the ER or other treatment areas, the RN in Charge or her/his representative, would be responsible for: 1. The movement of the patient(s) 2. Shutting off all electrical appliances and lights 3. Turning off oxygen 4. Securing adequate assistance to accompany patient(s) This is a SMOKE-FREE and TOBACCO-FREE Facility.

ANCILLARY DEPARTMENTS This is a SMOKE-FREE and TOBACCO-FREE Facility.
Fire Emergency Plan ANCILLARY DEPARTMENTS X-RAY & LABORATORY: Turn off all electrical equipment gas and oxygen if in use Close all doors Make sure all patients are accounted for and safe Remain in department and await instructions DIETARY: Turn off gas and electrical appliances Close all doors and await further MEDICAL RECORDS: Place all medical records in metal file cabinets. Close all drawers to protect records Close all doors and turn off electrical equipment Stand-by to evacuate records if ordered BUSINESS OFFICE: HOUSEKEEPING: Secure valuables and accounts receivables Get extra blankets and await Close all doors and turn off electrical equipment instructions Help reassure visitors in lobby Remain on nursing floor to Stand-by to assist with the switchboard and run errands assist where needed. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Fire Emergency Plan EVACUATION: Each section of the building has a posted evacuation route which shows the most direct route for the particular area. FIRE FIGHTING EQUIPMENT: There are two (2) types of extinguishers throughout the hospital. One is silver in color and is a pressurized water extinguisher. This should not be used on electrical or grease fires. It may be used on waste basket, mattress, paper, etc. The other type extinguisher is a dry chemical and can be used on any type of fire. It is the most effective on electrical fires and burning liquids. Instructions are clearly marked on each type extinguisher. Read and operate accordingly. PHONE NUMBERS: A list of all emergency numbers and phone numbers of all hospital personnel are available at the switchboard and nurses station. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Hazard communication The Safety Officer of our facility is Mr. Ken Hiatt OSHA – Right to Know Law: You, as an employee, have the right to know what chemicals you are working with. Your supervisor can provide you with this information. Chemicals are everywhere in the healthcare environment. They can be helpful when used correctly, but dangerous if mishandled. Information on an MSDS: Product name /agent Hazardous ingredients Physical characteristics Explosion data and fire health hazard information Reactivity data Spill or leak procedures Special protection requirements Medical precautions IN THE EVENT OF A CHEMICAL SPILL… Keep people away Provide first aid to the exposed Isolate spill if possible Prevent contact with chemical Stop the leak if you can do so without risk Call the spill team at Ext 261 or 325 The three (3) steps in protection are: Read warning labels on containers Obtain annual training on the handling, using and storing of chemicals Locate your department’s Material Safety Data Sheets (MSDS) for: (a) chemicals present in your environment (b) conditions to avoid and (c) precautions to take when working with materials This is a SMOKE-FREE and TOBACCO-FREE Facility.

SAFETY DATA SHEET SAMPLE

Confined space policy OSHA requires employers to implement practices and procedures to protect employees from hazards associated with entry and work within permit required confined spaces. CONFINED SPACE: A confined space by design has limited or restricted means for entry and exit and is not intended for continuous employee occupancy. Confined spaces include but are not limited to manholes, boilers, pipelines, servers, tunnels silos and vats. POLICY: Allendale County Hospital has assessed its facilities and determined that there are no spaces in any of its facilities that are considered confined spaces that require a permit to enter and work. However, employees are reminded to exercise certain precautions when entering certain work areas such as the basement area of the hospital and the walk-in refrigerators and freezer in the kitchen located in the main hospital building. Employees should always inform at least one other co-worker if they need to enter these areas and co-worker should check on the employee to insure their safety. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Lockout–tagout policy
LOCKOUT-TAGOUT is a safety procedure generally used in industrial and certain research type settings and operations to ensure that dangerous machines and equipment are properly shut off and not started up again until maintenance, service or other repairs are completed. The procedure requires that a tag and locking device be placed on the item indicating that it should not be turned on. Allendale County Hospital has assessed its equipment and other machinery and determined that while these procedures do not generally apply to the hospital facilities, certain procedures have been adopted to insure the safety of its equipment and personnel using equipment. All staff are directed to identify and tag any piece of equipment at any time it is found to be malfunctioning, broken, or not working properly. Electrical equipment and any other appliances should be unplugged, identified as not to be used, and reported immediately to other staff and maintenance. Tags can be handwritten and taped securely to the item. A maintenance work order should also be turned in immediately. This is a SMOKE-FREE and TOBACCO-FREE Facility.

