Workforce Orientation

Springfield Medical Care Systems

Springfield Medical Care Systems (SMCS) is a not-for-profit, community-based

health care system that includes a network of ten federally qualified health center locations, and Springfield Hospital serving southeastern Vermont

and southwestern New Hampshire.

SMCS provides an integrated system of care with National Committee for Quality Assurance (NCQA) Medical Home sites that emphasize

patient-centered care, evidence-based quality, access and affordability for all regardless of ability to pay, based on a sliding fee schedule.

Services include primary and preventive care for people of all ages, pediatrics,

health screenings, behavioral health services, dental care,vision care, access to discounted pharmaceuticals, diagnostic lab and radiology services,

and a broad array of acute hospital and specialty services.

Springfield Medical Care Systems

Mission and Vision

SMCS Mission Statement To excel at providing personalized, high quality care, “Where People Come First.”

SMCS Vision Statement

To be the provider of choice by creating a professional environment where:

•!Employees want to work; •!Clinicians want to practice medicine; and, •!Patients want to receive care.

Leadership

CEO – Timothy Ford

Chief of Practice Operations, HRSA Project Officer – Joshua Dufresne, MBA Chief of Patient Care Services – Janet Sherer, RN, MBA

Chief of Human Resources – Janet Lyle, MBA Chief of Financial Services and Allied Services – Scott Whittemore, CPA

Chief of Quality and Systems Improvement– Bob DeMarco, RN, MA Chief of Marketing and Corporate Communications– Anna Smith

SMCS Privacy Officer and Corporate Compliance Officer - Amanda Chaffee, JD SMCS Electronic Information Officer - Kyle Peoples

Director of Professional Development & Nurse Manager of Oncology Clinic– Linda Hurley, MS, RN Director of Inpatient Care and Cardiopulmonary – Sue DelloRusso, RN Nurse Manager of Emergency Department – Cathy Howland, BSN, RN

Nurse Manager of Childbirth Center – Lyndsey McIntyre, MSN, RN Director of Perioperative Services – Tammy Hendrick, MSN, RN

Nurse Manage of Windham Center for Psychiatric Care – Colleen Fisk, RN Director of Diagnostic Imaging – Karen Harrison Director of Practice Operations – Lori Twombly

Nurse Manager of Office Practices – Darcy Noble, BSN, RN

I am the Patient Experience

Please view the video titled, “I am the Patient Experience” You will find the link on the Workforce Orientation page.

Code of Conduct

Our Code of Conduct provides guidance to all individuals associated with Springfield Medical Care Systems, Inc. and assists us in carrying out our daily

activities within appropriate ethical and legal standards.

These obligations apply to our relationships with patients, affiliated physicians, third-party payors,

subcontractors, independent contractors, vendors, consultants, and one another.

Anonymous Compliance Hotline

If you have concerns regarding Compliance, Ethics, Privacy, Whistle Blower Law or Code of Conduct, please

call the Anonymous Hotline 24 hours a day, 7 days a week

You do not need to identify yourself and your concern will be handled in a timely manner by the Corporate Compliance and Privacy Officer/Risk Manager.

1-802-885-7490 In- house ext. 7490

HIPAA

Health Insurance Portability and Accountability Act • Federal law enacted in 1996. Focuses on Privacy,

Confidentiality, Security of protected health information (PHI).

• Ensuring the security of PHI through administrative, technical and physical safeguards. • Empowering patients regarding the use and disclosure of their PHI. • We protect any personal and/or health information which could potentially identify a patient.

Patient’s Confidentiality

!! Every patient has the right to privacy. !! It is the responsibility of every employee, volunteer, contractor and other members of the

workforce to protect that confidentiality. !! The Health Insurance Portability and Accountability Act (HIPAA) and Vermont state law

require the protection of all Patient Identifiable Health Information (PHI). Guidelines for protecting patient confidentiality include: •! Keep all patient information covered. •! Do not talk about patients in public. •! Use care with telephones, fax machine and emails: dispose of confidential patient

information in secured disposal containers; do not look up information not required for your work; do not use social media to discuss your work at SMCS.

•! Protect your computer passwords. Do not share them with anyone. •! Log off when you leave your workstation.

