Student/Instructor Orientation: Aurora Medical Center Oshkosh (AMCO)

1. Student/Instructor Orientation: Aurora Medical Center Oshkosh (AMCO) Welcome to Aurora Medical Center – Oshkosh We hope your clinical experience here will be a rewarding one. If you have any questions about our facility or any concerns while you are here, please feel free to contact the student phone line or email at 920-456-7389 or fv.clinical.requests@aurora.org For more immediate assistance, please contact the education department at 920-456-7347 or 7346. Thank you.

2. AMCO-Orientation • We know…you are probably thinking…“another PowerPoint”! • We just want to make sure you have information to keep you and our patients safe while you are here. • Navigation TIP: After viewing information from a link within this document, please use the “Back” arrow in the upper left corner of your screen to return to the PowerPoint (do not use the “X”).

3. AMCO-Orientation • Before you start, you will need to print off the following forms: • AMCO Orientation Checklist • Student Badge Issue Form • Minimum Necessary information • You will be filling these documents out as you go through this orientation. • Forward these forms to the Education Department when all activities are completed.

4. AMCO Orientation - Badges • All students and instructors must be identified with a badge. • You may use your school issued badge to identify you or the name of the school. • Aurora requires all students, volunteers, and employees wear an Aurora Badge. • Your instructor or an AMCO educator will provide you with a student badge. • Aurora badges will allow you access to specific work areas and break rooms.

5. Please note that badges with an orange stripe indicate employees or students working in the obstetrical or pediatric departments. This is a special security measure and allows special access. Please fill out the Student Badge Issue Form. You will obtain the badge number when you get your badge at the time of your tour (or from your instructor). Just a reminder, all badges need to be turned in at the end of your clinical or you will be charged a replacement fee. AMCO Orientation - Badges

6. AMCO Orientation – Orientation Checklist • Most of the orientation checklist will be completed by reviewing this PowerPoint. • Some items will need to be completed in person with a preceptor, instructor or nurse educator. • You will be instructed on these during your on-site visit or on the first day of your clinical.

7. AMCO Orientation – Orientation Checklist General Information about AMCO: • Our Mission and Values are posted on every unit. Click the link below for Aurora’s Mission. • http://www.aurorahealthcare.org/aboutus/mission.asp Our Vision: • Aurora Health Care was created around a single idea: There is a better way to provide health care. We will be satisfied only when Aurora gives people better access, better service, and better results than they can get anywhere else. • Working together, the people of Aurora will find a better way.

8. AMCO Orientation – Orientation Checklist Our #1 Priority: • Our patients deserve and expect the best care. • When we achieve top performance in our clinical, patient satisfaction and caregiver measures, patients receive a better care experience than they can get anywhere else. • For Aurora, there is no alternative. • This is our #1 priority.

9. AMCO Orientation – Orientation Checklist #1 Priority • We determine our success by measuring ourselves and by being measured by others. • Click on the link below to find out the goals we have set and how we are doing in achieving them. http://www.aurorahealthcare.org/aboutus/quality/details/default.aspx n

10. AMCO Orientation – Orientation Checklist • Aurora is committed to service and diversity. • We have interpreter service 24/7 – just contact the house supervisor. • Our interpreter service is also available to assist with answering questions regarding cultural differences and preferences. • We have an ethics committee that meets periodically and as needed. • If you have an ethical concern, please contact administration.

11. AMCO Orientation – Orientation Checklist • Our facility was built with the “Planetree” philosophy in mind. • The Planetree philosophy basically means providing patient-centered care; physically, spiritually, emotionally, socially and environmentally. • The environment and physical design of the building is intended to be calming, quiet and healing. • Open 24/7 visitation, promotes family, patient and healthcare provider interaction and communication.

12. AMCO Orientation – Orientation Checklist • AMCO offers many complementary services. • Services like pet therapy, • a healing garden, • aromatherapy, • special dietary requests, • limited overhead paging, • 24/7 family visitation, • and much more. • The goal is for a less threatening more homelike atmosphere for patients to heal.

