student and faculty core orientation approved 5 23 2011, revised 5 2012

Student and Faculty Core Orientation

Approved 5 23 2011, Revised 5 2012

Introduction

Welcome to the Student and Faculty Core Orientation! This presentation includes orientation information that is required by all healthcare agencies and is a requirement for undergraduate nursing students completing clinical rotations in the Triangle and Triad areas of North Carolina. The presentation was completed by the Triad Group and the Triangle Clinical Consortium, including both academic and clinical partners. The NC AHEC Program website is the host for the Core Orientation presentation. If you have trouble accessing the presentation, please contact your school coordinator.

Expectations

To provide the best healthcare possible, we believe that everyone must be committed to the healthcare agency’s values and standards of behavior.

Values

As mission-driven organizations, our values are:Outstanding Service

We are committed to outstanding care, services and management.

Caring Spirit

We demonstrate respect and compassion for all individuals.

Innovative Climate

We are committed to creativity and individual initiative.

Integrity

We are organizations characterized by high ethics and integrity.

Financial Viability

We are committed to financial viability to ensure the future of our organizations.

Standards of Behavior

Professional Appearance• Wear nametag at all times.

• Comply with dress code policy.

Positive Attitude• Acknowledge the presence of patients and visitors.

• Don’t conduct personal and non-emergent conversations around patients and family members.


Communicate with Compassion and Courtesy• Address all customers by their names, not room numbers.

• Avoid terms such as “Honey” and “Sweetie.”

• Acknowledge patient complaints and concerns.

Clean/Safe/Attractive Environment• Keep workstations and patient rooms neat and clean.


Anticipate Needs• Assist anyone who appears lost.

• Ask “Is there anything else I can do?” before leaving the room.

Privacy and Confidentiality• When entering a patient room, knock and wait for a response.

• Identify yourself.

• State the purpose of your visit.


Workplace Harassment

• Harassment – Sexual harassment or any form of physical, mental or emotional abuse will not be tolerated.

• Respect the rights of others.

• Be careful not to tell inappropriate jokes.

• Notify instructor or supervisor

of the unit if you experience any issues which concern you.


The Patient Care Partnership

Understanding Expectations, Rights and Responsibilities

• High Quality Care• Clean & Safe Environment• Involvement in Care• Privacy Protection• Help when Leaving• Help with Billing Claims

*American Hospital Association – replaces Patient’s Bill of Rights 2001

Corporate Compliance

Required to Report Concerns - most susceptible – Children, Disabled and Aged• Abuse - intentional inflection of pain, injury or mental anguish. Signs: multiple injuries,

bruises, inappropriate burns or fractures, repeated ED visits, no opposition to painful procedures.

• Neglect – failure to provide adequate materials, shelter or food necessary for the health. Signs: poor hygiene, hunger, emaciation, delay in reporting injuries, abandonment.

• Exploitation – the illegal or improper use of a child or a disabled adult or the person’s resources for another’s profit or advantage. Signs: sudden change in banking practices, unpaid bills when resources are available, previously uninvolved relatives claiming rights to possessions.If you suspect any of the above, seek guidance from Instructor or direct care Nurse

Corporate Compliance

These are laws and regulations students and faculty should know.

HIPAA = Health Insurance Portability and Accountability Act

The Privacy Rule:– Protects an individual’s health care information– Identifies permitted uses and disclosures of this protected health

information (“PHI”)– Gives patients control over their health information (Patient’s Rights)

The Security Rule:– Protects an individual’s health care information maintained or

transmitted electronically– Requires administrative, physical, and technical safeguards for

electronic PHI (ePHI)– Disciplines workforce members who fail to comply with security policies

and procedures

Corporate Compliance: HIPAACorporate Compliance: HIPAA

Privacy & Security

Corporate Compliance:HIPAA Privacy & Security

What is PHI?• Information that identifies a person who is living or deceased• Past, present, or future health information• Health information that is electronic, in paper form, or spoken in

conversation such as lab reports, conversations among clinicians, x-rays, nursing

notes

PHI identifiers include information such as:• Name• Name of relatives/family member/employer• Mailing and e-mail address• Phone number or fax number

– Social security number or medical record number– Date of birth, dates of service– Insurance and bank account numbers– Face photos, voice, finger or retinal prints– ZIP code– Unique identifiers

Corporate Compliance: HIPAA

• HIPAA is a federal law.

