View
2
Download
0
Category
Preview:
Citation preview
Revised 12/14/2017
2
Organizational Information
Our Mission We carry on the healing mission of Jesus Christ by promoting personal and community health, relieving
pain and suffering, and treating each person in a loving and caring way.
At PeaceHealth, the fulfillment of our Mission is our shared purpose. It drives all that we are and all that we do.
To those who embrace the spirit of these words and our commitment to Exceptional Medicine and
Compassionate Care, we offer the opportunity to learn and grow as a member of the PeaceHealth family.
Our Core Values Respect We respect the dignity and appreciate the worth of each person as demonstrated by our compassion, caring and
acceptance of individual differences.
Stewardship
We choose to serve the community and hold ourselves accountable to exercise ethical and responsible
stewardship in the allocation and utilization of human, financial and environmental resources.
Collaboration
We value the involvement, cooperation and creativity of all who work together to promote the health of the
community.
Social Justice
We build and evaluate the structures of our organization and those of society to promote the just distribution of
health care resources.
Our Vision Every person receives safe, compassionate care; every time, every touch.
Our Promise Our “Spirit of Health” promise is the embodiment of PeaceHealth.
Everything we do is in service to a higher purpose: to work with and help our neighbors live healthier, happier
lives.
We take care of the needs of people, we don’t simply treat patients. We put people at the center, enabling them
to be their best, and providing personalized, compassionate care when they are not. We make them feel
welcome, comfortable and safe. We are neighbors, caring for and loving one another, for the betterment of all.
Caring for those in our community is not new to PeaceHealth; it’s been in practice since the Sisters of St.
Joseph of Peace arrived in Fairhaven, Washington to serve the needs of the loggers, mill workers, fishermen and
their families. They knew strong, healthy communities benefit individuals and society, and that social and
economic factors can make some community members especially vulnerable. The Sisters believed they had a
responsibility to care for them, and that ultimately, healthier communities enable all of us to rise to a better life.
This philosophy inspires us today and guides us toward the future.
3
PeaceHealth at a glance PeaceHealth, based in Vancouver, Wash., is a not-for-profit Catholic health system offering care to
communities in Alaska, Washington and Oregon. PeaceHealth has approximately 16,000 caregivers
(employees), a multi-specialty medical group practice with more than 800 providers, and 10 medical centers
serving both urban and rural communities throughout the Northwest. In 1890, the Sisters of St. Joseph of Peace
founded what has become PeaceHealth. Today, PeaceHealth is the legacy of its founding Sisters and continues
to serve communities when invited to do so with a spirit of collaboration and stewardship. This is The Spirit of
Health- the Spirit of PeaceHealth. For more information, visit www.peacehealth.org.
PeaceHealth Facilities
Ketchikan Medical Center
Ketchikan, Alaska
St. Joseph Medical Center
Bellingham, Washington
Peace Island Medical Center
Friday Harbor, Washington
United General Medical Center
Sedro-Woolley, Washington
St. John Medical Center
Longview, Washington
Southwest Medical Center
Vancouver, Washington
Sacred Heart RiverBend
Springfield, Oregon
Sacred Heart University District
Eugene, Oregon
Cottage Grove Medical Center
Cottage Grove, Oregon
Peace Harbor Medical Center
Florence, Oregon
4
Important information to help you get started
Notice of Privacy Practices We are required by law to: maintain the privacy and security of patient health information. The Notice
of Privacy Practices (NPP) describes for patients how we use and/or disclose their health information. All
PeaceHealth workforce members (employees, volunteers, students, etc.) with access to patient information
MUST READ this information. It is found at: https://www.peacehealth.org/privacy-rights-and-practices.
To prepare for any clinical experience at PeaceHealth, a signed confidentiality agreement must be obtained and
on file. A computer user set up form is required for all experiences where documentation in the patient record is
required. Following is a sample of the agreement/form and key points to remember:
Confidentiality Agreement
CA.pdf
Computer User Set Up form
User Set up form.pdf
PeaceHealth’s Reporting Process When you have a concern, you have a duty to report or to ask questions. Likewise, the department/unit manager
or hospital supervisor has a duty to follow-up without retaliation. Reporting a compliance concern or problem
should be as natural as picking up the phone to report a leaky pipe or a frayed carpet. When you have a
question, or want to report a concern, we encourage you to refer to the following resources: 1. The facility supervisor and/or department/unit manager/director
2. The facility OI Officer
3. The PeaceHealth Integrity Line: (877) 261-8031 (an independent, confidential service open 24/7 except
holidays)
4. Online PeaceHealth Integrity Line at https://peacehealth.alertline.com.
Name Badge *Job shadows/observers do not require name badges as they must always be escorted by PeaceHealth
caregiver while on site. A written visitor badge may be provided by the unit/department.
