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Student Orientation Spring/Summer 2015

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Page 1: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Student OrientationSpring/Summer 2015

Page 2: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Program Manager, Students & Contract Workers Email: [email protected] Human Resources Phone: 405-271-6035

OUMS Contact Person

Page 3: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

For students to begin clinical rotations the following items must be complete:◦ Students have reviewed the orientation presentation

on the Student Programs website annually.◦ Required Student Forms have been submitted.◦ School has attested that all necessary requirements

have been met: Background check, drug screen, immunizations, TB test, etc.

Important Process Information

Page 4: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Meditech Access is only granted to students that will be at OU Medical System for a single clinical rotation for 6 weeks or more.

Meditech Access Forms should be sent at least two weeks prior to needing access and must be the updated Request Form from website with DOB, start date, and end dates listed.

Important Meditech Access Request Information

Page 5: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Meditech Access Forms will be sent to IS after HR review and confirmation that all student paperwork and requirements have been met. Student and Instructor logins and passwords will be sent to your school official.

NP students require a different Meditech Access form that can be requested by emailing the request to [email protected].

Important Meditech Access Request Information cont’d

Page 6: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

◦ Ensure that all students and instructors have met the necessary OU Medical System requirements including: Student Forms, Attestation of Requirements, and Meditech Access

Forms (if applicable). Attestation of Requirements includes:

Cleared background check, drug test, immunizations, and CPR certification.

Between November 1 and March 31 of every year, all students and instructors will be required to provide documentation of Influenza Vaccination or wear a mask while in OUMS facilities.

◦ All requirements must be emailed to [email protected] prior to clinical rotation start date.

School’s Responsibilities

Page 7: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

The students and instructor(s) names should be input into the Clinical Hub two weeks prior to the clinical rotation date in order to keep your slots. If the names are not put into the system, you will receive a reminder email before the slots are released for the week and the unit is notified.

If requesting slots for clinical rotations out of the normal negotiation period, please send an email to [email protected] in order for her to review the slots for approval/denial.

NESA Spreadsheets MUST be sent prior to the clinical rotation start date in order for your students to complete clinical rotations.

School’s Responsibilities (NESA Only)

Page 8: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

OUMS’s nursing student policy designates nursing activities appropriate for nursing students in registered nurse/licensed practical nurse programs when caring for our patients.

All patients with student assignments will have a registered nurse assigned to them who will maintain full and final responsibility for patient care.

Students and instructors must read the Student Nurses policy 5.2 A/P prior to patient care.

Nursing Student Policy

Page 9: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Schools that order a background investigation in compliance with this policy retain ownership of the report of the investigation. If attestations are accepted, OU Medical System must annually audit a sample of files for one-third of those entities that provide attestations.

OU Medical System must take into consideration the risk to patients presented by the type of individuals provided by the entities that provide attestations and focus on those that present the greatest risk (e.g. direct care providers present a greater risk than those who undertake administrative support or property management services).

A sufficient sample size of the audit will be the greater of five percent (5%) or thirty (30) files for each of the third parties.

Background Investigation Report and Audit Requirements

Page 10: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Anyone on OUMS campus that is not a patient or a visitor must be held to TJC (Joint Commission) requirements.◦ Employees◦ Students◦ Instructors

Packets (Instructors, Students)

Orientation Overview

Page 11: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

HCA – Hospital Corporation of AmericaStates with HCA Owned Hospitals

Page 12: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Three hospitals founded in the early 1900s:◦ Presbyterian (originally Wesley, 1910)◦ University Hospital (1912)◦ Children’s Hospital (1927)

February 5, 1998—Joint Operating Agreement with HCA Became OU Medical Center in 2001 Edmond Campus Joins OUMC in 2010 and we become OU Medical System. So

now we proudly have the following three hospitals:◦ Edmond OU Medical Center, Children’s OU Medical Center, and OU Medical

Center.

History of OU Medical System

Page 13: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

OUMS’s Future

New adult bed tower Recent construction

completions includes:◦ Education Center◦ Cancer Center◦ Surgery Center

Page 14: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Mission - Leading health care.