• Any information about a person’s healthcare treatment or payment plan that allows you to identify the individual is Protected Health Information (PHI) by HIPAA.

• Any information that can be used to figure out an individual’s identity, such as an account number or health plan enrollment number is also Protected Health Information (PHI).


Confidentiality is more than a legal and regulatory issue.

It is:

• A basic show of respect for all patients and employees.

• A trust issue. All patients must be able to trust the healthcare agency toprotect their medical information from inappropriate access.


Did you know?Within the Electronic Medical Records systems,

ACTIONS CAN BE TRACKED

• Each time a patient’s record is accessed.

• Which parts are accessed.

• Who accesses a record.

• How long a record is accessed.

Health Information Management (Medical Records) also tracks who accesses paper records.


What Information Can YOU Access?

It must be:

• Information to perform your duties as a student.

• Patient must be in your care.

You CANNOT Access

• Medical records of friends, family, high-profile patients, other employees or your own record.

• Former patients, even to see how they are progressing.

Remember: This information is Protected Health Information (PHI) and not needed for your duties.


If a student or faculty member needs his/her medical information or that of a family member, he/she MUST contact the appropriate healthcare agency Medical Records section or Health Information Management.


What Information Can You Share?• Note specific agency policy for patients who don’t want to

be identified for any reason.

Unless the patient objects, it is OK to share:

• Patient’s name, room number and condition with clergy andthose who ask for the patient by name in the hospital.

• PHI can be shared with the American Red Cross fordisaster relief purposes and for military emergencymessages.

Corporate Compliance: HIPAAWhen Can Information Be Given Without Prior

Authorization?

• In medical emergencies (life or death) when there is no one available to give consent.

• If there is a possibility of abuse and neglect, healthcare workers follow legal guidelines for reporting (follow healthcare agency policy).

• If there is a communicable disease, it must be reported to public health agencies. Therefore, you need to notify your instructor, who will notify the appropriate person/Infection Prevention/Control Department.

• In verifying medical treatment for insurance claims/Medicare payments.

• For subpoenas or court orders.

Always ask your instructor, clinical coordinator or supervisor before sharing PHI without an authorization. They will guide you as to the correct procedure.


Ask yourself this question:

Can I identify the patient from the information shown?

If the answer is “yes,” then this patient care information must be hidden from public view.

Caution: Confidentiality extends to social networking (Facebook, Twitter, YouTube, etc.) sites. As these become more commonplace, it is imperative no one discusses or posts patient information on these sites. Taking/posting photographs is not allowed.


Some Reasonable Safeguards to Protect PHI

Remember that PHI can be spoken, written and electronic

• Place charts and reports facedown.

• Log off before leaving the computer.

• Avoid discussing patients in public areas (elevators, cafeteria, hallways).

• Place census lists in an area not visible to the public.

• All hard copy reports –worksheets or report sheets- developed during clinical, and all electronic reports are to be protected from public view and must not to leave the Department.

See facilities’ policy regarding process for destroying paperwork.


Incidental Uses and Disclosures

• PHI is communicated without intent while performing normal and permitted activities.

• These cannot be prevented using reasonable measures and are limited in nature.


How to Prevent Violations?

• Keep telephone calls and oral reports confidential.• Protect computer passwords.• Verify fax numbers.• Remove patient names or other information that identifies a patient before recycling papers.

− Use the identified Shred containers or

− Use a heavy black marker

• “De-identify” other patient materials, e.g., such as armbands, before throwing away.

De-identify means removing all PHI identifiers, i.e., any item that can identify a patient. • Place in a secure container for disposal or cut them into small pieces.


Written Authorization

• Get the patient’s written authorization before you give out information from the medical record.

• Contact Health Information Management or Medical Records for guidance.

• Refer to the healthcare agency policies on uses and disclosures of Protected Health Information.


How to Say “No” with a Smile

• “I can’t talk about it. It’s private.”

• “We are required to protect the patient’s privacy.”


HIPAA Violations

• Patient charts left open.

