Tuality Healthcare Clinical Student Handbook 2016-2017 by Tuality P.I.N. The Professional Interdisciplinary Newsletter

Clinical Student Handbook 2016 â&#x20AC;&#x201C; 2017 School Year

Table of Contents

Student Welcome Letter....................................................................................................................................................2 Vision Statement [01/14]..................................................................................................................................................3 Mission Statement [01/14]...............................................................................................................................................3 Values and Standards of Success [01/14]...................................................................................................................3 People......................................................................................................................................................................................................................... 3 Service........................................................................................................................................................................................................................ 4 Quality........................................................................................................................................................................................................................ 4 Stewardship............................................................................................................................................................................................................. 5

Patient Promise [06/16].....................................................................................................................................................5 Code of Ethics & Patient Rights......................................................................................................................................5 Expectations for Students [07/16].................................................................................................................................6 Additional Nursing Student Guidelines* [07/16].......................................................................................................7 Dress Code.............................................................................................................................................................................8 ID Badges...............................................................................................................................................................................8 Cultural Diversity and Mutual Respect.........................................................................................................................9 Guidelines for Protecting Patient Privacy (HIPAA)....................................................................................................9 Infection Control: Immunization & Vaccination.......................................................................................................10 Personal Protective Equipment: Standard Precautions [06/09].........................................................................11 Blood and Body Fluid Exposure [07/16].....................................................................................................................12 Hand Washing Guidelines [07/15]................................................................................................................................13 Risks & Unsafe Conditions..............................................................................................................................................14 Codes and Emergencies [03/15]..................................................................................................................................15 Required Student Placement Forms............................................................................................................................19 Student Emergency Contact Information Form.......................................................................................................20 Faculty Contact and Program Information................................................................................................................20 Student Influenza Vaccine Declination Waiver Form (if applicable).................................................................21 Student Orientation Handbook Quiz Form................................................................................................................22 Confidentiality Statement for Students Form..........................................................................................................23

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Student Welcome Letter Dear Student, The staff and administration welcome you to Tuality Healthcare. Students are valued by Tuality, and we hope that your clinical learning experiences will be a source of enrichment and reward for you. This handbook will acquaint you with the Tuality mission and goals, and give you an understanding of our standards for the workplace environment, patient rights, safety, emergency procedures, and confidentiality. Please read the information carefully and discuss your student role and responsibilities with your Tuality preceptor. Since clinical situations may vary, it is important for you to ask questions as needed and communicate freely with your preceptor or other Tuality staff members. Please clarify your student role and follow procedures as directed by Tuality employees. Before your clinical experience begins, you must complete and sign the four forms included within this Student Orientation Handbook. Please submit all forms to your school faculty or school placement officer. 1. Form: Student Contact and Program Information Form 2. Quiz: Orientation Handbook Quiz 3. Form: Confidentiality Statement for Students 4. Declination or Proof of Influenza Vaccination Faculty should submit completed forms by mail, fax or scanned in email. Tuality HealthCare Clinical Education Department 334 SE 8th Avenue, Hillsboro, OR 97123. Fax: (503) 681-1952 | Email: clinical.education@tuality.org Again, we wish you a successful and rewarding student experience. Sincerely, Tuality HealthCare Clinical Education Specialists ANCC Board Certified Staff

• Allied Health Clinical Student Placement Coordinator: Nancy Bensen, M.S.N., R.N.- B.C. | 503-681-1987 | nancy.bensen@tuality.org • Nursing Student Placement Coordinator: AngelAnn Smith, M.S.N., B.S., R.N.-B.C. | 503-681-1480 | angelann.smith@tuality.org • High School Student Placement Coordinator: Marilyn Hickman, B.S.N., R.N.B.C. | 503-681-1383 | marilyn.hickman@tuality.org

2 © Student Orientation Handbook • 2016 – 2017 School Year

Vision Statement

[01/14]

To be the health system of choice for our region, our patients, our providers, and our employees by delivering the highest quality care at an exceptional level of service.

Mission Statement

[01/14]

Using skill and compassion, we are building a healthier community by bringing quality clinical care and unparalleled service to our region in partnership with our patients, physicians and health care professionals.

Values and Standards of Success

[01/14]

We believe that employees who possess the following “Standards for Success,” which are comprised of Tuality’s four fundamental values, People, Service, Quality and Stewardship, .will contribute to a workplace where employees, students and volunteers want to work and practice to help patients receive the best care to not only meet but exceed standards of excellence and improve the patient experience.

People We will care for our patients, their families and each other with understanding, empathy, concern and helpfulness because we respect the right and dignity of all individuals. We will follow through as promised, deal honestly and consistently with patients and one another, behave in a professional manner and encourage open communication so that we create trust and maintain credibility and respectability.  Respect individual differences to help you understand concerns so that you can respond appropriately.  Take responsibility for balancing family and work issues.  Develop strategies to deal with stress that occurs in everyday life.  Heighten your sensitivity to people you work with to help create a healthy environment.  Be truthful and honest in all communications. Be willing to admit mistakes.  If you have a problem with a person, deal directly with them instead of talking to others.  Keep your word.  Commit to doing what you say you will do.  Respect and guard the confidentiality of others.  Access and use only the information that is needed to do your job.  Listen to each customer.  Do all you can to help each person feel comfortable and at ease.  Think before you speak.  Filter your language and behavior to reflect your respect for your job and your co-workers.  Recognize that each customer is unique and that their perception is their reality.

