Transcript Welcome Print out all forms: Complete front and back   Test  Compliance and Confidentiality Form  TB Health Assessment Form.

Welcome
Print out all forms:
Complete front and back

 Test
 Compliance and Confidentiality Form
 TB Health Assessment Form
SAFETY
 KDMC Safety Officer: Clyde
Sbravati
 MSDS SHEET: Material Safety
Data Sheet: This information is
now available via phone.
 1-800-451-8346
 Information will be read for you
or they will FAX the information
to you.
MSDS FORM SHOULD HAVE THE
FOLLOWING INFORMATION:
 Where product come
from.
 Composition and
information on the
ingredients.
 Physical data.
 Boiling point
 Appearance
 Potential health effects

 Emergency and first aid
measures.
 Fire fighting measures
and procedures.
 Handling and storage of
the chemical.
 PPE needed to handle
the chemical spill. (The
hospital will provide
you with the equipment
needed.
Your Nametag:

 Should be worn by all employees while at work.
 Never loan your nametag to anyone.
Be Safety Alert:

 Report all unsafe practices, conditions, defective
equipment and or injuries to your supervisor, Safety
Committee or Safety Officer.
 Use required personal protective equipment in
specified areas and on designated job duties.
 Operate equipment only after have been authorized
and trained to do so, and follow all safety rules,
procedures and practices.
 Respond to emergency situations in accordance with
medical center and departmental polices and
procedures.
SENSITIVE AREAS OF KDMC
 Nursery
 Medical Records
 Back Loading dock
 Pharmacy
 Emergency Department
Chemical Spills
 Mercury spill kits are located at each nurses stations.
 There is a big gray barrel with red lettering, located
in materials management for chemical spills
Electrical Safety: Unplug Equipment from
wall immediately if you notice:

 A burning smell.
 Equipment is hot to
touch.
 Equipment is smoking
 You feel a shock or
tingling feeling.
 Report Cords and Wall
plugs if you notice:
 Cracks in insulation
 Bent or missing AC plug
or prongs
 Burn marks on AC plug
 Warm or Hot power
cords.
What is a Disaster or Code Black?

 An external or internal disaster occurs when an incident
produces casualties of such numbers, that the routine
methods for patient care are not adequate.
 If a disaster occurs while you are off duty, you will
received notice that you are needed at KDMC by phone,
radio or TV announcement.
 It is your responsibility to respond to any disaster at
KDMC. Be sure your home phone and cell phone
numbers are up to date in the Human Resources office
and with your immediate supervisor.
Code Force: Non-medical emergency
Available
employees should
report to the
location called.
Code Gray: Tornado
 Move as many
patients as possible
to the hallway.
 Move all others
away from the
windows.
 All other employees
should move to 1st
floor hallway by
dietary.
Code Red: Fire Alarm, RACE
 R-Remove anyone in
the danger area.
 A-Alarm, dial 711 and
announce the location
of the fire.
 C-Control fire with
extinguisher.
 E-Evacuate patients to
a safe part of hospital
Code Red: Fire
 Get Fire extinguisher
and report to area
called.
 Use Pass for fire
extinguisher.




P-Pull pin
A-Aim Nozzle
S-Squeeze handle
S-Sweep at the base of
the fire.
Code Pink / Code Adam:
Missing baby or missing child.
 Report to the nearest exit.
 No one should be able to leave or enter the
building.
 Try to obtain a description of child




Age
Sex
Race
Hair and eye color
Clothing
Type and color of shoes
Code Blue: Cardiac Arrest
Available medical staff,
Code Team, should
report to the location
called.
Proper Sitting:
 Sit in a chair that has proper
low back support.
 Keep your feet flat on the
floor.
 Keep your hips at a 90%
angle.
 Avoid slumped sitting.
 Keep your chin tucked in
and avoid head forward
posture.
 Avoid prolonged sitting.
Change positions
frequently.
Lifting Safely:
Bend your knees, not
your back, and you
greatly reduce stress to
your low back. Keep
the load close to your
body and carry heavy
objects waist high.
5 Key Points of Proper Lifting:

1.
2.
3.
4.
5.
Plan ahead, rearrange area and get help if needed.
Bend your knees not your back.
Keep the load or patient close to your body.
Use a good wide base of support.
Pivot your feet when turning-avoid twisting.
Pushing or Pulling?
If you have a choicePUSH!
 Pushing is more
mechanically efficient.
 Keep your back
straight. Bend as you
push.
 Reposition your body
as you push. Don’t let
the load get too far in
front of you.
Carrying a Load:

 Support the load in two places, side and bottom.
 Hold the load close to your body, keep your back
straight.
 Carry with a slight bend in your elbows.
 If you carrying shopping bag or luggage- split the
load and carry a lighter load on each side.
Reaching:

 Pace your work and get as close as you can.
 Avoid standing on your ‘tip toes’, use a stool or
ladder if necessary.
 Store frequently used items within easy reach.
 Use one hand for extra support if possible.
 Avoid prolonged overhead work without breaks.
Common Mistakes of
Body Mechanics:

 Lifting with the Back Bent and the leg Straight.
 Lift with your legs not your back.
 Using Fast Jerking Motions.
 This adds additional stress on back and joints
 Bending and twisting at the same time.
 This causes maximum stress on the lower back.
Common Mistakes Continue:

 Load too far away.
 Load at arms length weights 7-10 time more.
 Poor planning
 Failure to anticipate needing assistance
 Poor communication
 Let patients know what to expect, they can help.
 Insufficient strength
 Not strong enough to lift the patient or load.
Remember:
 Lift with your legs
and not your back.
 Keep back straight.
 Bend at the legs.
 Lift your head before
you lift.
 Maintain natural
sway in lower back.
Fall Risk Assessment

 Should be completed on every patient.
 If your patient does fall:
1.Complete Occurrence Report.
2.Complete Fall Report in Meditech Nursing
3.Place on “High Risk” Fall precautions if not on it already.
4.Notify physician and family.
“High Risk” Fall Precautions:
 Yellow armband and
door card.
 Room near nurses
station.
 Possible bed alarm.
 4 side rails up.
 Sitter at bedside.
 Bed in low position.
EVERY PATIENT SHOULD RECEIVE A
“Patient Rights & Responsibilities”
Hand Book
The Patient Bill of Rights.
Each Patient has the Right to:

 Be treated with
dignity & respect
 Expect privacy &
confidentiality
 Make informed
decisions
 Participate in all
aspects of care
 Establish advance
directives
 Receive impartial
access to care
 Be given full
financial information
Help Them Develop an
Advanced Directive




Advising of their right to advance directives.
Asking if they have an advance directive.
Assisting them in developing advanced directives.
Including the information in their medical record.
Patient’s Bill of Rights
Each patient has the right to:
 Know the identity &
professional status of all
healthcare workers.
 Participate voluntarily
in research & education
projects.
 Receive full knowledge
of their rights and
responsibilities.
Patient Restraints
When Are Restraints Used?

 Only with a doctors order to include:
The type of restraint to be used.
The length of time the restraint is to be used.
Reason for the restraint.
Document every two hours on restraint sheet
circulation and skin condition.
 Checked at least every 15 minutes.
 Signed by physician within 1 hour.
 New order every 24 hours




How Are Restraint Used?







Follow manufactures directions.
Use correct size.
Fasten straps tight but not constrictive.
Do not place over IV Site or wound.
Tie knots for easy release.
Only trained personnel should apply.
Problems That Can Occur
From Using Restraints:

 Increase agitation
 Circulatory
impairment
 Asphyxiation D/T
aspiration or
restricted respiratory
function.
 Seizure Pts can suffer
fractures or trauma.
 Alternative:
 Have family stay with
patient.
 Move them out to the
desk.
 Try to fix what is
bothering them.
National Bereavement Sign
If you see this sign on a patient door, it means there is a
“sensitive” situation going on involving possible loss
or death. Please be respectful.
Visitation Rights

Patients have the right to choose who may visit them.
They have the right to choose someone who is not
related by blood or law.
This includes, but is not limited to:
 A Friend
 A Domestic partner (any gender)
 A Neighbor
 A Significant Other
POLICY: KDMC does not tolerate acts of
workplace violence committed by or
against employees.
If Conflict Occurs:
1. Stay Calm
2. Listen attentively
3. Maintain eye contact
4. Be courteous, but maintain
your distance
5. Signal for someone to call for
help
6. Never try to grab a weapon
Early Warning Signs:
 Nervous behavior.
 Loud, over bearing
personality.
 Threatening others.
 Getting in your face.
 Clinched fist.
 Flashing a weapon.
 History of violence.
If Violence Strikes:
 Take action to
protect yourself.
 Call for Code Force.
 Remove patients &
visitors to safe area.
 Don’t try to take
away a weapon.
 Don’t try to restrain
the person alone.
Safe Practices:

 Don’t leave scalpels or needles unsecured.
 Obtain history: ask about cuts & bruises.
 Know way to contact Security.
 Overhead page
 Pager
 Radio
Watch for Signs of Abuse
to our Patients:
 Physical Indicators:
 Unexplained bruises in
different stages of
healing.
 Complains of abuse at
home.
 Patterned injuries.
(Buckles, belts, burns)
 Untreated old injuries.
 Delay in receiving help.
 Attempted suicide.
.
Questioning the Suspected Abuse Patient





Provide a safe environment.
Interview patient alone.
Have Security escort others out of the room if need.
Ask direct, non-threatening, non-judgmental
questions.
Bloodborne Pathogens
What are Bloodborne Pathogens?
They are viruses, bacteria and
other microorganisms that:
are carried (borne) in the person’s bloodstream and
in certain other body fluids
cause disease
If a person comes in contact with
infected blood or certain other
body fluids, he or she might
become infected too!
revised: 2012
Non-Infectious Body Fluids
for Bloodborne Pathogens:








Sweat
Saliva
Tears
Urine
Feces
Vomitus
Nasal secretions
revised: 2012
Infectious Body Fluids
for Bloodborne Pathogens:

 Blood
 Fluid around or in an organ
 Any body fluid that contains blood
revised: 2012
Three of the Most Serious
Bloodborne Pathogens

Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Human Immunodeficiency Virus (HIV)
revised: 2012
HEPATITIS
 Hepatitis A
 Hepatitis B*
 Hepatitis C*
 Hepatitis D
 Hepatitis E
revised: 2012
Symptoms of Hepatitis B & C

The primary symptom of HBV & HCV is
jaundice (yellowing of the skin and eyes)
THERE IS NO CURE.
revised: 2012
HIV

HIV = Human Immunodefiency Virus
The virus attacks the body’s ability to fight disease and
infection (immune system)
The virus causes AIDS
(acquired immune deficiency syndrome)
revised: 2012
Symptoms of HIV Infection

 The symptoms of HIV are:






none
weakness
weight loss
fever
sore throat
dark urine
 THERE IS NO CURE.
revised: 2012
How are these pathogens spread?
When infected fluids enter the body through:

needle-stick injuries or sharps injuries
cut, scrapes, and
other breaks in the skin
splashes in the mouth,
nose or eyes
revised: 2012
STANDARD PRECAUTIONS

Standard precautions (also known as universal
precautions) means that you will consider the blood
and certain other body fluids of another person
INFECTIOUS at all times
AND
You will use equipment to protect yourself
revised: 2012
Personal Protective Equipment
PPE

You must use certain PPE items to protect yourself. This will place a
barrier between you and the potentially infected material. These items
include:





gloves
masks
goggles
gowns
resuscitation equipment
revised: 2012
SHARPS!!

Sharps MUST be disposed
of properly!!!! You
should dispose of
sharps:
 in a labeled sharps container
only
 without recapping
 as soon as they are used
revised: 2012
HAZARD SIGNS, LABELS & COLOR CODING
Warning labels and colors
help you identify
hazardous or regulated
waste!
RED CANS, CONTAINERS,
LABELS OR BAGS MEAN
“INFECTIOUS”
revised: 2012
UNIVERSAL BIOHAZARD SIGN
HAVE I BEEN EXPOSED
to BLOODBORNE GERMS?

What is an exposure event?
 Did I get stuck with a needle or sharp used on

another person…
 Did I get a splash of blood or *OPIM from another person into my mouth
or eyes or up in my nose…
 Did the blood or *OPIM from another person enter my body through my
non-intact skin (cut, scrape, open wound)...
*OPIM = other potentially infectious material
revised: 2012
What if I Am Exposed?

 Wash the exposed area thoroughly with soap and running water.
 If splashed in the eye or mucous membrane, irrigate with running water for
15 minutes
 Report the exposure to your supervisor as soon as possible
 Fill out the EOR form provided on the units*
 Your supervisor will advise you of the next steps to be taken.
* students, physicians, visitors, contract staff are responsible for their testing costs.
revised: 2012
That’s Why You Should Get
Vaccinated!!