• Discussions about patients in hallways, cafeteria or other public places.

• Computer screen open and visible

• Reports left on fax machines and printers.


Report Privacy Violations

• Reports of a privacy violation should be reported per agency policy.

• Discuss first with your instructor, charge nurse, or health agency Privacy Officer or Corporate Compliance Officer.

Corporate Compliance: EMTALA

EMTALA: What Is It?

• It is a federal law.

• EMTALA: Emergency Medical Treatment Labor Act.

• Every patient who comes to the Emergency Department requesting emergency medical care gets evaluated: - By a qualified healthcare provider within the agency. - Regardless of the individual’s ability to pay.• If there is an emergency condition, the patient is treated or transferred to another hospital with specialized care.

Also known as COBRA and “Antidumping” Act

Corporate Compliance: Reporting

Safe Medical Devices Act (SMDA)

Medical devices include anything, other than drugs, used in a patient care or diagnostic setting such as:

• Beds • Defibrillators• Rehab Equipment • IV Sets

• Implants • Wheelchairs

• Bandages • Lift Equipment• Infusion Pumps • Monitors

• Lab Devices • Catheters


Safety Management

Be certain you have training before using equipment or performing procedures

You have a responsibility to report workplace hazards to your instructor/supervisor.

You must immediately report the following incidents to your instructor or supervisor:

Broken equipment or utility interruptionsInjuriesSpillsAny other health and safety incident


Safe Medical Devices Act (SMDA)

Federal law requires a report of all incidents where there is a reasonable suspicion that a medical device caused or contributed to a patient’s

• Serious injury • Serious illness • Death

Incidents are reportable if they:• Require surgery or medical intervention.

• Result in permanent impairment of a body function.

OR

• Permanently damage a body structure.


Safe Medical Devices Act (SMDA)If a patient is injured by a medical device, you should:

1. Take care of the patient’s immediate needs.

2. Remove the device (save all settings and disposables).

3. Label device “Do not use” and include date and time.

4. Alert your instructor, so he/she can alert the supervisor.

5. Report unsafe device according to agency policy.

Corporate Compliance: Code of Conduct

Important Compliance Issues and Definitions

• Fraud is intentionally filing an incorrect claim to state or federal government for payment.

• Abuse is accidentally filing a claim that you should have known was incorrect.

• Anti-kickback laws govern issues such as paying for referral of patients or accepting inappropriate gifts.


Federal False Claims Act (FFCA)

It is a crime for any person or organization to knowingly make a false record or file a false claim with the government for payment.

No proof of specific intent to commit fraudis required.


What Is a Violation of the Federal False Claims Act?

• Providing services such as drugs, oxygen or X-rays without a documented physician order and allowing billing to occur for those services.

• Caregivers without current licensure and required certifications.


Gifts from Patients

• Students/Faculty cannot personally accept gifts, tips, money or other gratuities from patients and/or their families.

• To allow the patient to show appreciation for care, small tokens such as cards, flowers, plants or candy may be accepted on behalf of the unit/department, but they are discouraged.


Consequences if Studentsand/or Faculty Don’t Comply

• Students/Faculty and/or the Nursing School could lose clinical privileges.

• Fines and/or imprisonment for clinical agency and school,

(everyone involved).

• Healthcare agency could lose its Medicare and Medicaid funding and ability to treat patients.


Questions or Concerns?

• Talk to department director/manager.

• See Compliance and Privacy (HIPAA) information in the specific agency policies/guidelines.

• Call the agency’s Compliance/Privacy Officer or hotline.

• Or call toll-free – 866-506-8890.

Hand Hygiene

The expectation is that each healthcareworker (including students) will performproper hand hygiene whether wearing gloves or not:

• Before touching a patient or his/her environment.

• After touching a patient or his/her environment.

Infection Prevention/Control

Hand Hygiene Compliance

As a healthcare agency, we take proper hand hygiene very seriously.


What if I fail to perform proper hand hygiene?

• If a student is observed failing to perform proper hand hygiene, the clinical instructor, as well as the school may be notified.

• Repeated failings could jeopardize a student’s clinical rotation.

