clear lake regional medical center · pdf fileclear lake regional medical center alvin campus,...
TRANSCRIPT
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Clear Lake Regional Medical Center 500 Medical Center Blvd., Webster , TX 77598
281-332-2511
Revised December 2013
P-922-0183
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On behalf of Clear Lake Regional Medical Center, we extend a
warm welcome to you. Thank you for choosing CLRMC for your
clinical rotation. Our goal is to provide meaningful learning
opportunities that will help you gain valuable experience in
your pursuit of a career in healthcare.
--CLRMC Education Department
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Above all else, we are committed to the care and improvement of human life. In
recognition of this commitment, we strive to deliver high quality, cost effective
healthcare in the communities we serve.
In pursuit of our mission, we believe the following value statements are essential
and timeless:
•We recognize and affirm the unique and intrinsic worth of each individual
•We treat all those we serve with compassion and kindness.
•We act with absolute honesty, integrity and fairness in the way we conduct our
business and the way we live our lives.
•We trust our colleagues as valuable members of our healthcare team and
pledge to treat one another with loyalty, respect and dignity.
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Clear Lake Regional Medical Center is a 595 bed private,
acute facility that opened its doors on March 12, 1972.
Since that time, it has maintained a consistent tradition of
high-quality patient care. Built with the support of the
community, the hospital mirrors the space age environment
of the surrounding area and is dedicated to serving the
medical needs of the local population.
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Medical/Surgical ICU Cardiovascular ICU Coronary Care Unit Emergency Department Chest Pain Unit CV Intermediate Units 1 & 2 Surgical Intermediate Care Units Medical Intermediate Care Units Labor & Delivery Ante-Partum Post Partum Newborn Nursery Neonatal Intensive Care Pediatrics Pediatric ICU Oncology Rehabilitation Outpatient Services Discharge Express
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Radiology Endoscopy Nuclear Medicine Sleep Lab Respiratory Therapy Laboratory Physical Therapy Occupational Therapy Electrodiagnostics Cardiac Cath Lab Diagnostic Imaging Pharmacy Breast Diagnostic Center
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Clear Lake Heart and Vascular Hospital is a free-standing 6 story building
located across from the main hospital at 495 Medical Center Blvd. It
opened its doors in April 2007. All cardiovascular care including CVICU,
CV OR, Cath Lab, CCU, CV Intermediate Units 1 and 2, and Cardiac
Rehab are located in this hospital. In the Spring of 2011, the 5th & 6th
medical floors opened. This represents the near completion of becoming
a hospital with all private rooms.
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The Education Department of Clear Lake Regional Medical Center is committed to the educational needs of employees and students throughout the hospital. Students are always welcome to attend hospital in-services and community classes. Call the Education Department at 281-338-3340 if you have any questions regarding the services provided by our department
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Privacy and Security of Protected
Health Information
Clear Lake Regional Medical Center requires that ALL students
view the provided HIPAA & HITECH PowerPoint presentation
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What is ethical & compliant behavior?
Doing what is right and encouraging others to do the same.
What is HCA’s Code of Conduct?
Our Code of Conduct provides guidance to all HCA colleagues
and assists us in carrying out our daily activities with
appropriate ethical and legal standards. These obligations apply
to our relationships with patients, affiliated physicians, third-
party payers, subcontractors, independent contractors, vendors,
consultants and one another.
How do you report an Ethics and Compliance issue?
Issues can be reported to the ECO, the department director or
manager, human resources or by calling the ethics hotline.
There is no retribution for reporting an issue in good faith.
Every effort will be made to maintain confidentiality.
Who Is our ECO?
ECO: Mark Rozell
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Greet others with a friendly smile and good eye
contact.
Call patients by their preferred name, located
on the white board in the patient room. Never
refer to a patients by their diagnoses or room
number. Using the surname communicates
respect and decreases the likelihood of
misidentifying a patient.
