©2003 mercy & unity hospitals all rights reserved. student and instructor orientation program...

©2003 Mercy & Unity Hospitals All Rights Reserved.

Student and Instructor Orientation Program

Mercy & Unity Hospitals

©2003 Mercy & Unity Hospitals All Rights Reserved.Revised 10/03

Welcome

You are the future of healthcare!

Mercy & Unity are excited to provide an environment where our professional staff and quality healthcare lends itself to an excellent learning experience for you.


Orientation Toolkit This orientation toolkit is intended for non-

employees who are completing academic experiences at our hospitals. This would include: Clinical instructors and students completing clinicals, internships, capstones, synthesis and others as required.

Completing this toolkit is part one of your orientation. The second portion is with the specific unit/dept you will be working on. You should meet with the unit/dept representative to obtain orientation specific to your role and department.


How to Proceed Read each slide and complete any

documentation required by your school. This orientation program is the property of

Mercy & Unity Hospitals, and is made available for those unable to attend the traditional classroom orientation..

Questions about the information contained in this toolkit should be directed to the Center for Learning and Development, Academic Liaison: 763/236-3030


Contents Who Are We Mission, Vision & Values Confidentiality/HIPAA Extraordinary Workplace with

Extraordinary Employees Safety Awareness Infection Control In Closing...


Who We Are Mercy & Unity Hospitals are part of Allina

Hospitals and Clinics Allina is a not-for-profit healthcare

organization serving Minnesota, Wisconsin and the Dakotas. Although we are not-for-profit, it is still

necessary to watch the financial bottom line. We need to be here to meet the current and future needs of the communities we serve. We reinvest profits in new equipment and advanced technologies to better care for our patients.


Allina Hospitals & Clinics 13 hospitals 2 nursing homes 42 clinics Medical transportation services serving 70

Minnesota communities Hospice a community service

providing health care information and referrals


Allina HospitalsMetro Hospitals: Mercy Unity Abbott Northwestern United Phillips Eye Institute

Regional Hospitals Buffalo Cambridge Owatonna St. Francis River Falls New Ulm


What we strive for... Mercy & Unity’s Vision

We place patients at the center of all we do as we care for and grow with the communities and region we serve.

Allina Mission We serve our communities by providing exceptional care, as we prevent illness, restore health and provide

comfort to all who entrust us with their care.


Allina Values: Integrity

Match our actions with our words. We live our values and mission in all decisions and actions.

Respect Treat everyone with honor, dignity and courtesy. Respect

values, cultures, beliefs and traditions of others. Value each others talents and contributions.

Trust We act in the best interests of out patients, physicians,

communities and one another.

Compassion Dedicated to creating a healing and caring environment to

support the emotional, physical & spiritual well-being of all.

Stewardship Use our resources wisely. Commit to being thoughtful

stewards of time, energy and talent.


Living the Values Why is it that some patients can have poor

outcomes and still say that they wouldn’t go anywhere else for their healthcare? The difference is the relationships that we

create with our patients. It’s the customer service we provide. People come back to our hospitals because we

live out our values and walk the talk-not just give them lip service.


Customer Service Basics Creating an excellent experience where

patients feel assured, included and appreciated.

While much of our work is of a high tech nature, we know the importance of connecting with our customers on a human/emotional level when beginning and ending any interaction.


Who are our customers?External Customers: Patients Families Physicians

Internal Customers: Coworkers Other departments


The impact of body language, voice, tone and wordsAre the words we are saying congruent with

our body language and our tone of voice? Do we say one thing but project the opposite?

When we breakdown communication, we realize that: 55% of the message is our body language 38% of the message is our tone of voice 7% of the message is the actual words we use.

(To make the biggest impact, you’re actions must match your words)


Confidentiality

HIPAA’s Privacy Law


Confidentiality Maintaining a patients privacy/confidentiality is not

only the ethical thing to do, it’s the law. We are committed to preserving the confidentiality

of patient information. The inappropriate release of information will result

in disciplinary action and possible legal action.


HIPAA?The Health Insurance Portability and Accountability Act (HIPAA).

This revised “Privacy Law” places strict regulations around the privacy and security of patients health information.

The law also mandates that we train everyone in the rules and provisions of this law.


Protected Health Information PHI is basically any information that

identifies an individual or could reasonably be used to identify an individual. Includes, but not limited to:

Name, address, age or SSN Health history and conditions, treatment or meds Hospital or clinic bill or payment record Any identification that an individual is a patient.

It can be in any form Verbal, written or electronic Past, present or future medical information


Minimum Necessary Rule Minimum Necessary Rule:

We must only use and disclose the minimum amount of patient information needed to do our jobs.

