Welcome to Piedmont Medical Center

Instructions

1. Read Material

2. Print the Test and Summary

3. Complete the Test

4. Sign the Summary

5. Return Test and Summary to the Education Dept.

Objectives

Recognize Piedmont Medical Centers Mission, Vision and

Values along with your role as a team member

Recognize HIPAA and methods used to protect patient

privacy

Understand your role in safety codes

Describe Quality measures and your role in Infection

Prevention

Recall Cultural Awareness

Identify your role in addressing pain

Recall restraint and seclusion process and identify

resources

Recognize your role in preventing falls

Teamwork & Collaboration

Mission, Vision &

Values

Our employees developed our Mission, Vision and

Values statement which we believe speaks to the very

heart of our culture here at Piedmont Medical Center.

Our Mission

To deliver exceptional health care to every person

we have the privilege to serve

Our Vision

To be your premier health care system

Our Values come from the HEART

Honesty

Do the right things for the right reasons

Excellence

Do our best every time, every day

Accountability

Acknowledge and assume responsibility

Respect

Treat everyone as we would want to be

treated

Teamwork

Support each other to find and create

solutions

Your pledge

If I notice a lost visitor or staff member, I will escort

them to their destination…even if I am in a hurry

If I see trash, I will pick it up…even if it’s not mine

By taking these pledges you will improve the

satisfaction and cleanliness of our facility

Dress Code

Uniform and dress code requirements are unit/department specific- please

speak with your unit leader for your specific dress code

*If you fail to follow personal appearance and hygiene guidelines, you will

be sent home and directed to return to work in proper form. Under such

circumstances, non-exempt employees will not be compensated for the time

away from work. (PMC Handbook)

Health Information

Management/ Confidentiality

Please view the following videos for information on healthcare ethics, compliance and privacy https://www.youtube.com/watch?v=QWRn2r5R7ts&index=2&list=PLACD9536723837201 https://www.tenethealth.com/about/ethics-compliance

HIPAA

Health Insurance Portability and Accountability Act of 1996

What you “see” here What you “hear” here

When you “leave” here Let it “stay” here!!

HIPAA

Avoid discussing patients in common areas (cafeteria,

elevators, hallway, etc.)

Utilize shred bins

Avoid discussing patients over the phone

Ask patients for permission prior to discussing their

care in front of visitors

HIPAA FAQ’s

Can I give a patient a copy of their record? NO-Patients may obtain

their medical records through HIM (Health Information Management)

located on the 1st floor-requires picture ID

Can a patient read their record? YES, requires HIM (Health Information

Management) to witness in order to protect the integrity of the record

Can I read anyone’s chart that I want? NO-you should not access a

chart unless it is required to perform your duties

Do I have access to my own, my children's or my spouses record?

No-you are required to go through HIM (Health Information

Management)

What happens if I violate HIPAA? Violation could result in termination

Medical Record Hospital “Documentation Policy”

• EHR (Electronic Health Record) – Cerner • Documentation is in black ink (no highlighters) • Legibility – Think about patient safety and need to reference documentation in the future • Legal Signature - First initial, Last name, Title and Credentials • Sign/date/time every entry!

If your pen touches the patient’s medical record, for any reason, you must sign/date/time it. • Late Entry

Same shift: "Late Entry“ in the time column AND the actual time of entry being documented. The date and time the event occurred is charted in the body of the note.

Next day: Documentation may only occur within 24 hours of the event. After 24 hours, do not document in the medical record, contact the Risk Management department for direction. If documenting within the 24 hour time frame, follow the guidelines for “Late Entry” described above.

• Errors - Single line through the error, a reason, initials with date/time (i.e. reason “correction”; do not put “error”)

Safety & Emergency

Response

In case of Emergency

Dial 6666 If you need to activate a hospital wide alert you call 6666 which will ring as a priority for the operator

Fire Safety

RACE Steps for patient and staff safety

Rescue

Activate Alarm

Contain

Extinguish

PASS Steps for use of fire extinguisher

Point

Aim

Squeeze

Sweep

Facility Alert-Fire Fire

Facility Alert- Hazardous Spill Hazardous material spill

Facility Alert- Tornado Watch/Warning Tornado Watch/Warning

Facility Alert- Utility Outage Utility outage (ex:water, air, phone)

