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2020

Student/Contract Orientation

WELCOME

TO

HIGHLANDS ARH REGIONAL MEDICAL CENTER

This packet contains a number of handouts and pamphlets that will be useful to you and will explain some of the vital information you will need to know while working in or around our facility.

If you have any questions about any information in the packets or you need any assistance, please contact the Education Department at 606-886-7490

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Highlands ARH Regional Medical Center in Prestonsburg, Kentucky joined the Appalachian Regional Healthcare Team August 1, 2019

HIGHLANDS ARH REGIONAL MEDICAL CENTER

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ORIENTATION PACKET

GENERAL INFORMATION

To meet the requirements of DNV, OSHA, and the policy of this organization, we require this information to be given upon employment, for contractual agreements as well as for forensic personnel in association with our facility.

Please review the following information and sign the in-service sheet. If you have any questions, please contact the Education Department at (606) 886-7490.

APPALACHIAN REGIONAL HEALTHCARE MISSION STATEMENT:

To improve health and promote well being of all the people in Central Appalachia in partnership with our communities.

APPALACHIAN REGIONAL HEALTHCARE VISION STATEMENT:

To earn the confidence and trust of the diverse communities we serve by offering healthcare excellence, delivered with compassion in a timely manner.

APPALACHIAN REGIONAL HEALTHCARE VALUES:

The following values guide the organization:

( Patient and Employee Safety

( Compassion, Integrity and Trust

( Excellent Facilities, and

( Clinical and Administrative Quality

CORPORATE COMPLIANCE

Appalachian Regional Healthcare’s mission is to enhance the quality of life of the communities and individuals we serve in Central Appalachia. ARH has established its Corporate Compliance Program and the Code of Conduct, because our ability to achieve our mission is dependent upon the quality and performance of our workforce. The Code of Conduct is intended to promote sound business ethics and provide guidance to all individuals associated with ARH by setting standards of conduct expected throughout the organization

HIPAA/CONFIDENTIALITY

It is the legal and moral obligation of this institution to protect the confidentiality of our patients. As you may know, failure to keep confidential information, confidential can result in legal actions against you.

Photographs taken of wounds, traumatic injury, etc., require written permission of the patient/family, with the exception of court demanded cases such as child/adult/elder abuse, rape, etc. A release form for photography is available upon request from nursing staff.

CONFLICT OF INTEREST

Appalachian Regional Healthcare, Inc. (ARH) strives to avoid activities that give or appear to give a private benefit. This policy also serves to protect the organization from unreported interests in transactions that might place ARH at a disadvantage.

This conflict of interest policy is designed to help trustees, officers and employees of ARH identify situations that present potential conflicts of interest and to provide ARH. with a procedure which, if observed, will allow a transaction to be treated as valid and binding even though a trustee, officer or employee has or may have a conflict of interest with respect to the transaction.

FIRE SAFETY

Fire alarms and extinguishers are located on the walls throughout the facility. Please note their location as you walk through the hospital. We use the RACE method of fire control. Your role at the fire’s point of origin is:

R: Rescue yourself and anyone near the fire

A: Alarm-sound the alarm and alert others to the fire

C: Contain the fire (shut the door, etc.)

E: Extinguish or evacuate

Your role away from the fire’s point of origin is to secure your area, monitor the patients you are seeing, and await for evacuation or “all clear” orders. Evacuation is first horizontal behind a set of fire doors, and then vertically downward if needed.

Our facility uses the PASS method of fire extinguishing. This means:

P: Pull the pin

A: Aim the extinguisher

S: Squeeze the handle

S: Spray at the base of the fire

In the hospital, when there is a fire/fire drill, the admissions clerk will page "Code Red (area of the fire)". This page alerts the staff without frightening the patients/visitors.

An "ALL CLEAR" page indicates the end of the drill or the absence of further hazard.

During construction, you will be updated on any changes to this policy. “Fire System Watch” page means the fire alarms have been disabled due to construction. More frequent safety rounds must be made and any fire must be reported by phone.

Clinics and Home Health use same codes and methods at this time.

DO NOT USE AN ELEVATOR DURING A FIRE/FIRE DRILL; USE ONLY THE STAIRS.

SMOKING - HIGHLANDS ARH IS A NON-SMOKING FACILITY CAMPUS. No one is allowed to smoke in any area of the campus. Disciplinary action will be addressed with violators.

EMERGENCY PREPAREDNESS

The page "Attention the hospital is operating under CODE YELLOW" is the signal for an internal or external disaster. Again the page "All clear” is used to notify staff the disaster/drill is over.

Physicians act under the direction of the Chief of Medical Staff. Courtesy/Consulting physicians and their staff may be asked by the Chief Medical Officer to act in full capacity in the event of a disaster.

In the event of a bomb threat, you would search your immediate area looking for suspicious packages, disturbances in ceiling tiles/furniture, etc. Do not attempt to move an object; just report anything unusual to the command team or bomb squad.

Clinics and Home Health are on standby in the event of a hospital disaster.

