New Hire Orientation: General Information

 During the time you are completing this module, you may call 802-3382 for any questions.  Questions that you have at night or on the weekends may be directed to the House Supervisor at 3037.

Our Mission StatementAbove all else, we are committed to the care and improvement of human life. In recognition of this commitment, we will provide exceptional healthcare to our expanding communities with compassion and integrity pursuing excellence in all we do.

Helping, Healing, Giving HOPE.

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Vision Statement

As the Nationally recognized tertiary care provider of the largest healthcare system in NW GA, Redmond will support and engage our medical staff, expand and modernize our facilities, grow our Primary Care, Occupational Health, and EMS networks, and enhance our community presence. We will promote staff development and deliver exceptional patient care every time. Our reputation for success will be recognized through service line growth, increased market share, exceptional clinical outcomes, and superior patient, physician and employee satisfaction.

We are Redmond.

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Values With Excellence

Compassion Accountability Respect & Ethics...

We are Redmond!

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Ethics and Compliance Redmond and HCA have a comprehensive, values-based

Ethics and Compliance Program, which is a vital part of the way we conduct ourselves. Because the Program rests on our Mission and Values, it has easily become incorporated into our daily activities and supports our tradition of caring – for our patients, our communities, and our colleagues. We strive to deliver healthcare compassionately and to act with absolute integrity in the way we do our work and the way we live our lives. All work must be done in an ethical and legal manner. It is your responsibility and your obligation to follow the code of conduct and maintain the highest standards of ethics and compliance.

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Ethics and Compliance If you have questions or encounter any situation which you

believe violates the provisions of the code of conduct or the corporate integrity agreement, you should immediately consult your supervisor, another member of the management team, the Human Resources Director (Patsy Adams ext 3023), the Ethics and Compliance Officer (Lori Baker ext 3015), or the HCA Ethics Line (1-800-455-1996).

Each employee and volunteer is required to attend one hour of initial code of conduct training and a one hour annual refresher training session. Leaders and individuals in key jobs have additional annual education requirements.

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Georgia False Claims Laws There is a federal False Claims Act, and there are also Georgia

laws that address fraud and abuse in the Georgia Medicaid program.

Any person or entity that knowingly submits a false or fraudulent claim for payment of funds is liable for significant penalties and fines.

The False Claims Act has a “qui tam” or “whistleblower” provision. This allows a private person with knowledge of a false claim to bring a civil action on behalf of the US Government. If the claim is successful, the whistleblower may be awarded a percentage of the funds recovered.

For additional information, please see the Georgia False Claims Statutes Policy.

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EMTALA The Emergency Medical Treatment and

Active Labor Act is commonly known as the Patient Anti-Dumping Statute.

This statute requires Medicare hospitals to provide emergency services to all patients, whether or not the patient can pay.

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EMTALA When a patient comes to the emergency

department (emergency can be located on any part of the hospital campus), the hospital must screen for a medical emergency.

If an emergency medical condition is found, the hospital must provide stabilizing treatment.

Patients with emergency medical conditions may not be transferred out of the hospital for economic reasons.

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Medical Ethics: End of Life Care Palliative Care

The goal of palliative care is not to cure the patient. The goal is to provide comfort.

Understand the importance of addressing all of the patient’s comfort needs near the end of life. This includes psychosocial, spiritual, and physical needs.

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Medical Ethics: End of Life Care End-of-Life Decisions

Patients have the right to refuse life-sustaining treatment.

Respect this right and this decision. Withdrawing Life-Sustaining Treatment

Withdrawing and withholding life-sustaining treatment are ethically and legally equivalent. Both are ethical and legal when the patient has given informed consent.

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Pet PartnerAnimal Visitation Program

Animal visitation is a short term intervention to help improve the patient’s well being and reduce loneliness. Pets provide opportunities for patients to display affection and emotion, practice social skills, and have positive experiences. The visit is determined by the patient’s needs at a particular time. Pets used for animal assisted activity are not patient’s pets. The adult dogs or cats brought to this facility will be certified through Delta Society (www.deltasociety.org).

Animal must be appropriately restrained with identification. Identification will include a Redmond picture ID Badge attached to the animal’s vest or collar.

Pet Partner Volunteer will contact the charge nurse on the floor of the patient on the day of the visit.

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Pet PartnerAnimal Visitation Program Staff Responsibility

Ensures that patient meets criteria for an animal visit. Animals are restricted from food preparation service

areas, and other high risk areas including: any patient with a decubitus, surgical patients, open wounds or burns, open tracheotomy, immune-suppression, all isolation precautions rooms, critical care area patients, patients with tuberculosis, salmonella, campylobacter, shigella, streptococcus A, MRSA, ringworms, giardia, and amebiasesis are excluded from this program.

In the event that a patient receives a bite or scratch, the patient’s nurse will complete an occurrence form about the incident. The nurse will notify the patient’s physician and the Infection Prevention Director.

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Teamwork: A cooperative effort by members of a group trying to achieve a common goal.

To make teamwork happen…Communication is a necessity.Must have interaction with others even when things are not going as planned.Get Feedback from other staff members and managers.Share the responsibility.

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Skills for Teamwork: Listening Questioning Respecting and supporting ideas Helping Sharing Participation

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Teamwork People who work in a hospital situation know how to manage

high-stress situations, but frustrations can build. Working as a team will reduce situations where a staff member feels overwhelmed by his/her workload or the temperament of an unpleasant staff member.

Compassion and common courtesy are appropriate not only when communicating with patients; they are also vital in how you treat your coworkers.

If everyone does his/her job in an efficient manner and is aware of the needs of other staff members, he/she can contribute to the overall morale.

Remember Teamwork is used everyday in healthcare: Rapid Response Code Team Response STEMI or Stroke Alert Patient Hand-Off – SBAR Process

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Ergonomic Safety Ergonomic Safety is adapting the equipment, procedures

and work areas to fit the person in order to help prevent injuries and improve efficiency. Musculoskeletal disorders (MSDs) affect muscles, nerves, tendons, ligaments, joints ,or spinal discs. Injuries can include strains, sprains, and repetitive motion injuries.

Signs and symptoms: pain, tingling, numbness, swelling, stiffness, burning sensation, etc. May experience decreased gripping strength, range of motion, muscle function, or inability to do everyday tasks. Risk factors: repetition, forceful exertions, awkward postures, contact stress, and vibration. Common MSDs: Carpal tunnel syndrome, rotator cuff syndrome, trigger finger, tendonitis, herniated spinal disc, and back pain.

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Ergonomic Safety Apply these tips to your job: Adjust chair height and

backrest (feet should be flat on the floor, knees level with hips, and lower back supported). Sit an arm's length away from the computer screen. Keep wrists straight and elbows at right angles. Alternate tasks. Use proper body mechanics when lifting, transferring, etc. Avoid reaching and stretching overhead.

 You may recommend ways to reduce the chance of developing musculoskeletal disorders to your supervisor. Your work space may be evaluated for ergonomic safety by notifying Employee Health at ext. 4968. Your departmental safety representative may assist with body mechanic in-services. Report signs, symptoms, illnesses ,and injuries to your supervisor, complete an occurrence report, and obtain medical treatment in Employee Health Services.

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Ergonomic Tips The best way to avoid the discomfort of MSDs

is: Change body positions frequently/Set up work stations

to fit your body/Stretch every 45 minutes to an hour/Perform stretches that are designed to decrease discomfort for job specific tasks

Decrease FatigueWarm-up exercisesInterrupt sustained posturesProper ergonomicsAppropriate work methodsLimited overtime

Increase RecoveryPhysical fitnessProper nutritionGood sleeping posturesIce after activitiesAvoid smokingAlternative job placement

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Performance Improvement(PI) Performance Improvement means simply doing

things a little bit better tomorrow than we did them today. Redmond is accredited by The Joint Commission which requires that we have an improvement plan in place. To make our improvement efforts as visible as possible, Redmond uses a tool called FAST-PDCA to document our improvement projects.

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Performance Improvement High quality organizations make continuous efforts to improve

their services and products. Opportunities to “do things better” exist in all departments of our hospital.

Performance improvement occurs the fastest when every employee asks themselves, "Is there a better way to do this?" or "Why are we doing this at all?” You know when a process is broken because you have to work with it every day. FAST-PDCA allows us to test a new or better idea, fine tune it if needed, then implement it.

Another way for patient care departments to improve their care delivered is to implement evidence-based medicine that has already been determined to be the best way, or best practice, to deliver medical care. Healthcare delivery changes constantly due to new innovation and continuing research. We have the responsibility to know what constitutes best practice and to see that it is implemented at Redmond. Please contact your manager or quality department when you hear, see, or read of best practices implemented at other facilities.

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Performance Improvement Core Measures, which are a series of evidence-based best

practices, are an integral part of how we deliver patient care at Redmond.

They are not optional for a couple of reasons: They represent best care. How well we adhere to Core Measures is compared to every other

hospital in our region and state, as well as across the United States, as an objective way for consumers to compare how well we deliver care.

Medical charts are audited continuously to determine our adherence to the Core Measures.

When we fail to adhere to them, an opportunity exists to improve our processes. If you were involved in a missed opportunity, the Quality Department will reach out to you to help determine how to improve our care delivery.

Nurses should commit to memory the next 8 slides on Core Measures, it’s that important!

