2010 Student Orientation CLRMC

Student Orientation Handbook:

Student Orientation Handbook Clear Lake Regional Medical Center 500 Medical Center Blvd., Webster , TX 77598 281-332-2511 Revised May 2010 P-922-0183

Welcome:

Welcome On behalf of Clear Lake Regional Medical Center, we extend you a warm welcome. We are delighted to have you as a member of our team. We encourage you to take advantage of the many learning opportunities available to you. Through each staff member of Clear Lake Regional Medical Center, we hope to assist each of you in your challenge to acquire professional competence. As you work with our patients, we ask you to consider our hospital’s theme: “Simply treat the patient as if he or she is a cherished member of your family.” Thank you for your participation in fulfilling our mission of being “responsive” to the needs of our patients. --CLRMC Education Department

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Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high quality, cost effective healthcare in the communities we serve. In pursuit of our mission, we believe the following value statements are essential and timeless: We recognize and affirm the unique and intrinsic worth of each individual We treat all those we serve with compassion and kindness. We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives. We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with loyalty, respect and dignity. Mission and Values

Clear lake Regional Medical Center:

Clear lake Regional Medical Center Clear Lake Regional Medical Center is a 595 bed private, acute facility that opened its doors on March 12, 1972. Since that time, it has maintained a consistent tradition of high-quality patient care. Built with the support of the community, the hospital mirrors the space age environment of the surrounding area and is dedicated to serving the medical needs of the local population.

Nursing Areas:

Nursing Areas Medical/Surgical ICU Cardiovascular ICU Coronary Care Unit Transitional Care Unit Emergency Department Chest Pain Unit CV Intermediate Units 1 & 2 Surgical Intermediate Care Units Medical Intermediate Care Units Labor & Delivery Ante-Partum Post Partum Newborn Nursery Neonatal Intensive Care Pediatrics Pediatric ICU Oncology Rehabilitation Outpatient Surgery and Recovery

Ancillary Departments:

Ancillary Departments Radiology Endoscopy Nuclear Medicine Sleep Lab Respiratory Therapy Laboratory Physical Therapy Occupational Therapy Electrodiagnostics Cardiac Cath Lab Magnetic Resonance Imaging.

The Heart hospital:

The Heart hospital Clear Lake Heart and Vascular Hospital is a free-standing 6 story building located across from the main hospital at 495 Medical Center Blvd. It opened its doors in April 2007. All cardiovascular care including CVICU, CV OR, Cath Lab, CCU, CV Intermediate Units 1 and 2, and Cardiac Rehab are located in this hospital.

EDUCATION DEPARTMENT :

EDUCATION DEPARTMENT The Education Department of Clear Lake Regional Medical Center is committed to the educational needs of employees and students throughout the hospital. Students are always welcome to attend hospital in-services and community classes. Call the Education Department at 281-338-3340 if you have any questions regarding the services provided by our department

HIPAA AND HITECH EDUCATION:

HIPAA AND HITECH EDUCATION Privacy and Security of Protected Health Information 9 Clear Lake Regional Medical Center requires that ALL students view the provided HIPAA & HITECH PowerPoint presentation

Ethics and Compliance :

Ethics and Compliance What is ethical & compliant behavior? Doing what is right and encouraging others to do the same. What is HCA’s Code of Conduct? Our Code of Conduct provides guidance to all HCA colleagues and assists us in carrying out our daily activities with appropriate ethical and legal standards. These obligations apply to our relationships with patients, affiliated physicians, third-party payers, subcontractors, independent contractors, vendors, consultants and one another. How do you report an Ethics and Compliance issue? Issues can be reported to the ECO, the department director or manager, human resources or by calling the ethics hotline. There is no retribution for reporting an issue in good faith. Every effort will be made to maintain confidentiality. Who Is our ECO? ECO: Randy Gross and Co-ECO: Mark Rozell E T H I C S H O T L I N E 8 0 0 - 4 5 5 - 1 9 9 6

Customer Service:

Customer Service Greet others with a friendly smile and good eye contact. Call patients by their surname (Mr./Ms./Mrs.) unless they give you permission to use their first names. You never refer to patients by their diagnoses, room numbers or even worse – both. Identify/introduce yourself at the beginning of all communications – in person, telephone, answering the call bell.

