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HOSPITAL ORIENTATION 2010

HOSPITAL ORIENTATION 2010. June 22, 2010 Center for Health and Healing . ACGME Core Competencies . Dr. Donald Girard , Associate Dean of GME & CME Dr. Andrea Cedfeldt , Assistant Dean for GME Dr.Tana Grady-Weliky , Associate Dean of Undergraduate Medical Education . Patient Advocate.

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HOSPITAL ORIENTATION 2010

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  1. HOSPITAL ORIENTATION 2010 June 22, 2010 Center for Health and Healing

  2. ACGME Core Competencies Dr. Donald Girard, Associate Dean of GME & CME Dr. Andrea Cedfeldt, Assistant Dean for GME Dr.Tana Grady-Weliky, Associate Dean of Undergraduate Medical Education

  3. Patient Advocate Susan Yoder, RN, BSN Director, Department of Patient Relations Administrator on Duty & Decedent Affairs Manager

  4. Department of Patient Relations • Patient Advocacy • Complaint Management • Mediation & Conflict Resolution • Accessing & Navigating Systems • Palliative Care Consult Service • Spiritual Support – Chaplaincy Services • Medical Ethics Consultation • Crisis Intervention & Debriefing for Staff

  5. Administrator on Duty & Decedent Affairs • Administrator on Duty • Front Line Hospital Administration • “House Supervisor” (on steroids) • Patient Placement/Access Management • Bereavement & Requesting Organ/Tissue Donation • Conflict Resolution/Crisis Intervention • Resource to the Healthcare Team (policies, etc.) • Decedent Affairs • Track documentation & location of deceased patient • Work with providers, staff, ME, Funeral Directors & Loved Ones for a smooth, compassionate process

  6. Contacts: • Patient Relations for an Advocate X4-7959 • Administrator on Duty (AOD) pager 12241 24X7 • Decedent Affairs Coordinator pager 12813 (covered by AOD after hours) • Hospital Chaplain – Campus Operator Susan Yoder pager 11405 Welcome to OHSU!

  7. E*Value System Christine Flores Evaluations and Time Keeping

  8. Sleep Deprivation in Residency Dr. Holger Link Sleep deprivation in residency Epworth Scale

  9. The Scope of the Problem “… I always had a prior theory that when you look up all the old sixties research how do you brainwash someone? You sleep deprive them. That’s number, two, and three. Sleep deprive them. You feed them bad food and you repeat things over and over again. It’s like that kind of covers residency.” © American Academy of Sleep Medicine

  10. American Academy of Sleep Medicine Epworth Sleepiness Scale Sleepiness in residents is equivalent to that found in patients with serious sleep disorders. Mustafa and Strohl, unpublished data. Papp, 2002 © American Academy of Sleep Medicine

  11. Consequences of Insufficient Sleep • Increased medical errors • Impaired judgment • Impaired learning • Impaired physical health • Impaired mood and energy • Drowsy driving

  12. Adapting to Sleep Loss • Sleep need is genetically determined • You can’t “adapt” to getting less sleep than you need • Performance may improve somewhat with effort • You can not achieve optimal performance!

  13. Recovering from Sleep Loss • Recovery from on-call sleep loss generally takes at least 2 nights of extended sleep • Most sleep debts can be paid off in 3-4 days!

  14. Source: www.drowsydriving.org

  15. Driving Home Post Call

  16. Signs of Drowsy Driving • Trouble focusing on the road • Difficulty keeping your eyes open • Nodding • Yawning repeatedly • Drifting from your lane, missing signs or exits • Not remembering driving the last few miles • Closing your eyes at stoplights

  17. Drowsy Driving: What Doesn’t Work • Turning up the radio • Opening the car window • Chewing gum • Blowing cold air (water) on your face • Slapping (pinching) yourself hard • Promising yourself a reward for staying awake

  18. 4 second lapse = drowsy crash

  19. Drive Smart and Safe Do not drive drowsy! • Take a 10-20 minute nap and/or drink a cup of coffee before going home post-call • Stop driving if you notice the warning signs of sleepiness • Pull off the road at a safe place, take a short nap • Get ride home, take taxi, or use public transportation

  20. Napping Benefit: Temporarily improves alertness Types: Preventative (pre-call) Operational (on the job) Length: Short naps: no longer than 20 minutes to avoid grogginessLong naps: 2 hours (range 30 to 180 minutes). Be aware of sleep-inertia.