Bloodborne Pathogens

The healthcare agency’s Bloodborne Pathogen (BBP) Exposure Control Plan provides information on:

• Hepatitis B Vaccinations.

• Jobs and tasks that are risky.

• How to choose Personal Protective Equipment (PPE).

If you have questions about BBP:

• Contact appropriate agency department or refer to the agency’s policy manual/resource

• After hours, contact the nursing supervisor or equivalent.

• To review the BBP Exposure Control Plan, access the agency’s resource/policy manual.


Blood Spills and PPE

When handling blood or “Other Potentially Infectious Materials” (OPIM) and anytime there is a risk of a splash, you MUST use the following Personal Protective Equipment (PPE):• Gloves – When handling blood, OPIM or non-intact skin.

• Gowns – When there is a risk of splash of blood or OPIM to clothing.

• Masks and Goggles (both) or Face Shields – When blood or OPIM could splash your face.

Make sure you know where to find these items and how to use PPE.

If it is wet, dripping, and doesn’t belong to you, wear PPE!


Blood Spills and Exposures

To clean a blood spill/exposure:

1. Put on gloves and other PPE appropriate to the size of the spill.

2. Contain the spill.

3. Spray the area with an approved disinfectant.

4. Wipe clean.

If you are exposed to blood or

other body fluids:

5. IMMEDIATELY wash the exposed skin with soap and water or flush mucous membranes with water or saline.

6. Report to infection prevention/control department or specialist/department per the agency policy.

7. Complete an appropriate report per agency policy.


Sharps SafetySharps Safety Devices are for your protection and, by law,you MUST use them. Examples of Sharps Safety devices:

• IM/SQ needles and syringes.

• Needle-less IV tubing sets.

• Safety lancets.

• Phlebotomy devices.

• IV safety catheter.

Sharps should never be thrown away in anything otherthan a Sharps disposal box.

If the agency is still using non-safety devices, ask your instructor about finding a safer alternative.


Standard Precautions

In addition to hand hygiene, PPE and safe injection practices, other elements of standard precautions include:

• Care and cleanliness of the work area.

• Cough etiquette and respiratory hygiene.

• Safe handling of laundry.

• Patient isolation and transportation.

• Handling of dirty patient-care equipment, instruments and devices.

Guidelines for Isolation PrecautionsRefer to agency policies and procedures


TB Precautions

To prevent the spread of TB, patients suspected of having TB must:

• Wear a surgical mask until they are placed in a negative pressure,* private room.

• Be placed on “Airborne Precautions.”• Wear a surgical mask anytime they are outside the negative pressure room.

Any one entering the room of a patient on Airborne Precautions must wear an N-95 mask or PAPR. Fit-testing is required for N-95 mask wear.

Students/faculty are not usually fit-tested for N-95 masks and therefore should NOT be caring for patients with

Airborne Precautions.


Frequent Safety Round Issues

Frequent infection prevention issues cited during safety rounds:• Open food and drink – No open food and drink

in clinical areas.

• Linen – Clean linen must be covered. NEVER place bags of linen on the floor.

• Portable patient care equipment – Must be cleaned between patients and identified

as “CLEAN” per agency policy.


• Contact specific healthcare agency to find out where to access Policies and Procedures.

• It is important you are familiar with individual agency’s Policies and Procedures in providing patient care.

Policies and Procedures


Patients have a Right to Pain Management• Pain is the fifth VS assessment

• Tools:

• Medications

• Emotional Support

• Comfort measures

• Alternative therapies

• Refer to the agency’s Pain Assessment & Reassessment Policy & Procedure


FALL REDUCTION

Is Everyone’s Business

In a hospital, an accidental fall can change a short stay for a minor problem into a prolonged stay.