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Service We will demonstrate quality, compassion, integrity and commitment to our patients, physicians and the community. We will help patients achieve their best state of health. We will respond to changes in the community by designing and offering needed programs and services. We will offer our staff a positive and enriching work experience, support and assist each other and reward excellence among staff members.                   

Make customer service your primary focus. Our goal is to reduce anxiety by using AIDET consistently (Acknowledge, Introduce, Duration, Explanation, & Time Frame). Be open and energetic in your communication and respond positively to customer questions and comments. Greet customers and co-workers in a helpful and professional manner. Be aware that making others feel welcome goes a long way toward helping them feel well-served and less anxious. Take responsibility to address customer concerns promptly. Keep in mind that the art of apology, ACT (Acknowledge, Correct & Thank), is a valuable skill and use it when appropriate. Maintain a clean and welcoming environment for our customers. This includes personal appearance and the appearance of your surroundings. Remember that you only have one chance to make a good first impression. Be a guardian for each customer’s personal privacy. Respect the personal space and dignity of others in the way they want to be treated. Take responsibility for your own actions and behaviors. Set an example of cooperation by helping others. Our common purpose is to serve each other, our customers and our community. Look beyond your job responsibilities for opportunities to exceed expectations. Commit yourself to the success of your co-workers and our organization. Seek opportunities to increase your value to the organization by learning new skills, accepting new challenges and being flexible. Everyone must be ready to meet the needs of the changing health care environment. Filter your language and behavior to reflect your respect for your job and your co-workers.

Quality We believe that quality means exceeding our customers’ needs, recognizing that customers include patients, their families, physicians and fellow employees. We understand safety is a top priority which directly impacts the success of providing quality patient outcomes.      

Make Tuality a great place for patients, employees, volunteers, physicians, students and other customers. Take responsibility for providing a safe environment for yourself, co-workers, customers and visitors. Look for improvement opportunities within your work area, department and within the organization. Do the right thing at the right time for the right reason, always keeping in mind the patient experience. Learn your role in safety, make appropriate choices and ask for help when you need it. If an error occurs, use it as an opportunity to learn and to improve processes.

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Stewardship Stewardship means to be fiscally or financially responsible about expenditures and saving. We will be a stewards to our community by maintaining a well-managed, efficient facility and return those resources in the form of high-quality, cost-effective healthcare services.

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      

Focus on what matters and make your performance a priority. Every employee, student and volunteer’s contribution is uniquely important to making Tuality Healthcare a provider of choice. Use work time, resources and energy wisely. Communicate opportunities to improve services and cost-effectiveness. You are contributing directly to Tuality’s success. Learn and support the larger role Tuality plays as a local business organization. Seek opportunities to give back to our community. Employees are ambassadors of Tuality Healthcare and a reflection of Tuality’s mission.

Patient Promise

[06/16]

The guiding principle of this new promise is that all physicians, employees and volunteers consistently provide excellent service for our patients and their families. All employees, volunteers, and medical staff proudly uphold this promise, and are always receptive to the needs of our patients and their families. We promise to: 

Introduce ourselves, listen to you, and communicate clearly.



Treat you with kindness and respect.



Respect your privacy.



Provide a safe, comfortable and clean environment.



Meet your needs in a timely manner.



Involve you and your family as important members of your health care team.

Code of Ethics & Patient Rights All Tuality employees, volunteers and students should comply with a professional code of ethics that includes protecting patients’ rights. Patients admitted to Tuality Healthcare have a right to:         

Be treated with fairness, dignity and respect without regard to race, religion, gender, sexual orientation, age, disability, or ability to pay for care. Make decisions regarding their own health care including refusal of treatment, composing one’s own advanced directive, making organ donation choices, or declining participation in research or the education of students. Be informed about treatment choices including risks, benefits and alternatives for care Know the names of caregivers and students Know the information in one’s medical record Have personal information kept confidential and receive a “privacy notice” Receive respectful customer service for themselves, their family members, or other persons participating in their care Receive appropriate assessment and management of pain Receive care in a safe environment.

Expectations for Students

[07/16]

Tuality believes that all students are valued members of the team who can contribute to the quality of our services. Expectations for students are based on the same Standards for Success that guide employee actions and set the tone of the workplace environment. As a student, you are expected to: 

Be consistent and reliable in your attendance. Do not report to your unit when you are ill. If you are sick or will not be in attendance, notify your unit preceptor or direct supervisor of your absence at least 2 hours prior to the start of your shift/training.



Arrive on time, at the right place and prepared to start. Notify your preceptor or direct supervisor if you are going to be arriving late or will need to leave prior to the end of your scheduled shift/training times.

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Comply with the Tuality dress code and hygiene standards. (See Dress Code in this handbook). Students who do not comply will be asked to leave and return with the corrected and approved stipulations for dress attire and hygiene standards.



Always wear your Tuality Student ID Badge that clearly identifies you as a student at all times. Students without name badges will be asked to leave and return with their proper identification. Lost name badges should be reported to faculty and Human Resources. Remember that patients must be informed that they have the right not to allow a student to participate in their care.



