Student / Instructor Orientation

1
Student / Instructor Orientation

• Welcome to Aurora Health Care and the
• Aurora Oshkosh / Fond du Lac Patient Service
  Market
• We hope your clinical or internship experience
  with us will be a rewarding one
• If you have any questions during your time here,
  please contact our student coordinator at
  920-456-7389 or email jenny.penn_at_aurora.org

2
Orientation Checklist Before you Start

• Before you start your clinical or student
  experience at our sites, complete the appropriate
  checklist below
• Print off the appropriate form below for your
  role
• Bring to first day of clinical/experience
• Review with your instructor or preceptor
• Sign and Return to the Education Department
• Undergraduate Student (Hospital)
• Undergraduate Student (Clinic)
• Graduate Students (Clinic or Hospital)

3
Orientation Checklist Before you can Start

• Before starting at Aurora, please review
• Our Health Requirements
• And Required Background checks
• Your school coordinator or instructor must ensure
  these are met prior to your arrival

4
Orientation Checklist Before you Start

• Our patients may not recognize the difference
  between our regular caregivers and students
• Before starting review the following policy
• Caregiver Appearance Policy
• This policy tells you what you can or cannot
  wear, grooming, fingernails (no shellac),
  piercings, tattoos, etc.

5
About Aurora

• Our purpose What we do
• We help people live well
• Our vision What we aspire to
• Provide people with better health care than they
  can get anywhere else
• Our values What we believe
• Every patient deserves the best care
• Responsibly managing resources
• Building a healthy workplace through
  accountability, teamwork and respect

6

About Aurora, Integrated Health System

• Private, not-for-profit integrated health care
  provider
• 15 hospitals
• 31 counties, 90 communities
• 1,000 Aurora Medical Group physicians
• 325 Aurora Advanced physicians
• 155 clinics
• VNA - largest in Wisconsin
• 83 retail pharmacies
• 30,000 caregivers
• 92,000 inpatient discharges
• 2.2 million outpatient visits
• 3.6 million ambulatory care visits

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Directions and Location
The following facilities are located in the
Oshkosh/Fond du Lac Patient Service Market and
are part of the Fox Valley Health Care Alliance
Click here for Facility Search and Directions

• Oshkosh Hospital
• Oshkosh Clinic
• Oshkosh Doctors Court Clinic Location
• Fond du Lac Clinic
• North Fond du Lac
• Lomira
• Mayville

• Fremont
• Neenah
• Omro
• Ripon
• Wautoma
• Winneconne
• Other Aurora facilities search by type and
  location

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About Aurora Hospital / Clinic - Parking

• Click here for a MAP of our Oshkosh facility
• Oshkosh campus, the hospital entrance is in the
  rear of the complex, clinic is in the front
• A piano is located in the hospital lobby
  staircase in the clinic
• Park between white lines, farthest away from the
  entrances
• Yellow lines are for our guests and patients

Park Here
9
About Aurora Smoke Free

• Aurora is a smoke free organization
• Smoking is not permitted in buildings and/or on
  the facility property
• Those that choose to smoke must leave the campus
  or the property

10
Aurora does not allow Firearms

• There are no firearms, handguns, or weapons
  allowed in any of Aurora facilities
• Must be locked in car
• If firearm or handgun found, security is notified
  they will keep locked in secure location (if
  security is on premises)

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Aurora health Care is a not-for-profit health
care provider and a national leader in the
efforts to improve the quality of health care.
12
Patient Experience

• Our goal is patients first, always
• We believe that patients rights and
  responsibilities are an integral part of
  healthcare
• Click here to review our patients rights and
  responsibilities

13
Patient Experience

• Aurora is committed to service and diversity
• We have access to interpreter services
• Contact the department or house supervisor if you
  need their services
• We offer many complementary services in the
  hospital
• Healing garden
• Massage therapy
• Pet therapy
• 24/7 family visitation
• Special dietary requests
• And more

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Patient Experience is Important

• Please Remember AIDET
• Acknowledge the patient by knocking first, saying
  hello
• Introduce yourself and your role as a student
• Duration discuss how long a procedure, an
  interaction, assessment, a test, or results may
  take
• Explain the purpose of your visit and what you
  will be doing
• Thank the patient for their time and close with
  is there anything else I can do or get for you?