Identify/introduce yourself at the beginning of
all communications – in person, telephone, and
when answering the call bell.
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Respect the privacy of patients by pulling the curtain,
knocking on the door before entering, covering the
patients, offering a second gown, etc.
Demonstrate the common courtesy that you were taught
such as saying “please”, “thank you”, and “may I”?
Provide patients, their loved ones and your co-workers as
much information as you can. Use terms they can
understand.
Apologize when necessary – on behalf of the hospital –
even when it wasn’t your “fault”. Take the opportunity for
“service recovery”. This is when something has happened
to the patient and you try to assist with “fixing” the
situation.
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Really listen to the patient and loved ones. Never
underestimate their knowledge of their bodies and their
health. Appreciate and respect that they can provide
information that will allow you to provide better care.
When discussing an issue with the patient or family, never
blame another staff member or a physician. This can
cause fear and loss of confidence in the hospital as a
whole.
Never tell a patient we are understaffed or that you don’t
have time. Once again, this will cause fear and loss of
confidence.
Always ask patients before touching a part of their bodies.
“May I please have your arm?” “I’ll need to listen to your
heart”.
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“Are there any questions
that I can answer for you
at this time?”
“Would another
blanket make you
feel more
comfortable?” “We’re all here to make
sure you have what you
need. Please let us know if
there is anything we can do
for you.”
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“I would like you to
be as comfortable
as possible. Let me
do ______ for you.”
“How are you feeling?
Are you having any
pain/nausea/discomfort?”
“Is there anything that I
can do for you before I
leave your room?”
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“I understand that you need _____. ______ will be with you very shortly to take care of that.
“He/she is with another patient. Is there something I can do for you?”
“I apologize for
the delay.”
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“Many people have concerns about being in the hospital. Is there anything you are worried about?”
“Do you have any fears or concerns that you like to talk about?”
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In addition to providing appropriate care to individuals in
at all stages of development providing Culturally
competent care is vital, acknowledging that people of
different cultures have different expectations of
Healthcare.
Development refers to predictable increases in physical,
cognitive, psychological and moral capacities that
individuals acquire to enable them to successfully adapt to
their environment.
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Health Care Providers must be able to meet the
distinct needs of patients based on their stage of
growth and development. Each patient, at all
phases of the life continuum, present distinct
clinical challenges. At Clear Lake Regional
Medical Center, we use the following age group
classifications to refer to various age groups:
Geriatric
Adult
Adolescent
child
Infant
Neonate
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Be familiar with age-specific characteristics
Identify each patient’s requirements relative
to his/her age specific needs and cultural
background.
Communicate with patients and families in
an age-appropriate manner keeping in mind
cultural expectations.
When age and developmental level or
functional capacity do not match, readjust to
relate to that patient appropriately
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Clear Lake Regional Medical Center
Alvin Campus, Clear Lake Campus,
Mainland Campus, Pearland Campus
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To improve:
1) effective communication
2) cultural competence
3) patient- and family-centered
care across the care continuum.
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The following are a few key terms which will
help you understand Population Specific Care:
Patient-
Centered
Approach Health
Literacy
Cultural
Competence
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• Patient-centered care means we take into
consideration each patients:
Age
Preferred language
Ethnicity
Health Literacy
Spirituality/Religion
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Understands symptoms
Understands diseases
Understands directions
Asks pertinent questions needed to make
appropriate decisions
Regarding medical information, how well
an individual :
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We strive to effectively respond to cultural and
language needs brought by the patient to the health
care setting. As an organization, this begins by
understanding and valuing the population we
serve.
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Population by Gender
Inpatient
Mainland Clear Lake
Female 59% 61%
Male 41% 39%
Outpatient
Mainland Clear Lake
Femal
e
63% 66%
Male 37% 34%
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Population by Race Must represent > 5% of total patients.