If a PeaceHealth badge is needed, it will be obtained through your placement coordinator. Otherwise, you must
always wear your school name badge above your waist while on site. Keep your badge safe when not in use.
At some sites or regions, it is an e-key for entrance or exit to secure areas and MUST be returned to
instructor/supervisor upon leaving the organization.
Dress Policy Please comply with guidelines that encourage professional attire. Modest and neat apparel is the overall guide.
Your assigned placement coordinator or your unit preceptor will provide you with further information.
No Smoking Policy Smoking is not allowed in any PeaceHealth building or on any PeaceHealth property.
Before signing a confidentiality agreement, please remember:
√ Access to patient health information is restricted to those
workforce members who need to know that information.
√ Sharing your log-on and password is NOT ALLOWED
√ Always log-off or lock the device when leaving it or walking
out of view of the workstation
√ You are responsible for information entered or viewed under
your user log-in
5
General Safety Information
Electrical Equipment All electrical equipment brought into the facility by staff or patients (radios, hair dryers, fans,
heaters, etc.) must be approved for use by a qualified staff member at each facility and have a
dated and signed label attached. Any electrical equipment purchased for patient care use must be checked out by
your regional Engineering Staff.
Lock-Out Tag If any electrical equipment malfunctions or shocks someone, Engineers will place a
LOCK-OUT label on it. Do not remove a LOCK-OUT label or use any equipment that has
been tagged as a LOCK-OUT.
Hazard Communication A Safety Data Sheet (SDS) reference guide must be made available to employees under the “Right
to Know Act”. Each department maintains a chemical inventory and corresponding SDS’s for
hazardous products in their area. Know where this reference guide is located online and review the
SDS before handling hazardous chemicals.
REMEMBER! In case of a spill:
1. Act quickly.
2. Wear Personal Protective Equipment (PPE).
3. Contain the spill.
4. Notify Switchboard if the spill is considered significant as noted in the Safety Data Sheet
(SDS).
5. Determine appropriateness of safe re-entry into area.
6. Complete an electronic incident report.
7. Report to the Emergency Department if exposed to a hazardous chemical.
8. Dispose of clean up materials following SDS and Departmental Guidelines.
Emergency Management Plan Participant Responsibilities:
1. Remain on duty until excused.
2. Report to person in charge of department for assignment and questions.
3. Department heads and others with specific responsibilities assume Emergency Management Plan roles.
During an emergency, remember to:
1. Use stairways. DO NOT USE ELEVATORS
2. Know where exits are and what the posted evacuation plan is for your area.
3. Limit use of phones as much as possible.
4. Wear ID badge.
If not on site:
1. Report to work at next scheduled time unless otherwise directed.
2. Report to work if specifically instructed by Emergency Broadcast message, pager or phone call.
*All students to report to clinical supervisor/preceptor immediately for directions
Lock Out!
6
General Patient Care Information
Patient Identification Standardized Patient Identification Wrist Bands are place on patients for accurate identification prior to
treatment to minimize medical errors and patient harm. These bands include:
• A patient label with bar codes used for patient identification and medication/blood administration
• Standardized color clips used as visual clues
Nursing validates the correct band and clips are placed on the patient:
• On admission
o During the initial assessment, the nurse assesses factors associated with:
▪ Fall risks
▪ Allergies
▪ Latex Allergy
▪ Limb Alert (restricted extremity)
▪ Do Not Resuscitate (DNR)
• At the beginning of the shift and time of transfer
o Any changes in orders and/or status that may impact the band or clip color(s), the nurse will either:
▪ Add a new clip
▪ Remove the old band and replace it with a new one that has the correct clips attached
Another clip needs to be added A clip needs to be removed
• Confirm the change with the patient
(family) and with the medical record
• Retrieve the correct color clip
• Apply the clip to the patient’s wrist
band
• Educate the patient and family to the
new clip
• Include the change in hand-off
communication with other caregivers
• Confirm the change with the patient
(family) and with the medical record
• Retrieve a new wrist band and add ALL
the correct color clips needed
• Remove the old band from the patient’s
wrist
• Apply the new band to the patient
• Educate the patient and family to the
change
• Include the change in hand-off
communication with other caregivers
7 Examples of each clip:
Allergies to:
•Drug(s)
•Food
•Environ
menta
l
Allergy to
latex
Fall alert
Implement fall
bundle
interventions
Restricted
extremity
movement, i.e.