15
Patient Experience is Important

• Other TIPS
• Always wear a name badge
• Always inform the patient of what you will be
  doing and why
• Show respect, provide dignity and privacy
• Think about how you would want to be treated if
  you were a patient
• While you are here, you are part of the team it
  is all about the patient

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Orientation - Badges

• All students instructors must be identified
  with a badge
• You may use your school issued badge to identify
  you or the name of the school
• Aurora Hospital (only) requires all students,
  volunteers, and caregivers wear an Aurora Badge
• Clinic students only require school issued badge
• Your instructor or preceptor may provide you with
  a student badge, or contact the education
  department at ext. 7389 or 7196

17
Orientation - Badges

• Aurora Badges with an orange stripe indicate
  caregivers or students working in the obstetrical
  or pediatric departments of the hospital
• This is a special security measure

18
Orientation - Badges

• If you are provided an Aurora Badge, please sign
  the badge agreement section on the orientation
  checklist and return to Education Department
• Reminder Badges are tracked by security
• All badges need to be returned at the end of your
  clinical/internship to the Education Department
  or you will be charged a replacement fee

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About Aurora Resources

• From our internal computers, you will have access
  to
• Our on-line library services
• Patient Education
• Other Resources
• Just ask our medical librarian (ext. 7039) or any
  of our caregivers if you need assistance with
  locating resources or policies on-line

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Aurora Resources

• If you are providing information to patients,
  please remember the following tips
• Keep information simple
• Use plain language (avoid medical jargon or
  abbreviations)
• Have the patient or family member teach back or
  tell you / show you what you just told /showed
  them
• Do not say, do you have any questions..
• Instead, ask them to
• Tell me what you know about.
• Tell me what your doctor told you, then clarify
  the information as needed
• How will you do this or take this when you get
  home?

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Safety

• We want you to be prepared in any of our Aurora
  facilities
• We use plain language alerts for situations where
  we may need to act fast
• Know numbers to call
• 5911 at Oshkosh Facility
• Other outlying facilities call 9-911
• Fond du Lac clinic, call 22

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Safety Emergency Preparedness
In order to practice safely at our facilities,
it is essential that you know any alerts that may
be announced Emergency Preparedness plans can
be located in each department Be sure to locate
and review the plan when you arrive
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Emergency Alerts Fire Alarm

• Fire Alarm
• In case of a fire, call for help immediately.
• In the hospital dial 5911
• Outlying clinics dial 9, then 911
• At Fond du Lac clinic dial 22
• In the hospital you will hear this announcement
• Attention Please Fire Alarm, then the location

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In case of a Fire Know RACE and PASS

• RACE

• PASS

• R Rescue (remove anyone from danger)
• A Alarm (pull the fire alarm or call
  appropriate number)
• C Contain or confine the fire (e.g., close
  doors)
• E Extinguish (if small enough) or Evacuate (if
  too large and your safety in jeopardy)

• P Pull the pin
• A Aim the nozzle
• S Squeeze the handle
• S Sweep back and forth covering the entire fire
  base

25
Emergency Alerts Missing Person or Abduction

• Abduction or Missing Person
• What you will hear,
• Attention Please, Missing person, then whether
  the person is an adult, child or infant, then any
  description and the location if known
• Description may include
• Gender
• Age
• Clothing
• Hair or eye color
• Direction last seen or going

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Emergency Alerts Medical Emergency

• If there is a medical emergency, perhaps a person
  or patient you find that has passed out, having a
  stroke, or is not breathing and you need help
  quickly
• Dial the emergency number
• 5911-Oshkosh
• 9-911- Outlying clinics
• or 22 Fond du Lac clinic
• Give as much information as possible
• Always let the operator hang up on you

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Emergency Alerts Medical Emergency

• When calling the operator at the Oshkosh campus,
  give details such as location and the type of
  help needed.
• The location (hospital, room ___ or clinic,
  suite ___ or whatever department the situation
  is located
• Patient is breathing, not breathing, having a
  stroke or a heart attack
• The announcement overhead will determine which
  team responds to the medical emergency

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Emergency Alerts Medical Emergency

• Rapid Response Team (RRT) is requested if urgent
  help is needed and the patient is still
  breathing/has a pulse
• Cardiac Arrest is announced if the patient is not
  breathing and has no pulse
• RRT Stroke is announced if the patient is having
  a stroke
• RRT STEMI is announced if the patient is having a
  heart
• External is announced if assistance is needed
  outside the building

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Emergency Alerts Severe Weather

• In case of severe weather, you will here this
  announcement
• Attention Please, Severe Weather, then one of
  the following
• Tornado watch
• Tornado warning
• Weather advisory
• And a timeline

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Emergency Alerts Facility Emergencies

• You may also hear other alerts related to
  facility emergencies that involve
• Communications
• Flood
• Evacuation
• Outages
• Hazardous Spills
• Once these have been resolved, All Clear will
  be announced
• A caregiver or a supervisor will direct you if
  action is needed