Uphold the policies and procedures of Tuality HealthCare at all times. This includes honoring the confidentiality of patients and staff.



Be responsible. You are held accountable for your actions. Accept directions and instructions from your Tuality preceptor or supervisor during your time on

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campus for the patient’s safety and your own. Listen to your patient, your preceptor /supervisor and faculty carefully. 

Make the quality of your work your highest concern. Give it your best effort every time.



Remember that patients must be informed of your role as a student and agree to participate and patients have the right to refuse treatment or care from a student.

Additional Nursing Student Guidelines*

[07/16]

*Specifically for Student Nurse Clinical Areas of Practice In addition to Student Expectations, Student Nurses are held to the State of Oregon Board of Nursing Laws and Regulations. These include but are not limited to compliance with guidelines for medication administration, IV fluid therapy, and other assigned treatments permissible by OSBN State Laws and according to Tuality Healthcare Policy. Student Nurses may perform the following under supervision of the clinical instructor or supervising Tuality preceptor: 

   

Student Nurses may administer medications delivered to patients during their senior practicum level following review by the RN clinical instructor or Tuality Nurse Preceptor, prior to administration. The staff nurse does not need to cosign for medications given by students. (Note: See Section B of the policy, C 55B, for Senior Practicum RN Student Guidelines.) Student Nurses may administer narcotics, at the discretion of the Tuality Nurse Preceptor. However, Student Nurses may not access narcotics independently. Narcotics will only be accessed by a Tuality Employee. Student Nurses may discontinue IV fluids and may discontinue peripheral saline locks. Student Nurses may monitor oxygen administration.. Student Nurses may perform dressing changes per facility policies.

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 

Student Nurses may provide IV flushes with saline. Student Nurses may access and administer regularly scheduled medications as they vary from unit to unit. o Students are expected to clarify unit-specific policies with a Tuality staff nurse preceptor.

Students may not perform the following as outlined below per Tuality policy and state regulations: 

    

Student Nurses may not verify blood for administration or independently initiate blood products, but may monitor the patient during a transfusion. Two Registered Nurses must verify blood for administration. Students may observe in this process. Student Nurses may not initially set up or change subsequent settings to a PCA pump without direct delegation and 1:1 supervision of the supervising Tuality Preceptor or RN clinical instructor. Student Nurses may not independently change continuous IV infusions such as; insulin, heparin, PCA, or epidural infusion rates. Student Nurses may never, under any circumstance, discontinue any central venous access devices. Student Nurses may not change oxygen settings independent, unless under the direct supervision of a Registered Nurse or Respiratory Therapist at the bedside. Student Nurses may not give IV push drugs other than saline flushes without direct 1:1 supervision. o Student Nurses are expected to provide patient assessment data and rationale to the Tuality Nurse Preceptor who is responsible for making changes to IV infusion settings.

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Dress Code A neat, clean appearance communicates respect for both self and others and is important for making a good first impression. Appropriate dress supports the confidence of patients, family members, and Tuality staff. All Tuality employees, volunteers and students are expected to comply with the policy on dress and personal appearance. The dress code is intended to be acceptable to a wide variety of customers, cultures, ages, patients, and guests who visit Tuality. In some cases, dress and appearance is dictated by regulatory agencies. Students are expected to comply with the following:         



Wear your Tuality Student ID Badge that clearly identifies you as a student at all times. If you are in uniform, wear an identifying school patch on your uniform in addition to your badge. Maintain good personal hygiene, proper dental and body hygiene, and wellgroomed hair. Keep long hair tied back and away from face. No perfumes, fragrances, or after shave. No jeans, shorts, tank tops, exposed midriff, or miniskirts. No open-toe shoes or spiked heels in clinical areas. Shoes should be clean and meet safety requirements for the assigned department. No slogans or logos that could be offensive on clothing. Jewelry must be kept to a minimum. No dangling earrings in clinical areas. Cover tattoos while on duty. Remove facial jewelry while in clinical areas. No artificial nails for students who participate in direct patient care.

ID Badges A Tuality ID Badge is required to be worn on campus while serving in a clinical student role. Students and Faculty will be instructed to go to the Tuality Human Resource Department to obtain their Tuality Photo ID Badge prior to their clinical start date and/or orientation training day. Bring a copy of your Seasonal Flu vaccination report (receipt) or flu declination form (see page 21) and your driver license or other state issued ID to your ID Badge HR

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appointment. Your evidence of vaccination will be indicated by a checkmark sticker placed on your Photo ID Badge. Tuality ID Badges are property of Tuality Healthcare and must be returned to the Tuality Human Resources Department at 545 SE Oak St. Hillsboro OR 97123. A 24 hours, after-hours drop-off box is located at the Human Resources front office door if the office is closed when you arrive to drop off your Tuality ID Badge. The phone number to contact Tuality Human Resources is 503-681-1158 if you have questions regarding your Tuality ID badge access level or any issues regarding your ID Badge. If your badge has been lost or stolen, please report this immediately to a Tuality Security Officer at 503-681-1082. Don’t Forget - All Students are REQUIRED to return their Tuality ID Badge to the Tuality Human Resources department at the conclusion of their clinical rotation.