Vision – OUMS will be the premier enterprise for advancing health care, medical education and research for the community, state and region. Through our combined efforts we strive to improve the lives of all people.

Goals - Uncompromising Quality, Exceptional Service, Innovative Education, Advancing Knowledge, Institutional Strength.

Our Foundation Principles

Page 15: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Values: We believe that caring for our patients must be at the center of all we do. We act with honesty and integrity. We respect our colleagues and co-workers. We magnify our effectiveness through teamwork. We improve continually through harnessing innovation and encouraging

high performance. We believe in open and effective communication. We are committed to providing outstanding educational programs. We will be a leader in the advancement of basic and clinical research.

Our Foundation Principles

Page 16: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Carefully review our Standards of Excellence prior to starting your Clinical Rotation. These Standards were developed by OUMS employees to establish specific behaviors that all employees, students, and instructors are expected to practice while on campus. As you complete your clinical rotation here at OUMS, please ensure that these Excel Standards of Behavior are consistent with your own work standards, beliefs, and behaviors. 

Excel Initiatives

Page 17: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

We approach our work in a professional manner.We believe effective communication is fundamental to everything we do.We are sensitive to the needs of those we serve.We are committed to quality service. We always look for better ways to take care of our patients.OUMS expects students and staff to always exhibit the Excel Standards of Behavior at all times. You can find an expanded version

of the Standards in your packets.

Excel Standards of Behavior

Page 18: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Republic Parking◦ PPOB, 7th Floor Suite 704, Phone: 271-7032OUHSC Parking◦ OUHSC Service Center, Phone: 271-2020Campus Police ◦ 271-4300◦ Call for assistance w/ flats, jumps, or escort to a parking area. However,

the police cannot help with locked keys in car. ◦ Always use the Buddy System to increase your safety. Edmond Campus◦ Steve Boos 359-5590◦ Security 359-5554

Who Do I Contact For Parking?

Page 19: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

If anyone on campus receives or perceives a threat or is a victim of violence immediately report.

OUPD may also be contacted. Downtown Campus:

OUHSC Police Department: 14911Downtown hospitals Emergency # 11911 (Code Blues, Person Down, Code Red)

Edmond Campus: Emergency: 444 | Non-emergency: 0

(Hospital Operator contacts Security)

Safety and Security

Page 20: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Emergency blue phones on downtown campus

The Emergency Blue Phones, scattered across campus, should be used to contact OUHSC Police to request help, report suspicious behavior, or to request help.

The Emergency Blue Phones, scattered across campus, should be used to contact OUHSC Police to request help, report suspicious behavior, or to request help.

Page 21: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Where Do I Park?

Students Park Here

Page 22: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Not parking in your assigned parking spot could result in the loss of OUMS as a clinical site.

Even if you pay, you are NOT to park in any of the visitor parking garages as this impacts patient parking.

Edmond Campus – Please use the northwest parking lot.

Contact Republic Parking at 271-7032 to get your parking pass for the OKC campus. (This is your Instructor’s Responsibility).

Republic Parking

Page 23: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Blue Phones & Police Services OKC Campus Police

◦ (405) 271-4300 non emergency ◦ 11911 emergency

Edmond Campus Security ◦ (405) 359-5554

OKC Campus Shuttle Service The University shuttles operate from 6 am – 6pm, M-F. OUMS

shuttle operates from 4:30 am – 11:30 pm, M-F.The evening clinical students can ride the OUMS Shuttle after 6 pm by letting the driver know that they are at the HHODC parking lot.

Security and Shuttle Info

Page 24: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

So who is TJC anyway and what are the BUZZ words: ◦ The Joint Commission or TJC evaluates hospitals in their

compliance with federal regulations. Tracer Methodology is an evaluation method in which surveyors

select a patient and use that patient’s record as a roadmap to move through an organization to assess and evaluate the organization’s compliance with standards and the organization’s systems of providing care and services.

Core Measures are mandated by the TJC and CMS and are a set of clinical interventions that result in consistent quality health care, reduced medical errors, and better patient outcomes.