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Emergency Alerts Security Alert

• There may be situations where caregivers,
  patients and/or visitors might be at risk.
• Security Alert will be announced followed by one
  of the following descriptors
• Security Assist (used for disruptive behavior,
  hostage, gun, knife situations)
• Building Threat (used if bomb threat)
• Active Shooter (used if there is an active
  shooter on the premises)
• Perimeter Control

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Active Shooter The 5 Outs
What to do if there is an active shooter

• GET OUT of the area to somewhere safe.
  Leave the room and go in the opposite direction
  from any shooter.
• CALL OUT to 911. Give as many details about what
  you saw or heard and your current location. Do
  not assume that someone else has called you may
  have new information for the police.
• HIDE OUT. If you can not leave, turn out the
  lights of the room you are in, and hide until
  help arrives. Avoid hallways, turn your cell
  phone on silent, and remain as quiet as possible.
  
• KEEP OUT. Lock, block, or barricade the door with
  any available furniture.
• TAKE OUT. This is a last resort when you have no
  other option, this is the life or death
  situation. Attempt to take out the shooter
  however you can.

33
Safety Exposures and Spills

• If you are exposed to any hazardous chemical, be
  sure to know how to locate Material Safety Data
  Sheets (MSDS)
• These will provide guidance on how to protect
  yourself and care following exposure, as well as
  how to clean a spill
• Located on-line, ask any caregiver

34
Safety Exposures and Spills

• If you have a blood spill
• Contact Environmental Services immediately
• If not available, notify the House Supervisor
  where applicable (Hospital)
• A blood spill kit is required for clean up
• Do not pick up broken glass with hands

35
Safety Exposures and Spills

• For blood spills when Environmental Services is
  unavailable

• Put on gloves and any other personal protective
  equipment (gown, mask and eye protection)
  depending on the size of the spill
• Apply absorbent powder from spill kit. Otherwise
  wipe up spill with paper toweling
• Sweep absorbent powder into a dustpan and place
  in a red bag or place paper towels into a red bag

Blood spill kit
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Safety Exposures and Spills

• Do not use your hands to pick up broken glass.
  Use a dustpan or tongs
• Place broken glass in a sharps container
• Apply antimicrobial cleaner onto spill area and
  let stand per manufacturers specifications
  before wiping up (Bleach packets can be used for
  small spills)
• Dispose of all soiled materials or the used spill
  kit into red bags
• Remove gloves and wash your hands

37
Safety Exposures and Spills

• If you are exposed to a spill, needle stick or
  any other injury during your student experience
• Notify your instructor or preceptor
• Notify the department supervisor or manager and
  employee health nurse
• Report to walk-in, urgent care, or the emergency
  department (after hours) for evaluation
• An incident report will need to be filled out

38
Safety Disposing of Wastes

• Healthcare workers generate a lot of waste
• Know where to throw
• Hazardous-infectious wastes
• Pharmaceutical wastes
• Chemotherapy wastes
• Radioactive wastes
• Recyclables

39
Safety Disposing of Wastes

• Hazardous-infectious wastes

• Dispose in red biohazard bins or bags
• Remember Infectious waste contains blood or high
  risk body fluids that are
• Drippable
• Pourable
• Squeezable
• Flakable
• Red bag all items containing blood or high risk
  body fluids

40
Safety Disposing of Wastes

• High-risk body fluids include
• Blood
• Semen
• Vaginal secretions
• Pleural fluid
• Amniotic fluid
• and Spinal fluid

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These items DO NOT belong in Red Bag

• IV Bags and lines without visible blood
• Syringes
• PPE
• Packaging materials
• Empty bedpans, emesis basins, wash basins and
  urinals

• Empty medication vials
• Stool blood cards
• Paper toweling
• Exam table paper
• Diapers and underpads only spotted with blood
• Dressings and bandages only spotted with blood

42
Safety Disposing of Wastes

• Radiology staff must dispose of radioactive
  waste appropriately
• Chemotherapy waste is disposed of in yellow bins
• Please be sure to dispose of recyclables
  where indicated
• Sharps such as syringe needles, broken glass,
  ampules

43
Safety Disposing of Wastes

• Pharmaceutical Wastes
• Any leftover medication in a vial, tube, inhaler,
  syringe, pill, IV bag, etc. must be discarded in
  a Black Container
• Before discarding any medication, ALWAYS ask a
  caregiver
• There are special situations regarding narcotics,
  nicotine patches, and warfarin (Coumadin)

