Mercy & Unity Hospitals

1. Mercy & Unity Hospitals Agency and Travel Non-Employee Orientation Program

2. Orientation Part One

3. Welcome to Mercy & Unity Hospitals Non-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 “Non-Employee Patient Care Staff Orientation Checklist” This form can be obtained from the site you found this program on or your agency. It is then to be returned to your agency 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 part of Allina Hospitals & Clinics • Allina is a not-for-profit healthcare organization serving Minnesota and western Wisconsin • Although we are not-for-profit, it is still necessary to watch the financial bottom line. We need to be able to meet the current and future needs of the communities we serve. We reinvest profits in new equipment and advanced technologies to better care for our patients. • Allina Hospitals & Clinics • 13 hospitals • 42 clinics • Medical transportation services serving 70 Minnesota communities • Home care, Hospice, and Palliative Care • Metro Hospitals: • Mercy • Unity • Abbott Northwestern • United • Phillips Eye Institute • Regional Hospitals • Buffalo • Cambridge • Owatonna • St. Francis • River Falls • New Ulm

6. 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.

7. 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

8. 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, you’re actions must match your words

9. 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.

10. Confidentiality HIPAA’s Privacy Law

11. 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.

12. 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.

13. 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.

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

15. 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

16. 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

17. 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.

18. Safety Vision To make Mercy & Unity Hospitals a safer place to give and receive care

19. 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.

20. 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.

21. 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.

22. 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.

23. Locating information on Hazardous Substances & Chemicals Material Safety Data Sheets (MSDS) provide information on the effects and properties of hazardous substances. These can be accessed from the Prosar program found on the Allina Knowledge Network (AKN).

24. 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. • Dr. Red Fire Alarm • Code Blue Adult Cardiac and/or Respiratory Arrest • Code Pink Neonate Cardiac and/or Respiratory Arrest • RPR Restraint Personnel Requested • RPR Alert Calls the RPR team in less severe • situations. • Dr. Shield Security help needed • Orange Alert Disaster Plan in effect • Code A Pediatric or Infant Abduction

25. 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

26. 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

27. How to Use Extinguishers Know the types of extinguisher in your work area. Choose the appropriate extinguisher for the type of fire. Then: • P Pull-the pin • A Aim-the extinguisher • S Squeeze-the handle • S Sweep-the extinguisher hose at the base of the fire.

28. Patient Safety Initiatives To provide our patients with a safe healing environment we have initiated safety goals around the care of the patient. Some of the goals you should become familiar with include: • 2 Patient Identifiers • Unacceptable abbreviations • Clinical Alarms • Pause for the Cause & Surgical Site Marking • Reduce hospital acquired infections: hand hygiene All five will be discussed in the following slides.

29. It Takes 2 • Matching the right patient to the right treatment or service: • When obtaining blood samples or administering medication or applying the patients armband, two patient identifiers will be used to compare to the same two printed identifiers on the lab request, medication record, or patient’s medical record. • Patient Identifiers Include: • Patient’s stated name and date of birth are compared against the printed name and DOB on the medication record, specimen label, or medical record. • Patient’s unable to state their name and DOB: • Verification by a family member • Verification by carefully matching the name and DOB on the wristband with the same info on the medical record, specimen label. • A patient room number will never be used as a method of patient identification or verification. • Exception to above is the administration of blood products. In this instance, use patient name, birth date and social security number.

30. Unacceptable Abbreviations • We have developed a list of abbreviations that are not approved for use within the medical record (documentation, notes or orders). • Orders written with an unacceptable abbreviation will not be accepted or executed. • Unacceptable orders will be clarified by the nurse and documented as a verbal order before executing. • Ask the unit charge nurse for more information regarding unacceptable abbreviations Clinical Alarms Goal: Improve the effectiveness of clinical alarms. • Examples of clinical alarms are : cardiac monitor alarms, fetal monitor alarms, apnea alarms, door alarms, elopement / abduction alarms, infusion pump alarms, bed alarms, bathroom alarms or respirator alarms Clinical Alarm Considerations: • Clinical alarms are basically all patient care equipment containing alarm functions • Alarm functions should be managed/adjusted by the assigned staff RN or other hospital designee. Collaborate with the charge nurse if you are having difficulty setting/adjusting alarm parameters with your patients. • Alarm policies are practiced • If an alarms fails, a Patient/Visitor Safety Report is completed, Risk Management is notified, and the equipment is immediately sent to Clinical Equipment Services (CES) for evaluation

31. Pause for the Cause Goal: Eliminate wrong site, wrong patient, wrong procedure/surgery. Done prior to local injection/incision/start of procedure – • Surgical Site Marking: The surgical site is marked for correct site and laterality, per policy. • Pause for the Cause: The circulating RN reads the patient’s full name and procedure including site / side, from the consent form. All members of the surgical team listen and confirm the correct procedure, patient, surgical site and side (laterality).

32. Safety & Ethical Situations • If you encounter a potential hazard or unsafe situation in our hospital or if you have an ethical concern regarding our practices or a patient care situation, you should discuss this with the charge nurse. • We encourage reporting of safety concerns, incidents, hazards and ethical concerns. • We have committees and processes in place to address these issues and make changes when appropriate. • Concerns reported to the charge nurse may be escalated to the unit leadership. • You may be asked to complete a “Patient/Safety Visitor Report” or “Area of Concern Form” to document the events. • When in doubt – fill it out!

33. Safety Phone Numbers • Dallas Anderson, Security Manager: 763/236-4306 • Deb Andrews, Employee Safety Director: 763/236-4712 • Shari Bakker, Patient Safety Director: 763/236-8084 • 763/236-SAFE These numbers can be found on each unit.

34. Infection Control Everyone’s Job

35. 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.

36. 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

37. 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.

38. 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

39. 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

40. Other Infection Control Issues

41. Other Infection Control Issues

42. Location of Exposure Control Plan and Infection Control Policies The Allina Knowledge Network (AKN) Ask your charge nurse about access to the AKN.

43. In Closing... Final Considerations

44. 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 of quick release tie and application of locking restraints (required for anyone working with patients).

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