Security Alert- Infant Abduction Infant abduction

Security Alert- Code Elopement Missing patient

Security Alert- Disruptive Situation Disruptive, assaultive person

Security Alert- Armed Subject Armed assailant

Security Alert- Suspicious Package Bomb threat

Medical Alert- RRT Person in distress

Medical Alert- Code Blue Medical emergency- cardiac and or respiratory arrest

Medical Alert- Code Stroke Stroke

Medical Alert- Code STEMI ST elevated myocardial infarction

Medical Alert- Hypothermic Procedure Induced Hypothermia Patient

Emergency Alerts

Hazardous Material Data Sheet (MSDS)- Contact # 800-451-8346 (found on all desk phones)

Patient Bracelet Triangles: Red: Allergies Yellow: Falls Risk Pink: Limited Limb Use Blue: Pressure Area Noted (Skin) Purple: Limited Resuscitation

Additional alerts

Emergency

Response

RRT- a Rapid Response Team is called when a patient

is deteriorating in an attempt to avoid a Code Blue

Code Blue- is called when a patient has had a Cardiac

or Respiratory Arrest

A Critical Care RN, Respiratory Tech,

Lab, EKG, Pharmacy and MD will respond

to each of these emergencies

Emergency

Response

• Code Fire-in case of fire-close all doors and plan on a lateral

move. Utilize RACE and PASS

• Code Disruptive Situation-in case of aggressive patient-

survey and remove any potential dangers such as IV poles,

phones and tables-security will attend

• Code Elopement- check stairwells and elevators on your

floor

• Code Infant Abduction- be on the look out for someone

carrying a baby

Quality and Infection Control

Accreditation and

Regulatory Readiness

We are governed by the following entities:

Centers for Medicare/Medicaid (CMS)

The Joint Commission (TJC)

Hospital

Stroke

Heart Failure

SC Department of Health and Environmental Control (DHEC)

Hospital and Food services

Infection/Disease prevention and control

Trauma services-Level 3 Trauma Center

Council of American Pathologists/American Association of Blood Banks (CAP/AABB)

Inpatient and Outpatient laboratory services

Blood services

Your Role in Quality

Be an active participant!

Know and perform within your scope of practice/job

description and delegate responsibilities appropriately

Be familiar with hospital policies and standards and

practice within them

2017 National Patient

Safety Goals Identify patients correctly

• 2 patient identification-EVERY

PATIENT/EVERY TIME

• Correct patient identification/crossmatch for

blood transfusions

Improve staff communication

• Get important test results to the right staff

person on time

Use medicine safely

• Label ALL medications used in a procedure

• Take extra care with patients who take blood

thinner medications

• Record and pass along correct information

about a patient’s medications

Use alarms safely

• Ensure alarms on medical equipment are heard

and responded to on time, evaluate alarm use

Prevent infection

• Wash your hands

• Use proven guidelines to prevent infections

that are difficult to treat (multidrug resistant-

MDRO’s)

• Use proven guidelines to prevent infections

of the blood from central lines, after surgery

and of the urinary tract that are caused by

catheters

Identify patient safety risks

• Find out which patients are most likely to

commit suicide

Prevent mistakes in surgery

• Make sure the correct surgery is done on

the correct patient and at the correct place

on the patient’s body

• Mark the correct place on the body where

the surgery is to be done

• Pause before the surgery to make sure that

a mistake is not being made

•

Event Identification and

Trending Reports…

Piedmont has an on-line risk management event

identification system called eSRM.

Employees are responsible for entering events into the

eSRM system.

Events should be entered into eSRM on the shift the

event/incident occurs or when it is discovered.

Managers/Directors are responsible for reviewing events

and responding with appropriate follow up information.

Examples of reportable

eSRM Events- this list

is not all inclusive

All falls

Present on admission wounds

Behavioral events

Environmental, equipment and/or medical device

hazards

Theft

Financial Fraud and Abuse

Violation of Protected Health Information

Infection Prevention

Washing your hands is the number one most effective way to reduce the spread of germs and infection

Products

Soap and water

• When hands are visibly

soiled

• After contact with C-Diff or

other infectious diarrhea

(Alcohol-based sanitizers

are not sufficient for spore

forming organisms)

• Before eating and after

using restroom

Alcohol-based

Sanitizer

• Hands are not visibly

soiled

• Prior to entering and

leaving every patient

room

• FOAM IN AND FOAM

OUT!

