Your Champion for Better Health

1. Your Champion for Better Health

2. Mission Statement To provide exceptional healthcare that meets the needs of our patients and the communities we serve. Our service area includes: Gaylord, Elmira, Wolverine, Vanderbilt, Johannesburg, Atlanta, Lewiston, Indian River, Cheboygan, Frederic and Waters.

3. Vision Statement To be the center of northern Michigan’s patient focused alliance dedicated to healthcare excellence.

4. Values Respect: Appreciating diversity and treating all with compassion, dignity and courtesy • Show the person you are interacting with that they are your priority • Convey empathy—put yourself in others’ shoes • Listen to and honor the personal, cultural and spiritual needs of patients and families • Recognize that every job is important and has value

5. Values Integrity: Unwavering commitment to honesty and trust • Do the right thing for the right reason • Protect confidentiality and privacy • Discuss differences constructively, directly and tactfully • Advocate for our patients, employees and organization

6. Values Excellence: Teamwork and communication dedicated to understanding and exceeding expectations of quality, safety and customer service • Take initiative to promote a culture of accomplishment, enthusiasm and expertise; take pride in your work • Promote an exceptional healing environment based on individual needs • Be open to giving and receiving feedback to accomplish mutual goals • Achieve the best results in all we do

7. Values Accountability: Accepting responsibility for our actions • See it • Be engaged to contribute positively • Acknowledge opportunities by learning from our experiences • Own it • Understand how individual actions contribute to desired outcomes • Solve it • Follow through on commitments and responsibilities

8. Customer Service • Patient satisfaction is directly related to how we treat our customers • You will be receiving addition education regarding our customer service • The following are the behaviors we ask our employees to exhibit

9. Customer Service • Greet • Value as a customer • Ask how you can help • Listen words, tone and body language • Help meet their needs • Invite them to contact us

10. Rights as a Patient Patients have a right to: • Considerate and respectful care • Understandable information • Patients will have a green dot on their ID bracelet if they have difficulty understanding basic communication • Please see their chart for more information regarding their communication challenge

11. Rights as a Patient Patients have a right to: • Be free from seclusion and physical/chemical restraint (refer to policy) • Consent or refuse treatment • Appropriate pain assessment/symptom management (see scale)

12. Pain Assessment When assessing pain, a number value should be assigned by the patient to make for consistent measurement

13. FLACC Scale Non Verbal

14. Rights Patients have a right to: • Privacy • Treatment records are confidential • Review their medical records • Be free from discrimination • Discuss continuing care needed after hospitalization

15. Rights Patients have a right to: • Know the hospital rules • Consult the Ethics committee • Know the physician who has primary responsibility • A second opinion • Advanced Directive

16. Rights Patients have a right to: • Be informed of outcomes of care including unanticipated outcomes • Raise concerns through a formal grievance • Access Protective Services

17. Rights Patients have a right to: • Comfort measures/peace and dignity at end of life • Patients who have a Do Not Resuscitate status will have a purple armband placed around their wrist • McReynold's Hall patients have a purple dot placed on their identification bracelet • Spiritual and pastoral care • Appropriate screening and stabilization before transfer to another facility

18. Patient Responsibilities Patients need to: • Provide Accurate Information • Keep Appointments • Understand consequences of refusing treatment • Follow hospital rules • Be considerate of others • Be responsible for financial obligation • Notify staff of communication issues • Ask questions if they do not understand • No Alcohol, recreational drugs, or firearms/weapons

19. Advance Directives Advance Directives are: • A legal document that gives the appointed advocate permission to make medical decisions whenthe patient is deemed incompetent by 2 physicians

20. OMH Process for Advanced Directives • Pt. are given information about advanced directives, if not familiar, at admission • Copies of advance directives are scanned into the medical record • Upon admission, the advance directive should be available to the area where the patient will be located

21. Infection Control Washing your hands frequently and properly is the single most important action you can take to prevent the spread of infection.

22. Infection Control Hand Sanitizer is effective for hand hygiene but you should wash with soap and water if hands are soiled or if caring for someone with C. diff

23. Infection Control Keystone Initiative Wash your hands upon entering a patient-care area and upon leaving WASH IN WASH OUT

24. Infection Control Standard Precautions “All the patients, all the time”

25. Infection Control Standard Precautions • Specific behaviors that healthcare workers (HCW) follow to protect both themselves and patients from infection • Practice 100% of the time

26. Infection Control • Apply to blood, all body fluids, excretions and secretions except sweat, plus non-intact skin and mucous membranes • Protect against bloodborne pathogens such as HIV, hepatitis B and hepatitis C • Protect against pathogens from moist body substances

27. Infection Control •Wear gloves when touching blood, body fluids, excretions, and contaminated surfaces • Wash your hands after contact with body substance even if gloves are worn • Wash your hands and change gloves between patients and between touching clean and dirty sites on the same patient • Wear a mask, eye protection and a gown if splashes or spatters are possible (Latex free products are available)

