Cone Health

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Cone Health

• 8,600 employees
• Largest private employer in Guilford County
• 5 hospitals (1,017 beds)
• 60 Physician Practices
• Three Urgent Care Centers

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Greetings From Our Chief Nursing Officer

• Welcome! I am excited as you embark on your
  new professional journey. My wish is that you
  will sincerely enjoy working at Cone Health and
  will thrive in our practice environment.
• Theresa Brodrick , RN, PhD, CNS, CNA Chief
  Nursing Officer

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Vision

• Cone Health will be
• a national leader in delivering
• measurably superior healthcare.

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Our MissionWe serve our communities by
preventing illness, restoring health and
providing comfort, through exceptional people
delivering exceptional care.Goal Be in the
top 10 nationally for Quality Service Cost

Strategic Plan
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Our Expectations
To provide the best healthcare possible, we
believe that everyone must be committed to the
Cone Health Values and our New Operating
Principles and Practices.
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Our Values
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Cone Health Operating Principles

• In caring for our patients, each other and our
  communities
• I use evidence based practices to provide safe
  and exceptional patient care.
• I communicate honestly and directly with care
  and respect.
• I include people with diverse backgrounds,
  experiences, and points of view.
• I see it, own it, solve it, do it, and celebrate
  it!

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Six New Practices

• I keep patients safe by practicing the 4 Rs
  (right patient, right place, right time, right
  service).
• I practice AIDET (acknowledge, introduce,
  duration, explain, thank you) for every patient
  interaction.
• I assume the best intention and seek to
  understand.
• I do not gossip I take issues to the person who
  can do something about it.
• I do what I say, when I say, and communicate.  If
  I cant I clean it up.
• I thank someone every day.

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Professional Model of Care

• Our philosophy summarizes our beliefs
• Our beliefs are the basis for how we deliver care
• Our Model of Care outlines how we conceptualize
  our beliefs
• This model is based on theories of caring

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Care Delivery Model

• Our Relationship Based Care Delivery Model is how
  we operationalize our Model of Care and
  Philosophy
• This model is patient and family centered
• Focuses on 3 Key Relationships
• Self
• Colleagues
• Patient Families

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HIPAA and Corporate Compliance
Special Note XXX xxx in front of the patients
name Strict Privacy When someone asks for that
person by name, state, There is no record of
that person being in the facility.
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HIPAA and Corporate Compliance
Report Privacy Violations Reports of a privacy
violation are entered into the electronic
Safety Zone Portal (SZP).
Discuss first with your instructor, charge nurse
or Cone Health Privacy Officer
Safety Zone Portal
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HIPAA and Corporate Compliance
Gifts from Patients Patients who would like
to honor a student should be referred to the
Office of Fund Development.
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Patient Care Partnership
A
Acknowledge
I
Introduce
D
Duration
E
Explanation
T
Thank You
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Patient Care Partnership
Acknowledge the patient and visitors. Say
hello.
A
Introduce yourself and state your business. Why
you are there and what you hope to accomplish.
I
Duration- If there is a delay in treatment tell
the pt. how long the wait will be.
D
Explanation Tell the pt. why you are doing the
treatment and/or giving the medication etc.
E
Thank You- Thank the pt. for allowing you to
care for him/her.
T
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The Patient Care Partnership

• Hourly Rounding with a Purpose
• 8 Behaviors important to Hourly Rounding with
  Purpose
• Use warm acknowledgement to reduce anxiety
• Perform scheduled tasks
• Address the 3 Ps (Pain, Potty, Positioning)
• Assess additional comfort needs
• Conduct an environmental assessment of the room
• Prior to leaving the room, ask, Is there
  anything else I can do for you?
• Tell each patient when you will be back
• Document the round on the chart

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Infection Control
Hand Hygiene The expectation is that each
healthcareworker (including students) will
perform proper hand hygiene with and without
wearing gloves Upon entering and exiting the
patients room
Cone Health policy Only use alcohol gel / foam
provided by Cone Health, or soap and water.
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Policies and Procedures

• Cone Health Nursing Policies and Procedures are
  available online on the Intranet Homepage under
  the Resources tab. The Intranet is available on
  every department computer desktop directly or
  through Citrix.
• Click on the icons for Citrix or the CH Intranet
  Homepage.