• Prevent Falls:

Bed in low position / call bell in reach / non-clutter / pain assess & med / med evaluation / routine rounds / adequate lighting / non-skid footwear / soft touch call light / routine toileting

• Prevent Falls by Identifying “at Risk” Patients

• Refer to the agency’s Fall Reduction Practices


Recognition & Response to a Deteriorating Change in a Patient’s Condition

Purpose is to provide early and rapid interventions to promote positive outcomes

• Identify Early Warning Signs & Report

• Refer to agency’s process for managing unstable patient situations


Reporting of Adverse Event

Events that are inconsistent with Standards of Care• Near Misses

• Serious & Non-Serious

• Goal: Improve Quality & Safety

• Refer to the agency’s Reporting of Adverse Events Policy & Procedure

RESTRAINTS

Limited use for Medical or Behavioral Reasons• Alternative Measures First

• Preserve Safety & Dignity

• Requires training

• Required periodic release and

offer of food, water & toileting

• Requires physician time-limited order, not PRN

Refer to the agency’s Restraint Policy & Procedure


Please Note:

Each healthcare agency has identified specific emergency codes and

terminology. Please refer to each specific agency’s orientation material for codes,

alerts, and emergency telephone numbers.

Emergency Codes

Fire

Emergency Codes

ctivate the alarm and call the emergency number.

4 steps to respond to a fire:escue anyone in immediate danger.

lose doors and windows.

xtinguish if possible. Evacuate if necessary.

R

CE

4 steps for using an extinguisher--“PASS”:

A

1 2 3 4

Fire

Emergency Codes

Oxygen tanks and other compressed gas cylinders can explode. They must be handled with extreme care – it’s federal law!

Secure with a chain or in a rack when stored

Use only an approved carrier during transport – an approved carrier is designed for this purpose.

Store in limited quantities

Full and empty tanks must be stored separately and clearly labeled for easy identification.

Hazardous Material or “Haz Mat” Incident

Emergency Codes

When a significant chemical spill/exposure has occurred within the health agency.

• Avoid the area until “all clear” is announced.• Trained health agency personnel will respond to the scene and notify the

Fire Department if necessary.• Nearby departments should prepare to receive re-routed traffic and be

ready for possible evacuation.• Other departments throughout the building are on stand-by to assist if

needed.

No announcement is made for spills that are manageable within the department.

Department staff should be trained to clean spills of chemicals they use regularly.

Emergency Codes

Controlling Chemical Hazards

• Respect and understand chemical characteristics.• Use only if you are qualified.• Use only properly labeled containers.• Never use unidentified chemicals.• Store chemicals in approved areas.• Immediately report spills, leaks, or accidents.• Use Personal Protective Equipment (PPE).• Properly dispose of used chemicals/ containers.• Ask instructor/supervisor if you don't understand label

information.• Know what to do in an emergency.

Internal Haz Mat Incident

Emergency Codes

• On product labels.

• Material Safety Data Sheets (MSDS).

• In departmental training.

• In safety policies.

Every chemical container must include:

Chemical Name Manufacturer Warnings

If a product is transferred into a new container, ALL the above information must be on the new container.

For the protection of employees, students, etc., safety information about chemicals used within the healthcare agency is available:

You have the right to know about the risks associated with the

hazardous chemicals that you use.

“Haz Mat” Incident

Emergency Codes

An MSDS tells how to:• Use• Store• Clean up a spill• Offer first aid • Dispose of a chemical

MSDS information is available in each department. Know how to access the MSDS information in the area you are assigned.

For emergencies:Call MSDS on-line:

1-888-362-7416

External Haz Mat Incident

Emergency Codes

If a chemical spill/exposure occurs in the community, and the agency is expecting to decontaminate and treat victims in the Emergency Departments, external haz mat precautions will be initiated.

In response:• Members of the HazMat response team should

respond to the Emergency Department.

• Contaminated patients should not be allowed into hospitals without decontamination.

• Other directions will be given per agency policy

• Only properly trained individuals may handle or administer radioactive materials.

• Signs must be posted in rooms where radioactive materials are stored or used.

• Do not enter without proper supervision.• You may not eat or store food in these areas.• When unattended, materials must be secured.

Radiation Safety

Emergency Codes

Bomb Threat

Emergency Codes

In response to a bomb threat announcement, each person should:

• Immediately check your department or area for any items (boxes, backpacks, computer cases, etc.) that don’t belong.

• Call Security to report anything found that could be related to the threat.

• Refer to specific agency policy for further information or talk with your area supervisor for specific directions.

• Prepare to evacuate if directed.

Disaster

Emergency Codes

Disaster means something has happened that changes the way we will deliver services, and may mean a large number of casualties.

