Student Orientation Packetresource.carrollhospitalcenter.org/Documents/All Students... · AIDET We...

Student Orientation Packet

2017 - 2018

This presentation will provide you with a

foundation of knowledge as you begin

your patient care here at Carroll Hospital!

Today…

• Carroll Hospital Center is part of the LifeBridge team!

• Carroll Hospital has more that 400 physicians on its staff representing

over 35 medical specialties.

• We have over 1,800 employees and are the second largest employer

in Carroll County.

• Annually we serve more that 300,000 individuals with direct medical

care, outreach and community programs, diagnostic and outpatient

services and health screenings.

Mission:

Our communities expect and deserve excellent medical treatment, compassionate care and expert guidance in maintaining their health and well-being. At Carroll Hospital, we offer an uncompromising commitment to the highest quality health care experience for people in all stages of life. We are the heart of health care in our communities.

Vision:

Founded by and for our communities, Carroll Hospital will help people maintain the highest attainable level of good health throughout their lives. We strive to be the best place to work, practice medicine and receive care. Our commitment is to be the hospital of choice.

Carroll Hospital Pillars of Excellence

Service

People

Quality

Financial

Growth

Community

AIDETWe expect all of our staff/students/ and volunteers to utilize

the AIDET concept.

AIDET is an acronym that indicates

“The Keys to Effective Patient and Customer Communication”

A: Acknowledge

I: Introduce

D: Duration

E:Explanation

T: Thank you

A- Acknowledge

• Acknowledge the patient by name

• Make eye contact, smile

• Acknowledge everyone in the room (patient and

families)

I: Introduce

• Yourself

• Your skill set

• Your professional certification

• Experience

(To the Staff; to the Manager; and to the patient if you are involved in patient care)

D:Duration

• Give an accurate time expectation for tests

and physician arrival

• Identify/communicate next steps

• When this is not possible, give a time in

which you will update patient on progress

E:Explanation

• Explain step by step what will happen

• Answer questions

• Leave a way to contact you; a nurse call button

or phone number

• Use language a patient can understand

T: Thank You!

• Thank the patient

• You may thank them for choosing

your hospital, and for their

communication and cooperation

• Thank the family for their assistance

and being there to support the

patient

Purpose of AIDET?

• Decreases patient

anxiety

• Builds trust

• Increases compliance

• Reduces complaints

We Impact Our Patients

First Touch……..

Last Touch……..

Heart to Heart…….

HCAHPS

Our Culture of Always

HCAHPS measure…

The perception of frequency versus degree of satisfaction

Patients rate:

- Always

- Usually

- Sometimes

- Never

Our Goals:

- Implement an action plan to increase consistency

and improve performance

- To maximize Medicare reimbursement under Value

Based Purchasing by raising our scores to 70

Some thoughts…

“If the other guy’s getting better, then you’d better be

getting better faster than the other guy’s getting

better….or you’re getting worse.”

Tom Peters

The Circle of Innovation

Survey Questions

• Nurse Communication

• Doctor Communication

• Responsiveness of Hospital Staff

• Pain Management

• Communication about Medications

• Discharge Information

• Noise at Night

• Room/Bathroom Cleanliness

Hardwiring Best Practices…

“The hardwiring of best practices and standardization of

leadership will create consistency.”

“Consistency will then improve performance across the board.”

Quint Studer

If a patient complains of pain to you, inform the patients nurse so that she

can get something to make the patient more comfortable.

Pain Management

Documentation Reminders

The next slide will review

important information that

you need to share with the

Staff Nurse caring for the

Patient you are assigned.

Documentation Reminders

• Are restraints in use? What kind and what is the patients’ response?

• Is the patient in pain? What is their score? Reassess score and obtain vital signs within 1 hour after giving pain medication.

• Fall Potential? What devices are we using to keep the patient safe?

• Is the Bed Alarm in use? If not, should it be? (If you need help to set the bed alarm please ask the Nurse assigned to your patient.

• Please obey all traffic signs!

• Register vehicles

• Lock your vehicle and secure your belongings

• Don’t leave valuables in plain sight

• Pay attention to your surroundings

• Park in appropriate areas

Safety on Campus

Use Emergency Call Boxes for

emergencies and accidents!

Smoking

You are acknowledging receipt of this information and

your understanding of the consequences associated

with any violations.

