Mercy Hospital Unity Hospital

1. Mercy Hospital Unity Hospital New Employee Orientation Program Part One

2. Orientation

3. Welcome to Mercy’s & Unity’s New Employee Orientation Program • The following slides will aid you in preparing yourself to provide an excellent healthcare experience for our patients. • To progress through the orientation information use the action buttons at the bottom right of the screen to proceed forward (right button) or backward (left button) by clicking on it with the mouse. • While you are reading through these slides check-off your progress on the “New-Employee Orientation Checklist” This form can be obtained from the site you found this program on. It is then to be returned to your manager upon completion of this program. • We hope you find this information helpful and look forward to having you join our exceptional health care team.

4. Contents • Who Are We • Mission, Vision & Values • Allina Hospitals Customers • Accessing the Allina Knowledge Network • Confidentiality / HIPAA • Extraordinary Workplace with Extraordinary Employees • Safety Awareness • Infection Control • Your Role in Restraint Use • Vital Patient Care Issues • Advanced Directives • Medication Safety • Documentation Overview • Information Services and Clinical Systems

5. Who We Are Mercy & Unity Hospitals are dedicated to providing quality, cost-effective health care to over 225,000 households in more than 26 neighboring communities. The hospitals have more than 3,700 employees, 842 affiliated physicians and more than 770 youth and adult volunteers to care for and assist you. • Mercy & Unity respond to a wide range of health care needs with specialty services including: • Bariatric Center *Behavioral Service • Cancer Centers *The Cardiac Centers • Emergency Services *Orthopedics • Neurosciences * Women’s & Children’s Services • A wide range of health education and support groups to help people quit smoking, deal with illness at the loss of a loved one, and other health and personal issues. • LifeLine, a low-cost emergency response system for the elderly or disabled. • Elk Ridge Health, a clinic and surgery center in Elk River

6. Allina Hospitals & Clinics Allina Hospitals & Clinics is a familyof hospitals, clinics and care services that believes the most valuable asset people can have is their good health. We offer a vast array of services and programs through our dedicated workforce of services and programs through our dedicated workforce of more than 22,000 employees. We provide a continuum of care, from disease prevention programs to technically advanced inpatient and outpatient care to medical transportation, home care to medical transportation, home care and hospice services. Medformation Medformation®, a community service of Allina Hospitals & Clinics, is a telephone health information and referral service, offering information on a broad range of hospital and clinic services and events: •Physician referrals •Hospital programs and health screenings •Registration for educational sessions and special events details. Call 651-628-4200. Allina.com Allina.com is offered as a community service of Allina Hospitals & Clinics to support Minnesotans in making informed health decisions. This trusted, local, free resource offers the most up-to-date, credible health information, news and services. Log on at: www.allina.com

7. What we strive for... • Allina Mission • We serve our communities by providing exceptional care, as we prevent illness, restore health and provide comfort to all who entrust us with their care. • Allina Vision • Put the patient first, • Make a difference in people’s lives by providing exceptional care & service, • Create a healing environment where passionate people thrive & excel, and • Lead collaborative efforts that solve our community’s health care challenges. • Allina Values: • Integrity - Match our actions with our words. We live our values and mission in all decisions and actions. • Respect - Treat everyone with honor, dignity and courtesy. Respect values, cultures, beliefs and traditions of others. Value each others talents and contributions. • Trust - We act in the best interests of out patients, physicians, communities and one another. • Compassion - Dedicated to creating a healing and caring environment to support the emotional, physical & spiritual well-being of all. • Stewardship - Use our resources wisely. Commit to being thoughtful stewards of time, energy and talent.

8. Living the Values • Why is it that some patients can have poor outcomes and still say that they wouldn’t go anywhere else for their healthcare? • The difference is the relationships that we create with our patients. • It’s the customer service we provide. • People come back to our hospitals because we live out our values and walk the talk-not just give them lip service. Customer Service Basics • Creating an excellent experience where patients feel assured, included and appreciated. • While much of our work is of a high tech nature, we know the importance of connecting with our customers on a human/emotional level when beginning and ending any interaction. • Who are our customers? • External Customers: • Patients • Families • Physicians • Internal Customers: • Coworkers • Other departments

9. The impact of body language, voice, tone and words Are the words you are saying congruent with your body language and our tone of voice? • Do we say one thing but project the opposite? • Do we ask “What else can I do for you?” each time before we leave their room? When we breakdown communication, we realize that: • 55% of the message is our body language • 38% of the message is our tone of voice • 7% of the message is the actual words we use. To make the biggest impact, your actions must match your words

10. How to access policies on the Allina Knowledge Network (AKN) • All policies are located on the AKN, an intranet site which can be accessed using our network computers. Ask the charge nurse to show you this site during your first shift.