For example:

• An outbreak of infectious disease.• A large plane crash.• A weather-related disaster.• Sudden increase in patient census.

Be ready to respond! Review your department’s disaster plan. Remain in your department – you will be contacted if needed.

Security Alert

Emergency Codes

What is security alert?• Response to an incident of civil or emotional unrest within

healthcare agency that threatens the safety of patients, visitors and staff.

• Potential reasons to activate security alert include, but are not limited to:– Heightened emotional or behavioral

response, even after de-escalation attempts.– Visible weapons.– Physical altercations.– Hostage situations.– Communication of threats.

Infant or Child Abduction

Emergency Codes

When an infant or child is missing everyone’s help is needed to locate an infant or child.

http://nnlm.gov/sea/seacurrents/2001/bioterrorism_logo.jpg

Missing Infant or Child

Emergency Codes

Be familiar with agency policy if you are working with infants and children.

The first few minutes are critical. Quick, decisive action may result in finding the infant.

• Stop : Unless you are involved in a life-saving procedure, immediately stop where you are and what you are doing to search the immediate area.

• Secure : All entrances and exits. • Search: Look for suspicious persons with bundles, bags, and/or carrying infants. Report suspicious persons or items to the organization’s security or law enforcement.

Some healthcare agencies are participating in the statewide program to implement standardized armband colors for improved safety. Check each agency’s orientation material for participation and use of the colored bands or other method of identification.

Banding Together for Patient Safety

Patient Safety

Cultural Diversity

To demonstrate the values of outstanding

customer service, integrity and a caring spirit,

honor individual differences by treating

everyone with respect, courtesy and

sensitivity to their unique needs, concerns or

beliefs.

About 32% of the U.S. population belongs to ethnic or racial minority groups: 12% African-American; 9% Hispanic; 4% Asian; and 2% belong to other groups. (CiNet Healthcare Learning: EDA 450-0069)

Cultural Diversity

Assumed Similarity:Thinking that everyone else seesthe world the same way you do.

Example: Nurse assumes that the patient can read a brochure because the nurse can read it.

Not all people learn the same way. A patient may understand spoken English but not be able to read it. Use multiple approaches when teaching patients and families.

Cultural Diversity

Comfort with the Familiar:We are often drawn to otherswho look, act, or think theway we do. Example: People froma specific unit will tend to eat with other members from their same department because they are familiar.

A new person may feel more comfortable eating with someone they met during orientation.

Cultural Diversity

Anxiety and Tension:

These emotions can happen when you feel uncomfortablearound people who are differentthan you. The key is how youhandle those emotions.

Example: A new person eatswith people from another department; co-workers or fellow students can invite him or her to eat with them.

How the co-workers treat the new person will affect everyone – it will either add to or cut down on the anxiety and tension.

Cultural Diversity

Ethnocentrism:

The belief that one’s own cultureor ethnic group is better than others. Differences are often viewed as inferior.

Example: If a new personthinks of boldness as a good thing, he or she may feel free to ask questions and debate issues with instructor/boss.

If the instructor/boss is from a different culture that values harmony over boldness, he or she may think the new person is bossy or rude.

Before taking offense, put yourself in the other person’s place. Think about their cultural norms.

Cultural Diversity

Stereotyping:

A stereotype is an exaggeratedbelief about a person based on his or her background.

Example: Thinking that all nurses from other countriesare poorly trained.

Judge a person based on what he or she actually does. Do not judge based on what you think that person will do.

Cultural Diversity

Prejudice:

Prejudice is a hostile attitude toward people who do not fit in with your group.

Example: Treating a co-worker/student

from another country as if he or she is not smart.

Language often can be a big problem for staff/students from another country. The medical terms are different, and medications have different names.

A co-worker/student with limited English communication skills often mentally translates words before responding.

Cultural Diversity

Patients from DifferentCultures:

It is possible to tailor your speaking style to the needs of the patient.

The more you know about your patient’s culture and values, the more likely you are to get your point across.

Interpreters are available at most agencies. Contact your department supervisor for more information.