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CORE MEASURES: Myocardial Infarction

• Beta blocker at discharge or document a reason if with-held

• Document LVSD or Ejection Fraction (EF)• ACEI or ARB for EF<40% or document a reason if

with-held• ASA for chest pain/or MI on arrival and discharge or

document reason if with-held• PCI within 90minutes for STEMI or LBBB• LDL within 24hrs of admit• LDL >100 discharged on statin or document a reason if

with-held

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CORE MEASURES:Congestive Heart Failure Document LVSD or EF ACEI or ARB for EF<40% or document a

reason if with-held Discharge instructions must include:

Activity & Diet & Follow-up visit Worsening symptoms Weight monitoring List medications as found on Med Reconciliation

Form

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CORE MEASURES:Pneumonia Blood cultures before antibiotics

1st antibiotic in ED within 6 hrs of arrival

Flu vaccine given – October–March (Must be current season – Remember to document)

Appropriate antibiotic selection

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CORE MEASURES:Surgical Care (SCIP) Prophylactic antibiotic 1 hour prior to incision (2 hours for

vancomycin)

Appropriate antibiotic

D/C antibiotic within 24hr (48 for CABG) after surgery end time or document reason for continuing antibiotic

Clip hair only/never shave

(continued)

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CORE MEASURESSurgical Care (SCIP) (continued)

Continue beta blockers (never stop abruptly and document received the day before surgery and/or the day of surgery as well as POD 1 or POD2!)

VTE (clot) prevention within 24 hours before surgery to 24 hours after surgery

Cardiac surgery (CABG, Valve, most CT pts) patients with controlled postoperative blood glucose (less than or equal to 180 mg/dl) in the timeframe of 18 – 24 hours after Anesthesia End Time.

D/C foley by POD#2 or document reason

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CORE MEASURESVenous Thromboembolism (VTE) NEW CORE MEASURE FOR 2013! Documentation required for:

VTE prophylaxis for ALL inpatients OR “Patient at low risk for VTE, no prophylaxis

needed” If VTE prophylaxis is not built in to an order

set, there is a new universal order set for VTE prophylaxis

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CORE MEASURESImmunization Measure

UNIVERSAL MEASURE for all patients Pneumonia vaccine status:

vaccines must be given, refused, or medically contraindicated due to allergy or current active chemotherapy

Influenza vaccine status: Oct 1-March 31 – If received prior to admission, it

must have been for the current flu season

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CORE MEASUREStroke Core Measure Venous Thromboembolism Prophylaxis

by the end of hospital Day 2 Antithrombotic Therapy:

for ischemic stroke patients by end of hospital Day 2

Discharged on statin medication Assessment for Rehabilitation Stroke Education

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Opportunities for Improvement

If you want to learn more about Performance Improvement or feel you have a better way of doing things at Redmond, please see your manager or Stephanie Jones, Nursing Administrator for Outcomes and Metrics (located in the Lower Level near Human Resources at extension 3155).

Thank you for all you do!

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2014 HospitalNational Patient Safety Goals

The purpose of the National Patient Safety Goals is to improve patient safety. The Goals focus on problems in health care safety and how to solve them.

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Identify Patients Correctly Use at least two ways to identify patients. We

use the patient’s name and date of birth. This is done to make sure that each patient gets the medicine and treatment meant for them. Ask the patient who they are and their date of

birth. Verify with the arm band. Make sure that the correct patient gets the

correct blood type when they get a blood transfusion. Follow BCTA process exactly. Match the identifiers on the armband to the order.

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Labeling Specimens

Label containers and specimens in the presence of the patient

Perform the Final Check by saying out loud the last 3 digits from the specimen label account number and the last three digits of the patient’s account number on the patient’s arm band

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Improve Staff Communication Get important test results to the right staff

person on time. Critical results from lab, radiology, or

cardiology must be reported quickly, a maximum of 30 – 45 minutes to physicians. Time can be a factor when addressing these issues for patient health.

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Use Medicines Safely Label medicines in syringes, cups and basins. Take extra care with patients who take medicines to

thin their blood. Educate the family and the patient. Record and pass along correct information about a

patient’s medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Make sure the patient knows which medicines to take when they are at home. Tell the patient it is important to bring their up-to-date list of medicines every time they visit a doctor.

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Prevent Infection Use the hand cleaning guidelines from the Centers

for Disease Control and Prevention or the World Health Organization.

Use proven guidelines to prevent infections that are difficult to treat.

Use proven guidelines to prevent infection of the blood from central lines.

Use proven guidelines to prevent infection after surgery.

Use proven guidelines to prevent infections of the urinary tract that are caused by catheters.

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Prevent Mistakes in Surgery Make sure that the correct surgery is done on the

correct patient and at the correct place on the patient’s body.

The physician mark’s the correct place on the patient’s body where the surgery is to be done.

Time out performed with the team before the surgery to make sure that a mistake is not being made.

Nurses complete the pre-surgery checklist prior to surgery to make sure the patient is ready to go.

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New Goal for 2014 Use clinical alarms safely. This has been established as a priority.

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Identify Patient Safety Risks Find out which patients are at risk for

committing suicide, or are abused or neglected.

Keep the patient safe and notify the physician.

Make sure these patients are referred for appropriate care and are kept safe in our hospital.

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I-Privilege If you are un-sure if a physician is

credentialed to perform a service here at RRMC you can use I-Privilege to look up his/her credentials.

From our home page click on the I-Privilege link in the right hand column

Then on the left of the screen that is pulled up click on I-Privilege again

Then use our COID -31052 for your User ID and Password

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Guidance Document: Tubing and Line Safety using I-TRACE

Behavioral expectations

I: Illuminate the patient care area whenever invasive medical lines and tubes are manipulated (initiated, accessed, maintained, or discontinued).

T: Perform hand hygiene. Touch the line or tube and trace it from the insertion point on the patient back to the point of origin.

R: Perform a cognitive review. What is the purpose/expected outcome of the line/tube intervention about to

occur? Visualize the actions planned; take time to ensure the planned actions will deliver the expected outcome.

Has a 2 point patient identification been carried out? Has BCMA been utilized to the fullest extent possible for the intervention about to

occur (e.g. medications; TPN)?

A: Act if any mismatch between the planned activity and desired outcome is discovered, either through BCMA alerts, independent double checks, or a cognitive review.

C: Clarify and correct. Concerns expressed by primary caregivers, colleagues, patients, or family member are valid and sufficient reasons to seek clarification before proceeding with a task involving lines and tubes. Correct any discrepancies before proceeding with the intervention.

E: Expect to use the ITRACE process: each time a line or tube is accessed, manipulated, or discontinued and when care is handed-off to another clinician or care team. 41

Do Not UseAbbreviations, Acronyms, and Symbols

Abbreviation Preferred Term

U Unit

IU International Unit

Q.D. & Q.O.D. daily & every other day

Trailing zero (X.0 mg)

Lack of leading zero (.X mg)

X mg

0.X mg

MS, MS04, & MgSO4 morphine sulfate or

magnesium sulfate

µg Mcg

T.I.W. 3 times weekly

c.c. Ml

ii, etc. (apothecary symbols) 2 or two42

Rapid Response Team The purpose of the Rapid Response Team is to provide

critical decision making and intervention at the first sign of patient decline; to prevent arrest situations, and save patient lives. The utilization of a Rapid Response Team will bring critical care expertise to the patient bedside before a crisis situation results in a cardiac/pulmonary arrest. The call is initiated by dialing (706) 233-5625 and

entering the patient’s three digit room number. Hospital staff or patient's family/visitors may initiate.

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Rapid Response Team The role of the Rapid Response Team (RRT)

will be to: Assess the patient and the situation. Assist with stabilizing and transporting, if needed, to a

higher level of care. Assist with organizing information to be communicated to

the patient’s physician using the SBAR tool. Educate and support the nursing staff. The RRT does not “replace” calling the primary physician –

but supplements, organizes, and expedites information to the physician.

Family members and visitors may also call the RRT.

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FALL RISK Nursing staff will assess the patient for safety/fall risk at the

time of admission, and as indicated by the unit assessment/ reassessment policy and with each change in condition: Identify problem as potential for injury related to fall risk on the care plan/problem list.

Safety rounds (with a purpose) are completed and documented Q 1 hour until 10pm, then Q 2 hours through 7am and also PRN.

PLEASE EXPLAIN that you are there to assist the patient to the bathroom, not

just ask if they have to use the bathroom.

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FALL RISKFall Reduction Activities

Place a yellow sign at the head of the bed. Place a yellow bracelet on the patient. Place yellow socks on the patient. Place fall risk magnetic stickers on the patient’s doorframe. Educate the patient and family about the risk of falling and to

call for help. Show them where the call light is located. See if family members can stay when patients do not follow

instructions. If they are not able, outside resources may be hired by the family.

Frequently round for pain, potty, proximity of patient needs, and position.

Use a low bed if you feel it would be a good tool to avoid a fall.

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Hand-off Communication Process The hand-off communication process for

Redmond is based on the SBAR communication format.

SBAR stands for S – Situation B – Background A – Assessment R – Recommendation

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Hand-off Communication Process The tools used in the hand-off process

include: Direct face-to-face communication. Phone report. Reports printed from Meditech - SBARD. Communication is a factor in more than 90%

of Sentinel Events reported to the Joint Commission.

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Patient rights Patients and healthcare workers need to understand patient rights and responsibilities

to ensure that quality care is provided and that the patient can participate fully in their treatment and care.

How are patients informed of their rights? Patient Hand Book Patient Bill of Rights Signage in all areas of the hospital.

Patients have a right to an advocate to stay with them during their hospitalization as long as it does not infringe upon other patient’s rights or interfere with clinical care or pose risk.

Patients must be asked about what language they prefer to receive their healthcare information. The hospital is responsible to provide information in the requested language.

A patient or an advocate who is participating in their care must have the opportunity to use a competent translator in the preferred language. If a patient or family member refuses to utilize the provided interpreter, a waiver must be signed.

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Patient rights What is your role in patient rights?

Every patient who does not speak English as their primary language, is deaf, hard of hearing, and/or blind, is entitled to an interpreter free of charge.

