NURSING STUDENT ORIENTATION

2009-2010

Welcome……

MISSION STATEMENT

To deliver accessible, high quality health services in a focused caring environment while providing health advocacy for the community and people we serve.

Our hospital…….

321 bedsNot for profitBuilt in 1956Huge ED with over 70,000 patients/year2 Health Centers EAST AND WESTHospice, home care, outpatient dialysisIs smoke free

Long Island Health Network (LIHN) Guidelines

Pathways/clinical maps developed through evidence based practice for disease processes that designs the patient’s plan of care

Identify your patients that are on guidelines and learn how they are used.

This process improves patient outcomes, and uses standard best practice

A CULTURE OF PATIENT SAFETY

Patient Identification2 identifiers: Name and DOB when giving meds, drawing blood, transporting patients, treatments….etc

Improve CommunicationAbbreviations: DO NOT USE LISTRead back telephone orders, do not accept verbal ordersRead back of critical lab resultsAppropriate ‘hand offs’

A CULTURE OF PATIENT SAFETY

Improve the Safety of Using Meds

Standardize drug concentrations

Watch for look alike/sound alike meds

Label all meds in your work area

Reduce the risk of health care associated infections

Wash your hands!!!

Hand gel available, not effective against C Diff.

A CULTURE OF PATIENT SAFETY

Reconcile meds across the continuum of careCommunicate a list of meds upon admission, at time of transfer, and upon discharge

Reduce the risk of patient harm from fallsGreen armbandsBe vigilantUse lifting equipmentReport all fallsBe alert to meds that may cause patient falls

A CULTURE OF PATIENT SAFETY

Encourage patients’ involvement in their own careSPEAK UP Campaign, see posters in the hospital

Identify safety risks, patients at risk for suicideSpecial assessment is done on these patients

UNIVERSAL PROTOCOL:Conduct a pre-operative verification processMark operative sitesConduct ‘TIME OUT’ immediately before starting any invasive procedure, even at the bedside.

SERVICE EXCELLENCE

Be friendly Wear your ID badge so we can say

hello to youIntroduce yourselves to your patientsKeep the environment cleanLook and act like the professional you

arePATIENTS ALWAYS COME FIRST!!

WHO’s WHO??

Mr. Ockers President and CEO

Mr. Margulis Senior VP of Operations

Dr. Kim Mendez Chief Nursing Officer

Mr. Phil Messina AVP Patient Care Services

Mrs. Gail Steiger Director of Nursing

Mrs. Mary Ellen Lindros Director of Nsg Prof. Development

NURSING DEPARTMENT

Kim Mendez/Gail SteigerNurse Managers

Nursing SupervisorsClinical Nursing Supervisors

Clinical Educators (med surg, diabetes, wounds, ICU)

RN’s and LPN’sCardiac Monitor Techs

Nursing Assistants

MISSION of the NURSING DEPARTMENT

To communicate…advocate……and promote safety and quality care for our patients, families, and each other.

UNIT SECRETARIES

On every nursing station

VERY HELPFUL!!

Maintain charts

Enter orders

Facilitate patient care

CASE MANAGERS

Discharge Planners

Coordinators of care

Social Work

Home Care/Hospice Referrals

Transportation

Complicated Cases

Home Care and Hospice

Some of you may rotate to the home care/hospice area…….

INFECTION CONTROL in the HOME

Nursing Bag Technique Handwashing is essential, hand cleanser is available Universal Precautions, discuss with CHN and review policies Double bag dirty dressings Dispose of sharps per home policy Oxygen safety in the home is paramount

Home Care and Hospice

Some of you may rotate to the home care/hospice area……

EMERGENCY PLANS

Follow HICS as set forth by the hospital Triage patients according to need and location (most common

events are snow and flooding) Follow policies for home care and hospice Home and Hospice participate in pandemic flu planning Work with Fire Department and/or Police Department as needed Radio announcements in events of emergency

WBLI FM 106.1 and WALK 97.5

CULTURAL DIVERSITY

Be respectful of others - Understand that there is a great diversity in BMHMC and all patients and staff should be treated with respect as you would expect to be treated.