Accountability

• Identify smoking history on patient assessment

• In a non-judgmental approach, assure the patient

that you understand their addiction

• Ensure the patient/visitor understands our smoke

free commitment and state law

As Healthcare professionals we must set the standard

to make our Community healthier!

Appropriate and Professional Attire

and Appearance

You are acknowledging receipt of this information

and your understanding of the consequences associated with any violations.

What to Wear: What not to Wear:Uniforms and /or scrubs in designated

departments

Facial and tongue piercings

Attire that complies with safety and health

regulations

Jeans on days other than Fridays

Attire that is in good taste Artificial nails in clinical and food areas

Attire that is appropriate for professional

contact with the public

Low-cut and sheer clothing

Clothing with holes

Flip-flops

Sweatshirts and sweatpants

According to Policy

If you are in the hospital for a business-related reason such as:

• Staff meeting

• Education including CPR

• Spirit Speak Out

• Other activity for which you are getting paid

Your are expected to dress in accordance with the policy including

your Carroll Hospital badge!

Infection Control

Standard Precautions and

Transmission-Based Precaution

guidelines and signage still

present challenge throughout

the organization.

Everyone must abide by

the standard identified on

the Infection Control

signs.

Transmission-Based Precautions require:

• Patients to be placed in a private room

• Appropriate precautions sign on the door frame

• PPE (gowns, gloves, masks) in caddy on the door or

on the cart

Airborne Precautions

Droplet Precautions

Contact Precautions

Airborne PrecautionsFor Measles/Chickenpox For Tuberculosis (TB)

Persons entering the room

MUST be immune to measles or

Chickenpox

For suspected or known TB patient,

People entering the room must wear an

N-95 or PAPR.

Contact Precautions

For patients with MRSA, VRE, and

other highly antibiotic-resistant

organisms, RSV, Scabies, etc.

Contact Precautions: Enhanced Contact

For patients with Clostridium difficile

(C.Diff.), wash hands thoroughly with

soap and water only

Droplet Precautions

For patients with influenza,

bacterial meningitis, pertussis, or

RSV, a surgical tie mask preferably

with face shield is recommended

NOTE: Patients with RSV also need to be placed in Contact Precautions

Reducing Healthcare Associated Infections

Associates must wash hands or apply a waterless hand antiseptic:

• Before having direct contact with a patient

• Before putting on sterile gloves to insert catheters or

other invasive devices

• After any contact with a patient, including intact skin

(taking a pulse, BP, or lifting a patient, etc.)

Associates MUST wash hands or apply

a waterless hand antiseptic:

• After contact with body fluids or

excretions, mucous membranes,

non-intact skin, and wound

dressings, even if hands are not

visibly soiled

• When moving from a

contaminated-body site to a clean-

body site during patient care

Associates MUST wash hands or apply

a waterless hand antiseptic:

• After contact with inanimate objects in the immediate vicinity

of the patient

• After using a computer keyboard and/or mouse and before

patient contact

• After removing gloves

Hand Hygiene Guidelines Staff must

wash hands with soap and water:

• When hands are visibly soiled

• After using a restroom

• After caring for a patient with C.

difficile

Corporate Compliance

Corporate Compliance

All Jump Drives (USB, Thumb drives, Flash drives, Memory

sticks, etc) must be cleared through IS (Information Systems)

before used by Associates, Physicians, Students or Outside

speakers

You MUST minimize or sign off a computer when there is the

potential for others to see information

Everyone has the responsibility to protect PHI (Patient Health

Information). This can be verbal, electronic or written. Be

aware of how you dispose of any paper with PHI on it! Never

use this as scrap paper

Do NOT access any information, especially a patient’s chart,

unless you have a work-related reason to be there

Patient Safety and the Joint

Commission

Your Role:

You are an Advocate for Patient Safety!

The Institute of Safe Medication(IOM) reports there are

44, 000 – 98,000 deaths/year from medical errors! This

equals the number of deaths from one 747 airplane

crashing everyday for 1 year. Medical errors are the 6th

leading cause of death.

Joint Commission

In 2002, Joint Commission established National Patient Safety Goals

(NPSG) to help educate Healthcare personnel on Medical Errors.

The Joint Commission developed Standards of Practice that must be

consistently met. Each Patient Safety Goal comes from a Nationally

Reported Sentinel Event. A Sentinel Event is when a Patient is

severely harmed or dies.