Commonly missed

areas of hand washing

http://www.clinicaladvisor.com/establishing-standard-infection-control-precautions/slideshow/1204/

Fingernails & Artificial

Nails Policy

There are MANY studies that prove through evidence based practice that

there is a reduction in the spread of germs by adhering to the following

guidelines on nails-

Artificial nails (overlays, wraps, tips, acrylics, silks, gel

nails) are prohibited

Dark or chipped nail polish, nail jewelry and glitter are

prohibited

Natural nails should be <1/4 inch long

Our policy is in keeping with the CDC Guidelines for Hand Hygiene in

Healthcare Setting. MMWR 2002; vol. 51,no. RR-16

Be Aware, Tuberculosis

(TB) is NOT Gone

2004 York County (YC) was number 1 in SC for TB

2013 YC ranked 15th in SC

All patients are screened

When suspected or known to have TB: patient is placed on airborne precautions in a

negative pressure room, door remains closed, all must wear an N95 respirator or

PAPR. (FAN and VOL do not enter airborne precaution rooms)

Signs and Symptoms (fever, night sweats, weight loss, bloody sputum, unexplained cough

>3 weeks, unexplained fatigue)

How spread………

Person to person through the air

When a person with TB sneezes, speaks, sings, coughs, droplet containing TB are

expelled into the air

Depending on the environment, these tiny particles can remain suspended in the air

for several hours

Probability of transmission depends on 4 factors

Infectiousness of person

The environment

Duration of exposure

Virulence of the organism

Personal Protective

Equipment

Easy Rule to Help You

Remember!

• Inside patient

room, cover

yourself

• Outside patient

room, cover the

patient

Germicidal Wipes

3 minutes

4 minutes

Use for: Keyboards,

surfaces, equipment,

carts, bedside

tables, wheelchairs,

stretchers, stethoscopes,

glucometers, phones,

etc.

Back Safety

Back Pain is the #1 cause of disability in the US for

those under 45

An upwards of 50 billion dollars is spent each year to

fix back problems

You only get one..SO protect it!!

Back Safety

Tips to Help Prevent Back Injury

1. Utilize back safety devices

2. Take your time

3. Plan ahead

4. Ask for help (then WAIT for it)

5. Avoid unnecessary twisting

6. Stay focused, minimize distraction

Back Safety

Equipment Equipment Name Why use? Location Weight Max

Slide sheet Vertical or lateral

transfer

Clean linen room on

each floor

N/A

Slider board Lateral transfer Each unit 250 lbs

Bariatric slider

board

Lateral transfer Equipment room

Ext-7417

450 lbs

Airpal Lateral transfer Equipment room

Ext-7417

1200 lbs

Hover Matt Lift patient off floor Equipment room

Ext-7417

1200 lbs

Ezlift Lift patient off floor

or chair to bed

2MS supply room

(located across from

staff elevators)

1000 lbs

Encore Sit to

Stand

Transfer patient from

a sitting position

2MS supply room

(located across from

staff elevators)

420 lbs

Questions? Call Work Injury Navigator @ 803-985-4699

Back Safety

Devices HoverMatt® Patient Transfer

http://www.patientflatlift.com This device is ordered from Equipment

Ezlift Instructions

1. Turn on Unit

2. Check battery level on screen

3. Red Emergency “STOP” button must be in the “UP” position or unit will not

operate. If the screen indicates “Emergency Stop” then the button is in the

wrong position

4. Using the spreader bar adjust the legs of the lift to go around items as needed

5. To position patient correctly roll sling under patient like a sheet to get it

under them correctly. The handles on the sling should be facing the mattress

each wing of the sling should be under the patient’s leg and brought through

the middle.

6. Attach the loops by the patients shoulders to the lift using the shortest loops

7. Take the wing that is lying over the left leg and hook it on the right hook on

the longest loop. Repeat the same on the other side.

8. Push “ UP” button on hand control

9. Once there is tension on loops, double check the loops to make sure they are

securely in the hooks

10. Once patient is ready to be lowered down, push the “ DOWN” button on the

hand control

EzLift (Hoyer Lift)

Sit to Stand Lift

Back Safety

devices

Transfer Board- Lives on each unit

Hoyer Lift®- Lives on the 2nd floor of Main Tower

Angel Slider®- Slide sheet lives in linen rooms

Cultural Awareness,

Special Needs,

End of Life Care &

Pain

Cultural Awareness

& Sensitivity

Cultural awareness is being mindful “to the ways in

which community members' values and perceptions

about health care differ from his or her own”

Cultural sensitivity involves being “aware of your

personal bias and prejudices and not allowing them to

affect the way in which you care for your community

members”