Patient’s Bill of Rights states the following:

While you are a patient in this hospital, you have the right to: !! Be informed of your rights in advance before you receive care. !! Submit a complaint or grievance to the Hospital and/or to the appropriate governmental

agencies. !! Participate in the development and implementation of your care, including a discharge plan. !! Make informed decisions regarding your care. This includes being informed of your health

status, being involved in care planning and treatment, and being able to request or refuse treatment. You also have the right to create an Advance Directive that hospital staff will follow.

!! Receive considerate and respectful care at all times and under all circumstances with recognition of your personal dignity.

!! Designate and receive visitors of your choosing. However, Springfield Hospital may impose reasonable restrictions on visitors where it is clinically necessary for the individual patient or other patients.

!! Have a family member, support person, representative, or physician of your choice notified promptly of your admission.

!! Respect for your personal privacy, dignity and comfort. !! Receive care in a safe setting. !! We will use restraints and seclusion only if they are necessary to ensure physical safety and if no

less restrictive intervention is possible.

Customer Relations/Patient Complaints

The following procedures will be used in receiving and responding to patient complaints:

• All formal customer complaints must be submitted in writing to Customer Relations.

• Customer Complaint/Grievance forms are available at www.springfieldmed.org.

• Persons who express a desire to file a formal complaint verbally, either in person or via a

telephone call (802-885-7299) will be instructed to complete and submit a written Customer Complaint/Grievance Form to Customer Relations.

• The Department Manager is responsible for resolving the formal written complaint or, if

necessary, to refer it to the Quality Improvement Office within 30 days for investigation, review, and resolution.

• Department Managers are responsible for following-up on all patient complaints and for

responses to patients, the Division Chief, or the Quality Improvement Office, as appropriate.

• If the patient is not satisfied with the resolution of the complaint, he/she may appeal this decision in writing directly to the Quality Improvement Office.

• Mail all submissions to Customer Relations #862, Springfield Medical Care Systems, 25

Ridgewood Rd., Springfield, VT 05156.

Social Media

Absolutely no patient information (INCLUDING PICTURES) should be posted on your personal

Facebook or Twitter account or similar social media sites. This includes protected health

information, stories about things that happened in the workplace and confidential business information.

Even if it seems harmless or doesn’t identify the patient,

you cannot put any information on personal Facebook pages. Think before you act. Protect patient privacy

and protect the organization’s confidential business information.

Adult and Child Abuse

All employees of SMCS are mandatory reporters of

adult and child abuse.

If you suspect abuse, speak with your supervisor to learn how to report the suspected abuse.

It is not our role to determine if abuse has occurred.

Our role is to report suspected abuse.

Baby Safe Haven

Springfield Hospital is considered to be a Baby Safe Haven under Vermont's Baby Safe Haven Law

Under the Baby Safe Haven Law, a person may voluntarily deliver a child of not more

than 30 days of age ("Baby") to Springfield Hospital as a Baby Safe Haven. !! If the baby is born in the Springfield Hospital's Childbirth Center (the "CBC"), and

the mother delivers the baby to Springfield Hospital as a Baby Safe Haven, then the baby will remain in the CBC. If the baby is delivered to Springfield Hospital as a Baby Safe Haven at any other Hospital location, then the baby should be admitted to the Emergency Department as either an unknown male or unknown female. The pediatrician on-call must be notified immediately in order to examine the baby. The baby should be admitted to Springfield Hospital as needed.

!! When a person voluntarily delivers a baby to the Hospital as a Baby Safe Haven,

the Hospital shall take temporary custody of the baby and ensure that he or she receives any necessary medical care. The Administrator on-call must be notified immediately. The Administrator on-call must immediately provide notice that the hospital has taken temporary custody of the baby to the Springfield Police Department and to the Department for Children and Family Services, which, under the Baby Safe Haven Law, must take custody of the baby as soon as practicable. If the baby is left after normal business hours, on a weekend, or on a state holiday, the Administrator on-call must call Family Services Emergency Service program at 1-800-649-5285 to make a report.