Customer Service:

Customer Service Respect the privacy of patients by pulling the curtain, knocking on the door before entering, covering the patients, offering a second gown, etc. Also respect patient confidentiality at all times. Demonstrate the common courtesy that you were taught such as saying “please”, “thank you”, and “may I”? Provide patients, their loved ones and your co-workers as much information as you can. Use terms they can understand. Apologize when necessary – on behalf of the hospital – even when it wasn’t your “fault”. Take the opportunity for “service recovery”. This is when something has happened to the patient and you try to assist with “fixing” the situation.

Customer Service:

Customer Service Really listen to the patient and loved ones. Never underestimate their knowledge of their bodies and their health. Appreciate and respect that they can provide information that will allow you to provide better care. Never blame another staff member or a physician to patients and/or loved ones. This can cause fear and loss of confidence in all of us. Never tell a patient we are understaffed or that you don’t have time. Once again, this will cause fear and loss of confidence. Always ask patients before touching a part of their bodies. “May I please have your arm?” “I’ll need to listen to your heart”.

Patient Care Techniques – Anticipating Needs:

Patient Care Techniques – Anticipating Needs “Are there any questions that I can answer for you at this time?” “Would another blanket make you feel more comfortable?” “We’re all here to make sure you have what you need. Please let us know if there is anything we can do for you.”

Patient Care Techniques – Showing Concern:

Patient Care Techniques – Showing Concern “I would like you to be as comfortable as possible. Let me do ______ for you.” “How are you feeling? Are you having any pain/nausea/discomfort?” “Is there anything that I can do for you before I leave your room?”

Patient Care Techniques – Responding in a timely manner:

Patient Care Techniques – Responding in a timely manner “ I understand that you need _____. ______ will be with you very shortly to take care of that. “ He/she is with another patient. Is there something I can do for you? ” “I apologize for the delay.”

Patient Care Techniques – Calming Fears:

Patient Care Techniques – Calming Fears “ Most people are afraid of something about being in the hospital. Is there anything you are concerned about? ” “ Do you have any fears or concerns that you like to talk about? ”

Age Specific Competencies:

Age Specific Competencies All people, from birth to death, pass through identifiable stages of growth and development. Growth refers to an increase in body size and functioning to the point of optimum maturity. Development refers to predictable increases in physical, cognitive, psychological and moral capacities that individuals acquire to enable them to successfully adapt to their environment.

Age specific Competencies:

Age specific Competencies Health Care Providers must be able to meet the distinct needs of patients based on their stage of growth and development. Each patient, at all phases of the life continuum, present distinct clinical challenges. At Clear Lake Regional Medical Center, we use the following age group classifications for reference to various age groups: Geriatric Adult Adolescent child Infant Neonate

Age specific Competencies Assessment:

Age specific Competencies Assessment Be familiar with age-specific characteristics Identify each patient’s requirements relative to his/her age specific needs Provide age specific care Communicate with patients and families in an age-appropriate manner When age and developmental level or functional capacity do not match, readjust to relate to that patient appropriately

Cultural Awareness:

Cultural Awareness In order to provide high quality care to all of our patients, we must have an understanding of their cultural backgrounds. Misinterpretations can occur that impede the formation of a therapeutic relationship.

Cultural Awareness:

Cultural Awareness “The key to understanding people of other cultures is to understand ourselves.” Our culture influences the following about us: What we eat How we think and view the world What language we speak How we communicate non-verbally How we respectfully address someone Our religious or spiritual beliefs How we perceive wellness and illness Our health practices Our response to & expression of pain How we view life events such as: birth, death, puberty, child bearing, etc…

Cultural Awareness: Stages:

Cultural Awareness: Stages My way is the only way People are aware of their way of doing things Their way is the only way. They ignore the impact of cultural differences I know their way, but my way is better People are aware of other ways of doing things Consider their way as the best one Cultural differences are perceived as source of problems People tend to ignore them or reduce their significance

Cultural Awareness: Stages:

