Maine General Medical Center Student Nurse Orientation 2021

Maine. General Medical Center Student Nurse Orientation 2021

Maine. General Nursing Vision "To serve all who enter our doors with skillful hands and compassionate hearts" It is an expectation that student nurses will adhere to the Maine. General Values and Standards: Giving Our Best Everyday. . .

COVID 19 Guidelines Please review Maine. General Guidelines for Health Professions Students within the Maine. General System. � Students will be required to be asymptomatic and complete Maine. General health screening tool prior to each clinical shift. Please refer to the Maine. General procedure process for the COVID-19 health screening. � Students will be required to wear surgical masks when on-site in the clinical setting. � To preserve PPE, students should not be involved in direct care with any known positive COVID-19 Patient or PUI. � Kennebec County is in the “yellow” status. Based on CDC guidelines for health care providers, this means all staff/students who work in direct patient contact settings (including non-direct care staff) will need to wear some form of eye protection along with their facemask as of, Friday, November 20 th. � Maine. General will supply students/instructors with eye protection. We are asking for students and staff to wear MG issued PPE and to not bring PPE from home/schools. Students/instructors will be given face shields upon arrival to their department they are doing clinical on. The face shields are reusable for a week. Students/instructors should do a final cleaning of their face shields and can use a paper bag to transport the face shield from here to home in between clinical time.

COVID 19 Guidelines � Students and instructors must comply with CDC travel mandates. � Students will adhere to social distancing practices. Students and instructors should be aware of spacing in all areas of the facility including cafeteria, hallways and elevators. We do not have a limit in our elevators but groups of students should not be taking the same elevator to ensure best spacing possible. � Please limit or keep to a minimum the amount of items you are bringing into the building. Students/instructors should only be bringing in what they need for the clinical day.

Health Screening Tool � All Maine. General employees, medical staff, contractors, volunteers and students will use an online (mobile phone or computer) screening tool before they enter a Maine. General facility each day. The tool we’ve selected is from Conversa Health. � The tool will give each healthcare worker an electronic “badge” that will be green, yellow or red. If the badge is green or yellow they are cleared for that day. If they get a red badge, they are not cleared and must follow your usual absentee protocol.

Health Screening Process � Each student/instructor will initially self-enroll to use the Conversa health screening tool. The screening tool can be accessed by texting “MGH” to 34108 or visiting www. mainegeneral. org/screener. � After completing the initial screening, individuals will receive a personalized link that can be used to complete the screening questions. The screening questions should be completed each scheduled day at MGH, no earlier than 4 hours prior to their scheduled shift. � The screening tool can be accessed remotely (off site) through a smart phone or on a computer or tablet via a web browser. At all sites the screening must be completed prior to walking into a Maine. General site. � Instructors/students should report to Maine. General when they are “Cleared to Work” (green) or “Cleared with Precautions” (yellow). If “Not Cleared to Work” (red), they should not report to work and should follow their standard call out procedure. Students should also notify their schools and can follow up with their medical care provider for return to work direction. � Upon starting their shift, students on site with an instructor will show their “Cleared” or “Cleared with Restrictions” badge to their Instructor. The instructor will show his/her own clearance badge to the unit charge nurse and will confirm that all students have shown a green or yellow badge and are eligible for clinical that day. Students at Maine. General without an instructor on site will need to show his/her own clearance badge to the unit charge nurse.

AIDET � AIDET is a acronym, used at MGMC for patient and visitor interactions. � It reinforces Respect & Trust with our patients and their families and visitors. � ALWAYS use AIDET to best communicate your interaction or purpose at each patient/family/visitor encounter

Hourly Rounding Hourly rounding involves checking in on the patient on an scheduled basis and demonstrating particular behaviors. • Hourly from 6 am-9 pm • Every 2 Hours from 10 pm-6 am Assess the “Four P’s” • How is your pain? • Are you comfortable/need repositioning? • Do you need to go to the bathroom? • Are your possession and call bell within reach? Assess the environment for safety • Call bell, telephone, urinal, garbage can, glasses within reach? • Bedside table properly positioned? • Patient covered to protect privacy? • Room tidy & neat? • Check water pitcher, offer water (as applicable)