There are forms in “Forms on Line” that are REQUIRED to be completed for each patient whether or not they chose to use the interpreter. Please see policies RI-05, RI-06 and RI-07.

This form should be placed on the patient chart after it has been signed and has a date and time.

Our patients will be thankful that they are are able to understand what is happening to them while they are in our care.

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Patient rightsPlease also remember -

All patients also have the right to:

Refuse or accept treatment

Formulate Advance Directives

Informed participation in deipcisions involving their health care

The right to know who is resonsible for authorizing and performing procedures or treatment

The right to have his/her own physician notified

promptly of his/her admission to the hospital

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Patient rights Everyone is involved in protecting the rights of patients.

For example, the right to confidentiality means not telling your friends or relatives when someone you know has been a patient.

We provide privacy for patients by always knocking before entering a patient or procedure room.

Patients have a right to a secure environment. Know how to respond during a disaster or fire.

Patients are informed of their right to establish advance directives or to change their current advance directive status.

Patients also have a right to file a grievance. You can assist with the investigation and response by contacting Risk Management at ext. 3950 or Administration at ext. 4100 should you have a question.

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Patient rights Where can you find a list of

patient rights? In facility Policy RI-04 Rights and

Responsibilities of Patients, the Patient Handbook, posted beside the elevator in the front lobby and at outpatient services, and on Redmond’s Intranet site.

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Patient rights Access the Ethics Committee and the Ethic Resolution Process.

Phone: 706-802-3037. Any concerns over patient safety may be reported to the Joint

Commission. Phone: 800-994-6610. Access the grievance process. Express complaints or concerns

regarding care or services, including discharge.   Facility contact: 706-802-3950

Independent Agency:

Office of Regulatory Health

2 Peachtree Street N.W., Suite 200

Atlanta, Georgia 30329

Telephone: 1-404- 657-5726

 Peer Review Organizations:

Georgia Medical Foundation [Medicare]

57 Executive Park South, Suite 200

Atlanta, Georgia 30329

Telephones: 1-800-282-2614

1-404-982-0411

 

Humana Military Healthcare

Services, Inc [Champus]

931 South Semoran Blvd., Suite 218

Winter Park, Florida 32702

Telephone: 1-800-658-1405

 

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When information involving healthcare is discussed with a patient, the patient is entitled to be able to speak and hear in a language they consider their primary language.

Language Services Associates will provide interpretation services for all patients or their family members or those assisting with making medical decisions with or for the patient in most any language.

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Translation Services

The process is simple – no matter what language is required. Just contact:

LANGUAGE SERVICES ASSOCIATES

Dial: 1.877.274.9745

Access Code 1808319#

(have the special telephones available when you call)

Please explain to the patient and family that this service is FREE of charge!

Document the use of service or the denial of service.

If you are in an area where you are not able to use the telephone or the laptop, we do have Interpreters available.

Please check with your Director for additional information. (This information should also be available on a pink sign located in your area).

We also have Hearing Impaired translation available from the Georgia Relay Center for Speech and Hearing Impaired.

This agency provides a conference-type telephone call for interpretation. It requires a special telephone located at the Switchboard.

There are forms that should be signed and placed in the chart if the patient refuses our interpreting services and/or if they want to use a family member instead of an interpreter.

These are located in the Accommodation policies under RI-05 (Limited English), RI-06 (Deaf) and RI-07 (Blind).

If you are unable to locate these, check with your Director of call EXT. 3950.

ADVANCED DIRECTIVES

Advance Directives include Living Will and Durable Power of Attorney (DPOA) for Health Care.

Living Will only applies to terminal conditions. DPOA for Health Care allows a person to name an agent to speak

on the person’s behalf, when the person cannot speak for their self.

Inside the hospital, the attending physician must be present when the patient names an agent. An agent can speak for the patient concerning any condition.

Patients should be asked at the time of admission if they have an advance directive. If the patient has a copy, obtain a copy for the chart BY CONTACTING HIM.

Patients should initial and date a copy of the directive(s) and the hospital staff should place it inside the current medical record.

Social Services can assist by answering general questions and providing blank forms.

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Pain Management Four major goals of pain management

Reduce the incidence and severity of patients' acute postoperative or posttraumatic pain.

Educate patients about the need to communicate unrelieved pain, so they can receive prompt evaluation and effective treatment.

Enhance patient comfort and satisfaction. Contribute to fewer postoperative complications and in

some cases, shorter stays after surgical procedures.

Effective pain management has additional benefits for the patient ,e.g., earlier mobilization, shortened hospital stay, and reduced costs.

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Unanticipated Adverse Events and How to Report

Occurrence Reporting An occurrence is an event that is unusual, significant or

notable. Categories include: Patient, Non-Patient (visitor, MD,

volunteer, student, facility, equipment) or Employee Examples include: Near Miss, Fall, Medication, Treatment and/or Testing, Adverse Effect, Equipment, Property, Assault (abuse or harassment), Error, Failure to follow policies & procedures, Failure to follow MD’s orders, User/Operator error, Defective or malfunctioning products, Incorrect action/activity, Inappropriate action/activity, Omission, Delay, Complications, Loss or theft of personal belongings, or Auto events with facility vehicles.

Occurrences should be documented in Meditech during the working shift or definitely within 24 hours. The department manager or house supervisor should be notified at the time of the event. Please notify the Risk Manager of all serious and potentially legal situations.

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Occurrence Reporting Meditech Reporting

Log onto Meditech - Select 500 Occurrence Reporting - Select Facility - Select Category - (If patient) At prompt type A# then the account number - (If Non-Patient or Employee) Type N into the first field to create a new report (For employee type in last name and press the look-up key) - If no previous Occurrence report exists for this patient , you will receive a message “No available notifications for this patient. Create a new one? “ Answer Y (Yes) - Answer all questions in field - Input will be by free text or pull down menu selection - Enter all the information you know or can obtain.

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Occurrence Reporting Look-up key (F9 ) displays a pull down menu. Previous field key (F6) allows you to backup. The enter key allows you to move forward one field. Magic or file key (F12):

This key will provide the menu for selection. You MUST FILE to save your work.

Exit key (F11): Caution exit does not save your work.

Text fields require typing from keyboard. An occurrence report is a confidential facility report that

should not be referenced in documentation on the patient’s record. If you have any difficulties, please don’t hesitate to contact

RISK MANAGEMENT at 3950.

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Sentinel events A sentinel event is an event which results in

unanticipated death or major permanent loss of function, not related to the natural course of the patient’s illness or underlying condition. Also, suicide; infant abduction or discharge to the wrong family; rape; hemolytic transfusion reaction involving administration of blood or blood products having a major blood group incompatibility; a health-care associated infection; and surgery on the wrong patient or wrong body part are all sentinel events. Please secure all information and items related to the event. If you have any questions, contact Risk Management at ext. 3950.

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Reportable Events State (Georgia) Reportable Events:

The following type events should be reported to the State of Georgia Office of Regulatory Services: 1. Any unanticipated patient death not related to the

natural course of the patient’s illness or underlying condition;

2. Any surgery on the wrong patient or the wrong body part of the patient;

3. Any rape of a patient which occurs in the hospital. We report all deaths where the patient has been in

restraints within the previous 24 hours to CMS or if a restraint was implicated in the cause of death

Report to the appropriate department leader and Risk Management at 3950 or Regulatory Compliance at 3038 in the event that any of the above situations occur . The situation is reviewed and reported to the Office of Regulatory Services within 24 hours of knowledge that the event meets one of the State definitions.

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Suspected Impairment of Licensed Independent Practitioner All healthcare workers including physicians and

nurses should be competent and able to carry out their patient care responsibilities free of any impairment(s) that adversely affect their judgment or clinical performance.

A licensed independent practitioner (LIP) is defined as any individual permitted by law and the hospital to provide care, treatment, and services without direction or supervision (e.g., doctor).

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Identification of an Impaired LIP An impaired LIP is defined as one who is

unable to provide care, treatment, or services with reasonable skill and safety to patients because of a physical or mental illness, including deterioration through the aging process, loss of motor skill, excessive use or abuse of drugs including alcohol.

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Signs and Symptoms of Impairment Signs and symptoms of potential impairment include, but

are not limited to: Personality changes/mood swings Loss of efficiency and reliability Increasing personal and professional isolation Inappropriate anger, resentments Abusive language, demeaning others Physical deterioration Memory loss Increase in tardiness, absenteeism, illness Lack of empathy towards others

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Reporting a LIP Suspected of Impairment If any individual in the hospital has a

reasonable suspicion that a LIP (or any other healthcare workers) may be impaired and this impairment may adversely affect patient care and safety, take immediate action by notifying your supervisor, and following the appropriate Chain of Command listed in policy LD 05.

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Environment of Care Defective Equipment

 Defective equipment should be reported to BIOMEDICAL Services via Meditech or at Ext. 4962 if equipment removal constitutes an emergency. Equipment will be tagged. Tag will say “danger defective equipment”.

Security Related Incidents Any incident requiring Security assistance (i.e. theft

or suspicious activity), contact security by dialing 0 and asking PBX to page a member of Security.

Please refer to the Environment of Care section of the policy manual for in-depth information on these topics.