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Policies and Procedures

• CareNotes Electronic Patient Education Resource
• CareNotes provide information in English and
  Spanish on a
• variety of topics
• Medications
• Tests
• Diagnosis
• Labs
• Procedures
• You can find a link to
• CareNotes on the Intranet
• Homepage under Applications.

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Policies and Procedures
Computer Training Faculty should
contact the Staff Education Department in order
to schedule training (832-8173) Nursing
students and faculty will be given computer
instructions and access codes upon successful
completion of the training exercise. .
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Policies and Procedures
Documentation Standards Do not share computer
IDs or passwords. Do not look at information in
patient medical records unless you are assigned
to the patient. (HIPAA Privacy Laws) Cone Health
Employees must use the computer password assigned
as student/faculty for documentation and not
their employee password when in the
student/faculty role.
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Policies and Procedures

• CBG Training
• Nursing students/faculty will not perform
  patient glucose testing at this time.
• Faculty and/or Students who are Cone Health
  employees are not permitted to perform the
  testing while in the faculty/student role.
• Students may work with the primary
  nurse/instructor in order to intervene as
  necessary r/t blood glucose test results and may
  chart the results in the patients documentation
  record.

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Policies and Procedures

• Risk Management
• Any incident, which may have adverse consequences
  for patients, visitors, faculty/student should be
  reported immediately to Leadership on the
  department and a safety Zone Portal entry
  completed.
• SAFETY ZONE PORTAL
• Events that are inconsistent with Cone Health
  Policies Procedures, or not part of routine
  care
• Goal Improve Quality Safety
• Leads to appropriate follow up
• Event to be documented in patient chart
• Do not document SZP record in patients chart

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Policies and Procedures

• Sentinel Event
• A Sentinel Event Is
• An unexpected occurrence involving death or
  serious physical or psychological injury or the
  risk thereof
• These events should be reported immediately.
• Work with the clinical instructor and the
  patients primary care nurse to report.
• See the Sentinel Event policy in the
  Administrative and Patient Care Manual)

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Policies and Procedures
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Red Rules
Policies and Procedures

• RED Rules are requirements that must be followed
  each and every time the occasion or situation
  arises
• Because they are such a priority, they are
  considered RED to signify their importance.
• RED Rules are rules that CANNOT be broken.
• They are few in number and easy to remember.
• They are associated with processes that can cause
  serious harm to patients.

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Cone Health Red Rule 1
Policies and Procedures

• A time out is completed before all invasive
  procedures.
• Invasive procedures are described in policy
  number IV-P-39 located in the Administrative
  Policy Manual.
• Cone Health Red Rule 2
• All inpatients receiving medication or blood
  products, or undergoing any procedure, will have
  an identification band in place and
  identification will be confirmed.

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Policies and Procedures
Patients in Cone Health are identification by
both Name AND Medical Record
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Policies and Procedures

• Ethical Issues
• Cone Health offers Ethics Consultation for
  patients, families, medical staff and ancillary
  staff involved in patient care.
• The patients primary nurse and your instructor
  can contact Pastoral Care to request an Ethics
  Consult

The American Nurses Association (ANA) Code of
Ethics for Nurses provides guidelines for
practice.
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Policies and Procedures

• Rapid Response Team (RRT)
• Provides early and rapid intervention for
  patients outside the ICU setting whose condition
  is deteriorating.
• Critical Care team responds to a call for
  critical care expertise to the patients bedside
  to assist with stabilizing and transferring to a
  higher level of care as needed
• CONDITION HELP
• A Safety Net Program for Patients and Families
• WHAT- Ability for patients and families to
  activate a Rapid Response Team to come to your
  room to work with your current healthcare team to
  address your concerns.
• HOW - CONDITION HELP Dial 2-1666 from any
  hospital phone