Security policies

Security policies The following policies and procedures are intended to provide guidance in maintaining security for all hospital property, employee property and protection for property of visitors and patients. Each department supervisor is responsible for all supplies and equipment assigned to their department. Each department supervisor is responsible for controlling all keys to the department. Keys must be limited to only those persons absolutely needing them. Locks are subject to change as deemed necessary by a department manager or Administration. Keys can only be duplicated upon the approval of the hospital administration. Replacement keys may be made at the employee’s expense. All offices and storage rooms must be kept locked when no one is in attendance. All personnel are responsible for monitoring the activities of visitors and patients. Suspicious behavior by visitors and/or patients should be reported immediately to your supervisor. No one is permitted to loiter in the hospital or nursing center. Department supervisors will be held responsible for open areas which are found unattended. Supervisors should immediately investigate any unauthorized personnel in any section of the building. If assistance is needed, contact the Administrator or local police station. Department Heads are required to report any missing property within 24 hours to the Administrator. A complete written report is required. Any incident deemed significant by the Administrator will be investigated by a group of three department heads appointed by the Administrator All employees are subject to a search of their person and possessions at any time while on hospital property. Searches will be conducted by Hospital Officials in conjunction with local law enforcement officials. Lockers utilized by hospital employees for storage of personal property must be marked with the name of the employee and utilize a lock approved by Administration. Lockers are subject to inspection and search by Administration at any time.

VIOLENCE IN THE WORKPLACE – SAFETY POLICY & PROCEDURE
Security policies VIOLENCE IN THE WORKPLACE – SAFETY POLICY & PROCEDURE POLICY: The safety and security of patients, visitors and staff is of vital importance to Allendale County Hospital. Therefore acts or threats of violence, physical or communicated by any means will not be tolerated, that any such act on hospital property will be considered misconduct and will lead to disciplinary and/or legal action as is appropriate. This prohibition against acts or threats of violence, extends to all persons on hospital property. PURPOSE: To provide the hospital and it’s associated facilities with a means of addressing workplace violence with a Management Response Team, means of assessment, action and education of staff, patients and visitors, to make a public announcement that workplace violence, in any form, will not be tolerated. DEFINITION: Workplace Violence includes but is not limited to Acts or threats of physical violence Harassment Intimidation Coercion Domestic violence carried out on hospital property Threatening telephone calls or Written or verbal threats Acts of sabotage intended to cause harm

Security policies MULTI-DISCIPLINARY MANAGEMENT TEAM:
The Management Response Team is responsible for the overall implementation and oversight of the Workplace Violence policies and procedures. The team consists of management level representatives from the following departments: - Human Resources - Safety - Security - Risk Management - Appropriate Department Head or Supervisor, relative to the incident The Management Response Team is chaired by the Human Resources Manager, who may be contacted by: , x225 or x226 The team’s responsibilities include but may not be limited to improving the hospital’s readiness to address workplace violence by: - Reviewing past incidents of violence at the hospital - Evaluating the hospital’s readiness to respond to workplace issues - Developing an expertise among the team members - Establishing a liaison between emergency services and local law enforcement - Training and education of all hospital employees regarding this issue - Initial employment screening, designed to minimize violence potentials that may be inherent in prospective hospital employees, contract persons and temporary workers. - Implementation, monitoring and revising the hospital’s workplace violence policies and procedures on an annual basis