National Patient Safety Goals are reviewed on the next few slides.

The “TJC”

Page 25: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

2015 National Patient Safety Goals

Improve the Accuracy of Patient IdentificationUse TWO identifiers (name, birth date, medical record number) before providing care. Make sure the correct patient gets the correct blood type when receiving a transfusion.

Improve Effectiveness of Communication Among CaregiversQuickly report critical tests and critical results to the physician/licensed caregiver.

Improve the Safety of Using MedicationsLabel ALL medications; including solutions on/off the sterile field.Take extra care with patients taking anticoagulants (blood thinners).Maintain/communicate accurate patient medication information (med reconciliation).

Page 26: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

2015 National Patient Safety GoalsReduce the Risk of Health Care-Associated InfectionsWash hands before AND after all patient contact.Prevent multidrug-resistant organisms (MRSA, VRE, C.Diff) with contact precautions - Prevent central-line bloodstream, surgical site, & catheter-associated urinary tract infections.

Identify Safety Risks Inherent in the Hospital’s Patient Population - Patients at risk for suicide are identified and a psych consult is initiated.

Reduce the harm associated with clinical alarm systems – Improve the safety of clinical alarm systems.

Universal Protocol: Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery - Pre-procedure verification of information, equipment, procedure, and patient – The LIP marks the procedure site – A time-out is performed immediately before the procedure.

Page 27: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

For detailed information on the National Patient Safety Goals Please visit - www.jointcommission.org

2015 National Patient Safety Goals

Page 28: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

What is cultural competence?The ability of health care providers and organizations to

understand and respond effectively to the cultural and language needs brought by diverse patients to health care encounters.

What is patient population specific care? As a caregiver we must modify our care to meet the needs

of our patients based on their individual needs. Patient Population Specific Care includes but is not limited to cultural competence.

.

Population Specific Care

Page 29: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Standard LD.04.03.01 The hospital provides services that meet patient needs.– The hospital uses available population-level data to help

determine the needs of the population(s)served. Age Sex Socioeconomic status Disability Language(s) Race/ethnicity Religions(s)

Population Specific Care

Page 30: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Infant Security

Security Measures◦ Limited Access units – only accessible via badge swipe.◦ Newborns receive transponder within 30 minutes of delivery.◦ Mom/Primary Caregiver for NICU baby submits an approved

guest list.◦ All parents/guardians, guests and visitors must check-in, sign

in/out, show proper photo ID.◦ Perinatal and Neonatal employees will wear scrubs unique to

the area and must swipe badge to enter.

OUMC Policy 15-56

Page 31: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Infant Security (Cont’d)

Hospital employees in these mandated areas will wear all black scrubs and have a pink identification badge.

Students and Instructors are not permitted to wear all black scrubs.

Students are not permitted to transport a baby off the unit without the RN present.

Code Pink is when someone is trying to leave the building inappropriately with a pediatric patient.

Page 32: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Code Pink Notify Hospital Operator & charge nurse

Downtown Campus: 14190 | Edmond Campus: 444 Check nearby stairwells and exits. Stay at the exit

until Code Pink All Clear is announced. Question anyone who is

Carrying a large purse or bagActing suspiciouslyAttempting to leave with an infant

DO NOT detain anyone Call OUPD or Security Services immediately.

OUMC Policy 15-08

Page 33: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

WHY IS DOCUMENTATION SO IMPORTANT? It is how we communicate our patient care. We are computerized

so documentation and results can be viewed at anytime, anywhere on campus and for physicians, from home, to facilitate patient care.

It is a legal record. Accurate and timely documentation protects the patient. Assists with accurate billing. What you document can have an effect elsewhere in the system.

Your documentation can be tied to warnings and alerts, clinical prompts and reminders for other caregivers.

Documentation

Page 34: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

CONSEQUENCES OF POOR DOCUMENTATION Incorrect or incomplete documentation can lead to

potential adverse patient events. It is falsification of a legal record. Inaccurate billing. Can lead to individual practice and licensure

consequences. Please always check with your instructors and the RNs

for any questions about charting patient data.