Baby Safe Haven

When a person delivers a baby to the Hospital as Baby Safe Haven, the volunteer, employee or staff member to whom the Baby is surrendered must: 1) offer the person the Safe Haven brochure published by the Vermont Agency of Human Services; 2) advise the person that while he or she is not required to reveal any identifying information, he or she can provide information about the baby's medical history using the voluntary medical form attached to the Baby Safe Haven brochure; 3) encourage the person to complete the voluntary medical form and leave it with the volunteer, employee, or staff member. If the form is left with the volunteer, employee or staff member, then he or she must complete the information at the bottom of the form with the date he or she received the baby and the location; and 4) document any additional information about the baby, the birthparents, and/or the situation that is offered voluntarily, including any names the person is willing to provide.

Diversity in the Workplace

Diversity reflected among our staff and patients is an asset to our organization.

SMCS values and respects these differences, which include ethnicity, nationality, race,

religion, gender, sexual orientation, economic class, age and disability.

Workplace diversity fosters mutual respect among employees.

Whether employees work in groups or teams comprised of co-workers with varied work styles, or

colleagues who represent different cultures or generations, a synergistic work environment become the norm.

Although an idyllic atmosphere may be difficult to achieve, employees nevertheless recognize the many strengths and talents that diversity brings to the workplace and they gain respect for their colleagues’

performance.

Respect all patients, family members and co-workers. Avoid biases. Be tolerant. Provide cultural competent care, which is the ability to provide patient-centered care to all patients regardless of cultural

differences.

Workplace Violence

It is the intent of Springfield Medical Care Systems, Inc. to

provide a workplace for all employees which is free from violence.

In doing so, we are complying with and

supporting the Federal Occupational Safety and Health Act of 1970 which requires that employer’s provide their employees

with a safe and healthy work environment.

Therefore, it is the policy of Springfield Medical Care Systems, Inc. to prohibit any workplace violence.

Workplace Violence

SMCS is committed to providing a workplace in which all employees are treated equally and with respect.

A major component of such an environment is the SMCS commitment to equal opportunities

and the elimination of discriminatory practices, including harassment or intimidation because of sex, race, color, religion, natural origin, sexual orientation, gender identity,

ancestry, place of birth, age, disability, military status, a positive test result from an HIV-related blood test, genetic information, or any other protected characteristic as provided by

state or federal law.

Harassment has the purpose or effect of creating any intimidating, hostile, or offensive work environment as defined by law, unreasonably interferes with the individual's work

performance, or otherwise adversely affects an individual's employment opportunities.

It is the SMCS philosophy that all employees are responsible for ensuring that the workplace is free from any type of conduct that harasses, interferes with, or disrupts another

employee's work, this including sexual harassment and bullying.

Employees should report incidents to the Corporate Compliance Officer or Chief of Human Resources.

Workplace Violence

Please watch the video titled: Workplace Bullying

Customer Service

Customer Service is our Mission Statement: Where People Come First

When we practice warmth, friendliness, honesty,

patience, tact, courtesy and promptness, other people respond in positive ways that we can see.

The need to be valued and respected is universal.

Customer Service

!! SMILE. !! Use direct eye contact when talking with people. !! When talking with patients (our customers), connect with them by addressing them

by Mr. or Mrs. or by the name they have chosen to be called. !! Introduce yourself and your role. !! Do not call a patient, guests or co-workers “sweetie” and honey. In many cultures

and among the elderly, these terms can have negative perceptions. !! Use “please” and “thank you” in all conversations. !! Communicate what you are going to do, how long it may take and how this will

impact upon them. !! Ask the patient or family if there are any questions or concerns. !! Not everyone may understand medical or technical jargon. Use words everyone can

understand and try to keep it simple. !! Respond to the patient’s questions or concerns within a timely manner by getting

direction from the RN in charge of the patient’s care, or from your supervisor. !! When leaving a patient’s room, exit politely and explain to the patient when you may

return. !! If you observe someone looking for help, offer assistance, escort if possible.

Quality Improvement and Risk Management

Springfield Hospital and SMCS take great pride in providing high quality care and achieving very high

scores for its quality measures.

For information about Springfield Hospital’s quality and patient safety, you can review the

Hospital’s Report Card. You can find the link on the homepage of www.springfieldhospital.org.

Tobacco-Free Campus

We are proud to say that we are a Tobacco-Free Campus.

SMCS is committed to the promotion of health,

which includes the prevention of disease. With this commitment comes the responsibility of providing

a safe and healthy environment. To establish and maintain the safest possible environment in which to deliver healthcare,

SMCS campus buildings, property, parking lots and operated vehicles (owned or leased) are tobacco free.