International Nurses – BMHMC staff includes nurses from other countries including the Philippines and India

Language – please be sure to speak only English when working at BMHMC

Cyra Phone for Interpreters – this phone is used for our non English speaking patients and a phone is available on each unit.

Deaf Talk - is used for hearing impaired ( ask your nurse if the patient needs this equipment)

FIRE SAFETY

R Remove patient from danger

A Activate the alarm

C Contain the fire and close doors

E Extinguish the fire if you can

THE CODE IS CALLED DR. PEPPERDial 3040 and state your location

CODE 64

This is the code for cardiac arrest

If it happens to your patient:

1. Call for help

2. Call or have someone call 7333 and state your location

3. Start CPR

DR. HEAVY

This is the code for violence!!

Call 7911 and state your location

Your responsibility is to get out of harm’s way and allow security to do their job

OTHER CODES…

CODE PINK: Infant Abduction, LOCKDOWN!!

Babies have HUGS tags

CODE GREEN: Oxygen Alarm

CODE DECON: Biohazard coming to ED

HICS: Hospital Incident Command Center. Mobilized in crisis events. Report to your instructor and wait for direction.

CODE RAPID RESPONSE: Team called to assess sudden acute changes in patient condition

HIPAA and PATIENT CONFIDENTIALITY

Any information learned in the hospital should be contained here and not discussed with anyone not associated with the patient ( this includes family and friends)

The computer should only be used for patients that have been assigned to you. Unauthorized use of the computer will result in your removal from the organization

Patient status should not be discussed in public Comply with all security and privacy regulations Report any concerns to your instructor Any documents with patient identification used during your shift

should be placed in the shredder box before leaving The confidentiality statement must be signed prior to starting your

hospital rotation

INFECTION CONTROL

WASH YOUR HANDS before and after caring for each patient and after removing gloves!!!

Infection Control Manuals on each unit Watch for ISOLATION SIGNS and follow

instructions Use gloves when you need to Put sharps in appropriate containers Red Bag Waste is in Dirty Utility Rooms

Patient Bill of Rights

See Handout and competency.Competency should be completed prior

to starting your rotation.

INCIDENT REPORTS/ERRORS

Do not be afraid to report an error!!!Errors are usually due to process issues and

must be reported. This information is used for performance improvement and can result in changing process to prevent future errors.

Reports are computerized and should be filled out prior to the end of the shift. All incidents must be reported to the Nurse Manager or Nursing Administrative Supervisor through your instructor.

MEDICATIONS

Be sure to check the patient’s identification with order, patient and screen of computer prior to any procedure

MAK System: Medication Administration Check System

Bar Coding scanner

Pharmacists on the Floors during the day

Patient Education for medications ongoing.

Hand outs available for printing on the Intranet

PROHIBITED ABBREVIATIONS

Do not use Must useU unitsQD DailyQOD Every other daySC, SQ Subq or subcutaneousTIW Three times a weekCC MLOD once daily or right eyeMS Morphine Sulfate

Do not use Zeros after a decimal point Write 1 mg, not 1.0 mg

Always use a Zero before a decimal pointWrite 0.5 mg, not .5 mg

MILITARY TIME

Based on a 24 hour clock, no am or pmUsed for all documentation2400 is Midnight

CHARTING

Interdisciplinary Database and Plan of CareAction Flow Records Vital signs and Intake and OutputRestraint documentation for compliance Initial FOCUS NotesPatient Education Sheets All on computer in Soarian DocumentationLIHN Guidelines continue to be paper

ID BAND COLORS

White: Standard band, name & DOB

Pink: Arm or side affected, no blood draws or BP’s

Green: Patient at risk for falls

Red: Allergy, read it for specifics

Orange: Latex Allergy

Blue: On anticoagulation therapyYellow: used for non admitted patient(should be

changed immediately on arrival to floor)

Your practice…..

BE SAFE!!!Do not give medications without your

instructorYou are beginning a very honorable

career, act professionally at all times. Any issues or concerns should be

reported immediately to your instructor

FINAL WORDS

Provide quality nursing care and be proud of your profession

Offer compassion to all patientsMaintain your integrityRespect the dignity and privacy of your patientsBe responsible for your actionsTake accountability for yourself

WELCOME TO BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER

BE PROUD TO BE A NURSE