Security policies DEPARTMENT HEAD, CLINICAL COORDINATORS AND SUPERVISORS: The duties and responsibilities of the above named individuals include, but may not be limited to, improving the hospital’s readiness to address workplace violence by: Create and maintain a personal relationship with the individual Do not attempt to overwhelm the individual. One person should maintain the dialog Body language is crucial. Never blade hands in a chopping gesture and never expose palms – both gestures suggest that at some point the use of hands to restrain the person is probable. Display the hands naturally with thumbs along the sides of the thighs, suggests to the individual that the hands will not be used, but they are not hidden either. Assume a position from four to six foot away from the person unless you intend to restrain them. This distance is the recognized “comfort zone” of most people, and does not violate “personal space”, thus lessening threat potential Introduce yourself by name and ask the individual “what seems to be the problem – may I help you in some way?” Let the person answer fully, without interruption, even if the explanation takes five minutes or more Be an emphatic listener, remember do not interrupt Use terms such as “Us” and “We” instead of “I” and “You”. For example – “What can we do to correct the situation?” Tone, inflection and candor are important, as is voice level, always strive to maintain a friendly, open conversation, conducted in a voice level appropriate to the situation. Never raise your voice to make a point – this can be construed as a threat.

Security policies DEPARTMENT HEAD, CLINICAL COORDINATORS AND SUPERVISORS: (cont) When the discourse has reached a point where the situation has been defused, or when it seems appropriate, inform the person that you want to introduce another person, Mr. ____________ / Ms. ____________, who can help “Us” reach an agreeable solution. Never use the word “Security”. At this time, notify or have a co-worker notify a member of the Management Response Team, Department Head or Supervisor. A uniformed security officer’s immediate response may cause the person to act negatively. The person summoned will notify security of the situation. If at any time the situation appears to be getting out of hand, security will be notified to respond immediately. Upon the arrival of the Management Response Team member, Supervisor or Department Head and Security, they will take over or assist with the situation. An occurrence report will be completed as soon as possible. TELEPHONE THREATS: Whenever a threat of any type is received by telephone, follow these steps: Attempt to get the caller to indentify themselves Attempt to determine why the threat is being made Write down all pertinent information Report the threat to your immediate Supervisor, the Security Manager and a member of the Management Response Team WRITTEN THREATS: When a written threat is received, the immediate recipient will refrain from handling the item as much as possible. If the threat is contained in an envelope, the letter and envelope will be considered evidence, minimize handling to preserve any evidence that may be lost by improper handling of the item. Place the threat letter and envelope in a large document container. Immediately convey the evidence to your immediate Supervisor, the Security Manager, and a member of the Management Response Team.

Security policies DOMESTIC VIOLENCE IN THE WORKPLACE:
All incidents of domestic violence in the workplace will be immediately reported to a member of the Management Response Team, the Security Manager, the Human Resources Manager, and the Supervisor or Department Head of the affected area. These individuals will immediately follow these procedures: All actions taken will be with the intent of preserving the individual’s right to privacy, dignity and self respect Question the victim in a quiet, private setting, away from the abuser Gently probe the victim for an understanding of the relationship and the potential for violence. Be sure to recognize and respect the wishes and desires of the victim. Assess the situation, determine the current state of the cycle of violence. Obtain information regarding legally reportable injuries or violations List problem behavior traits of the abuser, such as stalking, threats or harassment Ensure that the victim is aware of the danger potential of such behavior patterns If appropriate, the Security Manager will notify Law Enforcement immediately The Security Manager will be knowledgeable of legal statutes as applies to domestic violence situations and will be able to communicate these to the victim Remember, the victim must file any civil charges against the abuser, the hospital cannot do this. The victim must make this decision independently and of their own violation. If at any point in the interview, the victim expresses the desire to terminate discussions, the victim’s wishes will be honored and the interview concluded. The Management Response Team, with assistance from Social Services and Psychiatric Units, may assist the victim with referral plans to advocacy groups such as: - Victims Witness Programs - Crisis Intervention Centers - Local Rape Hotline Telephone Numbers - Shelters for Domestic Violence Victims - Mental Health Referral Programs - Law Enforcement Telephone Numbers