Cultural Diversity and Mutual Respect As diversity within our patient populations and our work force continues to increase, all health care providers need to become more skilled at understanding and responding to differences. We all have differences relating to gender, race, age, religion, culture and class. We cannot change many of these differences; however, we can change how we respond to one another despite these variables. Our common goal is to treat all people with respect regardless of ethnicity, religious beliefs, political affiliation, gender, age, race, social status, sexual orientation, or disability. We believe in the intentional practice of showing mutual respect in several ways. As students work in cross-cultural situations, students should strive to:    

Maintain the dignity of employees, patients, family members, and others by respectful listening, responding, and acknowledging feelings. Improve communication and show respect by seeking to understand before seeking to be understood. Take time to learn from the patient and family members which cultural practices are important to their care. Acknowledge the impact of cultural needs and practices on the quality of care.

Guidelines for Protecting Patient Privacy (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA) is a Federal law that includes regulations about protecting a patient’s privacy. During your student experience, you may come in contact with patient or employee-related personal information. You have a duty to keep personal information private and follow the privacy guidelines established by Tuality policy. According to Tuality policy, all students and employees must read and sign a Confidentiality Statement promising to keep personal information private. Learn the following common sense ways to protect patient privacy. Then read and sign the Confidentiality Statement for Students included with this handbook. Return the signed form to the Tuality Healthcare Clinical Education Department. Minimum necessary rule:

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Do not access information that you do not need to know for your job duties. Students are not allowed to make copies or print of any part of a patient’s record for learning purposes.         

Discussing treatments Close patient room doors. Close curtains and speak with a softer voice in semi-private rooms. Never talk about patients in elevator, cafeteria, hallways, waiting rooms, or other public spaces. Do not leave messages on answering machines or with anyone other than patient. Accessing electronic data Use screen savers to block information on unattended monitors. Point computer monitors away from view of visitors or passerby. Do not ask for or share passwords.

Faxing   

Make sure you are faxing to a machine in a secure location. Notify the receiver ahead of time that you are faxing information. Do not allow faxed copies to lie around machine unattended.

Social Networks and Smart Phone Usage  

Do not share any patient information that may be identifiable to a specific patient. Do not post patient or hospital information on any internet social networking site. o (i.e., Facebook, Instagram, Twitter).

Infection Control: Immunization & Vaccination

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Tuality requires all Students to provide evidence of immunity to the following communicable diseases before student placement: 1. 2. 3. 4. 5.

Varicella (Chickenpox) MMR (Measles, Mumps and Rubella) Hepatitis B Series (or signed declination) Seasonal Flu (or signed declination) Tuberculosis test (e.g. PPD or chest x-ray)

Acceptable evidence of immunity is by either a positive lab titer (natural immunization after exposure to a disease) or vaccination (inoculation of a vaccine). History of a disease alone is not adequate evidence of immunity. Tuality recognizes that influenza is a serious respiratory disease that kills an average of 36,000 persons and hospitalizes more than 200,000 persons in America each year. Infected individuals will shed and spread the virus for 24-48 hours before influenza symptoms appear. Vaccination or wearing a mask protects patients from influenza. Students choosing to decline the seasonal flu vaccination will be required to wear a mask in their student role at Tuality during the flu season: (See Student Vaccination Declination Form on page 21). While providing direct patient care activities, including patient transport in patient care areas where patient care contact and exposure may occur such as the hallways in patient care areas or waiting rooms

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In any work location where people interact such as meetings, nurses stations, and patient transport hallways.

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During indirect patient interaction such as patient registration, lab, case management, environmental services, volunteers, dietary services, security, visitor access desk and engineers who perform in room repairs and maintenance.

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Personal Protective Equipment: Standard Precautions

[06/09]

All blood and body fluids are treated as if they are infectious. Wear appropriate personal protective equipment (PPE) as directed by your preceptor or supervisor. Personal Protective Equipment includes, but is not limited to, gloves, fluid resistant gowns, laboratory coats, face shields, masks, eye protection, and ventilation devices, such as manual resuscitators and mouth-to-mask resuscitation devices. Students who are observers only should never handle bio-hazardous wastes, linens, needles or sharps of any kind. All personal protective equipment will be removed prior to leaving the work area and will be placed in a designated container. Never wear PPE equipment (gown, gloves, masks, or eye protection) outside the patients’ room or in hallways. In case of an exposure to blood or body fluid, see Blood and Body Fluid Exposure on Policy. When participating in patient care, use standard precautions with all patients at all times. Select the appropriate standard precautions for the situation. Standard precautions include: 

Hand washing: Use proper hand washing at the appropriate times (See the



Hand Washing Guidelines in this handbook.) Gloves: Wear gloves when touching blood, body fluids, and contaminated items. Use gloves when touching mucous membranes or non-intact skin.



Change gloves between procedures. Eye and face protection: Wear mask and eye protection or face shield in

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any situation that is likely to result in spray or splash of blood or body fluids. Gown: Wear a gown if a procedure is likely to generate a splash, spray, or



spill of blood or body fluids. Patient-care equipment: Discard single-use equipment promptly. Reusable equipment must be cleaned before use by another patient

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Clean environment: The hospital provides for routing disinfection of surfaces including beds, equipment, floors, walls, Report spills or soiled

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surfaces if you see them. Linens: Handle soiled linen in a manner that prevents cross contamination of

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microbes to other patients or the environment. Proper handling and disposal of needles and “sharps”: Needles are never recapped. Place all used syringes, needles, and sharp items in punctureresistant red containers.