28. Infection Control Practice Respiratory Etiquette all year •Use mouthpieces, resuscitation or other ventilation devices as an alternative to “mouth to mouth” resuscitation methods • Be sure reusable equipment is cleaned and disinfected before used on another patient

29. Infection Control • Handle all patient care equipment to prevent exposure to other patients, visitors, and healthcare workers • Keep used patient equipment including soiled linens away from your skin, mucous membranes and clothing • Don’t let used equipment or linens contaminate surfaces or clean items

30. Sharps Safety • Never bend, recap, or break used needles unless the procedure requires it • Place used sharps in a designated disposable container immediately after use

31. Infection Control Transmission Based Precautions • Additional precautions that healthcare workers practice when a patient is suspected of having an illness that spreads very easily and is based on how the infection is spread- CONTACT-AIRBORNE-DROPLET

32. AIRBORNE Precautions • Requires patients to be in a negative pressure room and staff need to wear a PAPR (Powered Air Purifying Respirator) • Good ventilation is important for preventing the spread of TB • Active TB patients need to wear a mask if they go outside of the room

33. Exposure toBlood or Fluids • Wash vigorously the area immediately with soap and water • Report the exposure to the supervisor of your Department • Complete the “Exposure Form” • Report to ED for evaluation • If exposure to eyes, flush for 15 minutes at eye wash station with COLD water

35. Age Specific Care • Be aware that all ages have different physical, psychological, and social needs • Tailor education to the patient’s age and needs • If staff and volunteers are aware then it is a safer environment • Involve family in the care

36. Abuse Types of abuse: • Elders • Physical Abuse, Neglect, Exploitation • Child • Abuse, Neglect • Observed or suspected • we are required by law to report it!

37. Patient Safety: A National Issue • In an effort to prevent medical errors for all patients in the healthcare setting, the Joint Commission issues annual National Patient Safety Goals • National Patient Safety Goalsare developed as medical errors that occur across the nation are analyzed and the root causes identified

38. How National Patient Safety Goals affect your practice • Your understanding and compliance with the National Patient Safety Goals and hospital policy is vital to our patients safety and your success at OMH

39. Goal 1: Improve the Accuracy of Patient/resident/client Identification. • To prevent medical errors, a patient must be identified by comparing two types of identifiers • According to OMH policy, the two patient identifiers include the patients nameand date of birthfound in the medical record documents and on the identification bracelet

40. Implementation Expectations 1A Use at least two patient identifiers whenever: • Collecting lab samples • Administering medications or blood products • Providing any treatment or procedure • Label sample collection containers in the presence of the patient.

41. 1B: Implement the Universal Protocol for Invasive Procedures The “time out” final verification process to confirm the correct patient, procedure, site, and availability of documents and equipmentmust occur in the location where the procedure is to be done and should involve the entire team

42. Goal 2: Improve Effectiveness of Communication • For verbal or telephone orders or for telephonic reporting of critical test results, verifythe complete order or test resultby having the person receiving the order or test result write down then “read back”the complete order or test result

43. Standardize a list of abbreviations, acronyms, and symbols that are not to be used throughout the organization The “Do Not Use”abbreviation list applies to all orders and other medication-related documentation when handwritten, entered as free text into a computer, or on pre-printed forms

44. The Official OMH “Do Not Use” List Includes:

45. 2E: Hand Off Communication Implement a standardized approach to “hand off” communications, including an opportunity to ask and respond to questions

46. Implementation Expectations “In health care there are numerous types of hand offs, including but not limited to: • Nursing shift changes • Physicians transferring complete responsibility for a patient • Physicians transferring on call responsibility…

47. S=Situation B=Background A=Assessment R=Recommendation Any Questions? Example S=Admitted an 82 year old with pneumonia, possible aspiration. B=History of stroke, has been having increased cough x 3 weeks per family, fever began today.. A=RR is 24 and unlabored, temp is 101 degrees F, swallowing evaluation ordered for a.m., alert and oriented x2. First antibiotic completed at 0300. R=Keep HOB elevated at least 30 degrees, remain NPO until swallowing sturdy complete and recommendations added to care plan. Next antibiotic is due at 0900. Additional assessment and care plan includes patient is a high risk for falls, bed alarm on and frequent rounds to assist with toileting needs. SBAR

48. Verify Labels • Label all medications, medication containers, (e.g., syringes, medicine cups, basins), or other solutions on and off the sterile field in perioperative and other procedural settings

49. Implementation Expectations: • All labels are verified both verbally and visually by two qualified individuals. • No more than one medication is labeled at one time. • Unlabeledmedications or solutions are discarded. • All original containers remain available for reference in the perioperative area until the conclusion of the procedure. • At shift change/break, all medications and solutions both on and off the sterile field are reviewed by entering and exiting personnel.

50. Anticoagulation Therapy Reduce patient harm associated with anticoagulation therapy