Cultural Diversity

Patients from Different Cultures: (continued)

Ask about the patient’s culture as it relates to treatment: • Some patients may have special dietary needs. • Explain to the patient what to expect in the way of treatment. • Explain how the treatment may differ from what the patient expects.

Asking questions about a patient’s culture will add to your ability to see issues from his or her point of view.

Cultural Diversity

Communication:

• Pay attention to how the patient answers questions• A person who values boldness may think it is polite to make eye contact.• Watch how close the person stands to you and gestures. Also note the tone of his or her voice.• In some cultures, standing close when speaking is a sign of respect.• If you accidentally offend someone, apologize.• Smile, speak in a friendly tone of voice, treat others fairly and respectfully.• Don’t forget that about 90% of communication is non-verbal.

Chain of Command

For any Concerns, Questions or Issues

• Speak with your Instructor or Nurse, first and as appropriate.

• The Instructor / Nurse will guide you further as needed.

General Guidelines

Palliative Care

The comprehensive care and management of the physical psychological emotional and spiritual needs of patients (all ages) with chronic, debilitating, life threatening illness and their families.

Palliative Care Focus• Pain management• Symptom management• Hydration / Nutrition• Holistic approach & support

General Guidelines

Transplant Safety

• Only Trained Personnel from an Organ Procurement Organization (OPO) is permitted to offer families the option to donate, recover donated organs, and distribute in an equitable manner

• Refer inquires to your clinical faculty and the patient’s primary nurse.

See the agency’s Policy and Procedure regarding Organ Transplantation

General Guidelines

General Guidelines

Hazardous Waste

Regulated Medical Waste:

Blood or body fluids in individual containers* Pathological waste (lab, tissues, organs) Microbiological waste Bloody (saturated) dressings, gauze Blood transfusion bags Materials used for cleaning blood spills

http://www.bing.com/images/search?q=red+bag+waste

General Guidelines

Meals Libraries

Student Parking

Many agencies encouragecarpooling and parking areasare agency specific for students.

See specific agency guidelinesfor details.

General Guidelines

Dress Code• Picture identification badges must be worn above the

waist and must be fully visible.

• Clothing must be clean, neat, pressed and non-tattered.

• Shoes should be in good repair. No sandals or open toe shoes in patient care areas.

• Good personal hygiene. Use good grooming habits, regular bathing and shampooing, to avoid obvious and unpleasant odors. No perfumes, fragrances or after-shaves are to be worn in patient-care areas.

• Hair should be styled as not to interfere with patient care. Beards and mustaches should be short, neat and trimmed.

General Guidelines

Dress Code

• Tattoos should be covered.

• Nails should be neat, clean and short.

NO artificial nails, nail applications or overlays are allowed for direct bedside caregivers.

• Underclothing must be worn and not visible.

• Use discretion for professional nursing attire in the agency. Wear a lab coat over street clothes.

NO tank tops, bare midriff, revealing clothing, sweat pants, biking shorts, jeans, capris, shorts or flip flops.

• Jewelry – Conservative and safe, based on the area assigned. Keep to a minimum in patient care areas.

General Guidelines

Phones/Valuables

• Personal phone calls should be limited to emergencies.

• Personal cellular phones are to be turned off and not used in clinical settings!

• Storage is limited for personal belongings.

• Valuables cannot be secured.

• Also, no cameras are allowed in the clinical

setting.

General Guidelines

Theft PreventionReduce your risk of becoming the victim of a theft. Your best defense is to limit the opportunity.

Here are some basic security reminders:

Parking Lots

• Keep valuables out of sight.

• Place money, purses/wallets, GPS devices, packages and shopping bags in your car’s trunk.

• Always lock your vehicle.

• Park in well-lighted areas.

• When it’s dark outside, walk to your car with friends and fellow students. At some facilities you also may request an escort by calling Security.

• Secure bikes, motorcycles and mopeds.Security awareness is everyone’s business.

General Guidelines

Now that you have completed the core orientation, please return to your school’s

website to take the orientation test.

If you have questions, contact your school coordinator.

Orientation Test

student and faculty core orientation approved 5 23 2011, revised 5 2012

Documents

outstanding care

core orientation presentation

patient complaints

care privacy protection

patients bill of rights

presence of patients

triangle clinical consortium

clinical rotations