Cultural Awareness: Stages My Way and Their Way People are aware of their own and others’ ways of doing things People chose the best way according to the situation People realize that cultural differences can lead to both problems and benefits Willing to use cultural diversity to create new solutions and alternatives. Our Way People dialogue repeatedly with others to create new meanings, new guidelines to meet the needs of a particular situation http://www.culturosity.com/pdfs/What%20is%20Cultural%20Awareness.pdf

Dying Person’s Bill of Rights :

Dying Person’s Bill of Rights I have the right to be treated as a living human being until I die. I have the right to express my feelings and emotions about my approaching death in my own way. I have the right to be free from pain. I have the right to die in peace and with dignity. I have the right to maintain a sense of helpfulness, however its focus may change. I have the right to participate in decisions concerning my care. I have the right not to die alone. I have the right to discuss and enlarge my religious and spiritual experiences, regardless of what they may mean to others. At Clear Lake Regional Medical Center, we are committed to preserving the rights of the dying.

Hospital Acquired Infections:

Hospital Acquired Infections It has been estimated that as many as one hospital patient in ten acquires a nosocomial infection Estimates of the annual healthcare cost range from $4.5 billion to $11 billion and up A majority of these infections could be eliminated through good hand washing technique and following infection control policies.

Hand Hygiene:

Hand Hygiene Hand Hygiene is critical to infection prevention Under nails Between fingers 3 inches above wrist Friction for 15 seconds

What to Use:

What to Use Soap and Water Visibly soiled Before & after: gloving Eating Toileting C-diff Alcohol hand gel Not visibly soiled Adjunct to soap and water Antimicrobial Soap High risk areas such as: Surgery Neonatal nurseries Critical care areas

Standard Precautions:

Standard Precautions Hand hygiene Gloves for body fluids, mucous membranes, contaminated items with prompt removal of gloves Change gloves between tasks on same patient if there is high concentration of microorganisms Mask, non-sterile gown, eye protection, face shield if likely to be splashed by body fluids Multi-use pt-care equipment: if soiled, send to CS in a “biohazard” bag for cleaning Blue bag: all dirty linen Red bag: biohazardous waste All Patients All the time

Isolation Precautions:

Isolation Precautions Use disposable equipment - Appropriate disposal of Red Bag Waste Don appropriate apparel - Remove gowns, etc. prior to leaving the room Check Isolation sign on door: Airborne, Droplet, Contact, or Special Contact Keep door closed Check the Isolation sign for specific instructions Students are not allowed to care for patients with TB in Airborne Isolation. Students are not fitted for the required N95 Mask.

Communicable diseases:

Communicable diseases Use caution in cases of confirmed or suspected communicable diseases such as: Chicken Pox, Measles, Conjunctivitis, the FLU Do not attend clinicals at CLRMC if you suspect you may have an illness that could be spread to others. Notify your instructor or the department/unit to which you are assigned.

Sharps Injuries:

Sharps Injuries Be Careful – use ALL available safety features If an injury occurs: Immediately bleed the injury (if appropriate) Wash the area Notify CLRMC Employee and Instructor immediately Complete Occurrence Report Get emergency care per school policy Follow-up care-Student responsibility per school policy

Safety and Health:

Safety and Health SAFETY ON THE JOB is everyone’s responsibility. Most accidents are a result of carelessness, thoughtlessness, fatigue, or neglect. Most accidents can be prevented through proper care and maintenance of equipment and facilities, alertness on the job, and good housekeeping procedures. Unauthorized use of equipment is prohibited. If you are injured while at Clear Lake Regional Medical Center, immediately report the accident to your instructor who must complete an Occurrence Report within 24 hours. The instructor should notify the supervisor or director of the department where the student is assigned and the Education Department.

Safe Patient Handling:

Safe Patient Handling Avoid hazardous patient handling and movement tasks whenever possible. If unavoidable, assess them carefully prior to initiating the transfer or movement. Use mechanical lifting devices and other approved patient handling aids for high-risk patient handling except when alternative methods are absolutely necessary, such as in a medical emergency. Use mechanical lifting devices and other approved patient handling aids in accordance with instructions and training. BE SAFE - Use good Body Mechanics REMEMBER that your back is your RESPONSIBILITY

FALLS:

FALLS A fall is defined as any of the following: Any witnessed event that is defined as a fall by a witness Any event where the patient states he/she fell whether it was witnessed or the patient/visitor states it occurred Patient found on the floor warrants an investigation to determine if the patient fell.

