New Employee Orientation Program

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Mercy Hospital Unity Hospital

• New Employee Orientation Program
• Part One

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Orientation
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Welcome to Mercys Unitys New Employee
Orientation Program

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

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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

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Who We Are

• Mercy Unity Hospitals are dedicated to
  providing quality, cost-effective health care to
  over 225,000 households in more than 26
  neighboring communities. The hospitals have more
  than 3,700 employees, 842 affiliated physicians
  and more than 770 youth and adult volunteers to
  care for and assist you.

• Mercy Unity respond to a wide range of health
  care needs with specialty services including
• Bariatric Center Behavioral Service
• Cancer Centers The Cardiac Centers
• Emergency Services Orthopedics
• Neurosciences Womens Childrens Services
• A wide range of health education and support
  groups to help people quit smoking, deal with
  illness at the loss of a loved one, and other
  health and personal issues.
• LifeLine, a low-cost emergency response system
  for the elderly or disabled.
• Elk Ridge Health, a clinic and surgery center in
  Elk River

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

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Living the Values

• Why is it that some patients can have poor
  outcomes and still say that they wouldnt go
  anywhere else for their healthcare?
• The difference is the relationships that we
  create with our patients.
• Its 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

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The impact of body language, voice, tone and words

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

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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.

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Confidentiality

• HIPAAs Privacy Law

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Confidentiality

• Maintaining a patients privacy and
  confidentiality is not only the ethical thing to
  do, its 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.

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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.

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Curiosity Killed the Cat Dont 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 its 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.

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An Extraordinary Workplace with Extraordinary
Employees

• A Culture of Caring

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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

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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

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Key Points on Harassment

• Its the impact, not the intent.
• Whether or not you intended harm doesnt 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.

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Safety Vision

• To make Mercy Unity Hospitals safer places to
  give and receive care

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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 or
  infectious 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 youll be in contact with one of the
  items during the normal course of your assigned
  work.

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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.

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What if Im 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 dont know how
  to use or handle hazardous materials and/or
  equipment.
• Report faulty equipment so it can be repaired or
  replaced.
• Dont 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.

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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.

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Locating information on Hazardous Substances
Chemicals on the AKN
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Material Safety Data Sheets (MSDS) provide
information on the effects and properties of
hazardous substances.
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Emergency Codes

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

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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

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R.A.C.E.
Rescue

• 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.

Alert
Confine
Extinguish
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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.

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Safety Phone Contacts

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

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Infection Control

• Everyones Job

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Where do germs come from?

• Environment
• surfaces
• floors
• gardens
• People
• skin
• intestines

• Equipment
• Water
• Flowers/plants

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.
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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

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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.

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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

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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

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Other Infection Control Issues

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Other Infection Control Issues
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Location of Exposure Control Plan and Infection
Control Policies

• The Allina Knowledge Network (AKN)
• Ask your charge nurse about access to the AKN.
• Ask your charge nurse about unit specific safety
  goals.

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Pharmaceutical Waste Collection

• Everyones Job

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Pharmaceutical Collection Process

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

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Pharmaceutical Waste (No sharps, controlled
drugs or infectious waste)

• Dispose of unused or outdated pharmaceutical
  products
• Partially used vials, tubes, inhalers, IV bags
  and tubing containing medications
• Discontinued medications
• Tablets or capsules dropped or refused by patient
• P-listed drugs including empty vials, bottles,
  IVs etc.

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Dual Waste Hazardous and a Sharp

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

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Dual Waste Hazardous and Infectious

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

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Bulk Chemotherapy

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

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In Closing...

• Final Considerations

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Department Specific Orientation Checklist

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

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JCAHO Requires That All Employees Are Aware

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

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

• Press the ESC key to end