Inpatient
Mainland Clear Lake
White 57% 65%
Hispanic 15% 19%
Black 26% 10%
Outpatient
Mainland Clear Lake
White 50% 62%
Hispani
c
18% 17%
Black 30% 15%
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Population by Age
Age
Mainland Clear Lake
Inpatient Outpatient Inpatient Outpatient
<5 5% 7% 18% 10%
5-19 2% 13% 6% 14%
20-44 19% 35% 27% 31%
45-64 29% 25% 20% 27%
>65 45% 20% 29% 18%
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Emergency Department Population by Gender
Emergency Departments
Mainland Clear Lake Alvin Pearland
Female 58% 61% 52% 57%
Male 42% 39% 48% 43%
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Emergency Department Population by Race Must represent > 5% of total patients.
Emergency Department
Mainland Clear Lake Alvin Pearland
White 57% 65% 63% 20%
Hispanic 15% 19% 29% 20%
Black 26% 10% 4% 55%
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Emergency Department Population by Age
Emergency Department
Age
Mainland Clear Lake
Alvin Pearland
<5 9% 11% 15% 16%
5-19 15% 13% 28% 26%
20-44 36% 38% 35% 40%
45-64 23% 20% 15% 13%
>65 17% 18% 7% 5%
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Population by Preferred Language
Population by Religious Preference
We are working with IT&S on a report to extract data
from Meditech.
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Identify:
• Preferred language
• Communication impairment
• Patient race & ethnicity
• Required assistive devices
• Additional needs affecting his or her care
Communicate:
• Unique patient needs to the care team
• Inform patients of their rights.
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Identify and Act:
•Patient communication needs
•Patient’s health literacy
•Patient’s cultural, religious, or spiritual beliefs or
practices that influence care.
•Dietary needs or restrictions that affect care.
Communicate:
•information about unique patient needs to the
care team.
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Monitor changes in communication status.
Involve patients and families in the care & education
Match informed consent process to health literacy
Accommodate patient cultural, religious, or spiritual
beliefs and practices.
Monitor changes in dietary needs or restrictions that
may impact the patient’s care.
Communicate information about unique patient
needs to the care team.
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• Monitor changes in the patient’s communication
status
• Involve the patient’s surrogate decision-maker and
family
• Identify patient cultural, religious, or spiritual
beliefs and practices related to the end of life
• Make sure the patient has access to his or her
chosen support person and or clergy
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• Engage patients and family in discharge and
transfer planning.
• Discharge instructions that meet patient needs.
• Identify follow op providers that meet patient
unique needs.
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• Interpretalk
• Use Interpretalk Phone: 2 handsets to conference call
• Plug the Interpretalk phone in phone jack
• Follow instructions for the phone
• Listen for the dial tone
• Press the Interpretalk button
• Press the Code button
• When greeted by coordinator provide:
• Department /unit
• Your Last and First name
• Your patient’s Medical Record Number (bring patient sticker with you)
RESOURCES…..
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• Request the language needed
• Coordinator will inform you when interpreter is “on
line” and give you the interpreter ID number
• Explain the objective of the call to the interpreter
• Speak directly to the non-English speaker in the first
person
• Upon completion of the call, all parties should simply
hang up
• Your time will be automatically recorded
RESOURCES…..
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Click on
“Links” Choose Quality
Interactions
Resource
1
2
3
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http://www.jointcommission.org/assets/1/6/ARoad
mapforHospitalsfinalversion727.pdf
http://www.cahealthliteracy.org/
http://www2.massgeneral.org/interpreters/bits.as
p
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I have the right to be treated as a living human being until I
die.
I have the right to express my feelings and emotions about
my approaching death in my own way.
I have the right to be free from pain.
I have the right to die in peace and with dignity.
I have the right to maintain a sense of helpfulness, however
its focus may change.
I have the right to participate in decisions concerning my
care.
I have the right not to die alone.
I have the right to discuss and enlarge my religious and
spiritual experiences, regardless of what they may mean to
others.