13. AMCO Orientation – Orientation Checklist Another reminder: • Please recognize when discussing any patient information, that it is protected by law. • Individuals can be fined up to $10,000 if caught. • Be alert to when and where you discuss patient information. • HIPAA – privacy law.

14. AMCO Orientation – Patient’s Rights We believe that patient’s rights and responsibilities are an integral part of healthcare. Please read, acknowledge and respect the following patient’s rights. Patients have the right to: • Access care. • Respect and dignity. • Be considerate of patients, treat them as you would want to be treated. • Be free from restraint. • Click on restraint policy or refer to tri-fold brochure (restraint info) • Privacy and confidentiality.

15. AMCO Orientation – Patient’s Rights Patients have the right to: • Know who is caring for them, their function and qualifications. • Wear your badge and nametag at all times and always introduce yourself. • Expect safe care and a safe environment. • Have their pain assessed and managed. • Request consultation and other services. • Be informed of their plan of care. • Continuity of care. • Agree to or refuse to participate in research studies.

16. AMCO Orientation – Patient’s Rights Patients have the right to: • Have their communication needs met. • Secure interpreter if needed. • Be able to communicate with persons outside the hospital. • Be fully informed prior to consenting to procedures. • Refuse treatment to extent permitted by law. • Formulate an advance directive. • Request and receive an itemized detail of their bill for services rendered. • Provide feedback or express a concern.

17. AMCO Orientation – Orientation Checklist Please Remember: • To identify yourself when entering a patient’s room; always wear a name badge. • Always inform them of what you will be doing and why. • Show respect, provide dignity and privacy. • Think about how you would like to be treated if you were in the hospital.

18. AMCO Orientation – Parking and Map • Click here for a MAP of our facility. • When you arrive, you will take the first right and drive around to the back of the complex. • There you will see a large glass-top canopy. • This is the Main Hospital Entrance. • A piano is located in the lobby.

19. AMCO Orientation – Parking and Map Park Here Our parking policy. • Please park within the WHITE painted lines – these spaces are for employees/students. • The YELLOWpainted lines are for our guests, patients and visitors only. • You may park anywhere in the rear of the building but will need a badge to access entry.

20. Smoke Free Policy Helps Prevent Fires • AMCO is a smoke free campus. • Smoking is not permitted in buildings and/or on the facility property. • Those that choose to smoke must leave the campus.

21. AMCO Orientation – Orientation Checklist Minimum Necessary Use of Information Worksheet • This form means you should only be accessing pertinent electronic information for your role. • If you accidentally click on the wrong person, get out of that record as soon as you can. • Our IS department security investigates any unauthorized access. • Example; accessing record of a patient at another Aurora hospital. Click on the form below to view: • Fill in your name on the paper form. • Sign and date. • Turn this form in to your clinical instructor, preceptor or the Education Department at the hospital. “Minimum Necessary Use of Information Worksheet”

22. AMCO Orientation – Aurora Intranet From our internal computers you will have access to: • Our on-line library services • Patient Education • Health condition finder • Diagnostic test information • Wellness information • And many other resources. Check out the links above.

23. AMCO Orientation – Emergency Conditions & Codes • In order to practice safely at our facility, it is essential that you know any codes or conditions that may be announced. • Along with your badge you will receive a tri-fold brochure and/or a reminder card (attached to your badge) to help you remember. Emergency Preparedness Environment of Care Policies Environment of Care Policy Manual

24. AMCO Orientation – Emergency Conditions & Codes • The tri-fold card or brochure contains information that all short-term students, volunteers, clergy, and forensic staff (guards, police officers, etc.) should know while in our building. • Like a cheat sheet of the important “stuff”. • These brochures are also provided to all forensic officers when they are in the building with prisoner patients. • They also need to know our conditions and codes while they are here.

25. AMCO Orientation – Emergency Conditions & Codes • For all emergencies at AMCO: call 5911 • The Operator will announce the emergency overhead and summon help.