 Hepatitis B vaccination is provided to you for free! You should take
the vaccination unless:



you have previously received the vaccination
antibody testing reveals you are immune
the vaccination is contraindicated (not recommended)
The vaccination process involves a series of 3 injections given in the arm
muscle over a 6 month period. That will protect you if you are
exposed to the blood or OPIM of someone with Hepatitis B.
HEPTITIS B VACCINATION ONLY PROTECTS YOU FROM HEPATITIS B,
NOT ANY OTHER TYPE OF HEPATITIS!
revised: 2012
RECAPPING NEEDLES
Rule =
No recapping!
Reality =
Sometimes you
have to...so
do it right!
revised: 2012
Gloves
Not a choice!!!
revised: 2012
Transfer of Infected Patients

Nursing Staff and/or EMS staff who have
knowledge of their patient having a known or
suspected infection must notify the receiving
facility PRIOR to the transport.
revised: 2012
HANDWASHING
Handwashing is the single and most
important practice used to prevent
transmission of bloodborne pathogens.
************************
IMPORTANT!
My patient has diarrhea?
Gloves, soap, water and friction!
(no alcohol rubs)
************************
Wash hands after removing gloves!
You touch your eyes, nose & mouth about
300 times/day!
revised: 2012
HIPAA REGULATIONS AT KDMC

HIPAA: Health Insurance Portability
and Accountability Act:
HIPAA was signed into law in 1996 by President Clinton.
The purpose is to improve portability and continuity of
health insurance coverage. It’s also used as an opportunity to
improve the efficiency and cost-effectiveness of the
healthcare industry. The HHS (Health and Human Services)
has established regulations for transmitting data and
protecting the security and confidentiality of all type of
patient information.
HIPAA – Your Responsibilities:

One of the main focuses is the privacy of information within
KDMC. We must take every precautions and measure to
ensure the privacy of our patients information. This can be
done in many ways, including:
1. Not leaving Medical Charts in an open area for
others to see.
2. Being aware of others around you when
discussing treatment or condition of patients.
3. Not leaving your computer screen with patient
information visible.
4. Not giving out sensitive patient information over
the phone.
5. Reporting misuse
Core members of the HIPAA
Committee at KDMC:
 Cathy Bridge-HIPAA
Coordinator
 Carl Smith- Information
Security Officer
 Teresa Brown-Privacy
Officer
 Janet Wesselhoft-TCI
Officer (Transactions,
Code Sets, Identifiers)
ELECTRONIC SECURITY

Electronic Security is based on Policy IM 2.5-2.6 and is maintained
by our HIPAA Committee. Please review both of these policies.
Policy and actions are based on HIPAA regulations, as well as Joint
Commission standards on Information Management. Meditech
Patient Information Audits are conducted quarterly to determine if
any potential violations have occurred. To do this, our committee
chooses random employees and observes all patients that a
particular employee has accessed. This not only pertains to clinical
personnel, but to all employees of King’s Daughters Medical
Center. Electronic Security extends beyond the Meditech System. It
also relates to Internet access, faxing, email, voice mail, and any
other type of electronic information. Access to computerized
patient information is handled the same way as a patient’s.
Medical Record or Chart.
The information is the same, whichever way
you decide to view it.

Please Review:
1) Policies IM 2.5 & IM 2.6
2) Non-Acceptable Justifications for
accessing electronic information.
3) Notes and Guidelines for Security
Badge Use.
If you have any questions, please call Carl Smith at ex.
9278
NON – ACCEPTABLE
JUSTIFICATION:

 “This is my child and I have a right to the data, I am
paying the bill.”
 This is my spouse and he/she asked me to look up
the information.”
 “I thought it was OK since I already have access to
everyone’s information. I’m a professional and I
won’t discuss it with anyone.”
NON – ACCEPTABLE
JUSTIFICATION:

 “I thought it was OK since I wasn’t going to tell
anyone.”
 “This is my co-worker and I am very worried about
him/her.”
 “This is my Mom’s pathology report and I am really
worried about it. I wasn’t going to tell her the results.
That’s the doctor’s job.”
NON – ACCEPTABLE
JUSTIFICATION:

 ‘My co-worker called me from home and asked me
to look up the information about their lab work. I
had his/her permission to look at he lab results and
tell them the results. They will verify that they gave
me permission.”
 “I can look at my OWN information when I want to.
It’s about me.”
NON – ACCEPTABLE
JUSTIFICATION:

 “I go to church with this patient and I may need to
pray for them.”
 “I know Dr Anderson is not his doctor but he is on
staff and he asked me to look up his father’s x-ray
report.”
NOTES & GUIDELINES FOR
SECURITY BADGE USE:

The new Access Control Door Security System uses
Proximity devices to recognize employees who wish to gain
access to certain areas. A Proximity device is a small black
box which you will see located at employee entrances and
certain departments. It recognizes the employee by sensing a
computer chip located in the employee’s badge or key-tag.
To gain access to a door, you must simply hold your card in
font of the reader until it beeps. The red light on the reader
will turn green and the door will be unlocked. The first time
you use the card, it will take about a second for it to read it.
After that, it will only take a split second.
Internal Electronic Doors

This include departments that are sensitive in nature and need
controlled access. External doors consist of basically all employee
entrances.
Your badge is not a standard generic card. It contains a number
that is assigned strictly to you. Do not loan your security badge to
anyone.
You must report loss of badge to Human Resources within 24
hours of loss.
No holes may be punched in the badge.
Security Badge Continues:

Loss or personal destruction of badge will result in a $10 charge for
replacement. This may be payroll deducted.
You must turn in your security badge to HR upon termination.
Report misuse of security badge to HR or Security officer
immediately.
Violation of these rules will be strictly enforced Under HR 2.2
policies and could result in termination.
Age-Specific Competencies
 Communication –


Speak softly, slowly, and calmly
Involve parents
 Comfort


Keep warm and dry. Infants are prone to hypothermia.
Do not separate from parent unless necessary.
 Growth and development


Dependent
Communicates by crying
 Safety



Keep side rails up.
Prone to head injuries from falls.
Airways obstruct easily.
 Collect data appropriately




Furrowed brow, tightly shut eyes are signs of pain.
Easily dehydrated with the loss of small amounts of blood, fluid or stool.
Compromised with heart rates greater 200 beats per minute
Poor gas exchange when congested.
 Modify care appropriately



Adjust medications and fluids
Use distractions
Keep parent in baby’s line-of-vision

Communication





Growth & Development




Do not leave unsupervised
Transport with side rails
Use caution around sharp edges
Collect data appropriately




Keep familiar things nearby
Give praise
Safety




Clumsy and trips easily
Self-centered thinking
Has vivid fears and imagination
Comfort



Communicate at child’s eye level
Talk in simple language
Give honest explanations
Be patient
Limited vocabulary
Be alert for signs of trauma
Look for dehydration
Modify care



Let child explore and touch equipment
May accept procedures performed first on “Teddy” or other toy.
Involve parent and child
 Communications





Do not “talk down” to child
Help child to fee useful
Explain procedures using correct terminology
Encourage child and parents to ask questions
Permit child some input in decisions
 Growth & Development



Active
Seeks independence
Understands cause & effect
 Comfort


Make intent of actions clear before touching child
Allow child some choices and control
 Collect date appropriately


Use appropriate-size equipment
Include parent & child
 Modify care


Allow child to make decisions (e.g. “In which arm to do you want to draw blood?”)
Adjust fluids and medications for child’s weight
 Comfort
 Communication
 Show acceptance & respect
 Use adult vocabulary
 Encourage open
communication
 Growth & Development
 Grows in spurts
 Maturing physically and
sexually
 Able to think abstractly
 Concerned about appearance
 Challenges authority
 Permit peer group contracts as
much as possible
 Maintain privacy; protect
modesty
 Safety
 Transport as adult
 Help recognize danger
 Collect data appropriately
 Prepare for procedure
separately from parents
 Explain procedures completely
in adult language
Nursing Interventions
 Physical Characteristics
 Skeletal growth completed at 25
years
 Coordination & response speed are
at maximum
 Sensory functions are at their peak
 Good problem-solving abilities
 Violence major cause of death
(MVA, etc.)
 Psychosocial Characteristics

20 – 30 Intimacy vs Isolation




Developing interpersonal
relationships
Capacity for intimate love
Influenced by social & cultural
concerns
30 – 45 Generatively vs. Stagnation


Productive
Nurtures next generation with care & concern
 Assess emotional, financial &
physical support systems
 Allow patient to set own pace & be
self-directed
 Encourage participation in care
 Identify values that may affect
health care.
 Physical Characteristic








Muscle mass & strength begin to decrease
Loss of agility
On-set of arthritis
Presbyopia occurs
Sensory functions decrease
Reaction times slow
Memory changes occur
Cardiovascular disease is major cause of death
Psychosocial Characteristics
 Generatively vs Stagnation