This includes electronic cigarettes, otherwise known as e-cigarettes.

Pain Management

Springfield Medical Care Systems Staff, including the Medical Staff, is committed to addressing Pain Management.

To this end: Springfield Medical Care Systems believes that all statements of pain and pain relief

are to be believed. It is our responsibility to provide information about pain and pain relief, and to ensure that the staff are committed to increasing patient comfort.

We are committed to raising awareness among staff about Pain Management and Pain Management Interventions. We aspire to identify and support patients' strengths and

individuality. We are committed to absolutely accepting that if we are going to treat pain, we are going to treat addiction. We will accept the premise that addiction is an illness. Acceptance does

not mean that we like the behaviors displayed by addiction, or that the behaviors are okay. Acceptance means that addicts are part of treating pain.

In our pursuit to provide the best possible treatment to our patients,

SMCS accepts the following premises:

1. Patients with chronic pain and/or addictions are ill and need treatment. 2. Springfield Hospital has the ability to treat both chronic pain and addictions. 3. Patients are doing the best they can. 4. Providers are also doing the best they can.

Pain Management

All patients will be assessed on initial presentation, relative to acute and chronic pain, using the Pain Intensity Scale in conjunction with the SMCS

Qualitative Pain Evaluation.

Appropriate scales relative to age and cognition will be selected.

Reassessment will be performed congruent to department policy on patient assessment and reassessment and designated frequency will be based on

patient condition.

Interventions will be based on a pain management plan, derived from patient/staff collaboration.

Hazardous Materials

In each department, there are hazardous materials. It is important

to become familiar with the hazardous materials you may

encounter and know how to handle, use, store and dispose of them

safety.

MSDS (Material Safety Data Sheets) are now called SDS (Safety Data

Sheets). These sheets can be found in the Emergency Dept. or you can

call the 800 number, 24/7 for information.

Report all hazardous materials spills

to your supervisor for details on proper clean up.

SDS is SDS M

Emergency Codes

Code 99 Life Threatening

Code Red FIRE

Code Orange Assistance Needed

Code Pink Infant Abduction

Code Silver Building Lockdown Code Black Bomb Threat

Code Magenta Radiation Alert

Code 5 Emergency Planning

Code Active Shooter

Emergency Codes

Actions to take during Emergency Codes A Code 99 is called when a person has suffered cardiac or respiratory arrest. The following staff is required to go immediately to the scene: one Emergency Dept. RN, the in-house Charge Nurse, one Emergency Dept. PA-C or Physician, one Respiratory Therapist, any in-house physician and any unit assigned code team member. Upon the announcement of Code Pink, go to the exit on your unit and observe for a person that may be leaving the building. Pay special attention to anyone carrying luggage, backpack, etc. Write down a description of the individual, description of vehicle and license number if leaving in a vehicle, and other observations that would be helpful to the police. If you cannot leave the unit, observe from the windows. For those responding to a Code Orange, the purpose is simply to present a “show of force”. Go to the paged location. Do not try to engage with the person causing the disturbance. Remove and reassure any patients/visitors that might be in harms way. Stay until the unit manager feels it is under control or until the police arrive.

Emergency Codes

Actions to take during Emergency Codes Code Silver will be overhead paged whenever a building lockdown has been implemented for security concerns. When you hear Code Silver, remain in your area. If a Code Black is paged, stand by for further instructions. If it is deemed necessary to evacuate, the Charge Nurse, Security Officer or Administrator on-call will give you those instructions. Code Magenta is for a Radiation Alert. Stand by for further instructions. To prevent exposure to Radiation, limit you time near the x-ray machine, make sure there is a shield to protect your body and keep as much distance from the machine as able. The Code 5 is for managers to do Emergency Planning. No action is necessary for staff until the manager returns to the unit with instructions or information. For the Code Active Shooter, people in the building are to take cover and listen for announcements on the overhead paging system.