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Greater than 70 Confused History of falls History of syncope Altered elimination Immediate postoperative period Determining Fall Risk Sensory/perceptual deficit Special medications Impaired judgment Generalized weakness Blind or severely impaired vision

Fall Prevention Program:

Fall Prevention Program Fall Potential assessed on admission and every shift YELLOW arm band on patients that are high risk Electronic Fall Monitor on ALL patients with yellow armband Education of patient and family regarding fall risk Bed in lowest position, call light within reach

Restraints Defined:

Restraints Defined Any manual method Physical or mechanical device, material , or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head freely. Examples : Tucking in sheets very tightly Use of side rails to prevent a patient from voluntarily getting out of bed Holding a patient to prevent movement Geri chairs, side rails, mittens when they have the effect of restricting a patient’s movement and cannot be easily removed by the patient A medication used to control behavior or to restrict the patient’s movement that is not a standard treatment, or not in a dosage used for the patient’s medical or psychiatric condition would be considered a restraint.

Restraints Preserving the patient’s Rights, Dignity and well-being :

Restraints Preserving the patient’s Rights, Dignity and well-being Respecting the patient as an individual Maintaining a clean and safe environment Encouraging the patient to participate in his/her own care Maintaining the patient’s privacy, preventing visibility to others, and protecting the patient from harm and harassment Ensuring the patient has the right be free from restraints of all forms that are not clinically necessary or are imposed as a means of coercion, discipline, convenience or retaliation by staff Restraints should be a LAST Resort! STUDENTS MAY NOT REMOVE OR APPLY RESTRAINTS!

Restraints Preserving the patient’s Rights, Dignity and well-being:

Restraints Preserving the patient’s Rights, Dignity and well-being Providing for a safe application and removal of the restraint by qualified staff Monitoring and meeting the patient’s needs while in restraints Reassessing and termination of restraint use at the earliest possible time Requiring that an LIP and RN shall be responsible for the use of restraints and for following the policy on assessment for informing patients of their rights. Restraints may be applied only under the supervision of an RN or LIP by trained and competent providers

Patient Rights Regarding Pain :

Patient Rights Regarding Pain On admission or during pre-admission, the patient will be taught the pain scale utilized to measure pain and how to communicate his or her pain The patient will be informed that pain management is included in the plan of care. The patient and family will receive education on pain medication control methods, and non-medication techniques to control pain. The patient has the right to know the potential limitations and side effects of the pain medications given. The patient should understand the importance of effective pain management.

Pain Management:

Pain Management PAIN – is an unpleasant sensory and emotional experience associated with actual or potential tissue damage PAIN – has both physical and emotional elements. It is “whatever the experiencing person says it is and exists whenever he/she says it does”. PAIN is the 5 th vital sign. Every patient will be provided appropriate pain management, and staff will respect and foster the patient’s sense of dignity and involvement in their own care. Fear of Pain, especially postoperative pain, ranks 2 nd only to the fear of death

Pain: Acute Vs. chronic:

Pain: Acute Vs. chronic Acute pain Rapid onset 1 second – 6 months Autonomic nervous system Tends to be more responsive to analgesic meds Chronic pain. Persistent or episodic in nature >6 months duration Habituation of autonomic response Tends not to be as responsive to analgesic meds May exhibit signs of depression

Manifestations of Pain :

Manifestations of Pain Crying, Grimacing, Moaning, Guarding, Restlessness, Repositioning, Holding extremely still – Especially in the elderly you may also see: Hitting, Anxiety, Sighing, Fright, Making demands, Rubbing Tachycardia Hypertension Tachypnea Dilated pupils ↑ muscle tension

Pain Assessment/Reassessment:

Pain Assessment/Reassessment Pain intensity Location Quality of pain, patterns of radiation (if any), character Onset, duration, variation, and patterns Alleviating and aggravating factors Present pain-management regimen and effectiveness Pain management history Effects of pain Patient’s pain goal Physical exam/observation of the site of pain Pain reassessment will occur within 1 hour of pain medication administration Pain is assessed using a 0-10 Scale, with “0” representing No pain and “10” representing the worst pain possible.