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Eye Wash Stations Know where they are located Do not block access to the station Flush eyes for 15 minutes unless MSDS indicates

different flush time for the substance involved in the exposure

Water should be temperate (not too hot or cold) Weekly checks and flushes must be performed for each

eye wash station Eye wash stations must be available everywhere

corrosive materials are used or stored

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Eye Wash Station Locations Employee Heath Outpatient Emergency Department Outpatient Oncology Lab Pharmacy Radiology Cardiology BioMed Maintenance – Boiler Room Environmental Services –

Equipment Room

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O2 Tank Storage Cylinders are designated as full or empty by the description

below: Unopened or Unused Cylinders = Full Used Cylinders = Empty

Cylinders that are unopened/Unused or Full should be properly secured in the green racks/Full

Cylinders that have been used or have been opened should be properly secured in the red racks/Empty. Even if gas remains in the cylinder. Cylinders of compressed gas should be stored in designated areas. All freestanding cylinders, whether empty or full should be

properly secured. Freestanding cylinders should never be secured to portable or

moveable equipment that is not designed for their use. Cylinders should never be placed on a stretcher. A patient should never be asked to hold an e-cylinder for

transport.

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Hazardous Material and WasteRead Container Labels—Before handling any chemical container, always read the label.

Warnings may be in words, pictures, or symbols.

Consult the Material Safety Data Sheet (MSDS)– A MSDS gives more detailed information on a chemical and its hazards. It also gives you specific precautions for protecting yourself from dangerous exposure. Your department should have a notebook with a list of the chemicals used in your area.

Use Proper Handling Techniques– Always wear proper personal protective equipment.

Dispose of Chemicals Properly– Carry and store chemicals only in approved, properly labeled, safety containers. Never dispose of chemicals in containers used for ordinary waste. Never pour them down sewers or drains. Always consult the MSDS sheet for approved method of disposal.

Contact Mike Stewart in the Lab at ext. 3117 or 4050

if you have questions.

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FIRE SAFETY Make good housekeeping part of your work

routine. Keep passageways and exits clear.

Don’t let furniture or equipment block stairways, halls, or exits.

Keep floors clear of waste and spills. Make sure exit paths and doors are well-lit and clearly

marked. Know your area.

Where are the fire pull stations and extinguishers Know how to extinguish

Cover and smother Be careful to not fan the flames

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FIRE SAFETY

Check fire doors.  Make sure nothing is blocking them. Never wedge or prop them open.

Dispose of trash safely. Put waste in approved containers.

Keep these away from heat sources. Put flammable substances in

approved metal cans or containers.

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FIRE SAFETY Prevention is the best defense

against fires. To prevent fires related to

electrical malfunction remove damaged or faulty equipment from service and submit malfunctioning equipment for repair.

To prevent fires related to equipment misuse do not use any piece of equipment you have not been trained to use. 79

FIRE SAFETYIt's easy to use a fire extinguisher if you can remember the acronym PASS, which stands for Pull, Aim, Squeeze, and Sweep.

Pull the pin. This will allow you to discharge the extinguisher.

Aim at the base of the fire. If you aim at the flames (which is frequently the temptation), the extinguishing agent will fly right through and do no good. You want to hit the fuel.

Squeeze the top handle or lever. This depresses a button that releases the pressurized extinguishing agent in the extinguisher.

Sweep from side to side until the fire is completely out. Start using the extinguisher from a safe distance away, then move forward. Once the fire is out, keep an eye on the area in case it re-ignites.

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IF YOU DISCOVER A FIRE – REMEMBER:

RACE R - RESCUE anyone

in immediate danger A - Activate the

ALARM C – CONFINE or

CONTAIN the fire (close the door)

E - EXTINGUISH small controllable fires/or EVACUATE

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All Foam and Gel Hand Cleaners Foam and gel hand cleaners are becoming very popular for hand

cleaning in the healthcare environment. For them to be effective, they must contain more than 60% alcohol. That makes the hand cleaners FLAMMABLE. It is not unsafe to use the hand cleaners, but you should be aware of the following information each time the hand cleaner is being used: After applying the gel or foam, the alcohol on the hands should be

allowed to evaporate for 30 seconds. The solution on your hands is flammable until the alcohol evaporates. If a flame or spark is near your hands before the alcohol evaporates, a

fire could occur. There have been reports of healthcare workers whose hands caught on fire from a spark or from static electricity after using an alcohol based hand cleaner.

Alcohol burns very clean and the flame is almost clear.

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Prepare Your Family

Visit www.ready.gov to find resources to prepare your family:

Prepare yourself by building an emergency preparedness kit Made sure your family is educated on where to find information regarding the kit and what to do Make sure your preparations and supplies will cover your family for 72-96 hours

Make sure you think about the following when preparing your kit Pets Special needs children or adults Seniors Infants & young children

Teach your family you may be required to work Have a safe place for them to stay If you have needs for child care in order to work, let us know

If you have other obligations which may prevent you from reporting to work, make sure you manage is aware ahead of time so they won’t surprised. These include:

Military obligations DMAT, other volunteer organizations

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How would Redmond handle an emergency event? Redmond utilizes the Hospital Emergency Incident Command System (HEICS)which

provides us with proven and predictable command structure designed to handle any event.

HEICS provides us with: Proven Incident Command System structure (ICS) for healthcare use Predictable chain of management Flexible organizational chart which allows for scalable responses Prioritized response checklists Defines position responsibilities Improves documentation for improved accountability and cost recovery

This Incident Command structure can be utilized for any event allowing Redmond to be prepared to manage “all hazards”.

Redmond has policies in place and uses drills to help improve our response.

When you hear a code announced do not call PBX to get details or find out what you should do (they are only responsible for knowing their role).

Don’t wait for an event to learn your role! Speak with your manager during orientation to find out what the response is specific to your department.

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Emergency, someone call FOR HELP!!! Question: What do you do in the hospital when you need

help in a hurry?

Answer: Call extension 4000. The switchboard will answer your call immediately.

This extension should be used the same as if you needed “911”. It is designed for emergency situations, not just to get through to the switchboard in a hurry. For example, this line could be used for a Code Blue or if a visitor was seriously hurt.

NEVER use this phone line for anything other than emergencies!

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EMERGENCY PREPAREDNESS CODES

Code Triage - Provides guidelines for operations in the event of an emergency - this is a multi-step code which will be shown on separate slide

Code 900 - Show of force Code 1000 - Visitor, associate, family member

needs assistance Code Manpower – Lifting assistance Tornado Watch or Warning – has been issued

for Floyd County

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EMERGENCY PREPAREDNESS CODES (cont’d)

Code Red—Fire Code Gray—Bomb Threat Code Blue—Adult Cardiopulmonary Arrest Code Blue PEDS — Pediatric

Cardiopulmonary Arrest Code Pink – Pediatric Abduction Code White – Adult Patient Elopement Code Green— Hostage Situation Code Orange—Hazardous Material Event Code Silver —Active Shooter Code Black - Structural damage to facility

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Code Triage Code Triage is announced when an event occurs which may exceed our resources. The different stages (standby, activate, and stand-down) allow the facility to determine our response based on the event.

Code Triage Standby: An event has occurred – HEICS structure in implemented.

Based on the information provided from the field, the Incident Commander and other leaders determine if we can meet the demands of the event or go into our disaster plan implementation. For staff during this phase: Develop a plan within the department – your manager can assist Call your immediate family to assure they are okay

Activate: Initiate the disaster plan – activate your department response Stand-down: Begin recovery and return to normal operations

Routine updates regarding the event and response will be disseminated from the Command Center.

Know your role!

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Code Manpower Associate should call for assistance when lifting the patient places either the

associate or the patients at risk of injury.

When lifting for a routine procedure, call the House Supervisor and allow her to arrange for staff to come and assist if at all possible to have an organized response.

If the need for assistance is due to a fall, try to get the attention of someone at the nurse’s station to call the PBX operation and announce Code Manpower and the location.

All available associates should respond immediately to assist. After assessing the patient, the nurse caring for the patient, the Charge Nurse and a Physical Therapist will determine the best plan for lifting patient to prevent injury to the patient or themselves.

Any patient requiring placement on a backboard for safety or treatment, staff should call EMS at 4911 and request a unit to respond to assist.

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Code Gray If a bomb threat is called in:

If you get the call, notify the switchboard at ext. 4000 Try to get as much information from the caller as

possible and try to keep them on the line while 911 is notified by PBX. Be prepared to give detailed information regarding the call to Law Enforcement officials.

If you hear Code Gray announced: Look for packages or people that should not be in your area

– if someone or something looks suspicious – be sure to get as much detail as possible to share with law enforcement.

Stay in your area and try to keep others from leaving the area

Take direction from Incident Command or law enforcement Only if there is a legitimate reason would we evacuate

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Code Blue & Code Blue PALS Code Blue

Adult cardiac or respiratory event. Don’t forget the Rapid Response Team (Call for the

Rapid Response Team when you feel a patient’s clinical status is in decline and you may prevent a Code Blue).

Know how to call a code and where your supplies are located.

Code Blue PALS Pediatric cardiac or respiratory event. ED Nurse will respond to assist with running the code.

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Code PinkRepresents a Pediatric Abduction

Can be a patient or visitorPatient Care Coordinator for the area in which the event occurred:

Call ext. 4000 Give gender and age Building must be locked down Each department has a response

PBX will announce: Code Pink b or g and age

Try to detain, but do not put yourself in harm’s way Get a good description of person, vehicle, tag, etc.

Make sure unoccupied rooms and areas are checked

No one with bags should be allowed to leave the building without the bag being checked.

If someone has an infant or child with them, do not allow them to leave the building without checking the identify of the infant or child in comparison to the missing child.

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Code White Patient Elopement/patient can’t be located: Patient Care Coordinator

Call ext. 4000 Give gender and age and clothing description Building must be locked down Each department has a response

PBX will announce: Code White m or f and age Make sure unoccupied rooms and areas are checked Plant Operations should check outside the building. Contact EMS at 4911 to assist with searching the

public area around the hospital

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Code Green Hostage situation is occurring

Lock down your area Do not try to negotiate Police should be alerted to enter in an area

distant from the hostage situation

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Code Silver “Active Shooter”WHEN AN ACTIVE SHOOTER IS IN YOUR VICINITYQUICKLY DETERMINE THE MOST REASONABLE WAY TO PROTECT YOUR OWN LIFE. VISITORS AND PATIENTS ARE LIKELY TO FOLLOW THE LEAD OF EMPLOYEES AND MANAGERS DURING AN ACTIVE SHOOTER SITUATION.