11. Confidentiality HIPAA’s Privacy Law

12. Confidentiality • Maintaining a patients privacy and confidentiality is not only the ethical thing to do, it’s the law. • We are committed to preserving the confidentiality of patient information. • The inappropriate use and or release of information will result in disciplinary action and possible legal action. HIPAA - The Health Insurance Portability and Accountability Act • This revised “Privacy Law” places strict regulations around the privacy and security of patients health information. • The law also mandates that we train everyone in the rules and provisions of this law.

13. Protected Health Information • PHI is basically any information that identifies an individual or could reasonably be used to identify an individual. • This includes, but is not limited to: • Name, address, age or SSN • Health history and conditions, treatment or meds • Hospital or clinic bill or payment record • Any identification that an individual is a patient. • It can be in any form • Verbal, written or electronic • Past, present or future medical information Minimum Necessary Rule • Minimum Necessary Rule: We must only use and disclose the minimum amount of patient information needed to do our jobs. • Simply put: You may only ask for, use and disclose patient information as needed for legitimate patient care or business purposes.

14. Curiosity Killed the Cat – Don’t let it get you! • Sharing with others that you saw someone at the hospital or sharing of their health information may seem harmless to you- but it can be very harmful to the patient-and it’s illegal! • You might be curious to look up information on a family member that is a patient here. Unless you need that information to do your job, you are prohibited from accessing that info. • If in doubt, caution on the side of maintaining patient privacy. Release of Health Information • We must have consent from the patient before giving any information to others, including spouse, family members, or friends. • The inappropriate release of protected health information is illegal and we must address any harm that occurs because of its inappropriate release. • You are held legally accountable to maintain a patients privacy and confidentiality.

15. An Extraordinary Workplace with Extraordinary Employees A Culture of Caring

16. An Environment for Healing When patients see how well we treat one another, they will know this is a good place for healing. • We cannot provide to patients what we are unable or unwilling to provide each other. • If they see or hear uncaring behaviors, they will not find the healthy, healing environment they need. Create a Respectful and Professional Workplace Where You Would Want to Give and Receive Care

17. Diversity Defined as all the differences and similarities that exist among people - including race, gender, age, sexual orientation, job status, physical differences, political affiliations and religious beliefs. We value the differing points of view, varied experiences and the talents of each and every person! • Harassment Free Workplace • We have a zero tolerance policy for harassment in all of its forms. Including, but not limited to, harassment based on: • Sex • Race • Age • National Origin • Religion • Sexual Orientation • Political Preference

18. Key Points on Harassment • It’s the impact, not the intent. • Whether or not you intended harm doesn’t change the fact that someone was impacted by your actions or behavior. • Direct or indirect, subtle or obvious • Employees expect to work in an environment that is not hostile or intimidating. This includes jokes, slurs, pictures, comments – anything that could be felt as harassment. • It can take place at the workplace or at off duty related activities such as social gatherings or calls to your home. • Act early and talk to the accused. Ask them to stop the behavior. If not resolved, escalate this situation by discussing with your leader or manager who will then investigate the activities with the assistance of human resources. If you are uncomfortable talking with the person contact your manager. If it is your manager that is the cause of the problem then speak with an human resource generalist.

19. Safety Vision To make Mercy & Unity Hospitals safer places to give and receive care

20. Minnesota Employee Right to Know Act (ERTK) 1983 The law was passed to make sure employees are told about the dangers associated in working with hazardous substances and harmful physical orinfectious agents. The law outlines both employer and employee responsibilities for safety from work related injury or illness. What does “exposed to” mean? You are considered routinely exposed to a substance or agent if there is a reasonable possibility you’ll be in contact with one of the items during the normal course of your assigned work.

21. Employer Requirements Education of staff and new employees on: • The types of hazardous materials, agents and equipment in your work area. • How to properly handle and work safely with the products. • Where information about hazardous materials is located. Education specific to the materials/agents in your work areas will need to be covered during unit specific orientation. Mercy and Unity uses the computerized “Prosar” system found on the AKN for obtaining Material Safety Data Sheets. Employee Requirements • The law gives you the right to refuse to work under imminent danger conditions or if information or training about how to safely proceed with your job is not provided. • Use personal protective equipment (PPE) available on each unit you will be assigned to. It is your responsibility to use this equipment when situations require protection. Ask the charge nurse if you have questions about the PPEs for that unit.

