Student Orientation

Student Orientation
to
MultiCare Health System
Content
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Mission Statements
History of MHS Hospitals
Dress Code
No-No’s
Emergency Codes
Wrist Bands
Customer Service
Diversity / Interpretive Services
Smoking
Falls / Restraints
Confidentiality
Documentation
PYXIS
Advance Directives
Patient Rights
Parking
Forms for Signature
Scope of Practice
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Mission Statements
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MultiCare Mission, Vision, Values
– Our Mission
• Quality Patient Care
– Our Vision
• To create a seamless, easy,
valued and sustainable continuum
of health care that enhances the
experience of our patients,
providers, caregivers and
employees.
– Our Values
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Excellent clinical outcomes
Exceptional customer service
Dedication to patient safety
Community service and
partnership
Clinical expertise
Innovative healthcare delivery
Financial sustainability
Employee development
Clinical and business ethics
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Good Samaritan Mission, Vision,
Philosophy
– Our Mission
• We provide quality health care in
the compassion and spirit of
Christ’s love. We meet individual
and community needs as a team,
reflecting our belief that health is
wholeness in body, mind and
spirit.
– Our Vision 2012
• Good Samaritan is the trusted
regional medical center of choice
for every person in East Pierce
County.
– Philosophy of Care
• We enrich the well being of every
life we touch in an environment
where healing is promoted and all
are honored.
MHS History –
Allenmore Hospital
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Allenmore Hospital’s roots come from the
Medical Arts Building in downtown Tacoma
in 1926. The building was full of doctors
offices and had a few floors put aside for a
hospital. It also included an operating
room.
The Medical Arts Hospital eventually
moved to it’s current location in 1975 at S.
19th and Union on land that was
bequeathed from Dr. Bridge. The Medical
Arts Building is still standing in Tacoma at
740 St. Helen’s Avenue.
Allenmore was eventually purchased and
run by the Humana Corporation.
The hospital was later sold to MultiCare in
1989.
Current Bed Capacity – 130.
The Medical Arts Building
Allenmore Hospital
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MHS History –
Good Samaritan Hospital
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The Lutheran Home and Welfare Society assumed
management of Puyallup General Hospital at the request
of the doctors who owned that facility. It was located in
downtown Puyallup, near Meridian Street and Fourth
Avenue Northwest.
The Lutheran Welfare Society changed the hospital’s
name to Good Samaritan in January 1952.
As the Lutheran Home and Welfare Society was taking
over management of Good Samaritan Hospital, they were
also completing construction of Lutheran Minor Hospital for
the Chronic Diseases of the Aging in Puyallup. The facility
was located on 14th Ave. SE and was dedicated in July of
1952. During the growth of Good Samaritan, the Lutheran
Minor Hospital was experiencing financial difficulties.
In 1957, after dramatic patient admission growth, the city’s
health and fire authorities informed the Good Samaritan
Board of Directors that it must either cease operation of
the hospital or move the healthcare program to a larger,
newer facility. It was determined to consolidate the two
hospitals into one, use the land, and renovate and expand
the building that was Lutheran Minor Hospital.
On October 5, 1958, the new Good Samaritan Hospital on
14th Avenue SE was opened.
Current bed capacity – 225.
Good Samaritan's Dally Tower addition
was completed in 2011.
Current Good
Samaritan Hospital
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MHS History –
Mary Bridge Children’s Hospital
Dr. Albert Bridge
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The Tacoma Orthopedic Association was
started in 1921 under the leadership of
Mrs. Frank Baker with the women of
Tacoma and formed the TOA to help
children in need of medical care.
Mary Bridge Children’s Hospital was
established in 1955 through the
perseverance of the dedicated women of
the TOA.
They were convinced of the need for a
specialized health care center in Tacoma
to serve the children of southwest
Washington.
Key funding came from the estate of Dr.
Albert W. Bridge, a pioneer physician
who practiced in Eatonville and Tacoma.
The hospital was named for his mother.
Current bed capacity – 72.
Mary Bridge – Dr.
Bridge’s mother
Current Mary Bridge
Hospital
New Outpatient Pavilion – left
Original Mary Bridge Hospital –
right, from 1955
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MHS History –
Tacoma General Hospital
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In 1881 Brooklyn, New York, the Reverend John
Paddock and his wife Fannie C. Paddock and
children were sent to the west to establish the
Diocese of Olympia in Washington Territory. They
inquired as to what was needed in Tacoma and it
was determined that this thriving logging and
shipping town needed a hospital.