Documentation

Page 35: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Scanning of Medications Immediately prior to administration, the dose of

medication to be administered to the patient is scanned by the individual administering the dose to confirm a medication order for that medication is on the medication profile. When administering more than one capsule or tablet, each capsule or tablet is to be scanned individually.

In the event the bar-code on the medication package will not scan, the dose of the medication is to be returned to the Pharmacy.

Medication Safety

Page 36: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Scanning the Patient’s Armband Always use two patient identifiers before giving medication Immediately prior to administration of the medication, the

patient’s armband will be scanned to ensure the correct medication is being administered to the correct patient.

Illegible/otherwise unreadable armbands should be replaced. Check with the RN to replace an armband.

Scanning a medication is documenting the administration. Documenting in Meditech is just like signing your name on

a paper document.

Medication Safety

Page 37: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Label ALL medications; including solutions on/off the sterile field.

Take extra care with patients taking anticoagulants (blood thinners).

Be aware of Look-A-Like/Sound-A-Like Meds. Medications that are easily confused are stored

separately.

Medication Safety

Page 38: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

All patients receive comprehensive screening for fall-risk assessment.

Automatically considered high risk for fall-injury (no signs placed):◦ ICU◦ Outpatient◦ Pediatric patients under age 3

Patients at risk for fall-injury receive a yellow armband. Yellow patient armbands immediately let us know a

patient is at risk for falling.

Patient Fall Prevention

Page 39: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Signs indicating fall risk placed on patient door and on front of chart.

Adult patient risk assessment levels:

Patient Fall Prevention

1. Low Fall-Injury Risk – no FALLING STAR

2. Moderate Fall-Injury Risk

3. High Fall-Injury Risk

4. Very High Fall-Injury Risk

• Pediatric patients, age 3+, high risk

Page 40: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Hospitals are not an environment that patients are used to.

Therefore we have to keep all patient spaces and walkways clear.

Ensure appropriate room lighting and low bed positioning.

Things to Remember

Remember the 4 P’s of Rounding

*Pain –address it frequently!*Position –and reposition often!*Potty –ask our patients if we can assist them to the toilet!*Personal Items/Placement

Page 41: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Every patient, Every time, saves lives!

The success of OUMS Fall Prevention program is dependent on all of us!

Be aware of your role in preventing patient fall and injury.

Page 42: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

The nurse and nursing student have a duty to serve as a patient advocate in ensuring appropriate pain management. The nurse is expected to use sound clinical judgment in evaluating pain management interventions and to pursue through both medical and nursing chains of command any concerns about appropriateness and/or effectiveness of prescribed pain management interventions. (OUMC Systems Pain Management Guidelines)

Pain Management

Page 43: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

If your patient is having severe pain issues contact the appropriate physician and RN and communicate/discuss the following: ◦ Period of time drug has been tried.◦ Current drug(s) amount, frequency of administration.◦ Average of patient’s pain rating over last 4,8 or 24 hours.◦ Home pain medications listed on medication reconciliation form not

ordered.◦ Suggestions for more effective use of current drugs or alternative

therapies (i.e. pain management consult, ice, heat, etc.).

Pain Management

Page 44: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Pain Assessment Tools(age range for recommended use): FLACC Scale (< 5 years old) FACES Pain Scale (5-13 years old) Verbal rating (older than 13 years old) Numeric scale Visual analogue scale

Remember, all pain assessments/re-assessments must

have a number assigned regarding intensity.

Pain Management

Page 45: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

To request a consult please have the physician write an order and call 523-0385 for Adults and 327-8961 for Pediatrics or talk to the RN in charge of the patient’s care if you feel like a referral to the Pain Control nurses is appropriate.

Edmond Campus: Contact the RN or physician for pain management consult .

Pain Management

Page 46: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

OU Medical System is dedicated to fostering a culture that supports a patient’s right to be free from restraint or seclusion.

Restraint or seclusion use will be limited to clinically justified situations.

The least restrictive restraint will be used with the goal of reducing, and ultimately eliminating, the use of restraints or seclusion.