Simply put: You may only ask for, use and disclose patient

information as needed for legitimate patient care or business purposes.


Curiosity Killed the Cat-Don’t let it get you! Our patients could be your neighbor, friend,

classmate or family friend. Sharing with others that you saw someone at the

hospital or sharing of their health information may seem harmless to you- but it can be very harmful to the patient-and it’s illegal!

You might be curious to look up information on a family member that is a patient here. Unless you need that information to do your job, you are prohibited from accessing that info.

If in doubt, caution on the side of maintaining patient privacy.


Release of Health Information We must have consent from the patient

before giving any information to others, including spouse, family members, or friends.

The inappropriate release of protected health information is illegal and we must address any harm that occurs because of its inappropriate release.

You are held legally accountable to maintain a patients privacy/confidentiality.


An Extraordinary Workplace with Extraordinary

Employees

A Culture of Caring


An Environment for HealingWhen patients see how well we treat one another, they will know this is a good place for healing. We cannot provide to patients what we are unable or

unwilling to provide each other. If they see or hear uncaring behaviors, they will not find

the healthy, healing environment they need.


Where You Would Want to Give and Receive Care

Create a Respectful and Professional Workplace


DiversityDefined as all the differences and similarities that exist among people - including race, gender, age, sexual orientation, job status, physical differences, etc..

We value the differing points of view, varied experiences and the talents of each and every person.


Harassment Free Workplace We have a zero tolerance policy for

harassment in all of its forms. Including, but not limited to, harassment based on: Sex Race Age Disability National Origin Religion Sexual Orientation


Key Points on Harassment It’s the impact, not the intent.

Whether or not you intended harm doesn’t change the fact that someone was impacted by your actions or behavior.

Direct or indirect, subtle or obvious We must own the ‘culture’ in which we work. Is this a

place you want to come and work or is someone else's behavior causing a hostile or intimidating environment.

At the workplace or off duty related activities such as social gatherings or calls to your home. Act early-talk to the accused and ask them to stop the

behavior. If no resolve, escalate by discussing with your instructor who will report to the hospitals academic liaison, unit manager or HR dept.


Safety Vision

To make Mercy & Unity Hospitals a safer place to give and receive care


Minnesota Employee Right to Know Act (ERTK) 1983The law was passed to make sure employees are told about the dangers associated in working with hazardous substances and harmful physical or infectious agents.

The law outlines both employer and employee responsibilities for safety from work related injury or illness.


What does “exposed to” mean?You are considered routinely exposed to a substance or agent if there is a reasonable possibility you’ll be in contact with one of the items during the normal course of your assigned work.


Employer RequirementsEducation of staff and new employees on:

The types of hazardous materials, agents and equipment in your work area.

How to properly handle and work safely with the products.

Where information about hazardous materials is located.

Education specific to the materials/agents in your work areas will need to be covered during unit specific orientation.


Employee Requirements The law gives you the right to:

Refuse to work under imminent danger conditions or if information or training about how to safely proceed with your job is not provided.

If you feel that this applies to a situation, then discuss with your instructor or unit leadership.


What if I’m asked to work in an unsafe situation? Tell your instructor or the unit leadership if you

feel a work situation may be dangerous Tell your instructor or the unit leadership if you

don’t know how to use or handle hazardous materials and/or equipment you are assigned to work with.

Report faulty equipment so it can be repaired or replaced.

Don’t put yourself in any situation where you could be injured or harmed. You have the right to refuse to work under dangerous conditions.


What Happens Next? The unit leadership will:

Evaluate the situation for safety and the presence of hazards.

Teach you how to safely use the product, direct you to the appropriate resource, provide you with learning materials, give you the appropriate Personal Protective Equipment.

Reassign you to an alternate job until a hazardous condition can be corrected or eliminated.


Chemical Spills/Release Each department maintains procedures for

the safe handling and spill clean-up of the hazardous products used in their areas.

You need to receive unit specific orientation on the hazards found in your area.

With any chemical spill, you should notify the supervisor and maintenance.


Locating information on Hazardous Substances & Chemicals.

Material Safety Data Sheets (MSDS) provide information on the effects and properties of hazardous substances. These can be accessed from the Allina Knowledge Network (AKN). Ask the unit educator/designee to access these sheets.


Emergency CodesYou might hear these emergency codes paged overhead, so it is important to know their meanings.

Dr. Red Fire Alarm Code Blue Adult Cardiac and/or Resp. Arrest Code Pink Neonate Cardiac and/ Resp. Arrest RPR Restraint Personnel Requested RPR Alert Calls the RPR team in less severe situations. Dr. Shield Security help needed Orange Alert Disaster Plan in effect Code A Pediatric or Infant Abduction


Severe Weather Codes Severe Thunderstorm Warning-conditions

are favorable for severe weather Tornado Warning (phase 1) - a tornado has

been sighted. Close windows, blinds and curtains. Keep corridors clear.