Fire Safety

Code Red is for a Fire. To be prepared for a Fire, follow these guidelines: !! Fire doors, hallways and stairs must always be free of debris and not an

area for storage to allow for safe evacuation during an emergency. !! There are always two exit routes out of your work area. Locate these

exits on your unit. !! Exits are marked clearly overhead. !! Do not use elevators during a fire, use the stairs. !! In patient-care areas, it is preferable to “defend-in-place” by closing

doors, unless the fire or smoke is directly threatening patients. !! The Fire Marshall or Safety Officer are the ones to instruct us if we need

to relocate or evacuate. !! Follow the RACER acronym (next slide)

Fire Safety

During a fire, always remember: RACER Rescue-remove all persons in danger, close door behind you

Alarm-pull alarm, and page “Code Red” on overhead page system (the switchboard operator can do this by calling “O” on any phone

Confine-close all doors

Extinguish-if the fire is small enough, put it out with a fire extinguisher

Relocate-move to a designated

Fire Safety

Types of Fire

The Fire Extinguishers that are in the public areas of the hospital are ABC Extinguishers. They can be used on any type of fire in the building.

Class A Wood, paper, etc.

Class C Electrical equipment

Class B Flammable liquids

Electrical Safety

The Engineering Dept. at Springfield Hospital is responsible for the electrical safety in the building. If there are any concerns about the electricity, ask the

Operator to contact them immediately. Basic guidelines include:

!! Read the operating instruction of each piece of electrical equipment prior to use. Including owned and rented equipment/devices such as beds, wound-vacs, mechanical lifts and mattresses.

!! Never use “cheaters” to convert a 3-pronged plug to a 2-pronged plug. !! Shut off the power before you touch a person that is being shocked by electricity. !! Never wrap call bells/lights or electrical cords around the bed rails. !! Do not use any electrical device that stalls, sparks or has worn cords. !! Remove power plugs from wall outlets by grasping the plug, not by pulling the cord. !! Prevent damage near-baseboard (low) plugs when moving beds. !! Keep fluids away from electrical equipment, e. g. computers, defibrillator, and suction equipment to

avoid shock damage of equipment and prevent electrical shock. !! Malfunctioning clinical patient care equipment e.g., defibrillator, monitors, pumps, mechanical lifts

are to be put out of service and reported to BioMedical Engineering. Report via BigGreenE. Malfunctioning non-clinical equipment, e.g., electrical beds are to be put out of service and reported to Engineering Department via a BigGreenE.

Radiation and MRI Safety

MRI Safety Magnetic Resonance Imaging is a painless and safe diagnostic procedure that uses a powerful magnet and radio waves to produce detailed images of the body's organs and structures, without the use of X-rays or other radiation. An MRI unit is located on the campus of Springfield Hospital. Iron or other magnetic objects must not be brought into Zone IV of the magnet. Such objects will be attracted by the magnet and may injure the patient or employees. Metal objects, such as jewelry cannot be worn while in the unit.

Radiation Safety Radiation is both natural and man-made. Our bodies are exposed to natural radiation every day -- from soil and underground gases to cosmic radiation from the sun and outer space. We're also exposed to radiation from our own inventions -- medical procedures, televisions, cell phones and microwave ovens. Radiation isn't necessarily always dangerous. It depends on its strength, type and the length of exposure. If you are near a radiation machine (X-ray) that is being used, you can protect yourself by doing three things: keeping your distance, limiting you time in the radiation field and shielding yourself from the radiation.

Safety for your Back

When lifting, follow these golden rules: "! Stand close to the object. "! Bend at the knees. "! Keep your back straight. "! Hold the object close to your body. "! Lift by straightening your legs slowly, don’t use your back.

When lifting/transferring a patient from one surface to another, USE the LIFTING/TRANSFERRING EQUIPMENT

and GET ASSISTANCE from OTHERS. (And of course, make sure you know how to use the equipment prior to using it!)

Fall Prevention

Patients at risk for falls include the following:

•! Those with medical problems causing them to feel weak or tired. •! Those with impaired mobility. •! Those using assistive devices (canes, crutches, wheelchair, walker, etc.). •! Those with difficulty seeing. •! Those with prior history of falls. •! Those who are walking on slippery or wet floors or through cluttered hallways. •! Those with a history of incontinence. •! Those receiving medications that may cause weakness, sleepiness, confusion or dizziness.