Security policies REPORTING & RECORDING ACTIONS:
All records, recordings, photographs of the victim and details of the interviews are maintained under strict confidentiality and filed under the supervisor of the Human Resource Manager. Such files may contain: Copies of the Emergency Department Records All written documentation and photographs relating to the incident Copies of protective orders and abuser photographs if available The originals of any security or hospital incident reports The Security Manager will provide special services to the victim while he/she is on the hospital campus, to include escort service, special parking and a means of communications between the victim and the Security Department, such as telephone check –in or other appropriate means. Periodic monitoring of the victim’s room or treatment area, by uniformed Security personnel 24 hours per day for as long as the victim is on the hospital campus. AFTER CARE: Following the threat or assault, all hospital employees, contract or temporary workers, who witnessed the event will be provided with on-site counseling, for themselves and their families. The intent of this counseling is to mitigate the effects of possible mental trauma associated with the event. The costs associated with this counseling will be borne by the hospital. Management and Human Resources will conduct a post-incident review to determine if the situation was handled properly and appropriately. Identify any weakness found and amend procedures to strengthen those identified areas. Corporate legal counsel should be informed of all events and documentation, actions taken, as well as the results of the post incident review.

DISASTER Plans & Procedures

Disaster Plans POLICY: PROCEDURE:
Allendale County Hospital and its affiliated operating units are an integral pat of the local response to major emergencies and disaster situations in the county and surrounding area. PROCEDURE: It is the responsibility of every employee to be familiar with their role and responsibilities should the hospital activate its disaster plan. A disaster condition may be declared due to an isolated internal situation or due to an event(s) happening away from the hospital. The hospital’s disaster plans address guidance for various emergency and disaster conditions. All personnel, including employees, medical staff and other affiliated personnel are expected to respond to declared emergency conditions when called upon. All personal and emergency contact information must be kept current at all times. Department supervisors and Human Resource must be notified of any changes in your emergency contact information. This orientation provides general guidance of the overall hospital disaster plans. You should further familiarize yourself with the details of the plans with your department manager.

DISASTER WRITTEN PLANS: Available in each Department / Administration
Coordinated with Local Emergency Preparedness Agency CATEGORIES OF DISASTERS: Internal – Affecting Hospital Buildings and Property External – Occurrences away from hospital, multiple victims need emergency treatment/shelter DISASTER SITUATIONS: Accidents with multiple victims/injured Severe Weather (hurricanes, tornados, floods, etc.) Bomb Threats Hazardous Chemical Spills Fires/Explosions Special Medical Needs Sheltering Bioterrorism Other RESPONSIBILITIES: Training/Orientation Know your role Participate in exercises/drills semii-annually Emergency information – keep up to date Respond as needed

DISASTER CODES RED - Fire BLUE - Medical Emergency YELLOW - Disaster
GREEN - Violence

SEVERE INCLEMENT WEATHER
GENERAL PROCEDURES: 1. Personnel will be briefed at least annually regarding: a. Evacuation procedures b. Best available shelters from inclement weather c. Special situations such as flooding areas, loose or downed electrical wiring, danger from lighting, protective measures, etc. 2. Staff will know: a. When/Where utilities can be turned off 1. Electricity – main switch in boiler room 2. Gas – outside (Gas Authority must turn off) 3. Water – outside at sidewalk, Hwy 278 b. Fire exit locations TORNADOES: 1. A “tornado watch” is a forecast of the possibility of one or more tornadoes in a large area. Continue normal activities but watch for tornadoes. a. Upon receiving notification of a tornado watch through the established warning system, the Charge Nurse on duty should alert each staff member of the situation b. Radios are provided at each nursing station and a staff member should be assigned to monitor constantly. Local radio station, WDOG, should be monitored constantly. c. One employee shall be assigned as a lookout. This lookout should insure a good, clear, unobstructed view of the local area is maintained at all times and that he/she is checking outside weather conditions from all directions.