mastectomy,
fistula, or new
pacemaker
placement
Order for Do Not
Resuscitate (DNR)
Continue
reviewing
allergies with
patient
Place sign on
door
Educate
patient/family to
call for help
getting out of bed
Restricted IVs,
BPs or blood
draws, i.e. fistula
Confirm provider’s
orders concerning
code status
Refer to
electronic
medical record
for specifics
Indicate
allergy on
patient’s
white board
Indicate risk on
patient’s white
board
Continue placing
signs at the head
of the patient’s
bed or on their
door
Click on the Pre-
Arrest Treatment
(DNR) tab on the
patient banner in
the electronic
medical record to
review the Pre
Arrest Medical Care
selections if
applicable
Label patient’s
door
Patient and/or student incidents All incidents involving student injuries and/or patient care provided by students MUST be reported to the
immediate supervisor, school supervisor/instructor and PeaceHealth student placement coordinator. Such events
require completion of an online incident report.
Arrangements for follow-up regarding an incident will be managed through the PeaceHealth student placement
coordinator and the school representative.
Daily Management System (DMS) aka Readiness Huddles Using the Daily Management System (DMS), caregivers learn to dedicate a small part of their day to making
improvements within their groups. Over time, the use of DMS enables caregivers to provide consistent excellent
service and care to our patients and families.
8 Who is involved?
• All caregivers in the areas participating in daily
huddles
What does it involve?
• Readiness huddles
o Routine, 5-10 minute daily huddles
o Sharing information
▪ What happened the day before
▪ Critical unit issues
▪ What the plan is for the day
o Focuses the team on performance measures
o Addresses key elements such as safety, workload, staffing, methods, equipment and supplies
o Reports issues and the fix, in addition to escalation of BIG issues
o Generates a sense of ownership among the team about its work and environment
• Performance Board
o Includes metrics used to measure the work unit’s progress in critical areas:
▪ Fall prevention
▪ Pressure ulcer prevention
▪ Hospital acquired infection rates
o Updated routinely
o Clearly states goals, metrics and objectives that
all team members are accountable for obtaining
Where does it occur?
• In front of the Readiness Board located in a
designated space in each department
When does it occur?
• Each department has a routine huddle schedule- during orientation ask when the huddle is scheduled for
the specific department
• It is required that all department/unit caregivers attend these huddles when patient care allows for the
opportunity
Why do we do this?
• Improves communication between teams, locations and supporting departments
• Tells a story at a glance on how well the department is doing (visible management system)
• Improves collaboration and reduce communication frustrations (i.e. “I didn’t know anything about that!)
• Improves patient and caregiver satisfaction
Students are invited and encouraged to attend unit/department huddles
9 Purposeful Rounding Reactive vs Proactive Care
Why is rounding important?
Evidence shows that when purposeful rounding is done, there is a:
▪ 50% decrease in falls
▪ 14% decrease in skin breakdown
▪ 35% decrease in calls for pain medication
▪ Overall decrease in anxiety, worry, and waiting
What are the benefits of rounding?
▪ Improves our patient’s perception of care
▪ Provides pro-active care instead of reactive care
▪ Decreases call light use to better control workflow with less interruptions
▪ Reduces patient falls and skin breakdown
▪ Increases workflow efficiency
▪ Increases patient and caregiver satisfaction
How is rounding done?
5P’s of Purposeful Rounding include:
10 Emergency Codes Please learn the following codes that are initiated by dialing the emergency number posted by your region.
*Be sure to check with your unit supervisor for directions regarding code initiation specific to your assigned unit/department.