At Clear Lake Regional Medical Center, we are committed to preserving the rights
of the dying.
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It has been estimated that as many as one
hospital patient in ten acquires a
nosocomial infection
Estimates of the annual healthcare cost
range from $4.5 billion to $11 billion and
up
A majority of these infections could be
eliminated through good hand washing
technique and following infection control
policies.
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Hand Hygiene is critical to
infection prevention
Under nails
Between fingers
3 inches above wrist
Friction for 15 seconds
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Soap and Water
Visibly soiled
Before & after:
gloving
Eating
Toileting
C-diff
Alcohol hand foam •Not visibly soiled
•Adjunct to soap and water, wash
with soap/water after 4 foam used
3- 4 times
Antimicrobial Soap
High risk areas such
as: •Surgery
•Neonatal nurseries
•Critical care areas
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All
Patients
All the
time
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Use disposable equipment - Appropriate
disposal of Red Bag Waste
Don appropriate apparel - Remove gowns,
etc. prior to leaving the room
Check Isolation sign on door: Airborne,
Droplet, Contact, or Special Contact
Keep door closed
Check the Isolation sign for specific instructions
Students are not allowed to care for patients with TB in
Airborne Isolation. Students are not fitted for the
required N95 Mask.
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Use caution in cases of confirmed or
suspected communicable diseases such as:
Chicken Pox, Measles, Conjunctivitis, the
FLU
Do not attend clinicals at CLRMC if you
suspect you may have an illness that could
be spread to others. Notify your instructor
or the department/unit to which you are
assigned.
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Be Careful – use ALL available safety features
If an injury occurs:
Immediately bleed the injury (if appropriate)
Wash the area
Notify CLRMC Employee and Instructor
immediately
Complete Occurrence Report
Get emergency care per school policy
Follow-up care-Student responsibility per
school policy
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SAFETY ON THE JOB is everyone’s responsibility.
Most accidents are a result of carelessness,
thoughtlessness, fatigue, or neglect.
Most accidents can be prevented through proper
care and maintenance of equipment and facilities,
alertness on the job, and good housekeeping
procedures.
Unauthorized use of equipment is prohibited. If you are injured while
at Clear Lake Regional Medical Center, immediately report the
accident to your instructor who must complete an Occurrence Report
within 24 hours. The instructor should notify the supervisor or
director of the department where the student is assigned and the
Education Department.
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Avoid hazardous patient handling and movement tasks
whenever possible. If unavoidable, assess them carefully
prior to initiating the transfer or movement.
Use mechanical lifting devices and other approved patient
handling aids for high-risk patient handling except when
alternative methods are absolutely necessary, such as in a
medical emergency.
Use mechanical lifting devices and other approved patient
handling aids in accordance with instructions and training.
BE SAFE - Use good Body Mechanics
REMEMBER that your back is your RESPONSIBILITY
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A fall is a sudden unplanned downward displacement of the body to the ground or lower level, excluding falls resulting from violent blows or other purposeful actions.
An un-witnessed fall occurs when a patient is found on the floor and neither the patient or anyone else knows how he or she got there.
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Medications: sedatives, hypnotics, anti-
hypertensives, diuretics, bowel preps, anti-
seizure medications, etc…
Assist devices: canes, walkers, wheelchairs
Cognitive impairment (age, developmental
delay, substance abuse, dementia/alzheimers
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Educate patient and family
Safe environment:
remove trip hazards
slip hazards
sharp edges
Patient Safety Rounding: 4P’s
Safe exit side
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Determining a patient’s potential fall risk: *NOTE: if ≥ 3 are met, patient is “high risk for falls”
• 70 years old
• Confused or disoriented
• Hx of Falls
• Impaired judgment, memory,
gait/transfer dysfunction
• Generalized weakness
• Hx of syncope/orthostatic BP
changes
• Altered elimination
• Sensory/perceptual deterioration
• Special meds: Narcotics, Sedatives,
Tranquillizers, Psychotropics,
Cardiovascular, Diuretics, Laxatives
Anticonvulsives, Antidepressants.