EVACUATE Have an escape route and plan in mind Leave your belongings behind Keep your hands visible Your goal is to keep yourself safe so that you can care for others

HIDE OUT Hide in an area out of the active shooter’s view Block entry to your hiding place and lock the doors Turn off all lights, computers and put phones on silent to prevent drawing attention to where

you are

TAKE ACTION As a last resort and only when your life is in imminent danger Attempt to incapacitate the active shooter Act with physical aggression and throw items at the active shooter

CALL 911 WHEN IT IS SAFE TO DO SO95

Code Silver “Active Shooter” (con’t) HOW TO RESPOND WHEN LAW ENFORCEMENT ARRIVES ON THE SCENE

HOW YOU SHOULD REACT WHEN LAW ENFORCEMENT

ARRIVES: Remain calm, and follow officers’ instructions

Avoid pointing, screaming and/or yelling

Immediately raise hands and spread fingers

Keep hands visible at all times

Do not stop to ask officers for help or direction when evacuating, just proceed in the direction from which officers are entering the premises

Avoid making quick movements toward officers such as attempting to hold on to them for safety

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Code Silver “Active Shooter” (con’t) RECOGNIZING SIGNS OF POTENTIAL WORKPLACE VIOLENCE

AN ACTIVE SHOOTER MAY BE A CURRENT OR FORMER EMPLOYEE. ALERT YOUR HUMAN RESOURCES DEPARTMENT IF YOU BELIEVE AN EMPLOYEE EXHIBITS POTENTIALLY VIOLENT BEHAVIOR.

INDICATORS OF POTENTIALLY VIOLENT BEHAVIOR MAY INCLUDE ONE OR MORE OF THE FOLLOWING:

Increased use of alcohol and/or illegal drugs Unexplained increase in absenteeism, and/or vague physical complaints Depression/Withdrawal Increased severe mood swings, and noticeably unstable or emotional

responses Increasingly talks of problems at home Increase in unsolicited comments about violence, firearms, and other

dangerous weapons and violent crimes

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Code Orange

Represents a Hazardous Material EventHaz Mat Team will respond. Decon is in ED or outside and only associates trained in handling hazardous material should be in the area

Don’t forget your PPE’s as you are receiving patients

If someone who has been contaminated walks in – don’t touch them – take them back out the way they came to prevent further contamination. The area in which they entered is now considered unsafe and foot traffic will be limited and rerouted.

Stay uphill and upwind if the event is outside.

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Code BlackThere is a structural damage to the building as a result from either a natural or man-made event.

Associates will call operator at extension 4000 to report the damage give as much information as possible.

PBX will notify the Administrator on Call and a Code Triage will be announced to implement the Incident Command structure.

Admin rep, Security, Maintenance, Plant Engineer, and EMS will respond to area if safe.

No associate should attempt to enter unstable area for rescue unless trained to respond, wearing appropriate PPE, and has recovery assistance.

Further response will determined based on information given to the Incident Commander regarding the severity of damage. If required, a Code Triage Activate will be announced and the facility will implement the disaster plan to manage the incident.

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Code 900

If you or someone else is in a situation in which you are threatened verbally or physically

Try to get someone’s attention and have them call PBX at ext. 4000. Code 900 will then be announced overhead

All males respond – this represents a show of force and may help deescalate the event

Avoid making physical contact with the agitated person

There are staff who have been trained in managing this type of incident and will direct others how to respond once they arrive

If needed, the Law Enforcement Officer in the ED will respond.

DO NOT USE THIS CODE FOR LIFTING HELP!!

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Code 1000 A visitor, family member, or staff member becomes

acutely ill or is injured Stay with person and have someone call ext. 4000 to

report the incident Make sure to give PBX Operator what happened and

where the person requiring help is located. A staff member should try to stay with them at all

times ED Nurse, House Supervisor will respond as will EMS if

they are in the building Call EMS if they aren’t in the building at ext 4911 if

“packaging” is required to safely transport to the ED ALWAYS offer the individual the opportunity to be taken

to the ED for treatment

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Tornado WarningTornado warnings are announced by PBX when the National Weather Services issues to warning for Floyd County. This way both staff and visitors will be aware of the severe weather potential.

The announcement will be, “Attention, Attention, Attention. Floyd County is currently under a tornado warning”.

If a Tornado Warning has been reported in our area Close patient doors and drapes Get everyone out of halls and away from glass Discourage visitors from leaving

Turn beds to inside walls Clear area of anything that can become a projectile Instruct family members & ambulatory patients to go into the

bathrooms and cover themselves Assure that ambulatory patients can access their shoes in the event

they need to leave the building.

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Inclement WeatherWhen the facility is made aware of a potential for weather that makes travel difficult or unsafe, plans will be made to have appropriate coverage to continue essential operations.

Each leader will review staffing and supplies for the anticipated periodEmployees are expected to report to duty. Administration or Managers will notify staff if there is a need to come in early to arrive before weather system hitsMake sure to pack clothing, medicines, personal items, foods, etc for 24-72 hoursWe will provide housing either on campus or with a local vendor to allow staff to be available as neededMake sure to have plans for family, family members with special needs and pets for 96 hrs.If you drive make sure you have supplies and a way to communicate if stranded

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Inclement Weather… cont Transportation may be provided through EMS

Department Call 706-291-0298 ext 4911 to arrange for

transportation Transportation Officer will assign a pickup time Be prepared to leave 30 minutes before the time If you live on a hill or in a valley, find a flat

area where you can shelter until pickup Please if you drive, know a couple of ways to get to

your destination and also make sure you know how to drive on icy roads

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EvacuationMany types of events could require either partial or full evacuation of our facility. The goal is to move patients and staff from an unsafe area to a safe area.

During evacuation, move patients in this order Ambulatory first Sickest last

Horizontal Evacuation Room to Room, Wing to Wing

Vertical Evacuation Floor to floor

Full Scale Triage and transport area will be established In general this will be the area across the tracks in the parking lot for most

inpatients In lower ED parking lot for ED, OP and Radiology patients

Make sure you account for all patients – a designee from each area will need to run a census report in order for us to accomplish this

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Organ Donation Timely referrals of potential organ donors is

critical. Healthcare professionals are required to identify

and refer patients who meet clinical triggers to the Donation Referral Line at (800) 882-7177.

Timely referrals preserve the option of donation for families of medically suitable patients.

A representative from LifeLink our organ procurement agency is the only one who can approach a family about donations.

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Heart Disease Remains #1 Cause of Death in the U.S.

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Each year, approximately 1.2 million Americans suffer a heart attack, and nearly one-third of these individuals die…many before they reach the hospital.

About every 26 seconds an American will suffer a coronary event, and about every minute someone will die from one.

Hundreds of thousands of Heart Attack victims survive, but are left with a damaged heart.

Heart Attack Facts

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A heart attack occurs, in most cases, when a blood vessel supplying the heart muscle becomes completely blocked. The vessel has become narrowed by a slow buildup of fatty deposits made mostly of cholesterol. These may crack open, forming a clot.

Heart Attack Facts

When a clot occurs in this narrowed vessel, it completely blocks the supply of blood to the heart muscle. That part of the muscle will begin to die if the individual does not seek immediate medical attention.

Blocked artery (before treatment)

Same blocked artery (with restored flow after

treatment) 109

The best way to stop the heart attack process is todetect the symptoms early, before damage to the heart muscle occurs.

It is critical for those who experience any chestdiscomfort or heart attack symptoms to call 9-1-1 and quickly get to the Emergency Department.

It is just not the heart attack itself that kills; it is alsothe time wasted when one is trying to decide whetheror not to go to the hospital.

Heart Attack Facts

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Delays in time result in loss of heart muscle.

It is important to note that 85% of muscle damage takes place within the first hour. This is often referred to as the “golden hour.” It is within this timeframe that the blocked heart vessel needs to be opened.

Complete destruction of the muscle being supplied by the blocked vessel continues over a six-hour period.

Time Wasted = Muscle Lost!!

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Time Wasted….Why?!

People often dismiss heart attack warning signs, such as chest pain, thinking they merely have heartburn or a pulled muscle. The unfortunate conclusion is that many people wait too long before getting help.

Because every minute counts when having a heart attack, it seems that getting to the ED as quickly as possible would be everyone’s first choice. Unfortunately, more than 50 percent of all patients experiencing chest pain walk into the ED rather than calling 911.

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Know the frequent signs of a heart attack Chest discomfort. Most heart attacks involve discomfort in the center

of the chest. The discomfort lasts for more than a few minutes or it may go away and come back. The discomfort may feel like pressure, squeezing, fullness, or pain.

Discomfort in other areas of the upper body. This may include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.

Shortness of breath may occur with or before chest discomfort.

Other symptoms may include breaking out in a cold sweat, nausea, or light-headedness. Treatments are most effective when they occur in the early stages of chest pain.

What You Need to Know

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Heart Attack Signs/Symptoms in Women include: Unusual fatigue Upper abdominal pressure or discomfort Nausea or Vomiting Lower chest discomfort Dizziness Unusual shortness of breath Back pain Light-headedness, fainting, sweating, Pressure, fullness, squeezing pain in the center of the

chest, spreading to the neck, shoulder, jaw or arm

Know that heart attacks are NOT just a man's problem! More women in the United States die of heart disease each year than men. Women often experience signs and symptoms that are different from men. Or signs in women may go unnoticed altogether.