Restraint and Seclusion

Page 47: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Restraint is any 1) manual method or physical or mechanical device, or 2) material or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely.  

Violent/Self- Destructive restraints are utilized due to an unexpected outburst of severely aggressive, destructive, or violent behavior that poses and imminent danger to the patient or others.  

Non-Violent/Non-Self Destructive restraints are used for patient safety, or to limit mobility to promote healing, avoid treatment interruptions, or to enable active interventions.

Restraint and Seclusion

Page 48: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Alternatives Psychosocial: diversion, family interaction, pastoral visits,

etc. Environmental: Commode at bedside, Music/TV, call light

within reach, etc. Physiological: Fluids/nutrition/snack, pain intervention, lab

values, etc. Sitters: Safety Attendants will be used for those patients

whose behavior is out of control and all other alternatives have proved ineffective.

Restraint and Seclusion

Page 49: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

All OUMS patient in restraints will be checked three times an hour for:◦ Rights◦ Dignity ◦ Safety

Restraints and Seclusion

Page 50: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

OUMC Policy 11-06 Applies to all healthcare professionals who have direct

responsibility in ordering, assessing, planning care and application of the restraint patient.

Always call the RN when any concerns regarding

patient restraints or seclusion arise.

Restraints and Seclusion

Page 51: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

A stroke is when the blood supply in part of the brain is reduced or stopped.

◦ Usually due to a blocked blood vessel to or in the brain◦ That portion of the brain dies

What is a Stroke?

Page 52: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Have high blood pressure Have heart disease Have Diabetes Are overweight Have fat deposits on your arteries Have high cholesterol Smoke cigarettes Have a family member who has had a stroke

Stroke Risk Factors

Page 53: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Severe headache Weakness or numbness on one side of body (tingling in

face, arm, leg). Dizziness Loss of speech (slurred speech). Confusion/changes in personality. Difficulty seeing in one or both eyes/double vision. Difficulty using muscles or swallowing.

What are the symptoms?

Page 54: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Call a Code Gray (Stroke Alert) The primary nurse will immediately inform the physician

and activate a Code Gray immediately by calling the emergency department charge nurse at 417-6796 (OKC) or 444 (Edmond).

(dial 9 first if calling from a hospital phone) Staff will follow all orders included in INPATIENT Initial

Orders for Stroke Patients.

If you suspect an OUMS patient has had a stroke

Page 55: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

If you, a family member or a co-worker are experiencing any of the signs and symptoms we have just reviewed, please call for help immediately.

If outside the hospital, call 911. And as a student always remember to call the RN

immediately if you are concerned about a patient’s condition.

Always call!

Page 56: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Many job aids exist on the Intranet to help facilitate knowledge of nursing processes. To locate a job aid:

Go to the Intranet Page Click on Departments Click on Nursing On the right side tool bar click on the job aid you are

interested in reviewing.

Nursing Job Aids

Page 57: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Is everyone’s responsibility. OUMS works to reduce workplace violence via policy

and practices. Offer assistance in directing or escorting visitors to

destinations. Inform supervisors, RNs, and instructors of suspicious

behavior. Weapons of any kind are not permitted on campus

except for official law enforcement officers.

Safety and Security

Page 58: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

If anyone on campus receives or perceives a threat or is a victim of violence immediately report.

OU Police or appropriate law enforcement agency will also be contacted.

Downtown Campus:

Emergency: 11911 | Non-emergency: 14911

Edmond Campus:

Emergency: 444 | Non-emergency: “0” (Hospital Operator contacts

Security)

Safety and Security

Page 59: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

Code Purple is to call for assistance for when anyone’s behavior undermines a culture of safety.iolent Crisis Intervention will respond)

Visitors◦ Allow to vent in a controlled manner.◦ When uncontrolled, ask to leave.◦ If person does not comply, notify police.

Code Purple

Page 60: Spring/Summer 2015.  Program Manager, Students & Contract Workers  Email: OUMC.StudentPrograms@hcahealthcare.comOUMC.StudentPrograms@hcahealthcare.com

All employees have a primary duty to report adverse occurrences involving the patient. Every student witnessing an adverse event involving a visitor, property damage or property loss should report the event to the charge nurse.