• Immediate Post Op period
• Blind or severely impaired vision
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Universal Fall Interventions
Critical Conversation w/patient and family
Signage
Yellow Armband
Non-skid blue socks/footwear
Bed alarm if patient confused/gait dysfunction
Stay with patient in bathroom or bedside commode
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• Age: ≥ 85
• Bones: Ortho Problems, Arthritis, Gout, Osteoporosis, Dystrophic Disease, Fractures, Contractures, Amputations, Deformities
• Coagulation: Anemia, Blood Dyscrasia, Clotting Disorder, Sickle Cell Anemia, Hemophilia, Hx of Transfusion Reactions, Anticoagulation
• Surgery: Immediate Post-Op
• This subgroup of patients are at risk for serious injury or even death if they fall. They are identified by:
*NOTE: if 1 or more criteria is met, patient is “at risk for injury”
ABCS
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• Universal Fall Interventions
• Critical conversation w/patient and family
• Yellow falling star with red band aid signage
• Yellow socks
• Yellow blanket
• Evolution Bed, low to ground also is air mattress for better skin integrity
• Assess sitter needs
• Stay with patient in bathroom or bedside commode if confused, gait dysfunction, or weak
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Universal Interventions
High Fall Risk Interventions
PLUS
Yellow gown
Bed alarm at all times
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• Review “Fall Prevention Guidelines for Patient and Family” with every patient.
• Use “Fall Prevention Guidelines for Patient and Family” to have a critical conversation with patient/family if the patient is at High Risk for falls.
• “Critical Conversation for Preventing Falls with Injury” is reviewed if the patient is identified as at Risk for Injury.
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Notify Director (or AOS) immediately.
Fall Debriefing must occur with a huddle on the same shift of the fall.
Use audit tool during fall debriefing to collect all pertinent info regarding fall.
Determine what could’ve been done better/ what could’ve prevented the fall.
Include what action steps will be taken to keep your patients safe.
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Bed/Chair Alarms: Must be used for high fall risk AND at risk for injury OR if your patient is confused or has gait dysfunction.
Rounding appropriately: Including the 4 P’s during safety rounding and staying with the patient when toileting will help prevent falls and keep our patients safe.
Alert the staff when a high risk patient is getting out of bed
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Any manual method, physical or mechanical device,
material, or equipment that immobilizes or reduces the
ability of a patient to move his or her arms, legs, body
or head freely.
Examples:
• Tucking in sheets very tightly
• Use of side rails x 4
• Holding a patient to prevent movement
• Geri chairs, side rails, mittens when
they have the effect of restricting a
patient’s movement and cannot be
easily removed by the patient
• A medication used to control behavior
that is not a standard treatment, or not
in a dosage used for the patient’s
medical or psychiatric condition would
be considered a restraint.
Two types of restraints
Violent-patient ‘s behavior poses
an immediate and serious threat to
himself or others
Non-violent- primary reason for
use directly supports an identified
treatment plan
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Goal: Minimize the use of restraints
Consider alternatives to restraints
Use the least restrictive restraint for the shortest amount of
time. RESTRAINTS SHOULD BE A LAST RESORT.
Restraints should only be applied and monitored by trained
staff. STUDENTS MAY NOT APPLY OR REMOVE RESTRAINTS.
Maintain and monitor a patients safety, rights, and dignity 3
times per hour
RN shall be responsible for the assessment and care of
restrained patient initially and every 2 hours thereafter.
All restraints must be accompanied by a doctor’s order & must
include a second tier review. NO PRN ORDERS
The patient a family should be educated about the reason for
restraints and the criterion for restraint removal.
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On admission or during pre-admission, the patient
will be taught the pain scale utilized to measure pain
and how to communicate his or her pain
The patient will be informed that pain management
is included in the plan of care.