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CONE HEALTH EMERGENCY CODES
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Emergency Codes
Code Gray Restricted Access

• What is Code Gray?
• Response to an incident of civil unrest
  withinCone Health that threatens the safety of
  patients, visitors and staff.
• Potential reasons to activate Code Gray include,
  but are not limited to
• Heightened emotional or behavioral response,
  even after de-escalation attempts
• Visible weapons
• Physical altercations
• Hostage situations
• Communication of threats

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Emergency Codes

• Code Gray RESTRICTED ACCESS
• When a Code Gray is announced
• Ancillary services and support staff avoid the
  area until Code Gray All Clear is announced
• All staff authorized to enter the restricted area
  must present appropriate identification

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Emergency Codes
Code Pink Abduction
When Code Pink is announced, some departments
have specific assignments. All other available
employees should

• Come into the hallways and stairwells.
• Keep an eye on any nearby exits.
• Call Security to report any activity that seems
  suspicious.

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Cone Health is a Certified Chest Pain
Stroke Center

• Heart Attack Symptoms
• How to Recognize
• What to Do

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Chest Discomfort May Be a Sign of a Heart Attack

• Pressure, heaviness
• Squeezing, tightness
• Burning
• Lasts more than 2 minutes
• May come go
• Sometimes Heart Attacks only cause Pain in
• One or both arms. Back. Neck
• Shortness of breath. Breaking out in a cold
  sweat
• Nausea, vomiting. Light headedness
• Extreme weakness, fatigue

Other Signs of a Heart Attack
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If a guest or employee has symptoms of a heart
attack- Notify an RN or other healthcare
provider- Assist him into a wheelchair- Take
him to the Emergency Department- If there is no
ED available, call 911 for emergency careIf a
patient has symptoms of a heart attack- Notify
the patients nurse or medical caregiver
immediately
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A Stroke Looks Like

• Stroke Signs and Symptoms
• Numbness or weakness of the face, arm or
  legespecially on one side!
• Trouble seeing in one or both eyes!

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A Stroke Looks Like

• Stroke Signs and Symptoms
• Trouble walking, loss of balance or coordination!
• The Worst Headache of my Life with no known
  cause!

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What should you do if you think a patient or
visitor is having a STROKE?
Notify a Nurse or other Healthcare Provider!
Call if you are not at the hospital!
911
Get Help Fast!
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You can make a difference in a stroke patients
life!
Be FAST

• REMEMBER

Facial Droop
Eyes Double Blurred
Speech
TIME!
Balance
Arm Leg Weakness
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Banding Together for Patient Safety
Cone Health is participating in the statewide
program to implement standardized armband colors
for improved safety.
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Banding Together for Patient Safety
BLUE Blood Bank Bracelet
The blood identification bracelet is now a blue
armband. The armband will continue to have a
patient identification number. Patient
identification is done by the white arm band.
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Safe Patient Handling

• POLICY All patient transfer/ lifting will be
  done safely and appropriately to protect the
  employee and patient from injury.
• All patient lifting, shifting, or transferring
  will be completed based on assessment, utilizing
  mechanical lift equipment and/or other approved
  patient handling aids.
• Consult with the Patients Primary Care Nurse
  and your nursing instructor for guidance.

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Safe Patient Handling

• Tubes/ Slides
• Tubes slides reduce friction and provide a
• safer, more comfortable move for patients
• and caregivers.
• Blue or Orange TUBE - Lateral transfer - bed to
  stretcher
• MAXI SLIDE boost patient in bed
• Students refer to clinical instructor and
  patients primary nurse for questions/instruction
  

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Safe Patient Handling

• Maxi Move- Lifting and transfer device for the
  totally dependent individual
• Able to lift from floor, bed, chair,
  toilet/bathing area and other areas
• Safe to use as a transportation device throughout
  the facility
• Able to double-task procedures - weigh individual
  during lifting and transfer activities
• Has selection of standard sized slings from
  x-small to x-large and various specialty slings
  (e.g. amputee slings)
• Refer to clinical instructor and patients
  primary nurse for questions/instruction.