  21. Caffeine • Strategic consumption is key • Effects within 15 – 30 minutes; half-life 3 to 7 hours • Use for temporary relief of sleepiness • Cons: • Disrupts subsequent sleep (more arousals) • Tolerance may develop • Diuretic effects

  22. Library Services Andrew Hamilton Overview of the Library

  23. OHSU Library Library is here

  24. Barcode • You need one • Where you can get one • Library circulation desk • Online at www.ohsu.edu/xd/education/library/services/forms/barcode.cfm

  25. The Library Home Pagewww.ohsu.edu/xd/education/library/ Get access from off-campus Online Catalog Databases Get help

  26. Electronic articles and journals are linked from within databases. Databases may include their own links to full text, as well as the “Find It@OHSU Library” link. 3 different ways to get to the article

  27. Manage your citations

  28. What if we don’t have it?

  29. Summit Catalog • Includes 36 college and university libraries in Oregon and Washington • You can request books, videos, CDs through Summit and they will be sent to the OHSU Library for you to pick up or will be sent directly to distance students • Generally it takes less that 72 hours to get the book • 95,000 titles at OHSU; 9.2 million titles in Summit • IT’S FREE • More information at www.ohsu.edu/library/orbiscascade.shtml

  30. Ways to get help: Ask a Librarian links Chat Email Phone

  31. Infection Prevention & Control Summer, 2010

  32. Department of Infection Prevention & Control: Objectives • How to contact our program • Review resources that will be helpful when caring for patients • Review the OHSU isolation categories • Organism – specific guidelines • Employee Health topics

  33. Department of Infection Prevention & Control • Phone: 494-6694 M-F 7:30AM - 5:00PM • Contact AOD after hours • Physician Epidemiologists • John Townes, MD Adult Infectious Diseases • Judy Guzman-Cottrill, DO Pediatric Infectious Diseases • Lynne Strasfeld, MD Transplant Infectious Diseases • Infection Control Program Manager • Marjorie Underwood RN, CIC • Infection Control Specialists • Linda Young RN, MSN, CIC • Molly Hale MPH, CIC • Emily Ackiss MPH, CIC • Gail Carberry RN, MSN VA Medical Center Rita Tjoelker- 5-7143 Sherri Atherton-5-7144 Tom Ward, MD– Infectious Diseases

  34. The IC Isolation Grid as a Resource

  35. Isolatable Infections & Conditions

  36. De-isolation Grid

  37. EPIC VRE Alert Screen

  38. Back to Basics:Hand Hygiene Cleaning your hands is the most important thing you can do to prevent transmission of infection

  39. Hand Hygiene Interrupts the chain of disease transmission • Antibacterial Soap & Water • Hand friction for 15 seconds • Hand Sanitizer needs to dry • Ensure all surfaces of hands, in between fingers & nail beds are cleaned

  40. WHO: “5 Moments of Hand Hygiene”

  41. Hands Visibly Dirty?Wash Your Hands with Soap and Water • Turn on faucet • Wet your hands with warm water • Apply soap • Scrub your hands for at least 15 seconds • Pay attention to fingernails and areas around jewelry (rings and watches) • Dry hands completely with a paper towel • Use a paper towel to turn off faucet

  42. Hands Not Visibly Dirty? Use alcohol-based waterless product Apply enough to cover all surfaces of the hands, rub until dry, about 15 seconds.

  43. Resident Hand Hygiene Compliance

  44. How do Residents Compare With Others?

  45. Standard Precautions: Protect Yourself! • 100% compliance with hand hygiene • Gloves if touching non-intact skin or rash, any body fluid or mucous membrane • Gown if you may get it on you • Mask/face protection if you may get sprayed or splashed in the face …Think about it before it happens!

  46. Remember - if it is wet and it is not yours- use a barrier!

  47. Standard PrecautionsDetails you might not know… • During aerosol generating procedures (bronchs, suctioning, intubation, nasal wash, NP cx, etc.) use face shield or mask & goggles • If pulmonary TB or other diseases requiring airborne isolation is suspected, wear a fit-tested N95 masks or PAPR • Wear masks for spinal procedures (myelograms, LPs, spinal or epidural anesthesia)

  48. Respiratory Hygiene & Cough Etiquette • YOU and your patients should follow these rules! • Wash hands after coughing and using tissue • Wear mask/eye protection if close to coughing patient (if contagious disease is suspected, patient should be in private room) • Provide patients with tissues, instruct them to cover their coughs, have hand sanitizer available

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