Keys to Prevention

By improving all these processes, we can greatly reduce medical

errors. We need to concentrate on the top three!

Let’s review Patient Safety Goals

1. Identify patients correctly

2. Improve staff communication

3. Use medicines safely

4. Uses alarms safely

5. Prevent infection

6. Identify patient safety risks

7. Prevent mistakes in surgery

1. Identify Patients Correctly

Patient identifiers are used when providing care or treatments

such as specimen collection, giving medications, and

tests/procedures

Use at least 2 ways to identify patients

2. Improve Staff communication

Critical Results must be communicated among caregivers.

Critical Results are those that if left untreated, can be life

threatening or place the patient at serious risk. Critical Results

need to be reported to the doctor within 60 minutes after

identification

When writing any orders, charting in the medical record or

using any preprinted form, “Do not use Abbreviations, “

acronyms, symbols and dose designations are not to be used

2. Improve Staff Communication

Handoff Communication is an interactive opportunity to ask and answer

questions. This conveys up-to-date information regarding the patient’s,

care, and treatment. Management of any unanticipated changes can be

discussed. Remember, Handoffs identify the potential risk for errors! A

“Ticket to Ride” is used to communicate essential information when a

patient is transported from department to department.

3. Use Medicines Safely

Labeling medications, medication containers and solutions is

essential. Medications and solutions are labeled even if only

one is being used. Labeling occurs when the medication is

taken from the original package to another container.

Take extra care with patients who take medications to thin

their blood.

Record and pass along correct information about a patient’s

medicines. Find out what medicines the patient is taking.

Compare that list to those being given to the patient. Make

sure the patient knows which medicines to take when they are

at home. Remind the patient to bring a current list of their

medicines when they go to the doctor.

4. Use Alarms Safely

Make improvement to ensure that alarms on medical

equipment are heard and responded to on time.

Check to make sure that the bed alarms are set and audible

to ensure that the patient doesn’t experience a fall.

5. Prevent Infections

Our Hand Hygiene Guideline requires that Associates,

Volunteers and students wash their hands with soap and

water when visibly soiled or contaminated, especially with

blood and/or body fluids. This also applies after using a

restroom or before preparing food or drinks.

Associates must wash hands or apply a waterless hand

antiseptic after contact with body fluids even if hands are not

visibly soiled, after contact with inanimate objects in the

immediate vicinity of the patient, after using a computer

keyboard and /or mouse before patient contact and after

removing gloves.

5. Prevent Infections

Patients and families should be

educated pre-op about preventing

surgical site infections.

6. Identify Patient Safety Risks

Across the country, suicide is the 2nd leading inpatient sentinel

event!

Patients are screened for suicide risk. If you notice a change in a

patient’s behavior, please report this to their nurse or Charge

person. It is better to be on the safe side.

7. 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 patient’s body where the

surgery is to be done.

Pause before the surgery to make sure that a mistake is not

being made.

A “Time Out” must occur prior to any procedure.

Additional goals at Carroll Hospital

Encourage patients to report safety concerns.

On admission, patients, and families are

made aware how to report safety concerns.

For example, calling for the COT team.

Encourage patients and families to ask for

assistance when their condition gets worse.

Don’t hesitate to ask for assistance if you see

a patient getting worse.

After years of working on

safety, the airline industry

has become very safe. Our

goal is to make Carroll

Hospital extremely safe too!

Reporting Safety Issues

You are instrumental to keep our

hospital safe.

Whenever you see an unsafe

condition, report it to your

Supervisor, call the Safety Hotline at

6909, or record it under “Incident

Reporting” on the intranet.

Don’t wait for someone to get hurt.

Universal Protocol

Universal Protocol focuses on safety for all surgical and

non-surgical invasive procedures. It prevents wrong

patient surgery.

Environment of Care

Environment of Care (EOC)

• Emergency codes provide a system to manage

unexpected situations that may occur on our campus

• Everyone should know how to report an emergency

• Know your responsibilities as a student during all of

the emergency response codes reviewed in this

program

• Identify each code and what it represents

The State of

Maryland adopted

the following codes

to be used

universally

throughout

Maryland hospitals.