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Cone Health Guidelines
Cone Health Approved Abbreviations

• Only approved abbreviations may be used.
• The list is found in Citrix / Resources /
  Policies Procedures / Approved Abbreviations
  List.
• Also Do Not Use list can be found on MD Order
  Sheet.

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Team Communication Tools
General Guidelines

• SBAR Effective communication tool. Consistent
  and organized to promote patient safety
• Gather information prior to communication
• Situation
• Background
• Assessment
• Recommendations

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Team Communication Tools
General Guidelines

• HAND-OFF / HALL PASS
• Internal and external transfer of care
• Shift Report
• Coverage for lunch / breaks
• Critical Lab and Radiology Results
• Uninterrupted time
• Requires ability to ask questions

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General Guidelines
Student Parking Carpooling is strongly encouraged
on each campus. Moses Cone Hospital Students
and faculty are required to part in the Wendover
and Church Street parking lot. Wesley Long
Hospital Students must park in the employee
parking lot located off N. Elam and Friendly
avenues. May have temporary modifications
confirm with Instructor Womens Hospital
Students may park in the Womens Education Center
parking lot. Turn onto Lendew Avenue from Green
Valley Road. Park in the lower area of the
parking lot. Annie Penn Hospital Students may
park in the employee parking lot located adjacent
to the South Main Street exit of the hospital
lot. Behavioral Health Hospital Students must
park in the upper middle lot and to the left of
the building.
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General Guidelines
Meals The Moses H. Cone Memorial Hospital
Wesley Long Hospital Womens Hospital Annie
Penn Hospital Moses Cone Behavioral Health
Hospital
Libraries Moses Cone Hospital Wesley Long
Hospital Womens Hospital Behavioral Health
Hospital
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General Guidelines

• Dress Code
• Dress professionally
• No tank tops, revealing clothing, sweat pants,
  biking shorts,
• jeans, capris, shorts or flip flops
• Follow the dress code policy of your school
  and Cone Health.
• Wear your school uniform.
• Lab coats are to be worn over your street
  clothes.
• Your photo ID must be worn at all times
• Mid Chest or above with no obstructions

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General Guidelines

• Dress Code
• Cleanliness and Scents
• Good personal hygiene must be maintained. Avoid
  obvious and natural odors.
• Scented products- e.g. perfumes, fragrances or
  after-shaves are not allowed.
• Tattoos- must be covered at all times.
• Nails- must be neat, clean and short.
• No artificial nails, nail applications or
  overlays, nail enamel or polish are allowed for
  direct bedside caregivers.
• Jewelry Minimal while providing patient care.
• No more than one ring on one hand
• Earrings- no more than 2 earrings per earlobe.
  Not greater than 1½ inches in diameter or length.
  
• No open gauges and none greater than ½ inch in
  diameter.
• No other visible piercing is acceptable.

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General Guidelines
Phones/Valuables Personal phone calls should be
limited to emergencies. Personal cellular
phones are to be turned off and not used in
clinical settings. Storage is limited for
personal belongings. Valuables cannot be
secured.
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General Guidelines

• Tobacco Use
• Tobacco Use is Prohibited on any Cone Health
  Campus
• In the interior and exterior of any CH property.
  This includes
• Vehicles parked on CH property
• Parking decks and lots
• Sidewalks on or adjacent to system property
• Balconies and picnic areas.

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THANK YOUWe wish you the best at Cone Health.
Please sign the Orientation Acknowledgement
Form and give it to your Instructor for safe
keeping.