22. What if I’m asked to work in an unsafe situation? • Tell the unit charge nurse if you feel a work situation may be dangerous • Tell the unit charge nurse if you don’t know how to use or handle hazardous materials and/or equipment. • Report faulty equipment so it can be repaired or replaced. • Don’t put yourself in any situation where you could be injured or harmed. You have the right to refuse to work under dangerous conditions. What Happens Next? • The unit charge nurse will: • Evaluate the situation for safety and the presence of hazards. • Teach you how to safely use the product, direct you to the appropriate resource, provide you with learning materials, give you the appropriate Personal Protective Equipment. • Reassign you to an alternate job until a hazardous condition can be corrected or eliminated.

23. Chemical Spills/Release • Each department maintains procedures for the safe handling and spill clean-up of the hazardous products used in their areas. • You need to receive unit specific orientation on the hazards found in your area. • With any chemical spill, you should notify the supervisor and maintenance.

24. Locating information on Hazardous Substances & Chemicals on the AKN

25. Material Safety Data Sheets (MSDS) provide information on the effects and properties of hazardous substances.

26. Emergency Codes You might hear these emergency codes paged overhead, so it is important to know their meanings. Ask the charge nurse for your role when one of these codes is paged. • Red Alert Fire • Pink Alert Infant/pediatric abduction • Code Blue Cardiac and/or Respiratory Arrest Adult ( 18 years and older). Peds (one month through 17 years) Neonatal (0 to less than one month) • Green Alert Restraint Personnel Requested (RPR) • Orange Alert Disaster Plan in effect • Yellow Alert Bomb Threat

27. Severe Weather Codes • Severe Thunderstorm Warning-conditions are favorable for severe weather • Tornado Warning (phase 1) - a tornado has been sighted. Close windows, blinds and curtains. Keep corridors clear. • Tornado Warning (phase 2) - hospital is in the path of the tornado. Move patients and visitors away from windows to interior corridors closing all doors. Visitors should stay with the patients and staff should move the the best shelter in the department. • Fire Safety Essentials in • Your Department • You will need to locate this information in the areas you work. • Location of the fire alarm pull boxes • Location and type(s) of extinguishers • Emergency phone number x63333 • The stations main oxygen shutoff valve(s) • Evacuation plans and routes

28. R.A.C.E. • Rescue: Move anyone in danger to a safe area. • Alert: Pull fire alarm box and call x63333 to report the fires location. • Confine: Close doors & windows in area, clear corridors and fire exit areas. • Extinguish: Fight the fire only if it will not place you in danger. Blankets can be used to smother the flames of small fires or waste basket fires as well as using extinguishers. Rescue Alert Confine Extinguish

29. How to Use Extinguishers Know the types of extinguisher in your work area. Choose the appropriate extinguisher for the type of fire. Then: • PPull-the pin • AAim-the extinguisher • SSqueeze-the handle • SSweep-the extinguisher hose at the base of the fire.

30. Safety Phone Contacts • Security Manager • Employee Safety Specialist • Patient Safety Director • 763/236-SAFE Phone Numbers can be found on each unit.

31. Infection Control Everyone’s Job

32. Environment surfaces floors gardens People skin intestines Equipment Water Flowers/plants Where do germs come from? Chain of Infection All links must be complete for an organism to spread from one place to another. Our goal is to break the chain in one or more links.

33. Risk of Transmission • Intact skin is a good barrier to organisms but remember that organisms can enter through non-intact skin (cuts, scrapes, eczema) • Mucous membranes allow transmission, such as through: • eyes • nose • mouth • Most transmission occurs through contact: • Direct contact- touching patient • Indirect contact - touching a contaminated surface • Spray/splashes: Fluids, sputum, etc • Most contact is with our hands

34. Hand Washing Hand washing is the single most effective way you can break the chain of infection. Hand Washing Basics • Soap - Use only hospital approved soaps, lotions & foam products. • Warm running water • 15 seconds – sing the ABCs song or “Happy Birthday” twice • Use friction • Turn off faucet with paper towel. Waterless Hand Washing (Quik-Care Alcohol foam) • Preferred method of hand cleaning if hands are not visibly soiled or contaminated with blood or body fluids. • Dispense a walnut size amount and rub hands and under nails until dry. • Use before and after every patient contact or contact with contaminated equipment. • Contains emollients, therefore is better for your hands and is less drying to hands than soap and water. • The emollients can build up on the hands after repeated use, so, wash with soap and water occasionally. Lotion • Accent Plus is the hospital approved lotion which is compatible with hospital microbial soap and gloves. • Use at least 3-4 times each shift.