Blood and Body Fluid Exposure

[07/16]

If you have been exposed to blood or other potentially infectious materials follow these steps: 1. Perform first aid such as flushing eyes / mucous membranes and wash cuts or puncture wounds with soap and water. 2. Notify a Staff Member immediately, a Preceptor, a Supervisor or a Nursing Supervisor of the event for instructions. 3. If you know the source of the blood, have their name/MRN available so their blood can be drawn. 4. Go to the Emergency Department to have your blood drawn and receive OSHA Mandated post exposure counseling. 5. Your Preceptor will complete an Accident Report Documentation Form through Employee Health Services. 6. After steps 1 -5, call Employee Health Services at ext: 1741 to notify them of the event for further investigation and follow up care. Basic First Aid for occupational exposures:

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A person sustaining an occupational exposure, which does not require immediate emergency department treatment, will administer first aid as appropriate for the exposure:    

Make the wound bleed if a puncture or laceration wound. Clean wound with soap and water. Flush mucous membranes with water or saline for 10 minutes. Other wound care as needed for specific injury or accident.

Definitions of a significant exposure      

Exposures that may place a worker at significant risk for HIV/Hepatitis infection include: Percutaneous wound (puncture wound) from needle or other sharp from patient or unknown source. Laceration from a contaminated instrument. Blood or body fluids from a patient or known source to mucous membranes or interrupted skin of an employee. Body fluids known to transmit HIV and HBV Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, amniotic fluid and body tissues.

Body fluids that do not apply unless they contain visible blood are:    

Feces nasal secretions sputum sweat

  

tears urine vomitus

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Hand Washing Guidelines

[07/15]

Good hand washing is the single most effective way to prevent the spread of infection. The Center for Disease Control and Prevention (CDC) developed the following hand hygiene guidelines for your protection. The purpose of hand hygiene is the physical removal of soil and transient microorganisms, including bacterial spores. Gloves must be worn when there is a potential for blood-borne pathogen exposure, including examination of a wound. The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Students may not wear artificial fingernails when having direct patient contact. A student with a removable or non-removable cast, splint or other device on an upper extremity that precludes appropriate hand hygiene, may not work in direct patient care, handle and reprocess equipment, clean or support patient care areas, or handle food. Remember, washing your hands reduces hospital acquired infections and spread of disease. It is preferred that the patient watches you wash your hands or use alcohol based hand foam. • WHEN TO WASH YOUR HANDS 1. When hands are visibly soiled; 2. When hands are contaminated with proteinaceous material; 3. When contaminated with blood or body fluids; 4. Before eating or handling food; 5. After using the restroom. • PROPER HANDWASHING TECHNIQUE WITH PLAIN OR ANTIMICROBIAL SOAP 1. Wet hands with water. 2. Apply soap to hands.

3. Rub hands vigorously together for 15-20 seconds, covering all surfaces of hands and fingers. 4. Rinse hands well to remove soap residue. 5. Dry with paper towel. 6. Use paper towel to turn off faucet all manually controlled faucets are considered contaminated. • PROPER HAND HYGIENE WITH ALCOHOL-BASED HAND RUBS The purpose of alcohol-based hand rubs is reduction of bacterial counts on hands when hands are NOT visibly soiled. Use hand hygiene before and after each

17 © Student Orientation Handbook • 2016 – 2017 School Year

patient contact and before entering and leaving patient rooms. 1. Apply product to palm of one hand. 2. Rub hands together, covering all surfaces of hands and fingers. 3. Rub until hands are dry. 4. Alcohol-based hand rubs take less time to use than traditional hand

washing, and actually is the preferred method of hand hygiene when hands are not visibly soiled. 5. Hand hygiene should be done after using keyboards, telephones, cell phones and pagers, as those items are not routinely cleaned.

The CDC hand hygiene guidelines require you to decontaminate your hands:     

Before direct contact with patient. After contact with the patient’s intact skin (e.g. when taking a pulse, blood pressure or lifting a patient). Before putting on gloves. After removing gloves. Upon leaving the patients room.

Risks & Unsafe Conditions Students are expected to use good safety practices and follow all policies and guidelines of Tuality Healthcare. The hospital environment may present many risks. Accidents can happen because unsafe conditions were not reported. All staff and students are responsible for reporting unsafe conditions or concerns about safety. Safe and appropriate conduct is expected from all staff and students. Tuality may request the school to withdraw any students whose conduct presents a risk to the facility, patients or staff.     

Unsafe conditions Wet floor Defects in floors Cords or wiring across floors Lights that are not working

  

Liquids that are not stored properly Fire doors or exits that are blocked Clinical alarms that are turned off or not working

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 

Spills that are not cleaned up Equipment failure

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Wastes that are not disposed of properly (chemical, radiation or human waste)

If you see an unsafe condition, report it right away to your Tuality preceptor or supervising staff.         

