Mandatory Annual Safety Education

1. ANTI- HARRASSMENT Mandatory Annual Safety Education

2. Anti-Harassment Policy Statement Culpeper Regional Hospital maintains that harassment of applicants and employees based on race, color, sex, religion, national origin, age, marital status, veteran status or disability, including sexual harassment (all as defined by applicable law) is prohibited and will not be tolerated. The Hospital will not tolerate unlawful harassment of any employee, patient, vendor, contractor or medical staff member by anyone else including hospital managers, co-workers, patients, visitors, vendors, contractors, or medical staff members. All forms of unwelcome and potentially unlawful conducts should be reported immediately to the Human Resources Director or the Senior Vice President of their area. Unlawful harassment by managers or employees will be grounds for prompt, appropriate disciplinary action up to and including termination.

3. Sexual Harassment Sexual Harassment is defined as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature when submission is made a term or condition of employment; employment decisions are based upon submission to or rejection of the conduct; or the conduct unreasonably interferes with an employee’s work performance or creates an intimidating, hostile or offensive work environment.

4. Sexual Harassment Both men and women can be victims of sexual harassment Quid Pro Quo – “this for that” describes a situation in which a supervisor conditions an employment decision on the exchange for sexual favors. For example, if a supervisor tells a female employee that she will not get a promotion unless she goes on a date with him. “Something for something”. Formal, courteous, respectful, pleasant and non-coercive contacts between individuals that are acceptable to both are not considered sexual harassment.

5. Hostile Work Environment Conduct that is pervasive enough to change the terms and conditions of employment. Hostile work environment harassment is a work environment that a reasonable person would find offensive. For example: Unwelcome sexual attention, sexually oriented conversation, displaying of graphic pictures or jokes, which are clearly considered offensive.

6. Types of Sexual Harassment Gender Harassment Same Sex Harassment Sexual Orientation Harassment Transgender Harassment

7. Other Types of Harassment Racial Harassment Racial slurs, jokes, offensive language, physical assaults or threats, offensive objects or pictures that creates an intimidating, hostile or offensive work environment.

8. Age Harassment The federal Age Discrimination in Employment Act protects employees from age discrimination and harassment Examples include: comments about older workers being slow, inept at technology and putdowns.

9. Disability Harassment The Americans with Disabilities Act prohibits discrimination based on a person’s disability. Disabilities include mental impairments as well as physical. Examples include making fun of someone who walks with a limp or using demeaning names for a disabled person.

10. Religious Harassment Occurs when employees are required or coerced to abandon, alter or adopt a religious practice as a condition of employment or when an employee is subjected to unwelcome statements or conduct that is based on religion that is so severe that the employee finds the work environment to be hostile or abusive. Mocking or derogatory comments about a person’s beliefs is also to be considered religious harassment.

11. More Types of Harassment Harassment based on someone’s filing a worker’s compensation claim Harassment based on someone taking leave under the Family Medical Leave Act Harassment based on a person’s political affiliation

12. Continued Harassment based on an employee’s status as a whistleblower Harassment based on union membership or non membership Harassment based on complaints about safety violations Harassment that is a result of retaliation

13. Anti-Harassment Culpeper Regional Hospital’s Anti-Harassment policy prohibits any type of harassment in the work place. All forms of unwelcome and potentially unlawful conduct should be reported immediately to your director, the Vice President of Human Resources or call the Hotline at (877) 888-4806. All complaints of harassment are taken seriously and will require a workplace investigation by Human Resources. The Anti-Harassment policy #602.0 can be found on the hospital share drive, S;\public\policies & procedures\CRH policies and procedures\0600-employment practices.

14. The Hospital is committed to maintaining a workplace free of harassment. No employee will be retaliated against for making a good faith complaint or assisting with the investigation of a complaint.

