Clinical Student Orientation
Clinical Student Orientation
Clinical Student Orientation
Welcome to Oconee Regional Medical Center’s Clinical Student orientation page. In order to prepare you for your experience, you are required to complete the orientation module and test prior to your first visit at the hospital. Begin by printing the following forms. After reading the entire module, complete the post-test and other forms. You can either fax the forms to 478-454-3555 OR deliver the forms to Shantee Henry.
You may pick up a temporary ORMC badge from me at the time you turn in your paperwork. It is imperative that you turn the badge in to me on your last day of clinicals.
We welcome you to Oconee Regional Medical Center (ORMC) and wish you a worthwhile experience on campus. Please feel to call me at 478-454-3709 or email me at email@example.com.
ORMC Mission Statement
The MISSION of Oconee Regional Medical Center is to provide high quality, safe, compassionate and patient-focused healthcare.
General guidelines for student responsibility
~A student will never assume total responsibility for a patient.
Foundations of Stellar Service
ORMC has partnered with Studer Group to employ tactics proven to move patient experience and quality outcomes. One of those tactics AIDET, an acronym that stands for Acknowledge, Introduce, Duration, Explanation, and Thank You. AIDET is a communication framework that:
We all differ from one another. As students in the health care industry, our differences can become more important due to the extremely personal nature of the service we provide. As we work with employees and patients/families, and maintain an environment that is respectful of all people.
No one can know and understand all the ways we differ from one another. However, we can create an environment that is respectful of differences. To do this, you must be aware of your own feelings about differences and consistently use behaviors that communicate respect.
Learn to recognize, respect and work with patient’s different cultures, values, beliefs, practices and rituals. If you need to access translation services, including sign language, promptly call the Patient Representative or the Overhouse Supervisor after hours.
You have a big role to play when it comes to embracing cultural difference and sensitivity toward other cultures. It is the policy of ORMC to respect the cultural and ethnic needs and desires of the patients that we serve if at all possible.
This may include:
Population Specific or Age Specific Considerations for Assessment
The goal of patient assessment is to develop and implement an individualized interdisciplinary plan of care for the patients and the families. In the creation and implementation of this plan of care, it is imperative that the appropriate age-related or population specific considerations be addressed. These considerations for care must address the chronological age of an individual and be amended to conform to the individual’s level of cognitive development. The following information outlines age categories and age appropriate considerations for assessment and treatment and can be readily utilized for plans of care.
Newborns quickly develop during their first month of life. They are growing rapidly and require tremendous amounts of attention to meet their developmental needs. As a nurse, you are responsible for helping to meet a newborn’s health needs and you are also tasked with preparing new parents through effective communication and education. As the child develops during that first year, care plans must follow their growth patterns to keep their safety and health in check.
Toddlers start gaining a sense of independence when entering this developmental stage. You will witness a drastic change in height and weight during these years, and toddlers will begin to understand their own movements such as balance, climbing, running and jumping. They will also gain control of their bodily functions, including those of the bowel and bladder. Communication is key in providing healthcare to this age group, as they are still relatively unaware of right and wrong but are cognizant of directions. You must thoroughly explain treatment plans in a tone that is easily understood by this age group.
This development stage is marked by extreme activity and discovery, with the significant development of motor skills and personality. Children in this age group are exploring their world, including their physical and emotional state. They are more prone to accidents, as their motor skills try to keep pace with their imagination. You must be adept in communicating with young patients and recognizing age-appropriate treatment plans. Parental involvement in patient treatment is still key at this development stage, so you must be willing and able to communicate with both the patient and their guardians.
School age (6-12)
This is a broad age group that will experience a tremendous amount of development, including an average weight gain of three to five pounds and a height increase of one to two inches every year. And, while they are shooting up the charts physically, they are also making leaps and bounds in their mental development by learning to read, write and do complicated calculations. It is within this age group that patients begin to fully understand their personal health and wellness, including hygiene, physicality and more. You should address a child’s needs on the full wellness spectrum.
Adolescence is a time of tremendous growth, including bodily changes, which can have both a physical and mental effect on this age group. Peer pressure is also at its height during this development stage, and this age group may encounter many challenges to their principles that could affect their health. Adolescent patients are fully aware of the cause and effect of their decisions on their health and wellness. You should openly communicate with these patients as well as their parents while also keeping a relative sense of privacy for the child.
This is a vital developmental age group that spans several decades. During this time, patients will experience many life changes that could affect their health and well-being both positively and negatively. Most body functions are at their prime during the early years in this developmental stage; however, after the age of 45, patients can expect to experience changes in their muscular strength, endurance and mobility as well as vision, hearing and joint activity. You must consider a patient’s lifestyle and age when devising a treatment plan, and most patients prefer open communication.
Older Adult (over 65)
The end of life doesn’t have to mean the end of quality healthcare. This age group often places tremendous patient demand on nurses; however, understanding how to communicate and treat elderly patients can ease your job. Many body functions of the patient will continue to deteriorate, and many patients will require serious healthcare.
Understanding the development and communicative needs of your patients is essential to quality patient care.