Unsafe Practices Smoking on campus grounds Running in halls or stairwells Pushing carts, beds, or other equipment recklessly Failure to pick up clutter or clean up spills Slamming doors carelessly Tilting back in chairs Horseplay or practical jokes Failure to comply with Tuality preceptor or staff direction

Report any unanticipated adverse events or unsafe conditions to a Tuality employee as soon as possible, such as;    

Patient or visitor injury Staff or personal injury Equipment malfunction Visitor or patient complaints

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Codes and Emergencies

[03/15]

Code Red: Fire If you hear “Code Red” paged overhead and you are in the area specified by the Code Red, help with the following:   

Clear hallways to permit safe passage of any emergency responders. Close hallway doors to contain possible fire. Search your area for signs of smoke, fire, smoke detector alarm (small red

 

light), or burning odor. Direct emergency responders and/or Fire Department to the fire area(s). Follow directions of Tuality staff if it is necessary to evacuate or move to another area.

If you discover smoke or fire, IMMEDIATELY alert a Tuality staf member, then R.A.C.E.R! >Immediately upon discovering smoke or fire: R.A.C.E.R. Rescue those in immediate danger, if safe to do so. Close doors to fire area. Activate the alarm systems; pull manual alarm & dial (TCH-1499, TFGH-7333, Others-911 or 9-911). Pulling the alarm will alert all employees in the building. It also will alert TCH Security, Engineering and the Nursing Supervisor of the fire, so they may send assistance as needed. Contain the fire; close all doors including doors to patient rooms and reassure patients. Extinguish the fire (PASS) if safe to do so. Evacuate the area, if appropriate, ensuring ALL individuals in the area at risk are evacuated to an area on the other side of the fire doors in the affected area. Do not open a door to extinguish a fire if the

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door or doorknob is hot to touch. This can cause the fire to spread quickly and/or spread smoke throughout the area. Relocate patients and staff to a safe area (possibly defined in your Department Specific Plan). >To extinguish a small fire: P.A.S.S. Pull the pin on the extinguisher. Aim the nozzle/hose at the base of the fire. Squeeze the handle. Sweep from side to side.

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Code Orange – Hazardous Materials Incident Code Orange is to alert the staff in the event of a hazardous materials incident. The primary response of staff is to protect self, others, and the environment from harm and/or contamination. The secondary response of staff is specific to each department’s policy for handling hazardous materials. The decontamination team may be paged for assistance if necessary. Follow instructions of Tuality staff until code is cleared.

Amber Alert – Missing Infant or Child

[SAF-11 07/10]

The purpose of Code Amber is to alert all available employees to station themselves at entrances and exits to prevent anyone from leaving the facility with an infant or child. Immediately upon hearing Code Amber paged overhead, all Tuality personnel stop all non-critical work and cover all interior doors to stairwells, elevators, and doors that exit the building. Should the person abandon the infant or child and escape, keep the minor with you and dial (TCH - 1499; TFGH - 7333) to notify the Operator. Await instructions. Others call 911 to notify the police and await instructions. As a student, you should follow directions of Tuality staff members until the code is cleared. The typical abductor is a female between 14 and 45 years old and exhibits these behaviors;  carrying an infant  carrying a bag large enough to hold an infant  covering the infant with her coat, baby blanket, or  may be in a nurse uniform carrying an infant

Code Masterlock – Building Lockdown Code Masterlock secures the building entrances in an emergency. All entrances/exits will be locked down by Security and manned to ensure no person enters or exits the building until lockdown is cleared. Follow instructions of Tuality staff until code is cleared.

Code Blue If you hear “Code Blue” paged overhead, a cardiopulmonary arrest has occurred and Tuality Code Team will respond. Continue work at your station and do not impede the movement of the team. If you witness an arrest and if you have current certification in Basic Life Support for Healthcare Providers from the American Heart Association. Begin CPR cardiopulmonary resuscitation following AHA guidelines for compressions to ventilations ratios. IMMEDIATELY call for help by dialing the appropriate emergency number or activating the code button if applicable in your area of training.

Rapid Response Team; i.e. Sepsis Response Team or Stroke Response Team 22 © Student Orientation Handbook • 2016 – 2017 School Year

You are instructed to call a rapid response for unstable patients who exhibit emergent or need urgent assessment by a qualified professional provider. To do so, dial x1499. For TCH, dial x7333 for Forest Grove Hospital. For suspected stroke or septic patients, call x1499. Potential sepsis patients present with the following assessment: heart rate over 100, temperature over 100F, SBP under 100, and suspected infection. Potential stroke patients present with the following assessment: facial droop, slurred speech, sudden change in LOC, numbness or paralysis in any extremity, and/or severe headache.

Code Purple – Missing Adult Patient The purpose of Code Purple is to conduct a rapid and thorough search of the Tuality Healthcare campus when it is determined that an adult patient is absent or missing from the unit or diagnostic testing areas without a physician’s order. Follow instructions of Tuality staff until code is cleared.

