Affiliate School Online Orientation

1. Affiliate School Online Orientation

2. Message from the CEO We are delighted that you have chosen Regional One Health as a clinical training site. We hope that your experience at Regional One Health will be a valuable learning opportunity that will enhance your career! Regional One Health is the oldest hospital in Tennessee and is committed to providing quality healthcare to all in this community. We enjoy a rich and historic 180-year tradition of providing excellent service and highly specialized care to the citizens of Shelby County and the entire Mid-South. It is our commitment to continue this tradition. I am deeply honored and proud to lead this great institution into the next chapter in its history. It is a privilege to foster and lead a team of healthcare professionals dedicated to excellence and committed to quality. Through the actions of and communications with our employees, you will experience a team of highly trained healthcare professionals delivering compassionate and quality care to you and your family. You will see a healthcare organization that achieves growth and sustainability by focusing on quality improvement and accountability. You will see a healthy and sustained Regional One Health. Sincerely, Reginald W. Coopwood, MDPresident and CEO

3. Learning Outcomes At the completion of orientation, participants will be able to: • State the mission of Regional One Health. • Identify roles and responsibilities of faculty and students. • Apply safety and infection prevention practices. • Discuss the role, expectation, and scope of practice for students. • Identify patients at highest risk for abuse. • State the student and faculty responsibility when abusive behavior occurs.

4. Orientation Purpose & Goals Affiliate School online orientation is designed to inform faculty and students of their role, expectations and scope of practice while involved in patient care at Regional One Health. Goals • Facilitate communication between affiliate schools and Regional One Health • Enhance Patient Safety

5. Regional One Health Overview • Since 1829, Regional One Health has been the forefront in attending to the healthcare needs of it's community. • Regional One Health, Tennessee's oldest hospital has always taken pride in it's unwavering dedication to providing patients with the best possible services. • Centers of Excellence include Trauma and Burn Centers; High Risk Obstetrics; and Neonatal Intensive Care Unit. • Rehabilitation Hospital, Wound Center, Sickle Cell Center, Adult Special Care and subspecialty outpatient clinics. • Visit www.regionalonehealth.org for additional information

6. Mission, Values & Vision Mission: To improve the health and well being of the people we serve by providing compassionate care and excellent services. Values: We value quality C.A.R.E. • Compassion • Accountability • Respect • Excellence Vision: In collaboration with our academic partners, we will be the premier healthcare system advancing the qualities of life in our communities.

7. Instructor Responsibilities Primary responsibility of instructors are the Students The primary responsibility for patient care is Regional One Health staff assigned to the patient (regardless of student assignment)

8. Instructor Responsibilities • Communicate with the Training and Development Coordinator (901-545-7242) to confirm scheduling needs (including numbers of students and types of experiences). • Provide student and faculty documentation of the required information.

9. Fundamentals of Communication Regional One Health has incorporated Studer principles referred to as AIDET to enhance customer service to our patients, family members and staff. AIDET: • Acknowledge • Introduce • Duration • Explain • Thanks

10. AcknowledgeGreet customer with a smile, maintain appropriate eye contact, and demonstrate a warm, receptive attitude with everyone you come in contact with. IntroduceOffer your name, your role in the customer’s care and communicate your ability and desire to help – this requires your full attention to the other person.DurationExplain how long a procedure will take, how long the patient may have to wait, or if you are walking with someone, how long it will take to reach your destination. ExplanationProvide detailed information about a test or procedure, such as why it is being performed, who will perform it, whether there is pain or discomfort, and what will happen afterward. Be sure to answer the patients’ or family members’ questions. Thank YouSincerely thank the patient or visitor for choosing the hospital and for trusting you to provide care.

11. Patient Rights Regional One Health recognizes its role in providing a foundation for respecting the rights and responsibilities of patients, their families, physicians, and other caregivers.

12. Patient Safety Patient Safety is a priority at Regional One Health. Our Leaders have established specific expectations that demonstrate our commitment to patient safety. Our Patient Safety Plan may be found in the Administrative Manual that is located on the intranet. Please ask manager/supervisor of unit for assistance.

13. Enhance Patient Safety • Report all Needle Sticks and Injuries • Use Standard Precautions when dealing with patient’s bodily secretions. • The use of Personal Protective Equipment (PPE) will be provided at no cost. Fit Testing is the responsibility of the affiliate school.