They collected money and supplies and brought
them out to the West. Mrs. Paddock never made it
here, dying in Portland Oregon. Her husband
purchased a building on Starr Street in Old Tacoma
and established the first hospital in Tacoma and
named it after his wife – Fannie C. Paddock in
1882.
In 1884, he also established Annie Wright Seminary
/ School. Both were run in conjunction with the
Episcopal Church. The hospital eventually moved
up to J Street, later separating from the Episcopal
Church and renamed Tacoma General Hospital in
1915.
Some Firsts
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First hospital on
Starr Street
Rev & Mrs.
Paddock
First hospital in Tacoma WA - 1882
First School of Nursing in Washington State 1895 –
1980
First Open Heart Surgery on bypass in WA State –
1958
Bed capacity today – 391.
Tacoma General
from the rose
garden
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Dress Code
• Badges
– MHS only provides badges to
students who will be working at
MHS for more than one year
– School name badge must be
worn at all times
– Above the waist
– Picture side out
Dress Code - continued
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Professional Attire
– Uniform, if your school requires
one
– Clothing appropriate to a bank or
hotel, otherwise – business/casual
– Clean, pressed, not excessively
worn or faded
– No shorter than 3 inches above
the top of the knee
– Free of slogans, pictures, and
advertisements unless preapproved by MHS (logos smaller
than 2” by 2” are acceptable)
– Sleeves must allow you to wash
up to your elbows
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If you wear a turtle neck or other shirt under
your uniform, the sleeves must be pushed
up above the elbows when entering the
patient room or contacting a patient outside
of the hospital room to prevent crosscontamination
This includes long-sleeved jackets, shirts,
lab coats, sweaters, etc. even if you do not
wear a uniform, even if you do not touch the
patient but only enter the room
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Inappropriate Attire:
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Tank tops
Blue jeans
Shorts of any type
Leggings, capri style pants
Overalls
Sweatshirts
Camouflage clothing of any kind
Sports apparel such as “sweats”,
“warm-ups”, jerseys
– Exposed backs or midriffs
– Form-fitting and revealing clothing
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i.e. stretch pants, stirrup pants, and
see-through apparel
Dress Code - continued
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Undergarments
– Appropriate for work setting
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Tattoos
– Not appropriate to a professional
image
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Must be covered unless covering
poses a risk
Make-up
– Business-like in style and color
– Should not be distracting
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Personal Hygiene
– Clean, well-groomed, free from
odor
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Includes smell of cigarette or other
tobacco odors
– Scents – i.e. perfumes, colognes,
scented body lotions, soap for
clothes washing
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Not allowed in patient care areas
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Footwear
– Shoes and socks or hose are
required
– Shoes must be clean and in good
repair
– Not appropriate
• Slipper-style sandals, opentoed sandals, flip-flops
– Shoes appropriate to working area
• Athletic shoes appropriate in
non-office settings
• Birkenstock-type shoes –
closed toed
• Business area
– Loafers, conservative dress
boots, flats, closed-toed sandals,
leather deck shoes, leather-type
dress shoes including open-toed
dress shoes
Dress Code - continued
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Hair
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– Neat, clean and conservative
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– Prohibited if they may be offensive
or derogatory in nature
Business-like in style and color
– Off the collar, pulled back and
secured in clinical areas
– Simple barrettes, ribbons, and
other securing devises
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Head Coverings
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Unless worn as part of an assigned
uniform, for religious reasons, or
health/safety reasons
Facial Hair
– Beards and mustaches
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Neat, clean, and appropriately
trimmed
Not allowed in clinical areas if they
may compromise the effectiveness
of Personal Protective Equipment
Hand Jewelry for areas listed
for artificial nails (see next
slide)
– Limited to one or two rings
– Rings need a low setting to
prevent glove tearing
– Limit wrist jewelry to a watch and
medic alert bracelet
– Hats, caps, and other head
coverings are inappropriate
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Buttons – badges – similar
items
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Body Piercing
– Jewelry may not be worn in any
visibly pierced body part except
ears
– Stents are not allowed in place of
piercings
Dress Code - continued
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Fingernails
– Neat, clean and in keeping with a
professional image in style and
color
– Artificial nails may NOT be worn if
you:
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Give direct patient care
Perform decontamination activities
Work with soiled or clean linens
Prepare sterile admixtures
Handle sterile supplies outside of the
primary shipping container
Handle or prepare food
Routinely wear protective gloves for
any reason
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Natural Nails
– Keep short and trimmed to
prevent snagging
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May not extend beyond the tip of the
finger
– Nail polish