Type of events that should be reported include:◦ Damage or loss to hospital property or equipment.◦ Violation of hospital policies and procedures that involve patient care, for

example: Medication errors. Treatment delays. IV-related complications.

◦ Accidents, with or without personal injury.◦ Mishaps due to possible faulty/defective equipment or environmental equipment.

When a significant medical adverse event in the patient’s care occurs, the physician will notify the patient/patient’s family/significant as soon as the adverse event is discovered.

Reporting & Patient Notification

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It is the policy of OU MEDICAL System to immediately report any and all instances where information reasonably suggests that there is a probability that a device has caused or contributed to a death, serious injury, or illness of an individual. When a patient, student, or an employee is injured, develops an illness or dies related to the use of medical device, this shall be immediately reported to the charge nurse.

The medical device should be sequestered with no changes made in control settings or other methods used to regulate the equipment. The device should be secured along with all accessories (cords, probes, etc.) in use at the time of the occurrence. A sticker should be placed over the power switch labeled “do not use.”

Reporting Injury, Serious Illness or Death Associated with the Use of a Medical Device

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Code Description Action

Code BlueCardiac/Respiratory Arrest Call "11911" or "9911" (OKC) or 444 (Edmond),

Initiate CPR.

Code RedFire/Smoke Initiate RACE, call "11911" (OKC) or "444" (Edmond).

Code Pink Infant/Child Abduction Activate alarm, search exit routes.

Code BlackSevere Weather (Tornado) Seek shelter away from windows, ensure foot wear

is on.

Code Silver Active Shooter/Hostages Run, Hide and Fight (as a last resort).

Code YellowExternal/Mass Casualty Disaster

Stay on, or report to your unit.

Code OrangeHazardous Exposure Requires Decontamination

Stay on, or report to your unit.

Code PurpleAggressive/Disruptive Person Call police at "14911" (OKC) or "0" (Edmond).

Code White Sudden Illness or Injury Call police at "14911" (OKC) or "0" (Edmond).Code Grey Stroke Alert Activates the Stroke Team.

Code Overview

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IN THE PRIMARY FIRE AREA: (RACE) R-Rescue anyone in immediate danger (if safe to do so). A-Activate the fire alarm (pull manual alarm pull box and call facility emergency #). C-Contain the fire (close all doors and windows). E-Extinguish the fire (if safe to do so).IN A SECONDARY FIRE AREA: (CALM). C-Close all doors and windows. A-Assure patients and visitors that all is under control. L-Leave someone by the telephone in case help is needed. M-Maintain normal operations as well as possible.TO EXTINGUISH THE FIRE WITH A PORTABLE FIRE EXTINGUISHER: (PASS). P-Pull the pin. A-Aim the nozzle at base of fire. S-Squeeze the handle. S-Sweep nozzle from side to side.

Fire Response

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You are a reflection of OU Medical System.

Patient and Visitor Satisfaction – always think of how you would feel if it was you or a loved one in the hospital.

We are a Smoke Free Campus.

Cultural Differences Religious Beliefs Political Views Language Assistance

Important Items to be Aware of

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OUMC Policy 7-03 defines harassment as verbal or physical conduct that denigrates, demeans or shows hostility or aversion toward an individual. Of specific concern is when that hostility or aversion is because of a person's race, skin color, religion, gender, sexual orientation, national origin, age, disability or other protected category. ◦ When in doubt, leave it out.◦ Zero Tolerance (Physical or Sexual Harassment).◦ Utilize chain of command or contact HRD Advisor.

Awareness

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Physical Evidence Conflicting stories on how

injuries occurred. Inconsistent developmental

level of a child. Complaint other than the one

associated with the abuse. Loss of weight, failure to gain

weight, unkempt appearance.

Caretaker keeps away from others.

Sudden change in behavior. Extreme withdrawal or

agitation. Financial exploitation. Untreated injuries in various

states of healing. Every Employee/Student

Responsible for reporting to supervisor or to Social Services.