Hospital Codes: Dial 4444:

Hospital Codes: Dial 4444 Code Type Meaning Red Fire Code Blue or Code Blue/Pedi Cardiac/Respiratory Arrest Rapid Response Team(RRT) ICU Nurse/Respiratory Therapist Responds Code 999 Any physician in house STAT Code OB Emergency in L&D Code Yellow Disaster Code Gray Needs Assistance (Dr. Strong) Code Pink Infant /Child Abduction Code Green Chemical Spill Code Orange Bioterrorism Code White Shelter in Place (armed Intruder) Code Black Bomb Threat

Code Red:

Code Red Preventing fires and knowing what to do in case of fire is the responsibility of all hospital employees. A Fire Manual and Code Red cards are located in each department and nursing unit. Know the location of fire extinguishers near your individual work area; If a fire is discovered, activate the closest fire alarm signal by pulling down on the handle of the Local Fire Alarm. Proceed with the individual fire duties, as designated on the Code Red cards. Fire drills are conducted in all areas. Be prepared to participate. You must know fire procedures for your area and the responsibilities you have when a fire occurs in other areas. RACE R -rescue A -alarm C -contain E -extinguish PASS P -pull the pin A -aim the nozzle S - squeeze the handle S - sweep from side to side at the base of the fire Code Red

Abuse and Neglect :

Abuse and Neglect It is a crime NOT to report suspected abuse of children and adults to the appropriate authorities. Clear Lake Regional Medical Center provides for the protection of all patients by making hospital staff aware of signs, symptoms, and physical indicators of abuse and/or neglect and how to report the suspected abuse. Students should immediately report any suspected abuse to your instructor and the charge nurse.

Indicators of abuse:

Indicators of abuse Bruises, welts, lacerations, or puncture wounds Dehydration or malnutrition Multiple injuries or fractures in various stages of healing Injuries inconsistent with explanation Difficulty walking or sitting; Torn, stained or bloody clothing Complaints of pain or itching in the genital area Bruises or bleeding from external genitalia Venereal disease, particularly, in a child <14 years old Signs of over-medication; Burns; Poor hygiene Lack of medical attention 24-hour Abuse hotline: 1-800-252-5400 to report abuse

Patients’ Rights :

Patients’ Rights The patient has the right to be informed of his/her rights in language he/she understands. The patient has the right to participate in the development and implementation of his/her plan of care and to make informed decisions regarding his/her care. The patient has the right to be able to request or refuse treatment. The patient has a right to give informed consent prior to the start of a procedure and/or treatment. The patient has the right to know the identity and professional status of individuals providing service to him/her, to know the name of the person responsible for any procedures and/or treatment, and to know which physician or other practitioner is primarily responsible for his/her care.

Patients’ Rights:

Patients’ Rights The patient has a right to refuse to participate in research and his/her refusal will not compromise his/her care. The patient has the right to have a family member or representative of his/her choice and his/her own physician notified promptly of his/her admission to the hospital. The patient has the right to include his/her family in care decisions and/or to delegate decision-making to specific person and/or appoint a surrogate to make healthcare decisions on his/her behalf (to the degree permitted by State Law). The patient has the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives. The patient has the right to appropriate assessment and management of pain.

Patients’ Rights:

Patients’ Rights The patient has the right to personal privacy. The patient has the right to security and to receive care in a safe setting. The patient has the right to be free from all forms of abuse or harassment. The patient has the right to access protective services. The patient has the right to be informed of any restrictions (i.e., patient visitors, mail, telephone calls, or other forms of communication). The patient has the right to be free from seclusion and restraints of any form that are not medically necessary and/or are imposed as a means of coercion, discipline, convenience, or retaliation by staff.