14. Restraints • Regional One Health directs efforts to prevent and reduce the use of restraint/seclusion.  Every patient has the right to be free from any physical restraint unless their safety or the safety of others is in jeopardy.   • The use of restraint requires utilization of the least restrictive measures based on the clinical assessment by the treating Resident/Licensed Independent Practitioner that restraint/seclusion is necessary.  • Only trained employees of Regional One Health are allowed to place a patient in clinical restraints. • Students are not allowed to place a patient in clinical restraints!

15. Restraint Safety To increase patient safety: • Remove all sharp objects, cigarette lighters, and matches from the patient. • Remove any loose objects from the room that could be harmful to patient or staff. • Leave 2 side rails up to prevent the patient from being lodged in split side rails. • Leave the bed in the lowest position. • Make sure that one finger will fit under any restraint used. • Make sure that rooms are clean in order to protect against nosocomial infections. • Patients are not be restrained in the prone position. • Patients are frequently assessed. • The head of the bed is elevated to minimize aspiration.

16. Incident Reporting Incident is defined as any event which is not consistent with the desired operation of the facility or care of the patient. Examples include: • Physical harm • Unauthorized leaves by patients • Patient dissatisfaction • Mistaken identity • Hospital acquired infections • Unexpected and unexplained returns to surgery

17. Incident Reporting: Faculty & Student’s Role • Incidents must be immediately reported to: - Regional One Health House Supervisor. • Who is included in an Incident? • Incidents involve healthcare employees, students, patients, family and/or non-employee.

18. Prevention and Reporting of Patient AbuseFor Faculty and Students

19. Definition of Abuse • All patients have the right to be free from abuse. • Abuse is defined as “the willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical, emotional or psychological harm, pain or mental anguish.” • Abusive conditions can occur between employee and patient.

20. Background & Characteristics of Challenging Behaviors • Five percent (5%) of patient abuse cases occur in hospitals. • Patients with the highest risk of abuse include those with mental health disorders, developmental disabilities, impaired cognition, or physical disabilities. • Patients that display challenging characteristics such as combativeness, resistant behaviors, or require large amounts of attention/monitoring increase the risk of abuse. • Patients may be abused by clinicians, other healthcare workers, students, or family members.

21. Policy and Procedure • The organization has developed and instituted policiesand procedures in regards to the prevention, identification and reporting of abuse. • All staff, faculty, and students have a responsibility to report abuse to their Instructor or House Supervisor. This includes personal involvement, knowledge or suspicion of abusive behavior. • Failure to do so will result in disciplinary action up to and including dismissal from clinical area. See Standards of Conduct – Allegations of Abuse

22. Types of Abuse • Physical abuse is any action that causes actual physical harm to a patient. Examples include rough handling of a patient, striking, shaking, or pushing. • Verbal abuse is the use of words to cause harm. Examples include using profanity, name calling,yelling,or cruel teasing of a patient. • Threats of any kind are not acceptable and may be interpreted as abuse.

23. Types of Abuse • Mental abuse is any act that makes a patient fearful, feel belittled or to make fun of a patient by mocking, imitating, or ridiculing. • Sexual abuse is touching of a patient in an intimate or suggestive manner, or making sexual comments.

24. Dealing with Difficult Patients • Dealing with difficult patients may lead to stress and cause staff to act on an impulse. • Signs of stress may include: Anxiety Sadness or depression Headaches Irritability or anger Muscle tension Restlessness Sleep problems Fatigue Lack of motivation or focus The outcome of your stress may be yelling at staff or patients, rough handling of patients, being inpatient with families, etc.

25. Ways to Manage Stress • Remove yourself from the stressful situation - take a break • Exercise • Use relaxation techniques • Yoga • Meditation • Eat a balanced diet • Limit excess caffeine and alcohol • Avoid tobacco use • Get plenty of rest

26. Physicians and Healthcare WorkerImpairment

27. Physician Impairment Impairment The inability to practice medicine with reasonable skill and safety to patients due to physical or mental illnesses or alcoholism or drug dependency.” American Medical Association (AMA)

28. Impaired Healthcare Staff Impairment is in the form of alcoholism, substance abuse, chemical dependency, mental/emotional, instability, or senility. Warning SignConsistently documents the administration of pain or nerve medications for patients who have not needed the medications before or after that nurse has cared for them.

29. Reporting & Investigation In the event of a suspected impairment posing a serious and immediate threat to a patient, report it immediately to Management. REPORT IT, REPORT IT, REPORT IT!