If you become aware of any type of abuse, you MUST report it. Silence equals acceptance.

If you become aware of any type of abuse, you MUST report it. Silence equals acceptance.

Signs of Abuse and Neglect

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Infection Control Practices

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Artificial nails (includes gel and shellac polish), nail tips, and wraps are PROHIBITED in a patient care areas.

Natural nails should be kept to 1/4” at the tip. If polish is worn, it should be transparent enough to observe whether nails are clean. Chipped polish is not allowed. You cannot provide patient care if your nails are not in compliance with policy.

Jewelry should be minimal since this has also been shown to harbor microorganisms.

Other Factors to Consider

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Standard precautions with the addition of Airborne Infection Isolation, Contact Isolation, Droplet Isolation, and Protective isolation.

With expanded precautions, you follow the guidelines set forth for that particular precaution no matter what activity is being performed.

Use goggles/face shields when there is a potential for a splash, splatter, or spray. For example, emptying a foley, dc’ing an IV, suctioning, etc.

Transmission Based Precautions

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Transmission Based Precaution Signs

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Transmission Based Precaution Signs

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Transmission Based Precaution Signs

Hand washing with antimicrobial soap and water ONLY.

Gowning & Gloving still required for all activity in the room.

Dedicate equipment to patient/room as much as possible.

Disinfect/clean items with BLEACH wipes that enter/exit room.

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Proper Way to Remove PPE

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Safe Practices to Keep in Mind

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Bloodborne pathogen Exposures

TREAT THE EXPOSURE SITE…

1. Wash the area with soap and water.

2. Flush mucous membranes with water.

3. Flush eyes with water or saline.

4. Do NOT apply caustic agents or inject antiseptics or disinfectants into the wound.

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OUHSC Students(Medical ,Nursing, Dental, Allied Health Students)

8:30 am - 4:00 pmCredentialed medical staff or competent OUMC employee

directly involved with the patient will obtain 2 Full Lavender Top Vacutainers* of SOURCE blood.

DO NOT label blood with any patient identifiers*May use microtainers for NICU source lab.

Contact OUHSC Student Health at 271-2577 and provide:1. SOURCE patient Name/MR # , location, nearest tube station #.

2. RN contact name/number responsible for SOURCE patient3. Exposed contact number to notify of SOURCE Rapid HIV result.

Infection Prevention Department will be notified by Student Health to coordinate source testing. Infection Preventions will

provide source exposure labels and requisition before responsible RN will send blood to the lab.

OUHSC Student Health Nurse will contact Exposed individual with SOURCE Rapid HIV results. Instructions will be given at that time

regarding follow up in Student Health office at the OU Family Medicine Clinic.

OUHSC Students(Medical, Nursing, Dental, Allied Health Students)

After Hours, Holidays, & Weekends

Credentialed medical staff or competent OUMC employee directly involved with patient's care will obtain 2 Full Lavender

Top Vacutainers* of the SOURCE blood. DO NOT label blood with any patient identifiers*May use microtainers for NICU source lab.

Go directly to OUMC ED with Source Blood

1. Take Source patient Name & MR # with you2. Exposed individual will be admitted to the OUMC ED.

3. Exposed individual baseline labs will be drawn.

Post Exposure Prophylaxis (PEP) offered only if source Rapid HIV result is POSITIVE.

Exposed individual will follow up with OUHSC Student Health office at the OU Family Medicine Clinic on next business day to obtain

baseline lab results and SOURCE Hepatitis B & C status.

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ZERO TOLERANCE

Mission Statement:OUMS has zero tolerance for NOT adhering to infection

prevention measures and broken systems that lead to harm.

Culture of Accountability

OUMC has a zero tolerance for non-compliance with basic infection prevention practices.

Every patient has the right to a clean safe environment.

Each employee is responsible for their own actions towards these goals as well as the actions of other members of the healthcare team..

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BEFORE:◦ ANY patient contact.◦ Full barrier precautions when inserting a centrally placed venous

catheter.◦ Before inserting or removing urinary catheters, peripheral vascular

catheters, or other invasive devices that do not require surgery.AFTER:

◦ ANY patient contact, including contact with intact skin, bloody fluids or excretions, non-intact skin, wound dressings, etc.