The patient and family will receive education on pain
medication control methods, and non-medication
techniques to control pain.
The patient has the right to know the potential
limitations and side effects of the pain medications
given.
The patient should understand the importance of
effective pain management.
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PAIN – is an unpleasant sensory and emotional
experience associated with actual or potential
tissue damage
PAIN – has both physical and emotional elements.
It is “whatever the experiencing person says it is
and exists whenever he/she says it does”.
PAIN is the 5th vital sign. Every patient will be
provided appropriate pain management, and staff
will respect and foster the patient’s sense of
dignity and involvement in their own care.
Fear of Pain, especially postoperative pain,
ranks 2nd only to the fear of death
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Acute pain
Rapid onset
1 second – 6 months
Autonomic nervous system
Tends to be more responsive to analgesic meds
Chronic pain.
Persistent or episodic in nature
>6 months duration
Habituation of autonomic response
Tends not to be as responsive to analgesic meds
May exhibit signs of depression
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Crying, Grimacing, Moaning, Guarding,
Restlessness, Repositioning,
Holding extremely still – Especially in the
elderly you may also see: Hitting, Anxiety,
Sighing, Fright, Making demands, Rubbing
Tachycardia
Hypertension
Tachypnea
Dilated pupils
↑ muscle tension
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Pain intensity
Location
Quality of pain, patterns of radiation (if any), character
Onset, duration, variation, and patterns
Alleviating and aggravating factors
Present pain-management regimen and effectiveness
Pain management history
Effects of pain
Patient’s pain goal
Physical exam/observation of the site of pain
Pain reassessment will occur
within 1 hour of pain
medication administration
Pain is assessed using a 0-10 Scale, with “0” representing
No pain and “10” representing the worst pain possible.
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Code Type Meaning
Red Fire
Code Blue or Code Blue/Pedi Cardiac/Respiratory Arrest
Rapid Response Team(RRT) ICU Nurse/Respiratory Therapist Responds
Code Neuro Patient having signs and symptoms of stroke
Code Yellow Disaster
Code Gray Emergency Security Assistance
Code Pink Infant/Child Abduction
Code Green Chemical Spill
Code Orange Bioterrorism Attack
Code White Active Shooter (armed Intruder)
Code Black Bomb Threat
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Preventing fires and knowing what to do in case of fire is the
responsibility of all hospital employees. A Fire Manual and
Code Red cards are located in each department and nursing
unit.
Know the location of fire extinguishers near your individual
work area;
If a fire is discovered, activate the closest fire alarm signal by
pulling down on the handle of the Local Fire Alarm. Proceed
with the individual fire duties, as designated on the Code Red
cards.
Fire drills are conducted in all areas. Be prepared to
participate.
You must know fire procedures for your area and the
responsibilities you have when a fire occurs in other areas.
RACE
R-rescue
A-alarm
C-contain
E-extinguish PASS
P-pull the pin
A-aim the nozzle
S-squeeze the handle
S-sweep from side to side
at the base of the fire
Code Red
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TEXAS: It is a crime NOT to report suspected
abuse/neglect of children and elders
Clear Lake Regional Medical Center provides
for the protection of all patients by making
hospital staff aware of signs, symptoms, and
physical indicators of abuse and/or neglect
and how to report the suspected abuse.
Students should immediately report any
suspected abuse to your instructor and the
charge nurse.
Please see the policies for abuse and neglect
for details.
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Bruises, welts, lacerations, or puncture wounds
Dehydration or malnutrition
Multiple injuries or fractures in various stages of healing
Injuries inconsistent with explanation
Difficulty walking or sitting; Torn, stained or bloody
clothing
Complaints of pain or itching in the genital area
Bruises or bleeding from external genitalia
Venereal disease, particularly, in a child <14 years old
Signs of over-medication; Burns; Poor hygiene
Lack of medical attention
24-hour Abuse hotline: 1-800-252-5400 to
report abuse
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The patient has the right to be informed of his/her rights in
language he/she understands.