Suspected Abuse, Neglect, Violence and Exploitation Assessment
Population specific considerations should also be utilized for patients when there is suspected abuse or neglect. ORMC policy ADM-CL-565 supports licensed health care providers in directing them to “disclose PHI about an individual whom ORMC reasonably believes has been a victim of abuse, neglect, or domestic violence to a government authority, including a social service or protective service agency, authorized by law to receive reports of such abuse, neglect, or domestic violence”. ORMC policy ADM-CL-563 addresses the reporting of suspected child abuse or neglect.
Health Insurance Portability and Accountability Act (HIPAA)
Definition of HIPAA
The Health Insurance Portability and Accountability Act of 1996 is a multifaceted piece of legislation covering three areas:
a. Insurance Portability:
Portability ensures that individuals moving from one health plan to another will have continuity of coverage and will not be denied coverage.
b. Fraud enforcement (accountability):
Significantly increases the federal government’s fraud enforcement authority in many different areas.
c. Administrative simplification:
Ensures system-wide, technical and policy changes, in healthcare organizations in order to protect patient’s privacy and the confidentiality of identifiable protected health information.
Patient confidentiality is a conscious effort by every healthcare worker to keep private all personal information revealed by patients and their families and/or medical records during a hospital visit. You may have access to confidential information about patients and their families. You must never discuss, disclose or review any information about a patient’s medical condition with any other person unless they have proper authorization.
Every student must read the Code of Conduct booklet and sign the Confidentiality Form.
Identifiable Protected Health Information
Protected health information (PHI), under the US Health Insurance Portability and Accountability Act (HIPAA), is any information about health status, provision of health care, or payment for health care that can be linked to a specific individual. Consider everything inside a patient’s chart (paper or electronic) as identifiable protected health information. Assure that patient confidentiality and privacy are not compromised.
The Emergency Medical Treatment and Active Labor Act ensures that anyone presenting on hospital property asking for medical treatment must be taken to the Emergency Department and given a medical screening exam (MSE). An emergency condition must be treated regardless of ability to pay.
EMTALA also requires:
Environment of Care
This section prepares you to safely respond to an emergency situation at work as well as at home. This section will help you learn how to respond to unexpected events and emergencies, as your actions could have an impact on patients, parents and coworkers. Following these procedures may ensure safety for you, our patients and their families.
Code Red = Fire
Code Red means there is a fire somewhere at the hospital.
RACE is a national acronym used to help you remember what you must do in case of a fire.
If there is a fire, remember the term “RACE”:
Evacuate horizontally following your unit’s evacuation plan. Do not use elevators, use only stairs. Remember to CLOSE ALL DOORS.
Code Blue = Adult Cardiopulmonary Arrest
Code Blue means cardiac arrest or respiratory arrest.
If a patient, visitor or employee has cardiac or respiratory arrest, call for help by dialing 3999 on any in-house phone. Most patient rooms have a “Code Blue” button. It is preferable to use this if available. Give the number of the patient’s room or area where the victim is located. The switchboard operator will page “Code Blue” on the Overhouse page. Begin CPR if you are certified to do so.
Code Pink = Infant/Child Cardiopulmonary Arrest
Code Black = Tornado sighted in the area
Code Adam = Infant/Child abduction
Code Triage = an event that significantly disrupts the environment of care and/or the care and treatment of patients
Code Silver = Active Shooter
You have 3 options:
When law enforcement arrives:
Information to provide to 911 operations:
Code Green = behavior health patient in the ED
These may include:
Code Brain = suspected stroke patient transferring into the ED or in the hospital
Patient incidents involving medical equipment or products must be reported to Risk Management (3552) and Biomed (3799) in accordance with the Safe Medical Devices Act (SMDA).
Personal Safety Tips
You can help us make the hospital a safer place by taking steps to protect yourself.
Hazardous materials are chemical products that can harm yours eyes, lungs or skin. Be sure to protect yourself when handling chemical products. Use Personal Protective Equipment including gloves, mask, gown, and protective eyewear.
Waste Disposal: There are several types of hospital waste. Each type of waste has its own type of waste container.
Biohazard Waste is any type of waste that is contaminated by blood or other body fluids contaminated with blood. All items contaminated with more than a small amount of blood, drainage, or infectious secretions are discarded in red bags for incineration. These containers have the Biohazard symbol. Note: always wear Personal Protective Equipment (PPE) when handling Biohazardous Waste.
Sharps are substances that can poke or cut your skin, such as needles, broken ampules and/or lancets. Sharps are disposed of into a hard, plastic Sharps Box. Sharps may be contaminated; therefore, you must always wear PPE when handling sharps.
ORMC students/volunteers need to follow a basic level of caution during their work activities. They include:
Hand washing is required before and after patient contact as it is the single most important action in preventing the transmission of disease.
Personal Protective Equipment (PPE) is worn to protect against blood/body fluid exposures. Staff should know location of PPE in each patient care area and be familiar with them when barriers are indicated and used as required.
*Gloves for hand protection
Avoid touching face or eyes during patient care activities. Many respiratory viruses are readily transmitted through the mucus membranes of the eyes, nose, and mouth.