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Permitted except in operating areas
Not chipped or cracked
No-No’s
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Don’t cook popcorn at MHS
– You can eat it, just cook it at home
– It can set off the smoke detectors
if it starts to burn
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Cell phones, I Pods, and other
electronics
– Please do not use over or in front
of patients, in the hallway outside
of patient rooms, or at the nurses
station
– If you need to contact your
instructor, please go to a private
area like the lounge and call
Emergency Codes
• Emergency Number
– 5555 for acute care facilities (hospitals)
– 9-911 for outpatient and ambulatory facilities
Code Red - Fire
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Fire Response
R – Rescue anyone in immediate
danger
A – Activate the nearest fire alarm
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If fire is present or when directed to do
so:
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Call 5555/9-911 – emergency number
Pull fire alarm station
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Close the doors and windows
E – Extinguish the fire and/or evacuate
Acute care hospitals
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C – Control ventilation
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All other sites
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Fire Extinguisher Operation
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P – Pull the safety pin from the handle
A – Aim (nozzle/cone/horn) at the base
of the fire
S – Squeeze the trigger handle
S – Sweep from side-to-side to
extinguish the fire
Evacuate patients, visitors, and staff to
the next fire compartment (i.e. another
wing away from the fire / lateral
transfer)
If not in fire zone, close windows and
doors, do not use elevators
Charge nurse is responsible for shutting
off oxygen (only if necessary)
Patients, visitors and staff should
evacuate in an orderly fashion to a predesignated area outside of the building
Code Blue / Cardiac Arrest
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Call immediately
– Dial 5555 / 9-911
– Indicate if pediatric or adult
– Press code button – if available
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Initiate CPR
– If you hold a current card
– Do NOT use AED on children with
adult pads
• Utilize the child designated pads
that reduce voltage
• If PALS certified, use the manual
defibrillator
– Do NOT leave the patient alone
– Do NOT do mouth to mouth
respirations – use a mask/bag
when crash cart arrives
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If sent to obtain the crash cart
– Please unplug the defibrillator and
suction before moving the cart
– All supplies are kept on the cart
including:
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Masks and intubation supplies
Back board
Drugs
IV supplies
Code Orange / Hazardous
Material
• Call in event of hazardous
material spill/release that is
likely to cause injury or illness
• May result in exposure that
exceeds exposure limits or
may harm the environment
• Consult hospital policy,
Material Safety Data Sheets
(MSDS) and container labels
before attempting to clean up
the spill
MSDS
MSDS label description
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MSDS
Label
Material Safety Data
Sheet
Formal document
containing important
information on the
characteristics and actual
or potential hazards of a
substance.
Code Gray / Combative
Person
• Immediately call emergency
number to protect:
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Patients
Staff
Visitors
Property
• Combative or abusive behavior
– Can be displayed by anyone
• Call when staff is concerned
about
– Their own safety
– Safety of others
– Due to abusive or assaultive
behavior
• Signs
– Single sign alone may not
require action
– Combination of any of the
following may be a cause for
concern and action
• Direct or verbal threats of
harm
• Destruction of property
• Intimidation of others by
words or action
Code Silver – Weapon /
Hostage Situation
• Call when staff are concerned
about their own safety and the
safety of others and suspect
that someone has a weapon or
has taken a hostage
• Weapon definition
– Firearm
– Knife
– Instrument that can cause
bodily harm
• Will not be announced
overhead
• A response team from internal
security and possibly external
law enforcement will be called
• Staff should NOT attempt to
intervene or negotiate
– Wait for emergency team to
arrive
Amber Alert – Infant or Child
Abduction
• Call immediately when an
infant or child is missing or
abducted
• Follow procedures:
– Control entry into your
department by unknown
persons
– Monitor common areas
– Post available personnel
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In hallways
At intersections
At elevators
At stairwells
– Personnel
• Remain in place until “All
Clear” is announced
• Abductor can be:
– A stranger to the child
– A family member
• Such as a non-custodial
parent
– A family acquaintance
Code External Triage /
External Disaster
• Examples:
– Any event with mass
casualties
– Natural disaster
• Flood
• Tornado
• Earthquake
– Massive power outage
– Bioterrorism
– Nuclear, biological and
chemical incidents
• Follow procedures in
Comprehensive Emergency
Management Plan
– Emergency Response Plan
• Stay in your department and
you will be directed
earthquake
Code Internal Triage /
Internal Disaster
• Examples:
– Total power outage, utility
disruption
– Plumbing outage and/or
problems
– Telephones not working
– Computer network down
– Flooding
– Explosion without fire
– Bomb/bomb threat
• Follow Comprehensive
Emergency Management Plan
– Emergency Response Plan
– You will be directed as to your
actions for this disaster by
your department
• Purpose of code
– Provide a mechanism that
allows facility to
• Respond to a variety of
internal emergency situations
• Ensure continued operations
of the facility under