Care & concern for next generation
Gender differences decrease
Begin personal freedom & planning for retirement
Reverses roles with parents
Nursing Interventions
 Support patient’s right to make an informed choice
 Support & affirm coping skills
 Provide referrals for emotional, financial & physical support
systems
 Allow patient to set own pace & be self-directed
 Encourage participation in care
 Identify values that may affect health care
 Growth & Development
 Communication
 Show respect and consideration.
Do not patronize patient.
 Speak distinctly and slowly
 Call patient by title and last name
unless patient asks to be called by
another name.
 If patient is hearing impaired:
 If patient uses a hearing aid, make
sure it is worn.
 Check hearing aid batteries
periodically.
 Look at patient while you speak.
 Use a deeper voice, not a louder
voice.
 Decreased auditory and visual
acuity
 Decreased ability to regulate heat
 Memory skills begin to decline
 Increased learning and reaction
times
 Nutritional needs for maintenance.
 Comfort
 Keep patient warm (may need extra
blankets)
 Follow home or nursing home
schedule as much as possible.
 Maintain adult privileges (e.g.
decision making, privacy, personal
habits
 Safety

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
Do not rush
Keep cords and equipment out of patient’s path
Weak or confused patients may need a safety belt while in wheelchair
If patient wears glasses


Offer to clean patient’s glasses.
Have patient to wear glasses while awake.
 Collect data appropriately

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Perform assessment slowly
Ask clear, precise questions – listen carefully
Assess for confusion, orientation, and unsteady gait
Monitor cardiovascular functions
 Modify care

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Involve patient in decision-making and control pain
Use caution with temperature of fluids, bath water, etc.
Elderly patients may have complex care requirements
Use extra precautions to prevent skin breakdown
Maintain hydration and fluid and electrolyte balance.
Risk Management

 Risk is the chance of loss or injury
 Risk Management is an organized effort to identify,
assess, reduce, and eliminate risk
revised: 2012
How Safe is Healthcare?

revised: 2012
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revised: 2012
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revised: 2012
revised: 2012

revised: 2012
revised: 2012
Transparency in Healthcare

The public is better informed about healthcare issues now
than they ever have been before.
 Accountability for outcomes is at an all time high.
 “hospitalcompare.com” is a public website.
 Facility information available:
What facility left a surgical instrument/sponge in a patient.
What facility has the happiest patients.
What facility has the most patient falls.
What facility gave a patient an infection they did not have when
they came in.
 And on and on and on…


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revised: 2012
Is It Really That Bad?

revised: 2012
Risk Management Program
Focus and Objectives

 To improve patient care by being aware, identifying, correcting,
and preventing potential hazards or areas of risk exposures
 To investigate and follow-up on incidents that do occur
 Claims management
 Risk prevention education
revised: 2012
Occurrence Reporting Depends
On YOU!!!!

 Major tool for the identification of risk is the
“Occurrence Report”
 Reporting is the responsibility of each person who
provides care, treatment, or a service for a patient or
witnesses an event.
 Never assume someone else will do it!
revised: 2012
Talking to Attorneys

 If you are contacted by an attorney about an
occurrence involving KDMC, you are requested not
to discuss any information.
 If you are approached, please contact me right away.
revised: 2012
What Should Be Reported To
Risk Management?

 Any Event or Condition Which:
 May result or has resulted in an injury to a patient or
impairment of patient care
 Reflects a major deviation from hospital policy, procedure,
or practice
revised: 2012
Examples of an Occurrence





Medication Events
Patient/Visitor Falls
Equipment Malfunction
Policy/Procedure Variance
revised: 2012




Serious Complaints
Behavior Events
Property Loss/Damage
AMA/Walkouts
Medication Events How To
Reduce The Risk!

 Remember the 5 Rights to Medication Administration:





Right Patient
Right Drug
Right Dose
Right Route
Right Time
revised: 2012
If You Administer Medication:

 Know the drug:




Use: Why is your patient receiving this drug?
Dosage: Did the physician order the correct dose?
Side Effects: Is your patient’s complaint a side effect?
Name: Do you know the drug’s trade and generic
name?
 Educate Your Patient and Their Families!
revised: 2012
Sentinel Events!!!