Code Announcement: Code (+ other) & Location
Repeat 3x
Description
CODE ORANGE Code Orange,
Pharmacy
Hazardous material spill or release, radiation exposure
CODE GRAY Code Gray, Medical
Unit
Combative person; patient or visitor
CODE BLACK
Code Black, 1st Floor Bomb threat
CODE RED Code Red, 1st Floor Fire: If you see smoke or fire: RACE
Rescue those in immediate danger if safe to do so
Alarm, pull the nearest one to the fire, call out “Code Red”
and phone in the alert following facility policy
Contain/Confine the fire (close doors and windows)
Extinguish (if safe to do so)
Pull, Aim, Squeeze, Sweep fire extinguisher, and
Evacuate if directed to do so
CODE AMBER Code Amber 3,
Pediatrics
Infant/child abduction
CODE SILVER Code Silver,1st Floor Weapon or hostage situation
CODE BLUE
CODE BLUE
Pediatric
Code Blue, ICU
Code Blue Pediatric (or
age), Emergency
Department
Advanced Cardiac Life Support Team requested
Pediatric Advanced Life Support Team requested for
infant/child
Trauma Alert Trauma Alert; trauma
team report to the
Emergency
Department
Trauma Team activation for possible groups of patients
coming to the hospital
Disaster Plan
SWW only:
Triage Plan
Implement the
external/internal
disaster plan
External Disaster; occurs outside of the medical facility
(earthquake, shooting, etc.)
Internal Disaster; occurs inside the medical facility (loss of
power, shooting, etc.)
Rapid Response
Team
Access the RRT by
following your unit’s
procedure
Call the Rapid Response Team if the patient has a: ➢ Change in heart rate with rate less than 40 or greater than 120 ➢ Change in systolic blood pressure less than 90mm/Hg
➢ Change in respiratory rate to less than 8 or greater than 24
➢ Threatened airway or change in oxygen saturation level (< 90% despite being on oxygen)
➢ Change in level of consciousness or mental status
➢ Failure to respond to a treatment
➢ Complaint of chest pain unrelieved by treatment ➢ Urine output of less than 50ml in 4 hours
Call the Rapid Response Team if:
➢ Staff member is concerned or worried about a patient
➢ Patient or family is concerned about patient status/condition
11 Infection Prevention Hand hygiene is a key expectation in patient safety for preventing the spread of infections. It is the
responsibility of every caregiver to utilize appropriate hand hygiene practices- every time, every touch. At
PeaceHealth we “wash-in” or gel when entering a patient room and “wash-out” with either gel or soap and
water when leaving. The following information provides other expectations of hand hygiene required of our
caregivers.
Glove Use Reminders:
Wearing gloves does not replace the need for hand
hygiene. Gloves can protect both patients and
caregivers from exposure to infectious agents.
Gloves should be worn as a single use item for:
• Each invasive procedure
• Contact with sterile sites and non-intact skin or mucous membranes
• Any activity that has been assessed as carrying a risk of exposure to blood, body substances, secretions
and excretions
Gloves should be changed:
• Between patients
• During the care of a patient, to prevent cross-contamination from dirty to clean body sites, e.g., enteral
to central line site
• If the patient interaction includes touching equipment that is transported room to room, e.g., glucose
meter
Hand hygiene is required with glove use at these times:
• Before putting on gloves
• Immediately after removing gloves
• In between the “5 Moments” while caring for a patient
• Do not apply hand hygiene products to gloves
Help each other to be successful:
• Assume positive intent
• Have each other’s backs. It’s ok to ask or speak up:
o “Can I help you with that while you wash your hands?”
o “I’d like you to remind me to do hand hygiene; may I remind you too?”
• Focus on safety
1. Before touching a patient (Wash-in) When? Clean your hands before touching a patient when approaching
him/her.
Why? To protect the patient against harmful germs carried on your
hands.
2. Before Clean/Aseptic Procedure When? Clean your hands immediately before performing a
clean/aseptic procedure.
Why? To protect the patient against harmful germs, including the
patient’s own, from entering his/her body.
3. After Body Fluid Exposure Risk When? Clean your hands immediately after an exposure risk to body
fluids (and after glove removal).
Why? To protect yourself and the health-care environment from
harmful patient germs.
4. After touching a patient When? Clean your hands after touching a patient and her/his
immediate surrounds, when leaving the patient’s side.
Why? To protect yourself and the health-care environment from
harmful patient germs.
5. After touching patient surroundings (Wash-out) When? Clean your hands after touching any object or furniture in the
patient’s immediate surroundings, when leaving- even if the patient
has not been touched.