Code

BRTTo activate ALL CODES

call

Extension 4444

Let’s review the codes we use at

Carroll Hospital

Code Green:

Used for Behavioral Emergency

What you need to know:

• Make the staff aware that the patient is starting

to “escalate”

• Position yourself in the room close to the door

so that you have a way out if need be

• Don’t corner yourself in the room

• Call a Code Green for any situation involving a

patient with aggressive behavior

Code Grey

Elopement


An elopement occurs when a patient attempts to

leave/flee the unit assigned and/or the hospital

A Code Gray or elopement is not when a patient

leaves against medical advice

All staff must observe corridors, look out windows and check general areas

for the eloped patient.

Code Orange

Hazardous Chemical Spill


Any time an associate works with a chemical, it’s their job to know and understand the hazards of risks to using that chemical.

Information about Hazardous materials can be found on Material Safety Data Sheets (MSDS) online link found at the top of the Intranet page.

Code Blue: Adult/Child/Infant

Cardiopulmonary Resuscitation Emergency:

This code is activated when anyone is

discovered in respiratory and/or cardiac arrest

Code Pink

A Code Pink alert is activated in the

event of an attempted or actual

infant or child abduction.


Cover the building exit nearest to your location in

accordance with the Code Pink Plan

Environmental Services and Maintenance

Associates will patrol the building perimeter

during a Code Pink Alarm

Be on Alert for:

Anyone acting suspicious

Any person or Associate carrying an infant or small child

Any person or Associate carrying a large bag, box, coat or

anything which could conceal an infant/child

OBRRT: OB Rapid Response Team

This team will respond to any woman

presenting with an obstetrical or

newborn emergency.


• The OBRRT can be initiated by any staff member

by dialing 4444

• Ask the operator to page an OBRRT

• Caller will need to give the patient location

• All OBRRT members carry pagers

• A group page is sent out to the team

• An overhead page will be announced

Code Gold Bomb Threat

Bomb Threat


All Associates will assess their own area for any

suspicious objects!

If a suspicious object is located, DO NOT move the object!

Do not touch the object or anything attached to it

Code O2

Oxygen Emergency Procedure


Telecommunications will page the:

Nursing Shift Coordinator

Cardiopulmonary Director

Respiratory Therapist

Maintenance personnel

Those on duty will report to Telecommunications

Code Purple

Firearm/Weapon Present


If you observe or receive a report of an individual(s) displaying a fire arm or other lethal weapon in a threatening manner, contact the following, if possible:

x4444 Maryland State Police – 911

Notify patients and visitors of the situation and direct them to an area of refuge.

Area of refuge:

Any area that will keep you out of harm’s way,

such as:

Locked room

Locked office

Closet

Exit the building

Code Silver

Active Assailant


Quickly determine the most reasonable way to

protect your own life. Patients and visitors will

follow the lead of employees and managers.

Know your environment.

Commit to your actions.

Area of refuge:

Any area that will keep you out of harm’s way,

such as:

Locked room

Locked office

Closet

Exit the building

RUN—HIDE--FIGHT

• Run - attempt to escape and evacuate the premises.

• Hide - locate place to hide out of shooter’s view.

• Fight – last resort, disrupt or incapacitate shooter

Code Red

Fire Response Plan

Code Red

• This code is activated in the event of a fire, smoke,

odor of smoke, suspected fire, etc.

• If you report the fire by telephone (ex.4444), you MUST

also activate the nearest Fire Alarm Pull Station.


Ensure that all exit doors, especially those to

stairways, are not propped open.

All stairwell doors must remain closed and latched

to prevent smoke and fire from entering escape

routes.

DO NOT use elevators during a fire

emergency!

To help you remember the steps to take in the

event of a fire, use the acronym RACE

R: Rescue

A: Alarm

C: Confine

E: Extinguish

COT

Critical Outreach Team


Inpatient requires urgent attention

Initiated by nurse or other clinical staff

Reasons for call: Acute clinical change or nurse

considers patient at risk

Code Emergency Response


Staff, Visitor, or Outpatient in need

Code Emergency Response is to ensure that all individuals

requiring emergency care, who are located on the hospital

campus, receive care in a well-coordinated manner.

Emergency Management Plan

When you aren’t

sure what to do,

here is a

resource for

you!

This concludes your Orientation CBT!

Make sure you print and sign all the necessary paperwork and

submit them to The Learning Center.

Education keeps us all informed and ready for various surveyors that come

throughout the year. Thank you for contributing to our success!

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