What You Need to Know

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Be able to recognize the early symptoms of a heart attack. Educate others in early heart attack care.

Be an advocate for the exceptional heart attack care coordinated by Redmond EMS and Redmond Regional Medical Center.

Inform others that our 911 dispatchers and Emergency Medical Services (EMS) are trained to recognize heart attack symptoms. Our EMS units transmit EKG’s directly to our ED from the scene so that by the time the patient arrives, the ED, Cardiologist and Cath Lab team are ready to assist.

What You Need to Do

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Know the signs of a heart attackCall 9-1-1 to get to the hospitalimmediately if you are concerned

Know your risk factors Be an advocate for your own health

Consider healthy lifestyle changes Get off the couch- begin exercising 20 minutes per day, 4-6 days per week

Stay active physically, mentally and socially Build social relationships through family, church,

even pets Eliminate stress by finding a hobby ……and always……REMEMBER REDMOND…………. FOR COMPLETE HEART CARE!

What You Need to Do

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We at Redmond take the “Golden Hour” Seriously!

The speed of opening the blocked artery is measured in door-to-balloon (D2B) time.

The time starts when the patient enters the hospital and ends when the clot causing the blockage is removed in the Cardiac Cath Lab.

The National goal for D2B time is less than 90 minutes. Redmond’s goal is 60 minutes!

In 2013, Redmond’s average D2B time was 53 minutes!

Our focus in 2014 is to targeting our population at risk for MI and educating them on risk factor modification and calling 911, not driving to the hospital.

We are Redmond! 117

And We Have the Awards to prove it!

Redmond’s Chest Pain program is accredited by the Society of Cardiovascular Patient Care and by The Joint Commission for Cardiovascular and Disease Specific Heart Attack care.

The accreditation philosophy is based on process improvement. It Encourages us to improve our quality by standardizing care processes across departments, including EMS, provide outreach education, and improve patient, physician, and staff education.

We promote EHAC (Early Heart Attack Care) which is a public awareness campaign to educate the public about signs of an impending heart attack AND that these signs and symptoms can occur days or weeks before the actual event.

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Heart Failure Facts Heart failure is the leading cause of morbidity (ill

health) and mortality (death) in the U.S. The most common reason for admission to the

hospital in the age group 65 years and older! 1 in 5 people diagnosed with Heart failure die

within 5 years of diagnosis. Many people can lead full and enjoyable lives if

Heart Failure is managed with lifestyle changes, education, diet, and medications.

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What is Heart Failure? A condition resulting from the heart’s inability to

pump an adequate amount of blood to meet the body’s needs.

It can be sudden, but usually develops over time. Basically the heart can’t keep up with the body’s

workload.

It Does Not mean your heart is going to STOP beating

It Does mean the heart pump is weak.

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What Causes Heart Failure?Anything that can damage the heart can cause Heart Failure: High blood pressure.. Common cause CAD and Heart attack….Most common cause High cholesterol and arrhythmias Damage to heart valves Viruses, drugs, excessive alcohol Advancing age or congenital heart defects Heart muscle disease Etc.

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When your heart is damaged At first the weakened heart tries to make up for it’s

inability to meet the needs of the body by: Enlarging to contract more strongly Beating faster (got to get that oxygen to the cells!) Blood pressure increasing to perfuse the organs

These temporary measures mask the problem of heart failure, but they don’t solve it. Heart failure continues and worsens until these substitute processes no longer work, and you start seeing signs of heart failure.

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Warning signs of Heart Failure

Shortness of breath Swelling in feet,

ankles, stomach Weight gain from

FLUID (not fat weight) Fatigue, tiredness Increased heart rate Coughing when lying

down

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Prevention of Heart Failure Lose weight (weight causes increased work) Stay active (exercise helps everything) Quit smoking (and avoid second hand smoke) Keep your BP under control Eat healthy (low fat …low SALT)…lower your

Cholesterol Limit alcohol (If you drink alcohol, do so in moderation.

This means no more than one or two drinks per day for men and one drink per day for women)

Control your Diabetes Routine MD checkups and immunizations If you have chest pain…get to the ER!!!

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Treatment of Heart Failure Treat the underlying Cause (BP, CAD, etc.). Weigh daily… looking for fluid build up. Heart healthy 2 GM Sodium diet …no added salt. Limit fluid intake (less than 2 liters). Medications for heart failure and BP control….Be

compliant! Lifestyle changes…(weight loss, exercise, smoking,

etc.). Limit Stress. Know the signs of heart failure!

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Redmond Regional Medical Center

Maintains Advanced Certification for the treatment of Heart Failure with The Joint Commission.

Has Gold Plus Achievement with American Heart Association in the treatment of Heart Failure.

We strive everyday to provided Evidence based care

for our patients with heart failure.

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Facts About Stroke3rd leading cause of death in the United States.

Risk increases with age, but people of any age can have a stroke.

Leading cause of adult disability in the U.S.: Without treatment, 62% of people who have

a stroke will have moderate to severe impairment.

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What is a stroke?

Old Term: CVA or Cerebrovascular accident.Bad term because stroke is preventable and treatable.New Terms: Stroke, TIA

It’s not an “accident.” A stroke occurs when something happens to interrupt the steady flow of blood to the brain.

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Three Types of Strokes

Mini-Stroke or Transient Ischemic Attacks (TIA) – brief episodes of stroke symptoms.

Ischemic Stroke is caused by blood clot. The clot blocks flow of blood to brain.

Hemorrhagic Stroke is caused by bleeding. Results from burst or leaking blood vessels in the brain.

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Stroke Symptoms: Remember “FAST”

Only one symptom

is necessary

to indicate stroke

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F = FaceF = Face • Droops on left or right side

• Sudden drooling

• Numbness

Ask person Ask person to smileto smile

• Look for difficulty holding things or putting on clothing

• Numbness

• One arm drifts down or won’t go up

• May have trouble walking

A = ArmsA = Arms

Ask person to Ask person to raise both armsraise both arms

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S = SpeechS = Speech • Slurred speech• Doesn’t make

sense• May not

understand what other people are saying

• Forgets how toread or write

Ask to Ask to repeat repeat phrase phrase or name or name objectobject

• Time lost is brain lost

• Save time and brain cells

• Go in an ambulance

T = TimeT = Time

At any sign, At any sign,

Call 9-1-1Call 9-1-1

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Stroke Prevention: Know your Risk Factors and develop a lifestyle to decrease you risk

High Blood pressure Tobacco use Diabetes TIAs Carotid or other artery

disease Atrial Fibrillation or

other heart disease Certain blood disorders

High blood cholesterol Physical inactivity and

obesity Excessive alcohol intake Illegal drug use Increasing age Gender Heredity and Race Prior stroke

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“Stroke Alert” EMS and Emergency Department play key role

in coordinating care of stroke patients admitted to our hospital

What if the patient is already here and starts having signs and symptoms of a stroke????

Call our Rapid Response Team at:

706-233-5625

Redmond Regional Medical Center is certified by The Joint Commission

as a Primary Stroke Center.

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Sexual Harassment

The following is prohibited: Unwelcome sexual advances, requests for sexual favors, and

all other verbal or physical conduct of a sexual or otherwise offensive nature.

Behavior that engenders a hostile or offensive work environment will not be tolerated. These behaviors may include but are not limited to: offensive comments, jokes, innuendoes and other sexually-oriented or culturally insensitive/inappropriate statements, printed material, material distributed through electronic media or items posted on walls or bulletin boards.

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Sexual Harassment You should promptly report the incident to your

supervisor, who will investigate the matter and take appropriate action, including reporting it to the Human Resources Department.

If you believe it would be inappropriate to discuss the matter with your supervisor, you may bypass your supervisor and report it directly to the Human Resources Department which will undertake an investigation.

Or you may call our Ethics and Compliance Officer, Deborah Branton, at 3036 or the Ethics Line at 1/800-455-1996. The complaint will be kept confidential to the maximum extent possible.

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VIOLENCE PREVENTION Violence can happen in any department or

area. Before violence strikes, there are usually

warning signs. These include:

Making threats, talking about or carrying weapons

Screaming, cursing, challenging authority Restlessness, pacing Violent gestures, such as pounding on a desk A loner, someone angry and depressed

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VIOLENCE PREVENTION You can help prevent violence by:

Treating everyone with respect Checking the patient charts for history of

violence or aggression, alcohol or other drug abuse

Trusting your gut feelings Watch for warning signs Try to spot—and head off—trouble before it

turns to violence Staying calm if someone starts to lose

control Don’t let your escape path get blocked

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VIOLENCE PREVENTION To reduce your risk for potential injury use

the following guidelines: Notify security at the first sign of a potentially

violent situation Communicate in a low, calm tone of voice Allow the person to voice their feelings It’s important to stay calm and maintain self-control Avoid defensive words or angry gestures Do not argue Do not turn your back on the person If possible, give the person what they demand

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RECOGNIZING ABUSE, NEGLECT And Exploitation Signs of Abuse

History inconsistent with nature and extent of injury

Delay in seeking medical treatment Frequent Emergency Room visits Accident prone Discrepancy in patient’s and family’s story Bruises in various stages of healing History of previous trauma in patient or

sibling

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The Definitions Abuse

To treat in a harmful, injurious or offensive way Neglect

To omit through indifference or carelessness Signs and symptoms include;

Failure to thrive Poor hygiene Dehydration Malnutrition Poor social skills

Exploitation To use for profit, to ask for money or materials

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Reporting Abuse, Neglect or Exploitation

Nursing Interventions: Routinely screen during each patient encounter. Screen one-on-one in a private environment. Assess patient’s immediate safety. Listen with a non-judgmental attitude. Document in the medical record the following: abuse history (subjective

and objective), results of safety assessment, authorities notified, family notified, treatment given, and any safety instructions provided.