Why? To protect yourself and the health-care environment from
harmful patient germs. World Health Organization, Patient Safety, Save Lives- Clean Your Hands
12 Infection Prevention continued Multidrug Resistant Organisms (MDROs) key points:
• These organisms are resistant to 1 or more classes of antibiotics
• Patients’ infected with MDROs are at an increased risk of prolonged illness and mortality
• Cost of caring for patients’ infected with MDROs is more than double than caring for those without
• Caregivers exposed can become infectious and then become carriers
• Most common MDROs:
o Methicillin Resistant Staphylococcus aureus (MRSA) commonly found on skin
o Vancomycin-resistant Enterococcus (VRE) found in the GI and Urinary Tracts
Active Infection vs colonization
• Active infection is defined as presence of the organism with infection present
• Colonization is defined as presence of the organism without infection present
o Colonized patients are 2.5 times more likely to get a new infection
o 4% of healthcare workers are colonized with MRSA
o Both active and colonized carriers spread the infection
o Patients, families and/or caregivers can transmit the infection
o Transmission occurs when hands come in contact with the infectious organism either from
another person or an object
Prevent transmission by:
• Adhering to standard precautions
o Hand hygiene
o Personal Protective Equipment (PPE)
• Cleaning rooms and equipment thoroughly
• Placing patients’ in private rooms with signage posted
Clostridium difficile (C. diff) is not a MDRO but it is considered an organism of concern.
C. diff:
• Has surpassed MRSA as the #1 hospital-acquired infection in the United States
• Is transmitted through the GI tract
• Is prevented by washing hands with soap and water after contact with a patient and/or equipment in a
patient’s room who has been identified as a carrier of C. diff
o Hand gel does NOT protect against this organism
C-Diff Soap Water
13
Incident Reporting All safety-related incidents are to be promptly reported using the electronic incident reporting system,
which is found on Crossroads, PeaceHealth’s internal electronic system.
✓ The person most directly involved in an incident, or the person who first discovers the incident, is
responsible for completing the incident report form using the instructions below.
✓ Incident reports are highly confidential and are not to be copied for any reason.
✓ The information contained in the incident report may be used only for risk management purposes and
may not be used for any other purpose including peer review or employee corrective action.
✓ Incident reports are not a part of the patient medical record and no mention of an incident report should
be documented in the medical record. Only the facts of an incident involving a patient are to be recorded
in the medical record.
Incident Reporting
Select the “Crossroads” icon on the lower left tool bar
Select “Report Incident” (use Caregiver Injury for injuries that occur to students)
Scroll down the menu and select “Caregiver Injury” or “Patient/Visitor Incident" and follow the instructions
Policies
From “Crossroads” click on “My Tools” on the upper tool bar and then scroll down the menu to “Policies”
14
Thank you for taking the time to read the orientation material.
While in a PeaceHealth facility, you will be responsible for this information. If you have any questions, please
ask your supervisor, manager, preceptor or educator. We hope you enjoy your experience at PeaceHealth.
Welcome!
REQUIRED POLICY REVIEW for all experiences except job shadowing
Immediately upon beginning an on-site experience at PeaceHealth, please use the instructions above to
review the following policies (you will be accountable for the information while at a PeaceHealth facility):
• Serious Safety Event #101.387.9
• Workplace Violence Prevention #101.356.42
• Infection Prevention:
o Infection Prevention and Control #SYS.82.17
o Standard Precautions #101.82.1
Additional Helpful Resources
From the Crossroads Home Page, go to “My Tools” and scroll down the menu to “Library”
15
Facility Specific Additional Information
Alaska Washington Oregon Ketchikan Medical Center-
Ketchikan, Alaska
St. Joseph Medical Center-
Bellingham, Washington
Sacred Heart RiverBend-
Springfield, Oregon
SHMCs.docx
Peace Island Medical Center-
Friday Harbor, Washington
Sacred Heart University
District- Eugene, Oregon
SHMCs.docx
United General Medical Center-
Sedro-Woolley, Washington
Cottage Grove Medical Center-
Cottage Grove, Oregon
CGCH.docx
St. John Medical Center-
Longview, Washington
Peace Harbor Medical Center-
Florence, Oregon
Florence.docx
Southwest Medical Center-
Vancouver, Washington
Recommended