• These do not belong in black box
• No sharps
• No empty containers
• No narcotics
• No biologicals (e.g., ablumin)

44
Patient Safety Is Important!

• Prevent infection wash your hands
• Follow isolation precautions
• Wear appropriate personal protective equipment
  (PPE)
• Prevent healthcare associated infections (HAIs)
• Surgical Site Infections (SSI)
• Central Line Associated Blood Stream Infection
  (CLABSI)
• Catheter Associated Urinary Tract Infection
  (CA-UTI)
• Use checklists and take a time out for procedures
• Identify the correct patient procedure every
  time
• Report critical test results immediately
• Communicate clearly with other caregivers
• Communicate clearly with patients
• Follow interventions to Prevent falls
• Be alert to signs of abuse, neglect or suicide

45
Patient Safety - Medications

• Prevent medication errors, always use 7 rights
• Right Patient
• Right Drug
• Right Dose
• Right Route
• Right Time/Day
• Right Form
• Right Documentation
• Label ALL medications and fluids
• Does patient understand list of medications
• Check expiration dates for all immunizations,
  document lot numbers

46
Patient Safety

• If your experience will be in the hospital
  setting, you will need to be aware of our
  restraint policy
• Alternatives to restraints are always used first
• Generally we dont use restraints except for
  specific situations where the patient could cause
  harm to self or others
• Students and instructors may not apply restraints

47
Personal Safety

• When dealing with an angry person
• Remember
• DO NOT argue
• Listen, listen, listen
• Do not let yourself be cornered
• Stand up if you were seated

• Watch for anything that could be used as a weapon
• Call for security assistance
• Ext. 7020 at Oshkosh campus
• 9-911 other sites
• Trust your instincts!

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Personal Safety Back Safety
49
Personal Safety Back Safety

1. Get help
2. Use appropriate lift/transfer devices
3. Use good body mechanics

50
Care Management and Quality Initiatives

• Aurora is involved in many initiatives that
  promote quality care
• Whether your experience is in a clinic,
  outpatient setting or hospital, be sure to ask
  the caregiver you are with about these
  initiatives and your role
• See next slide for our Quality Initiatives

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Our many Care Management or Quality Initiatives

• Advance Care Planning 
• Asthma
• Breast Health
• Cancer Screening Breast, Cervical and Colorectal
  
• Childhood and Adolescent Immunizations 
• Chronic Kidney Disease 
• Diabetes

• Heart Failure
• Hypertension
• Influenza Vaccination
• Ischemic Vascular Disease (IVD) Care
• Osteoporosis 
• Patient Safety
• Pressure Ulcer Prevention
• Stroke
• Tobacco 

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You are almost done!

• Be sure to ask our caregivers questions
• Dont do something you have not been trained or
  are prepared to do
• Your instructor or preceptor should guide your
  experiences
• This is your time to learn so be sure to ask for
  experiences, jump in when you are able
• If you are not sure if you can do something,
  Always ask

53
Finishing my Student OrientationDocument turned
in to Aurora

• Click on, Print, Complete and Sign one of the
  safety/orientation checklists below with your
  instructor or preceptor
• Undergraduate Student (Hospital)
• Undergraduate Student (Clinic)
• Graduate Students (Clinic or Hospital)
• Turn in Aurora checklist to Education Department
  at Aurora Medical Center Oshkosh

54
Finishing my Student Orientation Documents that
are returned to your school

• Click on and Print the FVHCA Clinical Agency
  Specific Orientation Form C
• This form confirms you have completed orientation
  at Aurora this documentation is a regulatory
  requirement
• Sign and Return Form C to your School Coordinator
  or Instructor
• All these forms are confusingwhat do I turn in
  to my school?

55
Finishing my Student Orientation Documents that
are returned to your school

• By now you should have completed the following
• Module 1 Infection Control / OSHA Bloodborne
  Pathogens / Safety Orientation (.pdf)
• Module 2 HIPAA / Confidentiality / Compliance /
  Professionalism Orientation (.pdf)
• And printed off Form A (Confidentiality
  Agreement) and Form B (Orientation Modules 1 and
  2 Completion Form)
• --------------------------------------------------
  --------------------------------------------------
  ------------------------------------
• You will turn in the following forms to your
  school or instructor
• FVHCA Form A Confidentiality Agreement
• FVHCA Form B Orientation Modules 1 and 2
  Completion Form
• FVHCA Form C Organization Specific Orientation
  Confirmation Form

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You are done!

• Welcome to Aurora and we hope you have a
  wonderful experience in our Oshkosh / Fond du Lac
  market