The person suspecting the abuse should notify Social Services during weekday hours and the House Supervisor at night and on weekends to inform them of the situation. These resource persons will assist with the notification of the authorities.

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Reporting Abuse

Reporting Responsibilities: Notify the MD. Notify DFACS or Adult Protective Services (APS) of the possibility

and the appropriate authorities. GA has general mandatory reporting laws. MUST report to law

enforcement the following: injuries resulting from general violence and injuries inflicted by gun, firearm, knife, or other sharp object.

Resources: Department of Family and Children Services (DFACS): 706-294-6500 / Police Dept: 911 / Battered Woman/Domestic Violence Hotline: 1-800-334-2836 / Prevent Child Abuse GA: 1-800-532-3208 /

Adult Protective Services: 1-888-774-0152

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Population Served at RRMCDemographic RRMC Population Served

White 84%

African American 12%

Hispanic 2%

0 - 19 Years Old 8%

20 - 44 Years Old 24%

45 - 65 Years Old 35%

Greater Than 65 Years Old 33%

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Population Served at RRMCMost Common Principal Diagnosis

Coronary Artery Disease

Acute Myocardial Infarction

Osteoarthritis Chest Pain

Atrial Fibrillation Renal Failure Pneumonia Congestive Heart

Failure Stroke

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CULTURAL COMPETENCY Cultural competence means

providing medical care in a way that takes into account each patient’s values, beliefs, and practices.

Culturally competent care promotes health and healing.

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CULTURAL COMPETENCY The healthcare provider must have an

understanding of the predominant cultures that exist in the geographic area in which s/he provides patient care. Because the U.S. is so diverse, certain cultures may not be seen in all areas of the country.

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CULTURAL COMPETENCY A very important aspect of cultural

competency is the avoidance of stereotyping.

We must not presume that all people of a certain culture adhere to all aspects of their culture. The healthcare provider must identify which aspects are appropriate for each patient during the admission process.

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CULTURAL COMPETENCY Communication begins with identifying the

patient’s primary language. Patient must be offered an interpreter in their

preferred language free of charge. If family interprets, a waiver must be signed.

As a staff member, if you have any cultural or religious preferences that might impact on your delivery of patient care please let your supervisor know.

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Cultural Competency To achieve the important goal of preventing, identifying and resolving barriers

maintain the following principles : Inclusiveness. Strive to prevent exclusion any of patient or staff member. Respect is showing appreciation and regard for the rights, values and

beliefs of others. Respect. Foster an environment that maintains respect for cultural

differences between patients and staff members. Value. Appreciate and value cultural differences. Diversity is a state of being diverse; difference; unlikeness; variety;

multiformity. Service. Strive to provide accessible services to every patient. Understanding. Try to assess and identify the needs of the culturally

evolving patient population and incorporate those needs into your programs and practices.

Compliance. Adhere to all applicable federal and state laws and regulations addressing limited English proficiency and cultural competency.

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Federal Privacy Rules• HIPAA: Health Insurance Portability &

Accountability Act – Protected Health Information (PHI) – established federal rules for healthcare organizations & staff to protect patient privacy

• HITECH: Health Information Technology for Economic and Clinical Health Act – expanded rules regarding breach notification to patients and government

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Patient Rights RegardingProtected Health Information

• Right to Privacy• Right to Access/Review• Right to Opt Out of Directory (Census listing)• Right to Request an Amendment• Right to Request Privacy Restrictions• Right to Confidential Communications• Request an Accounting of Disclosures (who received information) • HIPAA privacy standards require that facilities use and disclose only the

minimum amount of protected health information (PHI) necessary to accomplish the intended purpose.

• Authorization for uses and disclosures of protected health information (PHI) must be obtained for uses and disclosures outside of treatment, payment and health care operations, unless otherwise permitted by law

• HITECH require Breach Notification to the patient and the Department of Health and Human Services. The media must also be notified when breaches involving more than 500 individuals in the same state or jurisdiction occur.

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Protected Health Information Once patient information is given as

identification, it is protected; Name, DOB, SSN, insurance # ID, address,

telephone number, etc. Diagnosis, treatment, personal information Paper/electronic medical record, images,

photographs, voice recordings, spoken word

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Staff Responsibility• Protect health information

– Don’t leave PHI in plain site (counters/monitors)– Discard paper in shredding bin– Ask patient permission before discussing PHI in front of

visitors– Validate requestors authorization to information BEFORE

discussing or releasing– Share only what is minimally necessary– Refer privacy complaints/restriction requests to Facility

Privacy Officer– Document /log disclosures to others outside organization– Secure electronic media– Encrypt confidential emails

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Violations/Breaches Facility Privacy Officer to investigate

(Jamie Ferrell, Extension 3095) Substantiated Breach Notification to:

Patient Department of Health & Human Services Media, if more than 500 patients impacted

(example: loss of laptop with PHI on it)

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Examples of Breaches• Fax information to wrong number• Discuss PHI with unauthorized person• Throw PHI in the regular trash• Leave PHI unattended in public area• Write PHI on white board with patient ID in public

area• Take a photo of a patient without permission• Post PHI on Facebook or Twitter• Access electronic medical record on family member • Give patient another patient’s paperwork by mistake

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Violations/SanctionsTypes of Violations: Negligent: Accidental, oversight, lack of

education or failure to follow acceptable protocols

Intentional: Deliberate action/inaction

Employee Sanctions: Re-education Disciplinary action up to termination

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Civil & Criminal Penalties• Facility AND/OR the staff member who breaches

PHI may face: – Civil Penalties– Criminal Penalties

IT ISN’T WORTH IT TO LOSE:– Lose your job– Lose your credibility– Lose professional license– Pay a financial fine– Go to jail

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Information Security

The Who, What, Where, When, Why, and How of

protecting sensitiveinformation.

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Session Goals Review Common Information Security Terminology

Provide Key Contact Information - Who

Explain Types of Information - What

Provide Key Resources Information - Where

Share When to Report Concerns or Incidents - When

Describe Why You Should Care about Information Protection - Why

Give Specific Tips on What You Can Do to Protect Information - How

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Common Terminology Privacy - addresses the use and disclosure of individuals’ health

information as well as individuals‘ rights to understand and control how their health information is used.

Information Security – assures patients that the integrity, confidentiality, and availability of their electronic protected health information (ePHI) is protected as we collect, maintain, use, or transmit it.

PHI – Protected Health Information ePHI – electronic Protected Health Information PII – Personal Identifiable Information

Look for the blue bubble for more definitions through out the presentation.

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Contacts Angie Turner-Zone FISO contact information

706-331-9724 Angie.turner@hcahealthcare.com

Service Desk 888-821-2065

Division and Facility Information Security Contacts: o Director of Information Security Operations (DISO)-Monica Smith o Facility Information Security Official (FISO)-Brad Treglown

Atlas keyword DISO or FISO

Division and Facility Privacy Contacts: o Ethics and Compliance Officer (ECO)-Lori Bakero Facility Privacy Officer (FPO): -Jamie Comer

Atlas Keyword ECO or FPO

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Types of InformationInformation Security standards define sensitive data as data that includes one or more of the following types of information:Social Security numbersAny government issued identification numberAccount number in combination with any required security code, access code, or password (e.g., a PIN) that would permit access to an individual's financial account Electronic Protected Health Information as defined by the HIPAA Security RuleHuman Resources employee files

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Challenge!Which of the following is not PHI?

A. Medical record number

B. Finger prints

C. Shoe size

D. Photographic images

E. Fax number

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Examples of Protected Health Information (PHI) Name. Address including street,  city,

county, zip code and equivalent geocodes.

Names of relatives. Name of employers. All elements of dates except year

(i.e. DOB, Admission, Discharge, Expiration, etc.).

Telephone numbers. Fax Numbers. Electronic e-mail addresses. Social Security Number. Medical record number.

Health plan beneficiary number. Account number. Certificate/license number. Any vehicle or other device serial

number. Web Universal Resource

Locator (URL). Internet Protocol (IP) address

number. Finger or voice prints. Photographic images. Any other unique identifying

number, characteristic, code.

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Resources

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Am I in Compliance? What happens if I violate an IS policy or standard? See WS.SWB.03 - Sanctions Process Am I using email appropriately? See IS.SEC.002 Information Security - Electronic

Communications What did I agree to when I signed a Confidentiality & Security Agreement? See

Confidentiality & Security Agreement (Atlas Keyword: CSA) Do I use USB drives appropriately? See COM.MH.02 - Information Handling Procedures Do I encrypt emails containing sensitive data? See COM.EI.01 - Electronic Transmissions Do I lock my workstation when I leave it unattended? See AC.UR.02 - Session Security If my laptop or mobile phone was stolen, how quickly must I report it? See IR.RISE.01 -

Incident Reporting Do I know how to sanitize electronic media correctly? See COM.MH.01 - Media

Sanitization What is a business owner or CFO responsible for? See IS.SEC.009 Information Security -

Risk Acceptance and Accountability What are managers required to do? See WS.SWB.01 - Management Responsibilities

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Report Concerns or IncidentsTo one of the following within 24 hours:FISO FPO Service Desk

888-821-1065, choose the Security option

An incident could include: Stolen/lost computer or portable device

(phone) Misdirected fax or email Virus alert on your computer Posting of PHI on a social media site

WHY?

Reporting incidents or concerns promptly allow the appropriate personnel to respond in a timely manner in order to manage risks to the enterprise - even if the incident is accidental.

WHY?

Reporting incidents or concerns promptly allow the appropriate personnel to respond in a timely manner in order to manage risks to the enterprise - even if the incident is accidental.

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It’s Part of the Job It is the right thing to do.