15. BACK SAFETY Mandatory Annual Safety Education

16. Your Spine • Consists of: • 24 vertebrae • Shock-absorbing discs • 3 natural curves • Cervical, thoracic, and lumbar • Distribute weight evenly • Maintain these curves for good posture and body mechanics

17. 6 B’s for Better Back Safety • Be Prepared • Test the load before lifting or moving it by trying to move it with your foot • Clear the path of transfer of any debris • Ask for help if you are not sure you can perform something safely on your own • Bend Knees • Bent knees protect the back by maintaining a neutral spine • Lift with your legs and not your back

18. 6 B’s for Better Back Safety • Be Neutral • Keep spine in a neutral position to protect the spinal curves • Tighten the stomach muscles • Base of Support Should be Wide • Separate knees and feet about shoulder width apart • Ease of balance • Be Close • Keep the patient/object close to your body, no further away than elbows reach • Raise the bed surface to you to keep spine neutral

19. 6 B’s for Better Back Safety • Be Mobile • Move your feet, do not twist your spine • Transfer your weight from one foot to the other when moving a patient up in bed

20. Be Prepared Desktop should be clutter-free Tasks requiring 75% or more of your time should be at elbows reach Tasks requiring less than 25% of your time should be at shoulders reach Know when and how to take micro-breaks, stretching, etc. Be Close Computer monitor should be at fingertips reach directly in front of you Shoulders relaxed, elbows at sides and bent to 90 degrees to reach the keyboard tray Feet flat on the floor or propped up on a footrest Seated Activities

21. Be Neutral Use your back support Shoulders over your hips and your head over your shoulders Keep wrists neutral Be Mobile Pivot in the chair, no spinal twisting Push around on the wheels of the chair rather than overreach Seated Activities

22. Sitting/Standing Postures

23. Be Prepared Tasks requiring 75% or more of your time need to be at elbows reach Tasks requiring 25% or less of your time need to be at shoulders reach Bend Knees Do not stand with your knees locked backwards or straight Rest one foot up on a stool, a footrest, or a cabinet Bent knees assist with the neutral spine position Standing Activities

24. Be Neutral Keep spine in a neutral position Tighten stomach muscles to assist with keeping spinal curves stable Be Mobile Move your feet, do not twist your body Stretch periodically, forward, backward, and side to side Base of Support Should be Wide Better balance Able to get closer to the task Be Close Less stress on your back Standing Activities

25. Lifting • Common cause of back injury • Two general rules • Keep the load close • Bend at the knees

26. Analyze the load Place one foot out in front of you Feet flat on the floor Knees slightly bent When lifting: Move both feet closer to the load Bend at the hips Maintain neutral spine Move smoothly Lifting Safely

27. Golfer’s Lift • The golfer’s lift is a way to lift a light-weight object from the floor while still maintaining good body mechanics. • You can hold on to a solid object for balance if needed.

28. Reaching Overhead When performing a task involving reaching, always: • Get close to the object using a stool or ladder • Bring the object close to you when lifting • Take frequent breaks if reaching overhead for extended periods of time • Always maintain the 3 curves of your back

29. Mechanical Lift Systems Maxi Sky Maxi Sky Tempo

30. Maxi Sky Lift A Maxi Sky 600 is located in each patient room on the Med/Surg, Step Down and ICU units. This unit will accommodate up to a 600 lb person for transfers. There is a Maxi Sky 1000 located on Step Down that will accommodate up to 1000 lb. There are several size slings for these lifts, all stored on the individual floors. Slings are marked with the size and the type patient lift in which they are to be used.

31. Tempo Lift The Tempo Lift is located in the Storage Room on Step Down. It is a portable patient lift that can be used throughout the hospital. The Tempo Lift has several size slings that are stored with the unit. Each is marked with the size and the type of lift for which it is to be used. The Tempo Lift is designed to lift a person weighing up to 440lb.