Avoid eating, drinking, or applying lipstick or lip balm in patient care areas. Enteric viruses such as Rotavirus may survive for up to 5 days on environmental surfaces.
Staff should know the location of eye wash stations in patient care areas and use to immediately cleanse eye if contamination with blood, body fluid or hazardous chemicals should occur.
Injuries with contaminated sharps present a significant risk to healthcare workers. Blood borne pathogens, which have been documented to be transmitted by percutaneous exposure, include: Hepatitis B, Hepatitis C, and Human Immune-deficiency Virus (HIV). Hepatitis B is best prevented by administration of Hepatitis B vaccine. Post exposure prophylaxis for HIV requires administration of anti-retroviral medications. There is currently no prophylaxis for Hepatitis C.
Handling Sharps Safely
Reporting a Blood/Body Fluid Exposure
If you are injured by a contaminated sharp, the incident must be reported immediately.
Patient Safety Goals
Improve the accuracy of patient identification
ORMC requires the use of two identifiers whenever administering medications or blood products, taking blood samples and other specimens for clinical testing, or providing any other treatment or procedures. These two identifiers are specifically the Name and Birth date. All patients must have an ID bracelet.
Improve the effectiveness of communication among caregivers
ORMC has a standardized list of abbreviations and also a list of “Do Not Use Abbreviations” posted on each clinical unit. Reporting of critical results of tests and diagnostic procedures in a timely manner is defined in policy ADM-PC-060. Specific times are defined for Radiology, Cardiopulmonary, and Laboratory results.
Improve the safety of using medications
All medications, medication containers (ex. Syringes, medicine cups, basin), or other solutions on and off the sterile field must be labeled with the name of the medication, amount, dilution, date, and initials. ORMC has a standardized Heparin drip and protocol.
Reduce the risk of healthcare-associated infections
ORMC complies with CDC hand hygiene guidelines and implements evidence-based practices to prevent health care associated infections due to multiple drug-resistant organisms. Nasal swabs are done for certain populations and isolation procedures. There is a central line check sheet for guidelines to prevent central line-associated bloodstream infections. There are surgical guidelines for antibiotic administration and discontinuation.
Accurately and completely reconcile medications across the continuum of care
ORMC has a written process for reconciling medications on admission, at discharge, and throughout the hospital stay.
Identifies safety risks inherent in its patient population
ORMC identifies patients at risk for suicide using a suicide screen. The policy is HW-PC-210 on the Intranet. Nurses screen all patients for the risk of falls and institute the fall protocol if indicated.
Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery
*ORMC conducts a pre-procedure verification of the correct person, procedure, and site regardless of being elective or emergent.
*Site marking is done for all procedures involving incision or percutaneous puncture or insertion. The site is marked initially before the patient is moved to the location of the procedure and takes place with the patient involved, awake and aware. The physician will mark the site with a permanent marker.
*A time-out is conducted immediately prior to starting the procedure. The time-out addresses the following: correct patient identity, confirmation that the correct side and site are marked, an accurate procedure form, agreement on the procedure to be done, correct patient position, relevant images and results are properly labeled and appropriately displayed, the need to administer the antibiotics, and safety precautions based on patient history or medication use.
ORMC’s primary patient education systems are Krames and Micromedex. Both of these web-based software programs allow the hospital staff to access and print out patient information about illnesses or medications. The health sheets are available in English and Spanish, with many available in more languages than this. The content is written on a 6th through 8th grade reading level and is updated on a regular basis by the respective editorial boards. They are located on the hospital’s Intranet under “User Applications”. Any of our staff will be happy to assist you with accessing these.
At ORMC, the patient’s self-report of pain is the single most valuable indicator of pain. The patient and their caregiver can expect that pain will be evaluated using an appropriate pain scale. The pain scales include: 0-10 pain scale, FLACC pain scale, or the Wong-Baker Faces pain scale. Patients will be taught that the goal of pain management is prevention (when possible) and that early intervention in the course of pain management is important. Patient care providers will respond to the patient’s report of pain as quickly as possible. Nursing will assess the effectiveness of interventions within 1 hour or as appropriate according to the patient’s condition and/or the intervention utilized. The outcome goal for pain management is to bring the pain to a level acceptable to the patient. A pain assessment is performed and documented upon admission, after any known pain producing event, and with each new patient report of pain, and at every 2 hour rounds.
A restraint is any involuntary method of restricting an individual’s freedom of movement or normal access to his/her body. Restraints may be physical or chemical and may only be applied after all other measures have failed (moving closer to nurse’s station, family or sitter at bedside, distraction, etc). A physician’s order must be obtained and reordered every 24 hours as needed. During the time the patient is in the restraint, the patient is assessed every 2 hours for the following elements to ensure that the patient’s safety and health are maintained:
Patient’s physical needs (circulation checks, elimination, hydration, nutrition and hygiene) are met at least every two hours while the patient is awake. During these checks, the nurse should release the restraint and perform range of motion to the limb. Only staff that has been deemed competent to apply restraints may do so.