Fall Prevention

Springfield Hospital has a policy titled: Fall Prevention Program for Inpatients

Within this policy, patients are asked to:

1.! Use the call bell/light when assistance is needed. 2.! Wait for assistance in getting up to use the bathroom or bedside commode. 3.! Walk slowly and carefully. 4.! Wear non-skid shoes/slippers when ambulating. 5.! All patients being assisted with ambulation will have a gait belt that will be used by the

staff. 6.! All patients will be evaluated for use of side rails, protective devices and/or fall

prevention monitors (personal care alarm/bed alarm) that may be used as reminders for the patient to conduct safe practices while in the hospital.

7.! All patients will be evaluated for pain using a pain assessment tool – non-verbal cues will be considered during this evaluation (example: restlessness, agitation, anxiety, etc).

8.! Because hospital staff cannot remain with the patient constantly, arrangements may be made for a family member/friend to stay with the patient if needed.

Hand Hygiene

Wash your hands Wash your hands Wash your hands

Such a simple process, but it is so important in the care of your

patients and the health of everyone within the hospital.

Proper hand hygiene reduces the spread

of bacteria and viruses.

Direct contact with dirty hands is the primary way infections are transmitted.

Hand Hygiene

How to wash your hands with soap and water 1.! Wet hands thoroughly under running water. 2.! Apply the soap product. 3.! Rub hands together vigorously for at least 15 seconds,

covering all the surfaces of your fingers and hands. 4.! Rinse hands with water. 5.! Dry hands with a disposable towel. 6.! Turn the facet off with the towel. 7.! Avoid using hot water, because repeated exposure to

hot water may increase the risk of dermatitis.

Hand Hygiene

Use of Alcohol-based Hand Rub 1.! Apply the amount of product recommended by the

manufacturer to the palm of one hand 2.! Rub hands together, covering all surfaces of hands and

fingers, until hands are dry. 3.! This should take 15 – 20 seconds if the proper amount of

product is used. 4.! After using the alcohol-based hand rub for three times in a

row, you must then use soap and water before using the alcohol-based hand rub again.

5.! When exiting a room where there is a patient with c-diff, you must wash your hands with soap and water, not alcohol-based hand rub.

Standard Precautions

Standard Precautions are designed for care of all patients, regardless of diagnosis or presumed infection

status, to reduce the risk of transmission from both recognized and unrecognized sources of infection.

This includes: Good hand hygiene

Use Personal Protective Equipment (PPE) when there

is a risk of contact with blood or body-fluid, non-intact skin or mucous membranes.

Transmission-based Precautions

Use transmission-based precautions in addition to standard precautions to

prevent transmission of microorganisms, when certain circumstances are present. All patients requiring transmission-based precautions will be provided the same

quality of care as those not on precautions.

Types of Transmission:

Contact – Droplet – Airborne

Contact Precautions

Contact Precautions – are used for organisms that are spread by touch or carried along by hands and patient-care objects

Must be used for the following populations of patients !! Patients with diarrhea suspected or known to be infectious. !! A patient who is incontinent of diarrhea. !! Patients with wound drainage that is not covered and

contained with a dressing (regardless of organism). !! Patients with uncontained respiratory secretions (such as

tracheostomy patients).

Contact Precautions

Components of Contact Precautions Use Standard Precautions as well as the following: •! Private room assignment or cohorting of two patients with the same diagnosis. •! Gloves whenever entering the room. •! Gown when entering the room, unless there will be NO contact with the patient or environment. •! Dedicate patient equipment whenever feasible. (If equipment cannot be dedicated it must be cleaned

and disinfected upon leaving the room). Transporting the patient: •! Limit patient movement outside of the room to medically necessary purposes. •! Before transport, assure the patient is clean and infective material is contained. •! Don appropriate PPE to place the patient on the stretcher, remove PPE and perform hand hygiene to

transport the patient to the destination. (PPE may be worn during transport only if there is a reasonable chance the transporter could come into contact with infectious material on transport).

•! When the destination is reached, don PPE. Discontinue contact precautions when symptoms have resolved at least 24 hours or according to disease specific recommendations, whichever is later.

Airborne Precautions

Airborne Precautions – are used for organisms that are spread by small, droplet nuclei 5 microns or smaller. Such droplets are generated when talking, coughing or sneezing and during procedures involving the respiratory tract such as suction, intubation or bronchoscopy. They can be widely dispersed by air currents.