26. AMCO Orientation – Emergency Conditions & Codes Condition Red - Fire Condition Black - Tornado Warning Condition Grey - Severe Weather Condition White - Oxygen Failure Condition Orange - Chemical Spill/Hazardous Materials Code Blue/Code Blue Adam Security Assistance Condition Yellow - Bomb Threat Condition Utility Outage Condition Pink - Infant/Child Abduction Condition Alert - Internal/External Disaster Condition Clear – Resume Normal Activity

27. Condition Red • “Condition Red” is announced whenever there is a fire in the facility. • Fire doors close when the fire alarm is triggered. • Fire doors prevent the spread of smoke and flame from one part of the building to another. NEVER block open a fire door. • Make sure hallways are kept open and not blocked by equipment or supplies. • Learn the location of your area’s fire exits, alarms and extinguishers. • Evacuation signs are posted near exits.

28. Remember the word “RACE” R= Rescue A= alert or activate alarm C = Confine or close E = evacuate or extinguish Rescue those in immediate danger, including yourself. Alert the facility of the fire (activate the nearest fire alarm, then dial 5911). Confinethe fire & smoke.Close the door to the room where the fire is located. Close all doors that do not close automatically. Evacuatethe immediate area (past the first set of fire doors) & extinguish the fire only if you can do so without placing yourself in danger and you have been trained to use the fire extinguisher. Condition Red

29. Condition Red If you ever have to use a fire extinguisher: Pull the pin Aim the nozzle Squeeze the handle Sweep in a back and forth motion at the base of the flame. Stand at least 10 feet away from the fire

30. Medical Gas Shut Off • Medical gasses such as oxygen can fuel a fire. • The main supply of Medical gas for your unit may need to be shut off in the event of a fire. • Before the main oxygen supply can be turned off, oxygen dependent patients need to have another source of oxygen. • The supervisor or manager will direct staff along with the aid of Respiratory therapy.

31. Condition White • A condition white is not a snow storm. • This condition would be announced if there is a failure of the oxygen supply system. • What to do: • Return to your area. • Determine which patients need oxygen. • Work with Respiratory Therapy to identify how oxygen will be delivered (e.g., portable tanks).

32. Code Blue Code Blue is our plan to provide immediate assistance to someone who is not breathing or has no pulse. • Call for help. • Check for respirations (breathing). • In areas with a Code Blue Button, press the Code Blue Button. • In areas without a Code Blue Button, Dial 5911.

33. Code Blue • After you call, state your location. • “Code Blue-Adam” will be announced when the victim is an infant or child. • “Medical Alert” will be announced when the Code is at the Clinic (attached to the hospital). • Start CPR if you are trained to do so. • Obtain crash cart. Our AEDs are incorporated into our defibrillators located on all 21 crash carts. • Do not use the AED/defibrillator if you have not been trained to do so.

34. Rapid Response Team • AMCO has adopted a way to get extra help when a staff person feels a patient’s condition is deteriorating. • This is called a Rapid Response Team. • Qualified and specially trained staff are paged to assess and intervene before the patient situation turns into a Code Blue. • Dial 5911 and request • “RRT to room___”. • “RRT Adam to room ____.” (for pediatric patients). • “RRT Stroke to room ____.” (for patients experiencing stroke symptoms).

35. What was that number again? The one to call a condition, code or RRT? 5911 5911 is correct!

36. Condition Gray • Condition Graymeans there is Severe Weather or a Tornado Watch for the time period announced. • All employees report to their department immediately. • Advise patients and visitors of Tornado Watch. • Close curtains and blinds to prevent flying glass. • Be prepared to move patients to a safe area if necessary. • Secure additional blankets and pillows.

37. Condition Black • A “Condition Black” means a tornado is in the area. • Report to your department immediately. • Move bed patients as far from windows as possible. Cover them with blankets. • Ask patients who can walk and visitors to: • move into central hallways, • stay away from windows, • and remain there until “Condition Clear” is announced. • Close doors, windows, curtains and blinds.