Hourly Rounding (cont’d) Ø Always explain what you are doing and why you are doing it • “I’ve washed/ sanitized my hands for your safety. ” • “I’m checking your name band for your safety. ” • “May I pull the curtain/close the door for your privacy? ” Close the loop of communication when all tasks and hourly rounding have been completed Ø • “We will round again in an hour (two hours at night) or so” • “Is there anything else I can do for you, I have the time? ” • Document your rounding on the whiteboard Initial at the bottom of the white board in the room when hourly rounding is complete Ø

White Boards Ø Place your name on the white board Ø Update nursing plan of care/goals for patient Every patient should have a goal! Ø Use white board to communicate patient preferences and level of assist required for ambulation with other staff members

Precautions

Precautions (cont’d) � Note signs outside of precaution rooms � Follow all instructions on the sign prior to entering any type of precaution room � Note that for enteric precautions, hands must be washed with soap and water before leaving room � For protective care (neutropenic) patients, please check with primary RN for a complete list of restrictions (no fresh flowers or plants, no raw fruit or vegetables, no pets from home, no sick visitors, etc) � Students will not be students will not be involved in direct care with any known positive COVID-19 Patient or PUI. � As students, you will not take care of any patients on airborne precautions as you have not been fitted with the proper mask. If you are given a patient on airborne precautions, please do not assume care of the patient and discuss with your clinical instructor.

Quality Must Haves Catheter Acquired Urinary Tract Infection (CAUTI) - Urinary tract infections are the most common type of healthcare-associated infections, accounting for more than 30 percent of healthcare-associated infections reported by acute care hospitals. Virtually all healthcare-associated urinary-tract infections (UTIs) are caused by instrumentation of the urinary tract (e. g. insertion of catheters). CAUTI has been associated with increased morbidity, mortality, hospital cost, and length of stay. Pressure Ulcer Risk- a state in which the individual’s skin is at risk of altered skin integrity by unrelieved pressure between a bony prominence and an external surface, by friction and/or shear. Signs/symptoms include: nonblanchable erythema, decreased sensation, impaired tissue tolerance, ecchymosis, frank necrosis, ischemia, induration or boggy tissue, hypoxia CAUTI and Pressure Ulcer interventions are pertinent to quality care of our patients. Please ask your instructor/preceptor review appropriate interventions.

Fall Prevention- The hospitalized patients risk for injury is through multiple causes, accentuated by specific identified risk factors. Risk for injury encompasses all age groups; however certain age groups have higher risk for certain types of injury related to specific risk factors. Central Line Associated Blood Stream Infection- (CLABSI) is a serious infection that typically causes a prolongation of hospital stay and increased cost. Implementations of evidence-based practices such as the “central line bundle” have reduced CLABSI. Aseptic technique should be maintained for the insertion and care of all intravascular catheters. Adhering to the principles of aseptic technique has shown to decrease the risk of catheter-associated infection. CLABSI and Fall Prevention interventions are pertinent to quality care of our patients. Please ask your instructor/preceptor review appropriate interventions.

Communication � Answer call lights � When answering a call light, cancel the call by pushing the indicated button on the panel in the patient room, located on the wall next to the bathroom entrance � Communicate frequently with your nurse. � Use the ISBAR format when giving report. I Introduce S Situation B Background A Assessment R Recommendation

Rapid Response � A Rapid Response call activates a trained team that can assist with a rapid assessment of an inpatient with acute status changes and implement appropriate interventions. � Dial 1 -6444 from a landline phone to call a rapid response

Rapid Response Guidelines Student nurses are encouraged to call if: Patient experiences Acute Changes: � <40 or >130 beats per minute � Systolic Blood Pressure <90 mm. Hg � Respiratory Rate <8 or >28 breaths per minute � Level of Consciousness Patient experiencing Acute & Persistent changes: � Saturation< 90% with Oxygen Need for additional clinical opinion: � Concerned, Unsure, Scared, Safety Concerns