Must be used for the following populations of patients with: •! M. tuberculosis •! Measles •! Varicella •! Disseminated herpes zoster •! And other disease specific indications

Airborne Precautions

Components of Airborne Precautions

Use Standard Precautions as well as the following: •! Place patient in Negative Pressure Room. •! Keep door closed except to enter or exit the room. •! Respiratory protection N95 mask (personnel must be fit tested) or PAPR (must have training). •! Visitors should be asked to wear a surgical mask when in the room. •! For measles, varicella or disseminated zoster, non-immune personnel should not enter the room unless

absolutely necessary.

Transporting the patient •! Limit patient movement outside of the room to medically necessary purposes. •! The patient should wear a surgical mask when out of the room, the transporter does not need a mask. •! Before transport assure the patient is clean and infective material is contained. •! If the patient has skin lesions associated with varicella, smallpox or tuberculosis they are to be covered

and contained. •! Don appropriate PPE to place the patient on the stretcher, remove PPE and perform hand hygiene to

transport the patient to the destination. (PPE may be worn during transport only if there is a reasonable chance the transporter could come into contact with infectious material on transport).

Discontinue airborne precautions when symptoms have resolved at least 24 hours or according to disease specific recommendations, whichever is later.

Droplet Precautions

Droplet Precautions – are used for infections that are transmitted by large particle droplets (greater than 5um). Large droplet nuclei do not remain suspended in the air for long and travel only short distances. Transmission from large droplets requires close contact (i.e. within three feet) between infected source and the recipient.

Must be used for the following populations of patients with: •! Meningococcal meningitis •! Influenza •! Mumps •! Rubella •! Diphtheria •! Pneumonic plague •! Infection s caused by multidrug-resistant Streptococcus pneumoniae.

Droplet Precautions

Components of Droplet Precautions

Use Standard Precautions as well as the following: •! Private room assignment •! A surgical mask must be worn when within 3 feet of the patient. •! Dedicate patient equipment whenever feasible. (If equipment cannot be dedicated it must be cleaned

and disinfected upon leaving the room). Transporting the patient: •! Limit patient movement outside of the room to medically necessary purposes. •! The patient should wear a surgical mask when out of the room •! Before transport assure the patient is clean and infective material is contained. •! Don appropriate PPE to place the patient on the stretcher, remove PPE and perform hand hygiene to

transport the patient to the destination. (PPE may be worn during transport only if there is a reasonable chance the transporter could come into contact with infectious material on transport).

•! When the destination is reached don PPE. Discontinue droplet precautions when cough has been determined to be non-contagious or when signs and symptoms have resolved for at least 24 hours or according to disease specific recommendations, whichever is later.

Care of the Immune Compromised Patient

Tuberculosis

Tuberculosis is an airborne infection caused by Mycobacterium tuberculosis. It is not spread by contact with dirty items, soiled tissues or by touching a patient. The germ must be inhaled. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.

Latent TB Infection TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection do not feel sick and do not have any symptoms. People with latent TB infection are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease.

TB Disease TB bacteria become active if the immune system can't stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day. Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later when their immune system becomes weak for another reason. For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for people with normal immune systems.

All staff prior to employment are tested for TB. Many department staff are fitted to the N95 mask so that they may provide direct patient care to individuals with TB.

Personal Protective Equipment

Personal Protective Equipment (PPE) refers to

items that provide a temporary barrier to prevent direct contact with blood,

body fluids or organism exposure. These items can include: gloves, gowns, mask, eye protection, face shield and goggles.

It is important to know the process of

how to don and take off PPE as you do not want to contaminate yourself or

others. The process is explained in the policy:

N 95 Mask (Hepa Mask) Fit Testing and PAPR (powered air purifying

respirators), or HOOD Instruction and Maintenance

Please view the page, Centers for Disease Control-Donning and Doffing of PPE

Sharps Safety

!! Do not bend, break or re-cap dirty needles. !! Pay attention when placing sharps in sharps containers.

Make sure the sharp goes all the way into the container and close the container if needed.

!! Use safety devices for all sharps. !! Use aseptic technique for the preparation and

administration of IV medications. !! Do not reinsert used needles into multi-dose vials or

solution containers. !! Do not use the same needle/syringe on multiple patients.