Code Triage In the event where a code triage is called overhead, the code triage team members and a representative from each department will gather at the TCH conference rooms located on the first floor of the Tuality Healthcare Main Hospital. The TCH room is designated as the Incident Command Center (ICC) during its operation. Each representative will receive further instructions from the ICC. The purpose of these codes is to alert staff to a potential or actual disaster. There are 4 levels for a disaster alert depending on the extent or seriousness of the disaster situation. For all triage levels, if you hear “Code Internal/External Triage” paged overhead, clarify your student role to anyone delegating tasks and follow directions from Tuality staff. Code Internal Triage alerts staff to a disaster within the hospital. Code External Triage is to alert staff to a disaster outside the hospital. Code Internal/External Triage Level I alerts staff to standby for a potential or actual incident; whereas Code Internal/External Triage Level IV alerts staff that a disaster situation has been declared by the government. LEVEL I (STANDBY) This is a general notification of a potential or actual incident. LEVEL II This level begins the process where Clinical departments start to relocate or discharge patients depending on the critical need. A hospital employee Labor Pool will be organized to respond to the situation. Normal department mission may be impacted as staff members from hospital departments are sent to the ICC. LEVEL III This level is an elevated response to a disaster situation where most indirect inpatient care areas will stop normal work duties and fully support the incident. Outpatient care areas will then be instructed to stop services and support the incident response until further notice. LEVEL IV (DISASTER DECLARED BY GOVERNMENT) This level is the highest disaster level. All of the above protocols for resource allocation begin and battlefield-type conditions prevail throughout the facility.

Code Gray—Combative Person The purpose of the Code Gray is to provide a show of force when staff members or others are confronted by a combative person, within the facility or on its grounds. The objective of the Code Gray response team is to gain cooperation, subdue, or restrain the perpetrator, if necessary. The goal is to prevent injuries and minimize harm to perpetrator, staff members or other victims. Your role as a student is to: Be observant and report any unusual activity or person. Call for assistance.

Code Silver – Weapon or Hostage Situation If “Code Silver” is paged overhead with a location, this means someone in the building has displayed a weapon and/or taken a hostage, and presents an immediate

threat to staff or patients. If weapon is involved, take cover or leave the area. Security and police will respond. All students and staff are to stay clear of the area involved. Move away from the person who is threatening with a weapon if at all possible. Follow the directions of Tuality staff members.

Tuality HealthCare Main Hospital 335 SE 8th Ave, Hillsboro, OR 97123 © Student Orientation Handbook503-681-1111 • 2016 – 2017 School Year Tuality Healthcare Human Resources Dept. 372 SE 6th Ave Suite 100, Hillsboro, OR 97123 503-681-1856 | 503-681-1158

Complete the following Student Placement Forms, sign forms and return by mail, fax or email. Mail: Tuality HealthCare c/o Clinical Education Dept. 334 SE 8th Ave, Hillsboro, OR 97123 Fax: 503-681-1952 Email: clinical.education@tuality.org It is recommended you use a secure email option if submitting electronically – Use #secure# in the subject line.

Required Student Placement Forms 1. Student Emergency Contact Information Form 2. Student Influenza Vaccination Declination Waiver Form (if applicable) 3. Student Orientation Handbook Quiz 4. Confidentiality Statement for Students Form

Student Emergency Contact Information Form Full Name (First, Middle, Last): _______________________________________________________________ DOB (MM/DD/YYYY): _____________________________________________________________________

Last 4 Digits SSN: ___________________________________________________________________________

Home Address: _____________________________________________________________________________

Primary Communication Email: ____________________________________________________________ Primary Phone: ______________________________________________________________________

Emergency Contact Name: ____________________________________________________________________ Emergency Relation to Student: ______________________________________________________________ Emergency Contact Phone: ___________________________________________________________________

Faculty Contact and Program Information School/University: ___________________________________________________________________________

Type of Program: ____________________________________________________________________________

Primary Faculty Name: _______________________________________________________________________ School or Faculty Phone: _____________________________________________________________________ Clinical Program Placement Start Date: ______________________________________________________ Clinical Program Placement End Date:

________________________________________________________ Complete the following Student Placement Forms, sign forms and return by mail, fax or email. Mail: Tuality HealthCare c/o Clinical Education Dept. 334 SE 8th Ave, Hillsboro, OR 97123

Student Influenza Vaccine Declination Waiver Form (if Fax: 503-681-1952 applicable) Email: clinical.education@tuality.org

is recommendedwaiver you use aform secure email option if submitting Instructions: Complete this Student influenza vaccinationIt declination – Use #secure# in the subject line. ONLY if you are unable to receive the flu vaccine. There areelectronically four recognized reasons individuals may decline receiving the influenza vaccine.

1. History of Guillan-Barre Syndrome 2. Allergy to eggs

3. Allergy to one of the components in the flu vaccine 4. Against your religious beliefs

Check the box that describes your decision to decline influenza vaccination:

☐ I received my influenza vaccine elsewhere* *Documentation is required by Tuality Employee Health ☐ I have a medical contraindication or allergy to one of the components in the influenza vaccine. ☐ I believe I will get the flu, if I get the flu shot.

☐ I don’t like needles. ☐ I never get the flu, so I never get vaccinated. ☐ My philosophical or religious beliefs prohibit vaccination. ☐ I am concerned about side effects. ☐ I decline to provide a reason.