38. Condition Utility Outage If the power fails, emergency generators will resume power within 8-10 seconds to red electrical outlets. • To help you be prepared when utilities fail in the facility: • Know where the flashlights AND batteries are kept. • Know which phones will work if the phone system fails (red phones). • Have a plan on how patients will summon help in case the call system fails. • Example; Ring a bell

39. Condition Yellow – Bomb Threat • Condition Yellow is the plan we have in place if there is a bomb threat. • If you are the one who receives a bomb threat phone call: • Handle the call QUIETLY & CALMLY! • Complete the Bomb Threat Checklist – on Emergency Plan Flip chart. • Try to keep the caller talking, listen to background noises. • Signal for someone to call Loss Prevention (Security). • Do not touch or move suspicious objects. • Refer to Administrative Policy for Bomb Threat.

40. Condition Yellow – Bomb Threat • If you hear Condition Yellow paged: • Remain calm. • Return to your department. • Ask visitors/customers to leave. • Search department according to the procedure in the Safety manual. Look for suspicious items–do NOT touch or move anything out of the ordinary. • Avoid using wireless two-way communication, such as pagers, wireless phones, cell phones because they may activate the bomb. • Don’t TOUCH or MOVE suspicious objects!! • Avoid leaving your backpack unattended.

41. Condition Alert:Bioterrorism • Bioterrorism is the deliberate release of a harmful substance (bacteria, viruses, fungi or toxins) into a community. • You will be instructed how to protect yourself when a suspected outbreak occurs or a condition alert is called.

42. Condition Alert:Bioterrorism • To be prepared for bioterrorism AMCO has: • Personal Protective Equipment for first responders. • Decontamination showers. • Specialized training for first responders. • A Facility Security Lock Down Plan. Decontamination tent.

43. Condition Alert:External • Condition alert-external is our plan for an external disaster (such as a bus accident or other mass casualty). • This plan allows us to quickly respond with more staff and supplies to care for multiple victims.

44. Condition Alert:External • If you are here: check Disaster Manual for details but generally you will: • Continue your job and • Report to the supervisor/manager of the unit to see if you can assist on the unit or if you would be needed in the labor pool. • You may be asked to perform the following duties: • Runner • Identification clerk • Transporter • Patient care provider

45. Condition Alert:Internal • Condition Alert – internal means there is an internal disaster like utility failure, explosion, building damage, or fire. • If you are here: check Disaster Manual for details regarding your department response. • You may be asked to report to a labor pool to help out where needed. • If evacuation is necessary, check with department staff/manager regarding how you may be asked to assist and the process for evacuating patients.

46. Hazardous Chemicals and Materials • Did you know that ordinary products and cleaners that are used daily can be hazardous? • Exposure to chemicals: on your skin or by breathing them in, can cause illness now or at a later date! • Where can you find out about these chemicals?

47. MSDS(Material Safety Data Sheets) tell you how to protect yourself from hazardous materials. They include: Precautions for protecting yourself. Clean-up instructions. All chemical materials or products purchased or brought into the facility need to have a MSDS (Material Safety Data Sheet) Can be obtained on-line through Aurora intranet or click on the link below. MSDS Material Safety Data Sheets: MSDS

48. Condition Orange • Condition orange is a chemical spill. • Protect yourself. Resist the temptation to rush in. • Review the MSDS first to see if you can clean up the spill yourself. • Call facilities-give your name, department, and location of spill. • If indicated - evacuate and isolate area until response team arrives.

49. How Do I Safely Clean up a Blood Spill? • Put on gloves and any other personal protective equipment (gown, mask and eye protection) depending on the size of the spill. • Apply absorbent powder from spill kit. Otherwise wipe up spill with paper toweling. • Sweep absorbent powder into a dustpan and place in a red bag or place paper towels into a red bag.

50. How Do I Safely Clean up a Blood Spill? • Do not use your hands to pick up broken glass. Use a dustpan or tongs. • Place broken glass in a sharps container. • Apply antimicrobial cleaner onto spill area and let stand per manufacturer’s specifications before wiping up. Bleach packets can be used for small spills. • Dispose of all soiled materials or the used spill kit into red bags. • Remove gloves and wash your hands.