HCA’s mission says we are “committed to the care and improvement of human life”. This includes taking care of our patient’s information.

We are legally bound to protect the confidentiality of our patients, the company and its employees' information.

At HCA, we take privacy and information security seriously.

• HIPAA - Health Insurance Portability and Accountability Act• HITECH - Health Information Technology for Economic and Clinical Health Act

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To Reduce the Risks Identity Theft Loss of Privacy Loss of Trust Costly Breach Notifications Malware like Viruses, Worms, Trojans, Spyware Cyberbullying Online Predators

• Breach Notification – Usually in the form of letters sent out to individuals whose protected health information has been disclosed or compromised.

• Malware – malicious software

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How Can I Protect Information?

1. Passwords2. Workstation Security 3. Portable Device

Security4. Malware Protection5. Electronic

Communications

6. Phishing7. Social Engineering8. Social Media9. Mobile Devices10. Awareness

Learn more about ten areas where you can actively protect information.

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Passwords Your password is your key. Do not give your key to

any one else - ever!

HCA will never ask for your password

Use different user names and different passwords for work use and personal use.

Create a strong password. Use a combination of letters, number, special characters, upper and lower case.

WHY?

If someone uses your password to access unauthorized systems or information, it is very difficult to prove that you were not the one to access it. You could be held liable.

If someone steals your network password and it’s the same as your online banking password, the bad guys can get lots of information.

WHY?

If someone uses your password to access unauthorized systems or information, it is very difficult to prove that you were not the one to access it. You could be held liable.

If someone steals your network password and it’s the same as your online banking password, the bad guys can get lots of information.

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How Much Time Would it TakeTo crack your password…

The graph is from inetsolution.com

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Creating Strong Passwords“I love my dog Spot”

This example uses the first letter of each word of a sentence. If Spot is 5 years old, it is easy to remember the number "5" at the end of the password.  Strong Password = ilmdSx5

orStrong Password = Il0vemyD0gSp0t5!

Using the same phrase, here are examples of weak passwords:

Weak Password: mydogor

Weak Password: Spot1

WHY?

STRONG PASSWORDS •IMPROVE PATIENT SAFETY

•PROTECT YOU

•ARE UNIQUE

•IMPROVE CONFIDENTIALITY

WHY?

STRONG PASSWORDS •IMPROVE PATIENT SAFETY

•PROTECT YOU

•ARE UNIQUE

•IMPROVE CONFIDENTIALITY

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Workstation Security• Lock or log off when you are done to activate the

screensaver Lock: Press CTRL-ALT-DELETE, select LOCK Lock: Windows logo key and “l” Log off: Select START, and Logoff.

• Log out of applications on shared workstations when done

• To suspend a session in MEDITECH, press Shift F12 to lock the patient record.

Make sure no one is watching over your shoulder when you enter information, PIN numbers, or passwords.

If you feel someone is watching what you’re typing, lock your screen immediately and ask that person if you can help them.

WHY?

Prevent unauthorized viewing of data on your unattended workstation.

WHY?

Prevent unauthorized viewing of data on your unattended workstation.

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Device Security

Always keep portable equipment/devices with you and in your sight or lock them up when not in use.

If using or traveling with a company-owned laptop, request a cable lock from your IT&S Department.

If it is necessary to leave your laptop in your vehicle, make sure that it is out of sight.

If you require the use of a USB drive, ensure it is encrypted.

• Don’t store sensitive data on a portable device unless you need to for your job.

WHY?

One lost or stolen device could result in a costly breach notification. Even if there isn’t a breach, there is also the cost to the company to replace the hardware or device.

WHY?

One lost or stolen device could result in a costly breach notification. Even if there isn’t a breach, there is also the cost to the company to replace the hardware or device.

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Malware Protection Be aware of phishing. Avoid pop-ups that advertise anti-virus or anti-spyware

programs. Don’t install unapproved software to your device. Do not plug an unknown USB into your computer. Connect back to the HCA network through the VPN

gateway if you use your HCA device away from the office before using the internet.

Avoid using your HCA device to visit internet sites that are known for malware such as social networking sites (My Space and Facebook), coupon sites, etc.

WHY?

Malware disrupts or damages your computer’s operation, gathers sensitive or private information, or gains access to private computer systems. Malware is mean.

WHY?

Malware disrupts or damages your computer’s operation, gathers sensitive or private information, or gains access to private computer systems. Malware is mean.

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Electronic CommunicationsBefore you press the [SEND] button on an

email, Instant Message (IM), or Text, ask yourself four questions:1. Does it include sensitive data? 2. W here is it going (internal HCA

recipients or external)?3. Is the recipient authorized to have that

data?4. Is the data protected?

Refer to Electronic Communication policy-IS.SEC.002 for more information.

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Email Encryption Add [Encrypt] anywhere in the Subject line

to encrypt the email and any attachments.

WHY?Email is like a postcard. Encryption is like the envelope. Unless encrypted, the contents can be viewed during transit which could result in a costly breach notification.

HCA requires encryption of emails containing sensitive data.

WHY?Email is like a postcard. Encryption is like the envelope. Unless encrypted, the contents can be viewed during transit which could result in a costly breach notification.

HCA requires encryption of emails containing sensitive data.

• Do not include any sensitive information in the subject line.

• This encryption technique ONLY works if you are emailing from your HCA supplied email address. Messages to internal recipients do not require you to enter [Encrypt].

• Any of the brackets work – [], (), {}, <>.

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Other Email Requirements DON’T use your personal email accounts

(e.g., Gmail or Yahoo) to conduct Company business – use your Company email (e.g. Outlook or MOX).

DON’T forward company email to a personal

address.

NEVER access another person's e-mail

(unless specifically authorized).

WHY?If sensitive information is transmitted using other email systems, the data is no longer protected by the company’s security controls and the information could be compromised causing possible damage to the company reputation, financial loss, and liability to you.

WHY?If sensitive information is transmitted using other email systems, the data is no longer protected by the company’s security controls and the information could be compromised causing possible damage to the company reputation, financial loss, and liability to you.

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Know How to Catch a PHISH

Phishing - unlawful attempt to obtain personally identifiable information (PII) about you or others such as Social security numbers, Credit card numbers, Bank account information; usually occurs via email

WHY?Your identity could be stolen. Your credit could be ruined. Your computer could be infected with a virus. You could cause someone else’s identity to

be stolen.

WHY?Your identity could be stolen. Your credit could be ruined. Your computer could be infected with a virus. You could cause someone else’s identity to

be stolen.

P Personal Data Reference or Request

H Hyperlinks or Attachments

I Inaccurate Information

S Suspicious Sender

H Hurry Up and Respond

Look for these clues in an email:

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Verify or Report a PHISH Call the sender or the organization represented in the email or visit their

website (not using the link in the email) to see if they have reported any phishing attempts.

Send a separate email (not a reply) to the sender.

Contact your local Help Desk, FISO (Atlas Keyword: FISO), or DISO (Atlas Keyword: DISO).

Learn more about Phishing and hyperlinks on Information Security’s Atlas site. Keyword: Protect

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Social Engineering Don’t share sensitive information with anyone

over the phone or in person even If they appear as “friendly”. If they seem in a hurry to get the

information. If they use an agitated tone or are very

pleasant depending on how you respond. Ask to see a badge. Wear your badge.

Social Engineering - an attempt to gather information from you in order to gain access to systems and/or gain confidential information; can occur in person, over the phone, or electronically

WHY?Social engineers intend to get information from you without you knowing or understanding what they are doing.

WHY?Social engineers intend to get information from you without you knowing or understanding what they are doing.

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Social Media DO NOT post sensitive information (including

photos) on the Internet (e.g., discussion groups, Facebook, LinkedIn, Twitter, MySpace, YouTube, Flicker, bulletin boards, chat services, non-secured web sites, etc.)

Refer to HCA Social Media Guidelines posted to Atlas.

Report suspected violations of company policy regarding social media.

WHY?Posting patient or company information to social networking sites like Facebook and Twitter could cause a potential violation of HIPAA or could be an action that could result in Company fines and lawsuits. Email HIPAA Communication for clarification on what information can and cannot be shared.

WHY?Posting patient or company information to social networking sites like Facebook and Twitter could cause a potential violation of HIPAA or could be an action that could result in Company fines and lawsuits. Email HIPAA Communication for clarification on what information can and cannot be shared.

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Mobile Devices iPhones, iPADs, etc. Susceptible to the same risks as your computer. Same physical security rules apply. Same email rules apply.

Per the Confidentiality and Security Agreement (CSA): Personally owned devices that synchronize company data (email on your phone), must be encrypted

Mobile Device - Any electronic device that has the potential to store, process, or transmit Company information wirelessly and is designed for mobility or small enough to be easily transported or concealed such as smart phones, tablets, and personal digital assistants (PDA).

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Other Tips Setup a profile to use the Password Reset tool

Have you set up your profile yet? Atlas: Password Reset Stay informed

At work, use Atlas Keyword: Protect. Read emails sent from Information Security or your FISO/DISO.

Spread the word about safe security practices to your colleagues, family, and friends When you learn something new about security, share with others so

they can stay safe on the Internet

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Awareness: Threats Follow You Home

Your Information Security responsibilities do not stop at the end of your work day.

Remember the Risks?Identity TheftLoss of PrivacyLoss of TrustCostly Breach NotificationsMalware like Viruses, Worms, Trojans, SpywareCyberbullyingOnline Predators

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Review of Session Goals Review Common Information Security Terminology Provide Key Contact Information - Who Explain Types of Information - What Provide Key Resources Information - Where Share When to Report Concerns or Incidents - When Describe Why You Should Care about Information

Protection - Why Give Specific Tips on What You Can Do to Protect

Information - How

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