☐ If other not listed reason, please list below the reason for declination:

Tuality Healthcare has recommended that all students receive influenza vaccination in order to protect themselves, Tuality patients and other members of the Tuality workforce. Students who decline vaccination must acknowledge that they are aware of the following facts: Influenza is a serious respiratory disease that kills an average of 36,000 persons and hospitalizes more than 200,000 persons in America each year. Influenza vaccination is recommended for all health care workers. If I contract influenza, I will shed the virus for 24-48 hours before influenza symptoms appear. When I am shedding the virus, I can spread influenza disease to others. I understand that the strains of influenza change each year, which is why I need to be immunized each year. I understand that I cannot get influenza disease from the influenza vaccine. Refusing to be vaccinated could endanger my health and the health of patients, staff and others. Despite these facts, I am choosing to decline the influenza vaccination right now. I understand by declining the influenza vaccine I must follow these guidelines stated below. I will be required to wear a mask under the following circumstances, if I have not received the flu vaccination during my student clinical activities:

     

During direct patient care activities, including patient transport. Patient care areas where patient care contact and /or exposure may occur such as hallways in patient care areas or waiting rooms. Any work location where people interact such as meetings, nurse’s stations, and patient transport hallways. Jobs roles/tasks with patient interaction such as patient registration, lab, case management, environmental services, volunteers, dietary services, security, visitor access desk and engineers who perform in room repairs and maintenance. Failure to comply with this policy will require a situational review with student and faculty. Failure to comply may lead to dismissal from the clinical site.

I understand that I may change my mind at any time and accept influenza vaccination, if vaccine is available. I have read and fully understand the information on this declination form. Student Printed Name:____________________________________________Date: ____________________________________ Student Signature: ______________________________________________ Date: ____________________________________ Complete the following Student Placement Forms, sign forms and return by mail, fax or email. Mail: Tuality HealthCare c/o Clinical Education Dept. 334 SE 8th Ave, Hillsboro, OR 97123

Student Orientation Handbook Quiz Form

Fax: 503-681-1952 Email: clinical.education@tuality.org It is recommended you use a secure email option if submitting electronically – Use #secure# in the subject line.

Instructions: Read the following statements and circle True or False. Students who are exposed to blood or body fluid MUST go to the Emergency Department within 20 minutes without exception or delay.

True

Fals e

A Code Gray means there is a violent patient and a Code Silver means there is a person with a weapon. Dial 1499 on any Tuality Telephone for emergencies at Tuality Main Hospital.

True

Fals e

A Code Red means that there is a fire or see smoke. The first action you would take is to notify a Tuality Healthcare member and then follow the acronym would RACER.

True

Fals e

The Health Insurance Portability and Accountability Act (HIPAA) is a Federal law that includes regulations about protecting a patient’s privacy. Students have a duty to keep personal information private and may not make photocopies of patient’s charts or print patient’s records.

True

Fals e

Patients must always be informed that a student is participating in their care prior to providing any treatments or any assessment and verbally accept student’s participation of care.

True

Fals e

Students are responsible for reporting risks and unsafe conditions to a Tuality staff member as soon as possible.

True

Fals e

True

Fals e

True

Fals e

True

Fals e

All Students are REQUIRED to return their Tuality ID Badge to the Tuality Human Resources department at the conclusion of their clinical rotation. Failure to do so is a violation of Tuality Healthcare corporate operational policy O-124. Students are expected to comply with Tuality regulated safety dress code at all times while on campus. Examples are; wear a Tuality Student ID Badge at all times, maintain good dental and body hygiene, tie long hair back, no artificial nails, no fragrances or scented lotions, no jeans, shorts, tank tops, exposed midriff, or miniskirts, no open-toe shoes or spiked heels, no visible slogans or logos, minimum jewelry and no facial jewelry, and cover visible tattoos as appropriate. The number to dial on a Tuality Telephone for a Code Blue is x1499 at TCH and x7333 at Forest Grove Hospital. If you find or discover any individual on Tuality campus who is either in urgent distress or cardiac and/or respiratory failure active a Code Blue immediately and get help.

I have read the Student Orientation Handbook and completed the Handbook Quiz. I understand that I must clarify my student role and responsibilities with my preceptor/faculty. I agree to comply with Tuality policies and procedures during my clinical experience. Student Printed Name: ___________________________________________Date: ____________________________________ Student Signature: ______________________________________________ Date: ____________________________________ Complete the following Student Placement Forms, sign forms and return by mail, fax or email. Mail: Tuality HealthCare c/o Clinical Education Dept. 334 SE 8th Ave, Hillsboro, OR 97123 Fax: 503-681-1952 Email: clinical.education@tuality.org It is recommended you use a secure email option if submitting electronically – Use #secure# in the subject line.

Confidentiality Statement for Students Form I understand that I may come in contact with confidential information-both clinical and employee related through written records, documents, ledgers, internal verbal correspondence and communications, electronic programs and applications. I will not access, nor do I have the right to review or disclose personal information, medical or otherwise, except when fulfilling my job responsibilities. I agree not to divulge or disclose to anyone other than those persons of the corporation who have the “need to know” directly or indirectly, either during or after my clinical learning experience, any confidential information acquired during the course of my experience. I understand and acknowledge that in the event I breach any provision of this agreement, Tuality Healthcare, in addition to any other legal remedies available to it, has the right to reprimand, suspend and/or terminate

my clinical experience with or without notice, to impose fines pursuant to applicable laws, and to report to my school or licensing body. Student Printed Name:____________________________________________Date: ____________________________________ Student Signature: ______________________________________________ Date: ____________________________________ School/College:_________________________________________________________ Assigned Tuality Department: __________________________________________ Faculty Contact Information: ___________________________________________

Nursing Student Orientation Training Information

Thank you