2. A “tornado warning” means that a tornado has been sighted and may pose a danger to the facility. a. The public warning system – 3 minutes steady blast on emergency sirens – will be activated. This signal may be repeated if necessary. b. Radio station, WDOG, will repeat the warning if necessary c. The tornado warning alert will be disseminated to the hospital and nursing center from EOC warning point via radio d. Administration or Charge Nurse will disseminate warning to the staff. e. Internal signal system is as follows: WORD OF MOUTH – Staff should proceed with moving residents into the hallways. Residents should be moved out of open areas as day rooms, dining rooms and lobbies. They should be kept 20 feet from any glass areas. Doors to resident rooms and fire doors should be kept closed. f. Provisions shall be made to warn all persons outside the building in order that they may proceed to shelter g. All personnel shall be made aware of the established tornado procedures during orientation and the subject shall be reviewed at least annually. h. Classroom discussions should be conducted periodically concerning established tornado procedures.

SEVERE THUNDERSTORMS: 1. Public warning signal is received over radio or TV, sirens are not sounded unless there is a danger of tornado 2. Hospital / Nursing Center warning signal is as follows: BY WORD OF MOUTH Snow storms: 1. Public warning issued by Weather Bureau through the Office of Public Safety, radio or TV when hazardous conditions are anticipated. a. Follow instructions provided by authorized staff members b. Personnel off-duty must notify facility of whereabouts and if transportation is needed. Floods: 1. Some areas of South Carolina are subject to flooding conditions, dependent on their geographical location. Except for flash flooding, floods usually can be forecast sufficiently in advance for emergency action to be initiated before flood waters affect a specific area. a. When a general area is affected, notice will be given over the State warning system. Local government will be responsible for warning in the event of flash flooding. b. This is one of the few disaster conditions in which immediate evacuation is recommended. Prepare to leave immediately if advised to evacuate. c. The Charge Nurse will be responsible for medications and charts when feasible. Charts will be transferred with residents. d. Any evacuation will be in accordance with directives from local Emergency Preparedness officials and carried out in accordance with pre-established plans for relocating patients.

Hazardous accidents Warning of a hazardous accident is usually received from the fire or police department or from emergency preparedness officials when such accident occurs sufficiently near the hospital to be a threat to the safety of the hospital. An overturned tanker, either a truck or a train; a broken fuel line; and an accident in a commercial establishment that uses chemicals are all potential hazards if such accidents occur near the hospital or if the wind is such that it would carry fumes from such accidents to the hospital. Whether the accident occurs at the hospital or off the hospital grounds, the procedure to be followed is: The Administrator or designee will determine the need to evacuate the facilities and whether to evacuate the residents and staff from the grounds If decision to evacuate is made, move crosswind, never directly with or against the wind, which may be carrying fumes Maintain resident accountability If the Administrator is not on duty, notify as soon as possible. The Administrator or designee will direct further action as necessary. The facilities will not be re-occupied without authorization from proper officials The Charge Nurse will be responsible for medications and charts. Charts will be transferred with residents Actual movement and transport of residents and patients will be carried out in accordance with pre-established plans for relocation

Introduction This orientation program is designed to provide you with information about several key aspects of your employment with Allendale County Hospital.

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Introduction This orientation program is designed to provide you with information about several key aspects of your employment with Allendale County Hospital.

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Presentation on theme: "Introduction This orientation program is designed to provide you with information about several key aspects of your employment with Allendale County Hospital."— Presentation transcript:

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