35. Artificial Nail Restriction • This restriction must be followed by everyone who has direct patient contact, cleans rooms, handles patient supplies, prepares or serves food/drinks, handles medications or blood products. • Artificial nails including tips, wraps, overlays, acrylics, gels, any appliques, nail piercing, nail jewelry or any other artificial nail enhancements of any kind are not allowed in our facility. • Natural nails must be kept 1/4 inch or less. Blood Spills • Potential exposure to blood or body fluids could occur at any work site • There is a plan in place for each work site • Guiding principles of each plan: • Avoid direct contact with body fluid. • Wear gloves. • “Cleanup Twice” – once for the spill and once to disinfect the area. • Remove gloves • Wash hands. • Allow area to air dry e.g.; 10 minutes

36. Standard Precautions Standard Precautions considers all patients as potentially infectious. Prevent exposure to infectious organisms by wearing Personal Protective Equipment (PPE) when contact with the following is anticipated: • blood • body fluids, secretions and excretions • non-intact or broken skin • mucous membranes Personal Protective Equipment (PPE) PPE is located in all patient care areas. Exact location should be sought out during unit specific orientation. • Gloves - to keep hands clean • Gowns - to protect uniform from getting splashed or wet • Facial protection - to protect mucous membranes from getting splashed or sprayed

37. Other Infection Control Issues

38. Other Infection Control Issues

39. Location of Exposure Control Plan and Infection Control Policies • The Allina Knowledge Network (AKN) • Ask your charge nurse about access to the AKN. • Ask your charge nurse about unit specific safety goals.

40. Pharmaceutical Waste Collection Everyone’s Job

41. Pharmaceutical Collection Process • The EPA and MPCA have mandated that all unused pharmaceuticals will be collected as hazardous waste (no longer drained in sewer or trash) • Exception: DEA Controlled Drugs (Narcotics) must be witness wasted in sewer-empty containers are collected • The following slides describe different collection bins and the types of pharmaceutical waste that should be placed in them.

42. Pharmaceutical Waste (No sharps, controlled drugs or infectious waste) Dispose of unused or outdated pharmaceutical products • Partially used vials, tubes, inhalers, IV bags and tubing containing medications • Discontinued medications • Tablets or capsules dropped or refused by patient • P-listed drugs including empty vials, bottles, IVs etc.

43. Dual Waste: Hazardous and a Sharp • Hazardous Drug waste with sharp • Syringe not fully dispensed (partial) with sharp containing hazardous drug • Empty P-listed (Warfarin, Epinephrine, Phentermine, Nicotine, Physostigmine) drug ampules and syringes.

44. Dual Waste: Hazardous and Infectious • Hazardous Drug waste mixed with Infectious waste • Place in BLACK hazardous pharmaceutical waste container with red bag and a biohazard sticker • An example of this waste stream would be an IV bag or tubing containing a drug and patient blood in the tubing • By regulation this has to be handled separately and not thrown into Infectious Waste

45. Bulk Chemotherapy • Dispose of “bulk” chemotherapy drugs, products, and contaminated waste items containing more than residual “trace” contamination. • Label container “Bulk Chemo” • The container will also be identified with a Hazardous Waste Label.

46. In Closing... Final Considerations

47. Department Specific Orientation Checklist • Minimally, your department specific orientation should include the following items: • Location of: • Crash Cart • Emergency Equipment • Fire Safety • Personal Protective Equipment • Evacuation Map • Orientation to: • Documentation process and related technology • Medication administration and related technology • Accessing policies, procedures and other resources • Hospital and unit care & quality improvement initiatives • Demonstration and application of quick release tie and application of locking restraints (required for anyone working with patients).

48. JCAHO Requires That All Employees Are Aware… That Mercy and Unity Hospitals are accredited by the Joint Commission. If you (as an employee) have concerns about the safety or quality of care provided in this hospital, please feel free to bring them to your supervisor, manager or director. If you feel you have been unable to voice these concerns to your hospital leadership, you may report these concerns to the Joint Commission. Instructions for filing a concern with the Joint Commission can be found online at: www.jointcommission.org/GeneralPublic/Complaint Hospital leadership may not retaliate against any employee who voices a concern to Joint Commission.

49. You Have Completed Part One!Please turn in the checklist used for this training program to your manager or continue on to part Two based on the directions from your manager. Press the “ESC” key to end