30. Confidentiality & Diversity

31. Confidentiality • Protecting privacy of our patients is very critical to us because: • Protect the trust patients have in their healthcare providers • Code of Ethics • Required by regulatory and accrediting agencies • The Health Insurance Portability and Accountability Act (HIPAA) was enacted to ensure that personal Medical information is protected. • Therefore, faculty and students are required to submit a signed confidentiality form to Training and Development prior to clinical rotations to insure privacy of our patients

32. Protected Health Information Definition: Any information that can identify a patient. It can be transmitted verbally, recorded, on paper or electronically. Examples include: • Patient name and address • Social security number • Medical records(including diagnosis and treatment) • Billing information. Remember: Faculty and students should only interview or brief patients or family members in a private area.

33. Privacy & Students DO: • Faculty and students are allowed to make reasonable notes, including patient identifying data; however all PHI must be properly destroyed at the end of the assignment. • You may discuss patients by name or location only in a private area. • Be mindful that there are often patients & family members on employee elevators, in hallways and in the cafeteria. • Prior to sending a fax, check with management.

34. Privacy & Students, cont’d. • Do not read records that do not pertain to your assignment. • Do not leave patient information unattended in public areas. • Do not leave material unattended, when using a copier. • Do not leave computer displays showing confidential information—log off when finished.

35. Social Networking Never take pictures of patients or family members while in a clinical setting. Never discuss patients on social media sites. Bluetooth headsets, cell phone, iPod, and iPad use are prohibited in the clinical setting.

36. Cultural Diversity and Sensitivity Regional One Health is sensitive to cultural, racial, linguistic, religious, age, gender and other differences as well as the needs of persons with disabilities.

37. Interpreters Services A Medical Interpreter is a bilingual individual trained in interpretation skills and medical terminology. This person facilitates understanding in communication between individuals speaking different languages in the health care setting. A Medical Interpreter is the voice for the patient describing symptoms or asking questions.

38. How to reach an Interpreter? Page Interpreter for a Quicker Response (901) 790-9189 __________________________________ Call the Telephone Operator at (901) 545-7100 or (‘0” from hospital telephone)

39. Emergencies&Workplace Violence

40. Emergency Codes

41. Fire Response/Evacuation Information • Evacuation – Horizontal beyond the next smoke compartment • (Fire doors) Vertical is down the stairway • Fire Pull stations – summons Memphis Fire Department, located at every stairway door and exit door • Fire extinguisher location – at each nurse station and every 50’ of travel • Note the wall flags pointing to extinguisher and pull station

42. Regional One Health is concerned and committed to safety and health for its’ employees, patients and visitors. The Workplace Violence Prevention Program promote safety and security in the workplace. Regional One Health SecurityCall 911-Emergency 545-7700- Non Emergency

43. What is Workplace Violence (WPV)? WPV is any act of physical violence, threats of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the work site that can affect or involve affiliate school participants, employees, medical staff, contract staff, patients, visitors, vendors, etc.

44. Regional One Health Policy • Regional One Health will not tolerate violence in the workplace. • Regional One Health will make every effort to prevent violent incidents from occurring. • Acts or threats of physical violence, including intimidation, harassment, or coercion will not be tolerated and must be reported immediately. • Affiliate participants as well as staff, guests are required to help make Regional One Health a safe workplace.

45. Infection Prevention

46. Infection Control ALWAYS • Wash Hands • Use antimicrobial soap or alcohol antiseptic handrub before donning gloves after removing gloves. Use care to avoid touching contaminated surfaces in the room after washing your hands.

47. Infection Control Standard Precautions are to be used for the care of all patients. They are designed to reduce the risk of transmission of microorganisms (Bloodborne pathogens and other pathogens) from both recognized and unrecognized sources of infections. Standard Precautions Include: • Blood and all body fluids, secretions, and excretions, except sweat • Non-intact skin • Mucous membranes

48. Airborne Precautions: • Airborne Precautions are designed to reduce the risk of Airborne transmission of infectious agents • Airborne transmission occurs by dissemination of either airborne droplet nuclei or dust particle containing the infectious agent.

49. Airborne Precautions • Patient is to wear a surgical mask if transport or movement is necessary. • Notify the area where patient is being taken of the required isolation precautions and the reason to expedite the procedure. • Personal Protective Equipment (PPE): N-95 mask. • Staff should wear an approved N95 respiratory device and staff must be fit tested to wear the respiratory device. • Wear other PPE as required.

50. Contact Precautions • (In addition to Standard Precautions)Visitors Report to Nurses Station Before Entering the Patient Room. • Patient Placement: Private room. When not available, cohort with patient infected or colonized with the same microorganism. • Patient Transport: Patient must remain in room except for urgent procedures.