Tornado Warning (phase 2) - hospital is in the path of the tornado. Move patients and visitors away from windows to interior corridors closing all doors. Visitors should stay with the patients and staff should move the the best shelter in the department.


Fire Safety Essentials in Your Department

You will need to locate this information in the areas you work.

Location of the fire alarm pull boxes Location and type(s) of extinguishers Emergency phone number x63333 The stations main oxygen shutoff valve(s) Evacuation plans and routes


R.A.C.E. Fire Procedure

Rescue

Alert

Confine

Extinguish


R.A.C.E. Rescue: Move anyone in danger

to a safe area. Alert: Pull fire alarm box and call

x63333 to report the fires location. Confine: Close doors & windows

in area, clear corridors and fire exit areas.

Extinguish: Fight the fire only if it will not place you in danger. Blankets can be used to smother the flames of small fires or waste basket fires as well as using extinguishers.

Rescue

Alert

Confine

Extinguish


How to Use ExtinguishersKnow the types of extinguisher in your work area. Choose the appropriate extinguisher for the type of fire.

Then: P Pull-the pin A Aim-the extinguisher S Squeeze-the handle S Sweep-the extinguisher hose at the

base of the fire.


Patient Safety Initiatives To provide our patients with a safe healing

environment we have initiated safety goals around the care of the patient. Some of the goals you should become familiar with include: 2 Patient Identifiers Unacceptable abbreviations Clinical Alarms Pause for the Cause & Surgical Site Marking


Matching the right patient to the right treatment or service: When obtaining blood samples or administering medication or blood products or

applying the patients armband, two patient identifiers will be used to compare to the same two printed identifiers on the lab request, medication record, blood product label or patient’s medical record.

Patient Identifiers Include: Patient’s stated name and date of birth are compared against the printed name and

DOB on the medication record, blood product label, specimen label, or medical record.

Alternative to stated name and DOB included SSN, medical record number, patients phone number or address. These must be compared against the same two printed identifiers.

Patient’s unable to state their name and DOB: Verification by a family member Verification by carefully matching the name and DOB on the wristband with

the same info on the medical record, blood product label, specimen label.

A patient room number will never be used as a method of patient identification or verification.


Unacceptable Abbreviations

We have developed a list of abbreviations that are not approved for use within the medical record (documentation, notes or orders).

Orders written for an unacceptable abbreviation/practice will not be accepted or executed.

Unacceptable orders will be clarified by the nurse and documented as a verbal order before executing.


Abbreviation/Practice: U ug (microgram) Eliminate trailing Zeros after a

decimal (2.0 mg) Require leading zero before a

decimal (0.5 mg) AZT (Zidovudine) AZA (Azathioprine) HCT (Hydrocortisone) MSO4 (Morphine) MgSO4 (Magnesium Sulfate) Nitro & NTP

(Nitroglycerine or Nitroprusside) 6MP (6-Mercaptopurine) Chemotherapy Abbreviations QD, QOD, AS/AD/AU/OS/OD/OU

Correct Practice: Write the word “units” Use “mcg” Never use a zero after a decimal

point (2 mg) Always use a zero before a

decimal (0.5 mg) Write the full drug name for each

example

Write the full words

Unacceptable Abbreviations


Clinical Alarms

Goal: Improve the effectiveness of clinical alarms. Examples of clinical alarms are : cardiac

monitor alarms, fetal monitor alarms, apnea alarms, door alarms in behavioral health, elopement/abduction alarms, infusion pump alarms, bed alarms, bathroom alarms or respirator alarms.


Alarm Considerations Clinical alarms are basically all patient care equipment containing

alarm functions Alarm functions should be managed/adjusted by the assigned staff

RN or other hospital designee. Students/instructors should collaborate with assigned staff RN when setting/adjusting alarm parameters.

Staff/Students must be trained in the use of alarms: How parameters are set Who sets parameters Who responds to the alarm In the case of critical alarms, are they deactivated at the central desk or does a

qualified staff member enter the room and assess the patient.

Alarm policies are practiced If an alarms fails, a Patient/Visitor Safety Report is completed, Risk

Management is notified, and the equipment is immediately sent to Clinical Equipment Services (CES) for evaluation.


Pause for the Cause

Goal: Eliminate wrong site, wrong patient, wrong procedure/surgery.

Done prior to local injection/incision/start of procedure. Surgical Site Marking: The surgical site is marked for

correct site and laterality, per policy. Pause for the Cause: The circulating RN reads the

patient’s full name and procedure including site/side, from the consent form. All members of the surgical team listen and confirm the correct procedure, patient, surgical site and side (laterality).