 An event resulting in an unanticipated death or major
permanent loss of function, not related to the natural course of
the patient’s illness or underlying condition.
 Sentinel Events must be reported immediately to RM in person
or by phone.
revised: 2012
Ten of the Most Common
Sentinel Events

 Patient Suicide
 Medication Error
 Operative or PostOperative Complication
 Wrong Site Surgery
 Delay in Treatment
revised: 2012
 Patient Falls
 Assault/Rape/Homicide
 Patient Death/Injury due to
restraints
 Patient Elopement
 Transfusion Error
Completing an Occurrence
Report

 The employee who was directly
involved should complete
 Fill out all information correctly,
completely, and sign and date the
occurrence report
 Forward the report to the Risk
Manager within 24/48 hours
revised: 2012
 Do Not Make Copies!
 If follow-up is initiated, document
findings on the form, return to
RM after investigation and
documentation is completed
 All copies are maintained by the
Risk Manager.
Healthcare Compliance

Following all local, state and federal laws consistent with
the highest standards of business and professional ethics.
To make sure that happens,
KDMC has a COMPLIANCE OFFICER – Cathy Bridge
Privacy Officer – Teresa Brown
Security Officer – Carl Smith
Compliance Officer reports to the Board of Trustees
revised: 2012
Examples of
Laws and Regulations
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

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revised: 2012
Anti Kickback
Antitrust
Billing/Coding
Boycotts
Competitor Discussions
Confidentiality (HIPAA)
Conflict of Interest
Controlled Substances
Credentialing
Employment
EMTALA
False Claims Act
Fund Raising
Gifts/Tips
Hazardous Waste Disposal

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Laboratory
Mail/Wire Fraud
Marketing
OSHA
Patient Referrals
Patient Self Determination
Physician Recruitment
Political Contributions
Purchasing/Bidding
Record Retention/Disposal
Safe Medical Device Act
Securities
State Licensure
Tax
Trade Associations
Employee Responsibilities

 Read your Compliance Handbook
 Read the False Claims Act Policy
 Conduct yourself in a professional and ethical
manner at all times
 Report any concern or suspected violation(s). It is
your duty!
revised: 2012
Social Media

Please read policy LM.1.19
Key Point:
Under no circumstances will patient information,
written or visual, be published by a KDMC employee.
revised: 2012
Duty To Report Concerns
And/or Suspected Violations

 If you suspect it, report it!
 It is the duty of each employee to report
promptly any concern and/or suspected
violation(s)
 The following is the mechanism for
reporting:
 Supervisor
 Compliance officer (835-9175)
 Hotline (823-5327)
revised: 2012
Disciplinary Action

 Employees who willingly and intentionally commit
acts which are in violation of the law are subject to
disciplinary action, including criminal and civil
penalties
 No disciplinary action will be taken against an
employee for asking a question or reporting a
concern or suspected violation of KDMC’s code of
conduct
 Employees are subject to disciplinary action for NOT
reporting a concern or suspected violation
revised: 2012
Prevent Mistakes in Procedures.
Use “Time Out” Before Procedures.
 Correct Patient
 Correct Procedure
 Consent signed
 Correct site marked
 Diagnostic studies in
room.
COMMUNICATE
EFFECTIVELY
1). Get important test results to the Doctor or
Nurse on time.
2) “Do not use Abbreviations”
3) Good “Hand Off” patient reports
Hand off
Communication: SBAR
 Allow time for questions
and answers about your
patient’s:
 S-Situation
 B-Background
 A-Assessment
 R-Recommendation
Use Meds Safely
1.Label all medicines even
during a procedure.
2. Double check doses of
blood thinning medicines.
3. Be on alert for: “Look
alike” & “Sound alike
medicines”
AVOID !!!!!
“Do Not Use Abbreviations”

 U, u, IU
 QD or qd
 QOD or qod
 MS, MSO4, MgSO4
 Trailing zeros (3.0mg)
 Lack of leading zeros (.3mg)
Reduce Risk of Infection:
 Proper hand hygiene is
the best defense against
spreading germs.
 Clean your hands
whenever you go into a
patients room and
before you leave out,
Every Time.
Check!! Use Medicines Safely.

 Check all Patients Medicines:
 Before, during and after hospitalization.
 List medicines accurately and completely.
 Update medicine list each time patient
changes settings.
Identify Patient Safety Risks

 Help to identify patients at risk for suicide.
 Signs of abuse
 Depression
 Talk or history of suicide
Involve Patients In Their Care:
 Educate patients and
family about safety
strategies.
 Encourage patients’
active involvement in
their own safety.
 Provide and
communicate the means
for patients and families
to report concerns about
patient safety issues.
Identify Patients Correctly

 Use two ways to identify patients.
 Make sure the correct patient gets the correct blood
transfusion.
REMEMBER:
PATIENT SAFETY
IS EVERYONE’S JOB!!!
What you must know in today’s workplace.
What is Inappropriate Conduct?
(Harassment)

 Discrimination or segregation based on:







Race
Color
Religion
National origin
Gender
Age or
Genetics
Three Things about Inappropriate
Conduct: (harassment)

 How it is defined, and how the courts and the
government apply that definition.
 What specific steps you can take to ensure that you
are not breaking the law.
 What behavior can you expect from others.
EEOC’S Definition of Sexual
Harassment:

 Unwelcome sexual advances, request for sexual favors, and
other verbal or physical conduct of a sexual nature constitutes
sexual harassment when:
 Submission to such conduct is made either explicitly or
implicitly a term or condition of an individual’s
employment.
 Submission to or rejection of such conduct by an individual
is used as the basis for employment decisions effecting such
individual or:
 Such conduct has the purpose or effect of unreasonably
interfering with an individual ‘s work performance or
creating an intimidating, hostile, or offensive working
environment.
The Quick Picture:
(THE DANGER ZONES)
 The law defines three
kinds of conduct that are
considered sexually
harassing:
 Unwelcome sexual
advances.
 Request for sexual
favors.
 Other verbal or physical
conduct of a sexual
nature.
Defining Harassment:

 The conduct must be unwelcome.
 Participation in the conduct is made a term or
condition of employment or is used as the basis for
employment decision.
 The conduct has the purpose or effect of
unreasonably interfering with work performance, or
of creating an intimidating, hostile, or offensive
working environment.
WHY YOU MUST KNOW
ABOUT HARASSMENT?

 We must treat Co-workers fair and with
respect.
 It is unpleasant to work in an inhospitable
environment.
 It is a violation of Federal Laws.
 Consider the bottom line.
 Lost time and resources
 Legal fees
 Possible judgment
GUIDELINES FOR BEHAVIOR
 Avoid the danger zone
behaviors.
 Quid pro quo harassment.
(Something for Something)
 Hostile environment
harassment.
 Situations you might not
think of :
 Within your office walls
 Beyond the office walls
 Computer, e-mail, and the
web
 Non-employees
IF YOU FEEL YOU ARE
BEING HARASSED:
Ask yourself: Do I feel
uncomfortable?
Step #1:
Talk to the harasser.
Step #2:
Tell your supervisor.
Step #3:
Tell Human Resources.
WHAT WILL HAPPEN???
King’s Daughters Medical
Center will take action and
investigate.
What are Cultural
Competencies?

 They’re the skills you use to work well with coworkers and patients of all cultures.
 Considering a patients culture when giving care.
 Relating to each patient & co-worker as an individual.
Why Do We Have Cultural
Competencies?

 Help patients receive more effective care.
 Help our organization meet TJC standards.
 Improve your job performance.
Gaining Self Awareness
 Know your own
beliefs & practices
 Think about how your
culture & upbringing
affect you.
 Showing politeness
 Expressing pain
 Appropriate ways to
treat children or
older adults
Cultural Factors To Be Aware Of:


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
Country of origin
Preferred language
Communication style
Views of health
Family & community relationships
Religion
Food preferences
Consider other factors that may affect care.
 Age, Gender, Sexual orientation
 Socio-economic status
 Presence of a physical or mental disability.
Cultural Competencies

 Developing cultural competencies does not mean
knowing everything about every cultural group you
work with. It does mean:
 being aware of cultural factors
 taking appropriate steps to learn about each
individual.
Stereotypes v/s Cultures

 What is a Culture? Religion, Family, Nationality
 What are Stereotypes? Filters by which We view &
hear others.
 Mostly negative
 Where do Stereotypes come from?
 Developed by groups due to their lack of knowledge
about another group. (Ignorance)
 Most are taught to us as children by parents,
grandparents, aunts and uncles.
Communicate Effectively

 Listen to how the patient talks about his or her
condition.
 Ask indirect questions, if needed.
 Look for clues.
 Talk with others who know the patient.
 Ask for the patient’s views on treatment.
 Use interpreters effectively.
Use Cultural Knowledge to
Improve Patient Care
 When staff members
make the effort to work
well together:
 Job satisfaction
increases.
 Patients receive the best
care.
 Challenge Stereotypes
 Ask questions to avoid cultural
stereotypes.
 Get to know co-worker and
patients as individuals rather
than as a member of a group.
Change…
The One Constant in the Universe.
We must change to
master change.
Lyndon B. Johnson
How to complete
Annual Review

After filling out your test packet in it’s entirety, YOU
must turn it in to get credit to:
Kim Bridge or Tammy Calcote
Education Annex
(601) 835-9406
[email protected]