The patient has the right to participate in the development
and implementation of his/her plan of care and to make
informed decisions regarding his/her care.
The patient has the right to be able to request or refuse
treatment.
The patient has a right to give informed consent prior to
the start of a procedure and/or treatment.
The patient has the right to know the identity and
professional status of individuals providing service to
him/her, to know the name of the person responsible for
any procedures and/or treatment, and to know which
physician or other practitioner is primarily responsible for
his/her care.
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The patient has a right to refuse to participate in research
and his/her refusal will not compromise his/her care.
The patient has the right to have a family member or
representative of his/her choice and his/her own physician
notified promptly of his/her admission to the hospital.
The patient has the right to include his/her family in care
decisions and/or to delegate decision-making to specific
person and/or appoint a surrogate to make healthcare
decisions on his/her behalf (to the degree permitted by
State Law).
The patient has the right to formulate advance directives
and to have hospital staff and practitioners who provide
care in the hospital comply with these directives.
The patient has the right to appropriate assessment and
management of pain.
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The patient has the right to personal privacy.
The patient has the right to security and to receive care in
a safe setting.
The patient has the right to be free from all forms of
abuse or harassment.
The patient has the right to access protective services.
The patient has the right to be informed of any restrictions
(i.e., patient visitors, mail, telephone calls, or other forms
of communication).
The patient has the right to be free from seclusion and
restraints of any form that are not medically necessary
and/or are imposed as a means of coercion, discipline,
convenience, or retaliation by staff.
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The patient has the right to respective and supportive
treatment and service at all times and under all
circumstances with recognition of his/her person dignity.
The patient has a right to receive pastoral counseling.
The patient has a right to be involved in resolving dilemmas
about care decisions
The patient has a right to complain.
The patient has the right to the confidentiality of his/her
clinical records
The patient has the right to access information in his/her
clinical records within a reasonable timeframe.
Regardless of the source of payment for his/her care, the
patient has the right to request and receive an itemized and
detailed explanation of his/her total bill for services
rendered in the Hospital.
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The patient shall be accorded impartial access to
treatment or accommodations that are available
within the Hospital’s capacity, its stated mission,
and applicable law and regulation. Regardless of
the reason a patient seeks medical/hospital
care, patients with the same health problem
shall receive the same level of quality care
throughout the organization.
The care of the dying patient provided by Clear
Lake Regional Medical Center will optimize the
comfort and dignity of the patient.
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Standards – Students will be held to the
standards of competent professionals when
performing all duties.
Uniform – Each student must wear appropriate
uniform, school picture ID and badge provided by
Education Dept while on Hospital property AT ALL
TIMES. Students are expected to follow other
dress code policies of the hospital. The hygiene
and appearance of healthcare professionals has a
significant effect on the confidence our patients
and visitors have in us.
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Calling in if unable to report to duty – The student is
expected to call their instructor or the specific unit or
department assigned to him/her if they do not have an
instructor present during their clinical rotation. Please
call at least 2 hours before the shift and provide the
following information: name, school, unit, instructor’s
name and reason for absence.
Transcription of Doctor’s Orders – Students may NOT
transcribe doctor’s orders. The nurse or employee taking
care of the patient is responsible for transcribing the
doctor’s orders and communicating new orders to the
student. The student may not receive verbal or telephone
orders from a physician.
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No eating or drinking in areas outside the
cafeteria or break rooms. (You cannot eat
in the lobby)
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Cafeteria – The student will receive a discount on meals
purchased in the Cafeteria while they are at this facility
during a clinical rotation.
Elevators – The back “service” elevators should be used
for transporting patients and/or equipment from one area
to another. The front elevators may be used when
discharging patients.
Parking – See the last page of this booklet for approved
parking areas. Carpooling is highly encouraged due to
the high volume of students. The student may be asked to
move their vehicle if they are parked in an unapproved
area.