Housekeeping Details

!! If you are sick, please do not come into work. Call you supervisor to inform him/her

of your reason for not coming to work. !! Parking-all students must park in the upper parking lot of the Emergency Dept.

parking lot !! All staff are to park as far away from the buildings as possible. !! Cellphones and other electronic devices are not to be used while you are working.

Some devices allow for you to look up meds and that may be an acceptable use of an electronic device. But, in general, all these devices are to be turned off so that you can focus on patient care. If you need to have your electronic device on for emergency purposes, please speak to your instructor or supervisor.

!! Electronic Bulletin Board: this in an online newsletter that discusses the operations, events, programs offered at Springfield Hospital and SMCS. Access to this newsletter can be obtained by speaking to your supervisor/instructor.

Dress Code

Professional appearance shall project competency, inspire confidence, and communicate respect to patients and their families as well as to all customers and colleagues. The following standards have been established to ensure minimum standards. In some instances, departments may have a dress code policy that is more stringent due to patient safety or work environment. However, no department shall have a policy that is less stringent with the

exception of the childcare centers. !! 1. Personal clothing shall be neat and clean and tailored so as to ensure that they are not extremely tight, baggy

or short. !! 2. A SPRINGFIELD MEDICAL CARE SYSTEMS, INC. name tag shall be worn where the employee’s name,

position, and department are easily visible (the chest area) at all times while on duty. !! 3. Employees will not be permitted to work in shorts, denim blue jeans, t-shirts (except those with the

Springfield Hospital logo), spaghetti strap tops, halter tops, bare midriff shirts and blouses, or sweat suits. Employees will be permitted to wear shorts (no more than 3 inches above the knee) and/or jeans in departments where this is part of the uniform. Skirts may not be more than 3 inches above the knee.

!! 4. Shoes must be worn at all times. Due to safety and personal protection concerns, certain departments are

not allowed to wear open-toed shoes with or without nylons or socks. Departments where open-toed shoes are deemed a personal safety hazard and are not allowed include, but are not limited to: diagnostic imaging, laboratory, all nursing units, respiratory therapy, physical/occupational therapy, engineering, housekeeping, dietary, materials management, and all hospital and physician practice patient care areas. Opened-toed shoes may be allowed in other departments and may be worn without nylons or socks. Absolutely no flip flops will be allowed in any department.

Dress Code

!! 5. Good personal hygiene should be observed by all employees. !! 6. Uniforms must be worn in areas where required. !! 7. Fingernails should not be excessively long. A length of !” from the finger tip is

recommended. (Long nails could cause harm to patients). Employees working in patient care areas are not allowed to use artificial nails due to infection control issues.

!! 8. Strong fragrances in the form of perfume, cologne, shampoo, lotion, etc. should not be used

in any areas of the hospital. Some fragrances may irritate and cause complications for some patients and employees.

!! 9. For employee and patient safety, consideration should be given to the length and type of

earrings and other jewelry worn by employees involved with patient care or who are working around equipment.

!! 10. With regard to visible body piercing ornaments and body art such as tattoos, we ask that you

exhibit them discretely and within the intent of this policy. Earrings must be appropriate for a professional business environment.

Patient Identification

To ensure patient safety and accuracy, all patients and/or patient specimens must be positively identified by using two identifiers.

The two positive identifiers for the hospital inpatients are the name and medical record number. Specialty areas may have other unique identifiers that must be

utilized.

The patient must be identified prior to: 1.! Any medication administration

2.! Transfusion 3.! Treatment/procedure 4.! Specimen collection

5.! Patient handoff to include transport of patient, transport of the newborn to mother

Caring for Inmates from Southern State Correctional Facility

Springfield Hospital provides care to prisoners who require medical attention in the inpatient and outpatient setting.

There will be a least one Correctional Officer with the patient.

All prisoner patients are kept in forensic restraints except

when required removal for treatment. Removal and application of the restraint is done by the Officer/Guard.

Prison patients are opted out of the census. Only the prison

can give out information about the patient.

Next Steps to Complete This Part of Orientation

Thank you for reviewing this presentation as part of your orientation to our organization. To complete this part of orientation,

please follow the instructions below. For Students: Complete the attached Workforce Orientation Checklist 2016. Also, sign and date the Confidentiality Form. Give these two forms to your instructor.

Welcome to Springfield Hospital and Springfield Medical Care Systems.