◦ Removing gloves.

Specific Indications for Hand Hygiene

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Substance Use in the Workplace

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Definitions Controlled Substance: Any drug or chemical substance

whose possession and use are regulated under the Controlled Substances Act.

Illegal Substance: Any drug the possession or sale of which violates federal law (in the U.S.) or the county, state or local law of the jurisdiction in which the facility is located.

Impairment: Practitioner impairment occurs when a substance-related disorder interferes with his or her ability to engage in professional activities competently and safely.

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Responsibilities Employees and Students have a duty to report to his/her

supervisor:◦ Your own use of prescription or over-the-counter.

medications that could impair your ability to perform your job.

◦ Any reasonable suspicions of a coworker, contractor or student who may be in violation of the Substance in the Workplace policy.

Cooperate fully with investigations of violations. Safeguard controlled substances from unauthorized access.

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Prohibited Behavior

Sale, manufacture, distribution, purchase, use or possession of alcoholic beverages, illegal substances or non-prescribed controlled substances.

Reporting to duty or being at work while under the influence or impaired.

Reporting to duty or being at work smelling of alcohol or with a measurable quantity of non-prescribed controlled substances in one’s blood or urine.

Theft or diversion of facility medications.

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Prohibited Behavior, continued

Conviction for sale or possession with intent to distribute any drugs, including prescription drugs.

Refusal to submit to consent to drug/alcohol screen. Participation in any act that would create false

documentation of security or safety practices. Tampering with drug testing samples or security

equipment.

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Drug Screening

Drug screening is conducted as part of the post-accident process.

Reasonable suspicion of impairment regarding an employee, contractors or student can result in a for-cause drug screen.

Searches may be conducted as part of the investigation process.

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HIPAA and HITECHWhat is HIPAA? The Health Insurance Portability and Accountability Act (HIPAA) was

enacted by Congress in 1996. The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information.

Federal Law.

What is the purpose of the law? Guarantee privacy and security of health information. Protect health insurance coverage, improve access to healthcare. Reduce fraud, abuse and administrative health care cost. Improve quality of healthcare in general.

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What is HITECH? The Health Information Technology for Economic and Clinical Health

Act (HITECH) was signed into law by the President on February 17, 2009. It is the part of the American Recovery and Reinvestment Act of 2009.

It is a Federal Law. HITECH Act strengthens those patient privacy protections of HIPAA

and places additional requirements on the healthcare community.

What is the purpose of the law? Makes massive changes to existing privacy and security laws. Increases penalties for privacy and security violations. Creates a nationwide electronic health record.

HIPAA and HITECH

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HIPAA/HITECH Confidentiality Information may be considered identifiable if it contains, but is

not limited to, any of the following: Unique ID number given at admission, name, discharge date, address including street, city, county, zip code and equivalent geocodes, health plan beneficiary number, names of relatives, account number, birthdates, telephone numbers, email addresses, social security numbers or medical record numbers.

The Notice of Patient Privacy requires patients are notified when their protected health information is breached by a hospital.

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Photographing/Videotaping

OUMS is responsible for protecting patients, employees and visitors from unauthorized photography/digital taping/video taping, etc. Photographing patients or patient test results with any photographic or video device is prohibited and considered a violation of HIPAA.

HIPAA/HITECH guidelines now state that Electronic Media now includes flash drives and digital memory cards.

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Photographing/Videotaping

Displaying and/or distributing images of patients without approval is not permitted. This includes images which may have been taken by others and images which may be on non-OUMS computers. Demonstrating respect and confidentiality of all patient information and images is expected of students at all times.

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Apply online – www.oumedicine.com HR Role – Pre-Screening; Questions Offer – Made by HR Pre-Employment Processes – Drug screen, Physical,

and Background Check. Contact a member of the Recruitment team for questions

at 405-271-6035 or email [email protected]

Employment Process

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Questions?

If you have questions, please feel free to contact your Clinical Instructor

or Human Resources

at 405-271-6035