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Handling of Narcotics –
A student nurse may be allowed to administer narcotics under
the supervision of his/her instructor or employee preceptor.
Narcotics will be dispensed from the PYXIS Medication System.
The instructor or employee will enter the system with an
access code and a secure password. Medications are then
documented in eMAR.
The instructor or nurse will check all medications prior to
student administration. Medications are dispensed via the
PYXIS medication cabinet or the Robot system.
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IV Therapy/Phlebotomy – Students may perform IV therapy and
phlebotomy techniques following instruction and skills practice
in their academic program. Students may obtain blood using
butterflies, needle and needle holder and start cathlon IV’s.
They may also change IV tubing and bags; hang medications
(IVPB); and monitor drip rates as set forth by their school
guidelines.
DO NOT
ATTEMPT
MORE THAN
2 IV STICKS
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Students will work in conjunction with the
CLRMC employee to give patient care. When
reporting on duty, the student will communicate
his/her responsibilities for patient care to the
assigned employee. When reporting off duty,
the student will provide the hospital employee
with completed documentation forms for each
patient, along with a verbal report. The
instructor must be present if the student has not
attained clinical competency in a procedure.
At the department level: Staff will work with the
students on their assigned unit to become
familiar with pertinent unit-specific policies and
procedures.
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When discharging a patient, the student must
have the Primary Nurse co-sign the discharge
summary sheet. (Remember to give the
patient the “patient copy” of the form).
Students may not take discharged patients
to the patient pick up area alone. They
must be accompanied by a CLRMC
Employee.
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VERY IMPORTANT!
Students may NOT hang blood or blood
products.
Students may NOT ‘pick up’ blood or blood
products from the Blood Bank.
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When supplies are issued to a patient, the caregiver is
responsible for ensuring that the supplies given are scanned
and accounted for. Supplies are scanned for two reasons. One
is for inventory control. When an item is scanned out to a
patient, it is deducted from inventory and our central supply
department will know when supplies need to be restocked.
The second reason an item is scanned it to charge the patient.
Some items are “chargeable” to the patient and some are not.
If an item is not patient chargeable, the department will be
charged.
**Please make sure you scan ALL items that are taken out of
the supply or POU room.**
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This is used to transport specimens between the Nursing units and
Laboratory as well as to transport medications from the Pharmacy to
the Nursing units. The CTS bins are kept locked. A key is available on
each nursing unit, AOS, Engineering and Pharmacy.
ITEMS NOT APPROVED FOR TRANSPORT IN CTS
24 hour urines
Empty blood bags
Blood components
Ice
Drinks or food items
Contaminated supplies
Money/checks
Sharps
Patient valuables
Non-leakproof containers
containing liquids
Formalin or other hazardous
chemicals
Chemotherapy drugs
Narcotics
Albumin/immune globulin
Vaccines
Home medications
Colony Stimulating Factors
TPA
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PACKAGING
Potentially infectious items must be
contained and transported in a manner that
prevents breakage, leakage or contamination
of the system. In accordance with Standard
Precautions and OSHA Bloodborne Pathogen
regulations, all blood and body fluids must
be handled as potentially infectious. A
combination of ziplock bag, Zip-N-Fold
pouches, and foam liners will be used to
immobilize and package items.
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The TIGR System is our patient education Video on Demand
system. These videos are stored in a computer database that can
be accessed 24 hours a day to educate patients on various topics
such as cardiovascular, diabetes, mother-baby, and other
pertinent health care topics related to their needs.
The TIGR system can be easily accessed on the bedside phones at
extension 2983. The phone will give you prompts to pick one of
the 60 programs with its 3 digit codes. There are bright orange
flyers on the units with program selection guides.
It is important to know that none of these patient video services
cost the patient any fees. The costs are included in their room
charges.
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Students
may park
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For additional information including updated
approved parking locations, please contact
the Education department.
Education Department
281-338-3340