Special Respects

Age Specific Considerations- be aware of your

audience-you will speak very differently to a toddler

versus an elder person, utilize age appropriate teaching

methods

Bariatric Populations- utilize bariatric gowns, bedside

commodes and wheelchairs for the safety and comfort

of these patients

Special Needs Tools

• Uniphone TTY for the hearing impaired

• Video Remote Interpreter for the deaf

• “I Speak” Language Identification Tool and Tele-language Telephone

Caring for patients

and their families at

the end of life

Comfort and

Compassion at the

end of life We provide comfort and compassion at the end of life by meeting the patient and families physical, emotional and spiritual needs. Physical Needs- pain relief, quiet music, privacy, extra chairs, Kleenex, coffee, a shoulder to cry on or simply a hug Emotional needs- be patient of the fear/anger felt by the patient and family-allow them to talk-be understanding, consult Palliative Care or Hospice Spiritual needs- we have multi-faith services through chaplains on call-the Operator has a monthly call schedule

The experience we provide will be the last memories our families have of this most difficult and emotional time-make a positive compassionate mark

Pain

Non-Pharmacological

Any staff member can assist

• Decreased external stimulation

• Distraction

• Exercise

• Heat/Cold

Pain Scale

examples:

• Numeric Scale: 0-10

0 = no pain and

10 = worst imaginable pain

• Wong-Baker Faces: Images of faces from “the happiest face (best feeling)” to “the saddest face (worst feeling)”

When should you

assess pain?

1. On Admission- Current, Usual, Acceptable

2. As part of routine patient assessments

3. At the time of any pain intervention and within 1 hour after

Restraints & Seclusion

Abuse & Neglect

Falls

Restraints &

Seclusion

Immediately seek the experience of your Clinical

Supervisor should you receive a patient in restraints

or have to place your patient in restraints

There are multiple steps and documentation

requirements required for all restraint situations and

your are responsible to ensure the accuracy and

timeliness of each by referring to your Clinical

Supervisor

Restraints

Limit use to those situations where it is necessary to ensure the immediate safety of patients and staff -PMC Restraint/Seclusion Policy

What is a restraint?

-a restraint is any manual method- physical, chemical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his or her body, arms, legs, or head freely in an effort to manage behavior-

Seclusion

What is Seclusion

-the involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving.

May only be used for management of Violent or Self-Destructive behavior (VSD/Behavioral).

42 CFR 482.13 (e)(1)

CAMH, 2014 PC.03.05.09

Types of Restraints

4 Side Rails

Mitt Restraints

Freedom Splints

Soft-Limb Restraints

Manual/Physical Holds

Four Point Locked Behavioral Restraints

Seclusion-open/locked rooms

Chemical Restraints

Types of mechanical

restraints

Soft Limb Restraints 4 Point Restraints

Restraint first aid

Notify a RN if:

• You suspect a patient injury

• Patient complains of pain

• Limb is turned in unnatural position

• Restraint is secured to a moving part of the bed

• Any other reason you feel the patient in restraints

needs to be seen

Abuse & Neglect Reportable events

Abuse

Child

Vulnerable Adult

Physical

Sexual

Domestic

Neglect

Failure to supply a child with adequate food, clothing, shelter and health care.

Abandoning a child is neglect

REPORTING ABUSE

& NEGLECT

All Nurses, Physicians and any other medical and/or

mental health licensed providers are required by law to

report

Non-licensed staff will report to the primary RN

The person suspecting the abuse is required to report

Once a report has been made to the appropriate agency

(DSS, Police, etc.), report to the MD and Unit Leader

Facts about Falls

Falls are harmful to the patient due to injury and increased

length of stay

Harmful to the hospital-preventable falls increase medical

costs related to injuries and length of stay

Most falls are due to toileting needs- round on your

patients every hour and address toileting needs

CDC estimates the direct medical costs of older adult falls

at $30 billion!!

http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html

Morse Fall Risk

Score Tool

Fall Prevention Measures

based on risk level

Low 0-24

Minimal Interventions

• Purposeful rounding every 2 hrs. for 5 P’s- Pain, Position, Potty, Possessions, Pt. Safety

• Non-skid socks

• Bed in low position, locked, side rails x2 up

• Room free of clutter

• Call bell within reach

• Orient & Education-patient/family

Moderate

25-44

All Minimal interventions

PLUS

• Yellow Non-skid socks/triangle/door sign/chart sticker

• Bed/Chair Alarm after 2100

• Careview bedrails activated at 2100

• Assistive devices not in eyesight of patient

High

>45

All Minimum and Moderate

PLUS

• Move closer to desk if able

• Bed/Chair Alarm activated at all times

• Careview bedrails activated at all times

Fall Prevention

Alarm Devices

Bed Alarm –set on Zone 2

Chair Alarm- used on all patients that require a bed

alarm

CareView- virtual bed rail system

Thank you and welcome to the team!