Safety & Ethical Situations If you encounter a potential hazard or unsafe

situation in our hospital or if you have an ethical concern regarding our practices or a patient care situation, you should discuss this with the staff co-assigned with you and/or your instructor. We encourage reporting of safety concerns, incidents,

hazards and ethical concerns. We have committees and processes in place to address

these issues and make changes when appropriate.

Concerns reported to your instructor or co-assigned staff will be escalated to the unit leadership. You may be asked to complete a “Patient/Safety Visitor

Report” or “Area of Concern Form” to document the events.


Safety Phone Numbers Dallas Anderson, Security Manager:

763/236-4306 Deb Andrews, Employee Safety Director:

763/236-4712 Shari Bakker, Patient Safety Director:

763/236-8084 763/236-SAFE


Infection Control


Where do germs come from? Environment

surfaces floors gardens

People skin intestines

Equipment Water Flowers/plants


Chain of Infection

SUSCEPTIBLEHOST

SOURCE

METHOD OFTRANSMISSION

All links must be complete for an organism to spread from one place to another. Our goal is to break the chain in one or more links.


Risk of Transmission Intact skin is a good barrier to organisms

organisms can enter through non-intact skin

(cuts, scrapes, eczema) Mucous membranes allow transmission,

such as through: eyes nose mouth


Risk of Transmission Most transmission occurs through contact:

Direct contact- touching patient Indirect contact - touching a contaminated

surface Spray/splashes: Fluids, sputum, etc

Most contact is with our hands


Hand Washing

Hand washing is the single most effective way you can break the chain of infection.


Hand Washing Basics Soap

Use only hospital approved soaps, lotions & foam products.

Warm running water 10-15 seconds Use friction Turn off faucet with paper towel.


Waterless Hand Washing (Quik-Care Alcohol foam)

Can be used instead of soap and water if hands are not visibly soiled or contaminated with blood or body fluids.

Dispense a walnut size amount and rub hands and under nails until dry.

Use before and after every patient contact or contact with contaminated equipment.

Contains emollients, therefore is better for your hands and is less drying to hands than soap and water.

The emollients can build up on the hands after repeated use, so, wash with soap and water occasionally.


Artificial Nail Restriction This restriction must be followed by everyone who

has direct patient contact, cleans rooms, handles patient supplies, prepares or serves food/drinks, handles medications or blood products. Artificial nails including tips, wraps, overlays,

acrylics, gels, any appliques, nail piercing, nail jewelry or any other artificial nail enhancements of any kind are not allowed in our facility.

Natural nails must be kept 1/4 inch or less.


Standard PrecautionsStandard Precautions considers all patients as potentially infectious.

Prevent exposure to infectious organisms by wearing Personal Protective Equipment (PPE) when contact with the following is anticipated: blood body fluids, secretions and excretions non-intact or broken skin mucous membranes


Personal Protective Equipment (PPE)

PPE is located in all patient care areas. Exact location should be sought out during unit specific orientation. Gloves - to keep hands clean Gowns - to protect uniform from getting

splashed or wet Facial protection - to protect mucous

membranes from getting splashed or sprayed


Blood Spills Potential exposure to blood or

body fluids could occur at any work site

There is a plan in place for each work site

Guiding principles of each plan: Avoid direct contact with body

fluid. Clean up spill and then disinfect

area. Wash hands.


Location of Exposure Control Plan and Infection Control Policies

•The Allina Knowledge

Network (AKN)


In Closing...


Documentation of Orientation You have now completed general orientation to

Mercy & Unity Hospitals. The 2nd part of your orientation will be obtained in

your specific dept/unit, based on your specific role. Either your instructor or the unit leadership will provide this information.

It is our expectation that orientation is completed prior to an experience at our hospitals. However, verification and tracking of its completion is the responsibility of the school.


Department Specific Orientation Checklist Minimally, your department specific orientation should

include the following items: Location of:

Crash Cart Emergency Equipment Personal Protective Equipment Evacuation Map

Orientation to: Documentation process and related technology Medication administration and related technology Accessing policies, procedures and other resources Hospital and unit care & quality improvement initiatives

Demonstration of quick release tie and application of locking restraints (required for anyone working with patients).


How to access policies on the Allina Knowledge Network (AKN)

All policies are located on the AKN, an intranet site which can be accessed using our network computers.


You Are Finished!!!

©2003 mercy & unity hospitals all rights reserved. student and instructor orientation program...

Documents

allina hospitals clinics

mercy unitys vision

allina values

new ulm slide

orientation toolkit

clinics allina

orientation specific

allina mission