Emergency Codes Refer to the Nursing Student Handbook on the Centralized Clinical Placement System for a comprehensive list of codes used at Maine. General. A list of all applicable codes and their meaning is located on the reverse side of your Maine. General student nurse badge. Note that you can also receive rapid assistance from your floor staff by pressing the “Staff Assist” button indicated to the left. In a medical emergency that requires immediate assistance, the “Code” button underneath may be used as well. IMPORTANT – Extension 1 -6444 MUST be called to activate the emergency response system, even if you have already pushed the code button in the room.

i. Bed Awareness In the Med Surg rooms at Maine. General, we have the Stryker S 3 Beds. To assist in preventing falls the beds are equipped with i. Bed Awareness: Alerts you if the parameters you have set have been altered. Green light= all parameters still in place. Flashing amber light=parameters changed i. Bed monitors: -Brake -Side rail position -Low height (optional) -Bed exit (optional) -Fowler 30 degree lock (optional) Set your bed the way you want it and press Awareness ON/OFF to enable i. Bed

Finding your way. . . Park in the Staff Parking Lot • Take the 2 nd Left on Medical Center Parkway Drive • Follow the drive around to the back of the hospital • Park in the furthest parking lot ****Plan on 15 minute walk time to the staff entrance****

Can I get there from here? Use these maps to become familiar with what is on each floor. What is located on the Terrace level? � Rehab Unit � Terrace West � Security � IT Training Rooms/ Computer Lab � Clinical Skills Lab � Cafeteria � Spiritual Center

What is located on the First Floor? � 1 West � CCU � ED � Medical office buildings � Main Entrance � Gift shops, Main Street Cafe � Outpatient Lab � Imaging Department � Conference Rooms 1 -3

What is located on the Second Floor? � 2 West � Maternal Child Health Unit � Medical Office Buildings - OB/GYN and Surgical � Wound Clinic � OR and Surgical services � Cardiac Cath Lab � Endoscopy � Classrooms 1 -3 � Library

What is on the Third Floor? � What located on the 3 rd Floor? � 3 West � Mental Health and Substance Abuse Unit � PT/OT Inpatient Gym � Administration Offices � Meeting Rooms 1 -4 � Professional Development Offices

Become familiar with your Surroundings

As A Student Nurse I Will. . . • Come prepared to seek learning experiences and actively engage in the experience offered. • Be motivated, enthusiastic, willing to learn and be an active part of the healthcare team • Maintain Confidentiality at all times • Assist the unit team if available Open the doors to learning • Be appropriately prepared for my clinical experience ü Follow the dress code ü Adhere to the student code of conduct ü Be Punctual ü Be Knowledgeable in relevant anatomy, physiology, pathophysiology and clinical practice guidelines for your clinical area ü Bring required equipment

Student Nurse Documentation Utilize the Clinical Practice Guidelines for Evidence Based Practice Clinical Practice Guidelines help to guide your nursing practice by answering these questions: 1. What are the potential complications related to this diagnosis? 2. What should I be aware of or how do I identify these complications? 3. What does the most current evidence say about this disease/disorder? 4. What do I need to educate my patient about this disease/disorder?

Document in Real Time � Use the computer in the patient’s room

Use Bar Code Scanners for Medication Administration � Bar Code Scanners are located in every patient room. � Use the Bar Code Scanners for every medication given STOP and SCAN

Guidelines for Students regarding COVID-19 � Students will be required to be asymptomatic and will self-screen for symptoms prior to each clinical shift. � Students will be required to wear surgical masks when on-site in the clinical setting. � Students will adhere to social distancing practices. � To preserve PPE, students should not be involved in direct care with any known positive COVID-19 Patient or PUI. � Students from outside of Maine must comply with State of Maine mandates relevant to limiting the spread of Covid-19. At the time of this writing, a 14 -day quarantine is required and must be completed before entering all Maine. General facilities. Per guidance from State of Maine, this requirement can be met by completing the quarantine in the state of origin prior to entry into Maine. � For nursing students we continue to ask that students and instructors do not work with patients requiring PPE beyond gloving. Please limit or keep to a minimum the amount of items you are bringing into the building. Students/instructors should only be bringing in what they need for the clinical day

Thank you. . . for being part of the Maine. General team! For any questions regarding students or student placement at Maine. General Medical Center, please contact: Sarah Moody 624 -4397 Or Email: sarah. moody@mainegeneral. org