32. Maxi Sky and Tempo Lifts These units will: 1. Lift a patient from the floor 2. Lift a patient from bed to chair/chair to bed 3. Lift a patient to scoot them up in bed 4. Lift a patient to change the bed linens

33. Patient Transfers • Proper body mechanics • Ask the patient to help • Get an assistant • Mechanical lift

34. Other Patient Lift/Transfer Equipment Hover Matt Hover Jack

35. Pushing vs. Pulling • Push, don’t pull!! • Remain close to the load • Don’t lean forward • Use both arms and tighten stomach muscles • Keep elbows close to your body to help maintain a better spine position

36. Protect your Back! • Repetitive motion can cause an injury over time. • Being aware of your body mechanics during everyday activity can help prevent injury in the future!

37. Pressure Ulcer Prevention Wound Care Education

38. What is a Pressure Ulcer? • Areas of damaged skin and tissue that develop when sustained pressure decreases circulation to vulnerable parts of your body, especially the skin over bony areas (buttocks, hips and heels). Without adequate blood flow, the affected tissue dies.

39. Pressure Ulcer Facts from The Joint Commission • An estimated 2.5 million patients are treated for pressure ulcers in acute care facilities in the United States each year. • An estimated 60,000 patients die each year from complications due to hospital-acquired pressure ulcers. • The estimated cost of managing a pressure ulcer is as high as $70,000, and the total cost for treatment of pressure ulcers in the United States is estimated at $11 billion per year.

40. How does this impact CRH? • If a pressure ulcer develops or worsens in a Hospital, the hospital can be held responsible for all costs related to the pressure ulcers. Insurance may also deny payment for the entire inpatient stay. • Therefore, it is each person’s responsibility to thoroughly assess and document all reddened and broken areas of a patient’s skin upon admission and at regular intervals while in our care.

41. How does this impact CRH? • It is everyone’s responsibility to recognize signs of breakdown and know how to implement an immediate course of action. • Hospital Acquired Pressure Ulcers lead to decreased patient satisfaction, increased patient health complications, and increased legal actions.

42. How does this affect you? • Emergency Room – mattresses are typically very thin; skin breakdown can begin to occur in a matter of a few hours; a thorough skin assessment should be done with brief notations of where current breakdown is located, especially if the patient is there for more than an hour and is at a higher risk for breakdown

43. How does this affect you? • ICU/StepDown/MedSurg – Patients may be admitted with existing wounds. Immobility and multiple other factors can lead to skin breakdown if not closely monitored. • FBC – Skin breakdown can begin to occur within a few hours. If the patient has existing medical problems that increase the risk of breakdown, even a new mother can end up with a pressure ulcer. Surgical patients are at times admitted to this unit as overflow. Due to decreased mobility, these patients are at a higher risk of developing a pressure ulcer.

44. How does this affect you? • O.R. – Surgical patients who are under anesthesia for extended periods often have an increased risk of developing pressure ulcers. • Diagnostic testing – Stretchers and tables are typically very thin. 30 minutes to an hour on these surfaces can be enough to cause a Stage I pressure ulcer in an at risk patient.

45. How does this affect you? • Dietary/Housekeeping – These departments may enter the patient’s room several times a day for various reasons. If you notice the patient is in the same position they were in the last time you saw them, mention this to their nurse; they may need nursing to assist them in turning to a different position.

46. Pressure Ulcer Prevention • Leading cause of most pressure ulcers: • Friction • Shear • Moisture • Pressure **Even though a patient may be on an air mattress or placed on a total care bed with rotation settings, the patient must still be repositioned at least every 2 hours.**

47. Pressure Ulcers • Risk Factors: • Age • Immobility • Incontinence • Inadequate nutrition • Sensory deficiency • Multiple co-morbidities • Circulatory abnormalities • Dehydration • Altered level of consciousness/mentation • Prior history of pressure ulcers • Chronic Disease states (Diabetes, CAD…)

48. Patient Positioning • Prevention of pressure ulcers is an important aspect of care in any patient at any age. • It is Culpeper Regional Hospital’s policy to reposition patients at least every 2 hours.

49. Patient Positioning • Reasons for repositioning a patient: • Prevent a pressure ulcer • Provide comfort for the patient

50. Areas of Pressure • Main pressure points found on the body • Sacrum • Hips • Shoulders • Heels • Elbows • Ankles • Back • Back of the head