emergency conditions
Code STEMI – Acute MI
• Hospital Only
• Standardized team
response
– To assure rapid care for
the patient having an
acute Myocardial
Infarction (heart attack)
– If you suspect your
patient is having a heart
attack
• Call the Rapid Response
Team
– If the patient’s heart or
breathing stops
• Call a Code Blue
Code Neuro - Stroke
• Hospital Only
• Standardized team
response to assure rapid
care for the patient
having a stroke
– If you suspect your
patient is having a stroke
• Call a Rapid Response
Team
– If the patient’s heart or
breathing stops
• Call a Code Blue
Rapid Response /Hospitals
Only
• For in-patients only
• Provides:
– An early response
– Additional support
• for the health care
professional
– To slow or prevent
patient clinical
deterioration
• If the patient’s heart or
breathing stops:
– Call a Code Blue
Wrist Bands
• Allergy Band
– Red
• Do Not Resuscitate
– DNR
– Purple
• Parent of
Hospitalized Child
– Blue
• Falls Precaution
– Yellow
• Limb Precaution
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No BP
No IV
No Blood Draws
Pink
Customer Service
The MultiCare Difference
The MultiCare Difference is what
customers experience when the best
clinical care available is combined with
excellent customer service.
Our goal is to deliver the ideal patient
experience!
Remember that the patient and their
family and friends are the reason that we
are here!
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Give them the Pickle!
Do the extra and special things that keep
our customers happy and meet their needs!
– Walk them to their destination instead
of telling them how to get there
– Smile and greet them
– Make them feel like they have your
undivided attention
Diversity / Interpretive
Services
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Diversity
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In circumstances where any patient, close
family member or statutory substitute
decision-maker is unable to adequately
express his/her needs, understand directions
or explanations due to such person’s limited
English proficiency or due to any visual or
hearing impairment, interpretive services
and/or auxiliary aids or devices will be
provided to ensure essential communication
in the provision of care.
MultiCare Health System does not
discriminate in the delivery of, or access to,
any MultiCare service on the basis of any
person’s limited English proficiency, visual or
hearing impairment, race, color, national
origin, creed or any other ground unrelated to
an individual’s need for the service.
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Interpretive Services
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Certified, qualified or otherwise authorized
interpreters will be used for all circumstances
in which an interpreter is required. Interpreter
services are provided at no cost to the patient.
Documents in languages other than English,
supplement, but do not replace the need for
interpreters.
Interpretive Services used for, but
not limited to:
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Obtaining informed consent
Making provisions for health care power of
attorney
Explanation and documentation of discharge
instructions
Safe and effective use of medications
Continuing care after discharge
Confirming patient appointments (via
telephonic services)
Safe and effective use of equipment
Multidisciplinary patient / family conference
Smoking Policy
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No tobacco use will be allowed at any
time on MultiCare owned or leased
property
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In the case of MHS employees,
volunteers, contractors and agency
staff and students
This property ban includes and extends
to public right of ways that bisect MHS
property and public sidewalks that
immediately surround MHS property
Nicotine replacement products are not
prohibited
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Patients will be informed of the no
smoking policy on admission, arrival or
as soon thereafter as medically
appropriate
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Please remember, if you are a smoker,
you may be asked to leave if you
return to your department and an odor
of tobacco products is detected
Falls / Restraints
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Falls
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Definition
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TG/AH – Green Sign
Good Sam – routine patient preparations
MB – developmentally appropriate
High falls risk
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TG/AH – Red Sign / Red non-skid footwear
Good Sam – coded Red / Leaf at the door
MB – developmentally appropriate
If a patient should fall, assess for injury
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Check to make sure airway is clear, breathing
and pulse are present
Assess vital signs
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including orthostatic blood pressure
assessment if appropriate to patient
Evaluate for
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Standard falls risk
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Unplanned descent to the floor, with or without
injury to the patient
An RN will assess each patient for risk of fall /
injury on patient admission to the acute care
setting using the Morse scale
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Restraints
normal body alignment
ability to move all extremities
Specifically note injuries and presence or
absence of joint/head trauma
Check for pain and tenderness
Inspect for skin injuries, lacerations, bumps,
bruises
Evaluate neurological / mental status
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MHS will first use preventive and alternative
strategies and as a last resort the least
restrictive method of restraint to assure the
well being, health, dignity and safety of the
patient and others.