Patients’ Rights:

Patients’ Rights The patient has the right to respective and supportive treatment and service at all times and under all circumstances with recognition of his/her person dignity. The patient has a right to receive pastoral counseling. The patient has a right to be involved in resolving dilemmas about care decisions The patient has a right to complain. The patient has the right to the confidentiality of his/her clinical records The patient has the right to access information in his/her clinical records within a reasonable timeframe. Regardless of the source of payment for his/her care, the patient has the right to request and receive an itemized and detailed explanation of his/her total bill for services rendered in the Hospital.

Patients’ Rights:

Patients’ Rights The patient shall be accorded impartial access to treatment or accommodations that are available within the Hospital’s capacity, its stated mission, and applicable law and regulation. Regardless of the reason a patient seeks medical/hospital care, patients with the same health problem shall receive the same level of quality care throughout the organization. The care of the dying patient provided by Clear Lake Regional Medical Center will optimize the comfort and dignity of the patient.

Policies Governing Students :

Policies Governing Students Standards – Students will be held to the standards of competent professionals when performing all duties. Uniform – Each student must wear appropriate uniform and name tag while on duty in this hospital. Lab coats will be permitted when the student is picking up an assignment. Students are expected to follow other dress code policies of the hospital. The hygiene and appearance of healthcare professionals has a significant effect on the confidence our patients and visitors have in us.

Policies Governing Students:

Policies Governing Students Calling in if unable to report to duty – The student is expected to call their instructor or the specific unit or department assigned to him/her if they do not have an instructor present during their clinical rotation. Please call at least 2 hours before your shift was to begin and give the following information: name, school, unit, instructor’s name and reason for absence. Transcription of Doctor’s Orders – Students may NOT transcribe doctor’s orders. The nurse or employee taking care of the patient is responsible for transcribing the doctor’s orders and communicating new orders to the student. The student may not receive verbal or telephone orders from a physician.

Policies Governing Students:

Policies Governing Students Cafeteria – The student will receive a discount on meals purchased in the Cafeteria while they are at this facility during a clinical rotation. Elevators – The back “service” elevators should be used for transporting patients and/or equipment from one area to another. The front elevators may be used when discharging patients. Parking – See the last page of this booklet for approved parking areas. Carpooling is highly encouraged due to the high volume of students. The student may be asked to move their vehicle if they are parked in an unapproved area.

Policies Governing Students:

Policies Governing Students Computer Documentation – Selected students may be allowed to document limited information in the Meditech computer system. This is called PCD – Patient Centered Documentation. After completion of a Security Access Form, a student may be given an access code secure password that will expire on the last day of clinical in the hospital. Other HCA facilities in the Houston area may utilize the same access code. Therefore, once an access code is put in the system for a student, it may be activated or inactivated at different facilities. Please indicate on the security access form if you have previously had an HCA Student Access Code. Computer training will be performed by the school instructor or CLRMC employee as appropriate. Instructors who allow students computer access are required to attend one of the PCD and/or EMAR Classes held during new hire orientation and are responsible for training for their students. Training materials are available in the Information Services or Education Departments. Students must remember to never share their access code or password and not to use the access code or password of another student or employee. They are required to follow the guidelines listed on the security access form.

Policies Governing Students:

Policies Governing Students Handling of Narcotics – A student nurse may be allowed to administer narcotics under the supervision of his/her instructor or employee preceptor. Narcotics will be dispensed from the AcuDose-Rx system. The instructor or employee will enter the system with an access code and a secure password. Medications are then documented in eMAR. The instructor or nurse will check all medications prior to student administration. Medications are dispensed via the AcuDose-Rx medication cabinet or the Robot system. This system improves the efficiency of medication administration and increases security of medications. The AcuDose-Rx receives orders and dispensing information from a connection with the hospital Meditech system. Medications will be documented via eMAR, electronic Medication Administration Record. Students, after attending a class, will be allowed to utilize the eMAR system for medication administration at their instructor’s or preceptor’s discretion. The student must have an access code and will need to have a secure password. The student must have the instructor co-sign all narcotics and occurrence reports.

Policies Governing Students:

Policies Governing Students IV Therapy/Phlebotomy – Students may perform IV therapy and phlebotomy techniques following instruction and skills practice in their academic program. Students may obtain blood using butterflies, needle and needle holder and start cathlon IV’s. They may also change IV tubing and bags; hang medications (IVPB); and monitor drip rates as set forth by their school guidelines. DO NOT ATTEMPT MORE THAN 2 IV STICKS

Policies Governing Students:

Policies Governing Students Students will work in conjunction with the CLRMC employee to give patient care. When reporting on duty, the student will communicate his/her responsibilities for patient care to the assigned employee. When reporting off duty, the student will provide the hospital employee with completed documentation forms for each patient, along with a verbal report. The instructor must be present if the student has not attained clinical competency in a procedure. At the department level: Staff will work with the students on their assigned unit to become familiar with pertinent unit-specific policies and procedures.

Policies Governing Students:

Policies Governing Students When discharging a patient, the student must have the Primary Nurse co-sign the discharge summary sheet. (Remember to give the patient the “patient copy” of the form). Students may not take discharged patients to the patient pick up area alone. They must be accompanied by a CLRMC Employee.

Policies Governing Students:

Policies Governing Students VERY IMPORTANT! Students may NOT hang blood or blood products. Students may NOT ‘pick up’ blood or blood products from the Blood Bank. Students may NOT interpret fecal occult blood test, as this requires competency verification and color deficient testing.

POINT OF USE Supply Scan :

POINT OF USE Supply Scan When supplies are issued to a patient, the caregiver is responsible for ensuring that the supplies given are scanned and accounted for. Supplies are scanned for two reasons. One is for inventory control. When an item is scanned out to a patient, it is deducted from inventory and our central supply department will know when supplies need to be restocked. The second reason an item is scanned it to charge the patient. Some items are “chargeable” to the patient and some are not. If an item is not patient chargeable, the department will be charged. **Please make sure you scan ALL items that are taken out of the supply or POU room.**

Computerized Tube System (CTS) :

Computerized Tube System (CTS) This is used to transport specimens between the Nursing units and Laboratory as well as to transport medications from the Pharmacy to the Nursing units. The CTS bins are kept locked. A key is available on each nursing unit, AOS, Engineering and Pharmacy. ITEMS NOT APPROVED FOR TRANSPORT IN CTS 24 hour urines Empty blood bags Blood components Ice Drinks or food items Contaminated supplies Money/checks Sharps Patient valuables Non- leakproof containers containing liquids Formalin or other hazardous chemicals Chemotherapy drugs Narcotics Xigris Albumin/immune globulin Vaccines Home medications Colony Stimulating Factors TPA

Computerized Tube System (CTS):

Computerized Tube System (CTS) PACKAGING Potentially infectious items must be contained and transported in a manner that prevents breakage, leakage or contamination of the system. In accordance with Standard Precautions and OSHA Bloodborne Pathogen regulations, all blood and body fluids must be handled as potentially infectious. A combination of ziplock bag, Zip-N-Fold pouches, and foam liners will be used to immobilize and package items.

What’s a TIGR Doing Loose at Clear Lake? :

What’s a TIGR Doing Loose at Clear Lake? The TIGR System is our new patient education Video on Demand system. These videos are stored in a computer database that can be accessed 24 hours a day to educate patients on various topics such as cardiovascular, diabetes, mother-baby, and other pertinent health care topics related to their needs. The TIGR system can be easily accessed on the bedside phones at extension 2983 . The phone will give you prompts to pick one of the 60 programs with its 3 digit codes. There are bright orange flyers on the units with program selection guides. It is important to know that none of these patient video services cost the patient any fees. The costs are included in their room charges.

Parking :

Parking As a Student, you may NOT park in the free valet parking at any time. Follow the parking rules. We have many patients and visitors, so please park as far away as you can and walk to the area where you are assigned. You may not EVER park in front of or behind the 450 Medical Center or 400 Medical Center Buildings. Park here Blossom Texas Ave. Student Gravel Lot CLRMC Medical Tower Physician Offices 450 400 Park here Medical Center Blvd

Parking At the Heart Hospital:

Parking At the Heart Hospital Medical Center Blvd . Heart Hospital CLRMC Park Here