The use of restraint poses a significant risk to
the physical and psychological health and
safety of both the patient and staff.
Review the attached policies by clicking on
the appropriate link below
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Allenmore, Mary Bridge, and Tacoma General
Restraint and Seclusion
Good Samaritan Restraint and Seclusion
Confidentiality
• Electronic documentation is
currently in use at Allenmore,
Mary Bridge, and Tacoma
General Hospitals, and all
outpatient MultiCare facilities
• Electronic documentation will
be implemented at Good
Samaritan in 2010
• All MHS patient care records
are accessible through these
computer accounts
• Only access the records of
those patients that you are
assigned to care for
• Please do NOT access patient
care records of your friends,
family, or yourself
• If you are interested in your
personal records, please go
through appropriate channels
in Health Information
Management to access this
information
• If you access records that you
are not entitled to, you will be
asked to leave MHS
Documentation / Electronic
Medical Record
• Documentation is done
electronically at all MHS sites
via Epic
• You will be guided by your
instructor as to which
electronic medical records
systems you will need to learn
before starting at your clinical
location
• Please complete the required
electronic medical record
education as soon as possible
PYXIS
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Allenmore, Tacoma General, and Mary
Bridge, Good Samaritan Hospital, Auburn
Medical Center
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precepted nursing students
– Pharmacy Interns and Residents will use the
education available in the Pharmacy
– A practice PYXIS med station is available on
the 4th floor in the M wing at Tacoma General
Hospital
– An MHS badge is required to access this area
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Contact your preceptor for access to this area
The med station is available 24 hours / 7 days
a week and is not attached to the network
Use the self-study guides and work sheets at
the med station to practice
Please do not attempt to use the bio ID
feature or change the passwords on this
practice med station
Advance Directives /
POLST
•
Please click on the following links
to access the policies at MHS on
Advance Directives and the Health
Care Directive forms
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The Physician Orders for LifeSustaining Treatment (POLST)
form
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MHS Advance Directive Policy
Good Samaritan Advance Directive
Policy
Advance Directive Form
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Represents a way of summarizing wishes of
an individual regarding life-sustaining
treatment. The form is intended for any
individual with an advanced life-limiting
illness.
Printed on lime green cardstock in
Washington State
The form accomplishes two major
purposes
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It is portable from one care setting to another.
It translates wishes of an individual into actual
physician orders.
The attending physician, nurse practitioner or
PA-C should complete the document with the
patient. The attending physician, ARNP or
PA-C must sign the form and assume full
responsibility for its accuracy.
The POLST form facilitates the process of
translating end-of-life discussions with
patients into actual treatment decisions, and
provides security for the individual and
physician that the expressed wishes will be
carried out. There is no other form that
streamlines the process in this way.
Patient Rights
• Please click on the
attached link to view
the brochure on
Patient and
Adolescent Rights
• Please click on the
attached link to view
the brochure on
Children’s Rights
– Children’s Rights
– Patient and
Adolescent Rights
Parking
• Tacoma General and Mary
Bridge Campus
– All students are to park in the
5th Street garage in any space
which is not reserved or
already designated for another
department.
– Do NOT park in the Baker
Garage or the Jackson Hall
Parking Garage as your
parking will not be validated or
paid.
• Allenmore Campus
– Park in the back by the Elks
campus
• Good Samaritan Campus
– Bottom two floors of the
parking garage
• Take the elevator to the 6th
level and enter the building at
the Family Birth Center (FBC)
• Follow the hallway on the
right to the cafeteria on the
first floor
– Park in the Bronze Fair
parking lot and take the shuttle
• Shuttle will drop you off at the
main lobby near Starbucks
• Shuttle stops running in early
evening
– Check the schedule prior to
an evening shift
Please Print and Sign!
• Please print out each of the following two documents,
read then sign and give them to your instructor to submit.
– Needle Stick Policy
– Student/Faculty Intake Form
– Drug Screen Form (all students must have current
drug screen).
– Student Passport (school must sign off).
• Please print out the following document and have your
preceptor or instructor orient you to the department, then
sign and give them to your instructor to submit.
– Department Orientation Checklist
Clinical Scopes of Practice
• Please click on this link and view the clinical
skills approved within specific scopes of
practice at MultiCare
– Scopes of Practice
Welcome to MultiCare
Please be complete the following documents and submit to
your instructor/coordinator to submit.
1. Student/Faculty Intake Form
2. Needle Stick Policy
3. IS Form if Epic or any other IS functions are needed.
4. Department Orientation Checklist
5. Student Passport
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