EMERGENCY CODES

• Code Blue—Medical Emergency

• Code Red---Fire Emergency or Drill

• Code Green—Psychiatric Security Situation (Aggressive Patient/Visitor)

• Code Pink---Infant/Child Abduction

• Code Black---Bomb Threat

• Code Yellow---Disaster

• Code Gray—Patient Elopement

• Code White—MRI Quench

• Code Orange—Hazardous Chemical Spill

• Code Silver---emergency Security Situation involving a weapon

• Rapid Response---Patient Status Change

• Code STEMI—Patient with possible heart attack

• Stroke Alert—Patient having possible stroke

• Tornado Watch—Weather conditions are favorable for formation of tornado—be alert no action needed

• Tornado Warning---Tornado has been spotted-be alert for instructions for patient evaluation to hallways

SAFETY

A healthcare organization’s culture significantly affects the safety of patients. “Culture” refers to the attitudes of senior leaders that shape staff behavior. The safety culture of an organization is the product of several factors: individual and group values, attitudes, perceptions, competencies, and patterns of behavior. Highlands ARH is committed to promoting a “Culture of Safety.”

Some key safety issues to keep in mind are:

• Scan your environment and look for possible hazards that could cause injury to patients. This particularly important with behavioral health patients. Look for broken glass, blocked hallways, and other hazards. Keep all chemicals or poisonous substances out of reach. Always be aware of and monitor housekeeping, medicine, and other work related equipment and keep it secure.

• Don’t leave small or sharp objects and tools within reach of patients, especially infants, children and the confused.

• Warn patients and visitors of hazards of wet floors, use of water around electricity and other general safety issues.

• Look for other infection control issues, for instance, sharps disposal boxes that are too full, visible blood or body fluids on surfaces and contaminated products in appropriate places.

• Always report problems and safety issues to a staff member and correct them when possible.

• Sharps boxes for needle disposal are located in each patient room. These boxes are also used for razor blades and any other sharps requiring disposal.

• Body mechanics (safe lifting techniques) are reviewed with each employee annually. If you need further instruction on body mechanics, please contact the Education Department.

• Patient as well as Worker safety is of utmost importance. Please look at your environment and be alert for cords stretched across your pathway, wet floors, rugs, and other fall hazards. Report any hazards to maintenance or housekeeping immediately. Notify maintenance for any electrical hazards you may observe.

• Patients are assessed for Fall Risk throughout their hospital stay. Patients are increased fall risk are educated to help reduce risk. Fall risk is communicated to staff by the use of a yellow arm band, yellow non-skid socks and a yellow magnet that is placed outside the patient’s room.

• Two patient identifiers (name and date of birth) are used when identifying a patient for a test or procedure.

RADIATION SAFETY

Avoid X-ray, CT scan and mammography unless you are appropriately draped. Knock before entering a closed door in that department to avoid potential exposure. Stand clear 8 feet or more for portable X-ray unless you are wearing an apron. Do not enter the MRI area unless a MRI staff member is with you and you have completed the screening process.

SECURITY

Some areas of the hospital are by law, secured. The Pharmacy, Emergency Rooms, Medical Records, and all Drug Rooms are locked areas.

MEDICAL EQUIPMENT

Please do not attempt to operate any medical equipment that you are not trained for. If you hear an equipment alarm, get a staff member of that unit to respond to the patient.

Staff members have special training, to use each piece of medical equipment in the hospital.

If equipment that you are using malfunctions, contact maintenance immediately and remove the equipment from the patient care area. A “LOCK OUT/TAG OUT” procedure must be followed to disable the equipment until it can be repaired.

HAZARDOUS COMMUNICATION

There are hazardous chemicals in the workplace. These can be as complicated as cleaning agents, or sterilization agents, or as simple as hydrogen peroxide. These chemicals must be supported with a (M) SDS (Material Safety Data Sheets). These sheets provide information about the chemical makeup, PPE (Personal Protective Equipment) needed while using this chemical, and what measures to take if exposed. Poison Control can be contacted if further information is required.

Do not use any unlabeled cleaning agents, or sprays. This is for your protection and safety. Remember, all employees have the “right to know” about the chemicals with which they work

HAZARDOUS MATERIAL/WASTE

Biohazard waste must be handled in a special manner. Garbage cans with red liners are biohazard cans. Please do not throw regular garbage in these cans. NEVER HANDLE BIOHAZARD BAGS OR ANY TRASH OR LINENS STAINED WITH BODY FLUIDS WITHOUT PROPER ATTIRE.

PHARMACEUTICAL WASTE

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INFECTION CONTROL

An infection is a condition of the body, after a disease-producing microorganism (germ) has invaded it. This infection can be either bacterial or viral. The microorganism then multiplies until the body’s immune system can no longer fight it off.

Here at the hospital, we have a program in place that monitors the spread of these infections. This is called an Infection Control Program.

A chain of events, which go something like this, spreads infections:

1. Microorganism

2. Carrier (person)

3. An escape route from the carrier (such as sneezing)

4. Method of travel (handling a dirty tissue)

5. A route into another person (such as eating without washing hands)

6. Another infected person

The way to control the infection is to break the chain. Therefore, good rules to follow are:

1. Do not come to the hospital to visit when you are sick and encourage others to stay away, also.

2. Observe all signage and instructions if entering and leaving Isolation Rooms. If you have questions, ask a staff member.

3. Wash your hands when entering and leaving a patient room, between patient contact, before and after breaks, before eating, after restroom breaks, and before leaving the hospital

a. Alcohol hand sanitizer stations are located in patient rooms and hallways. They can be used when the hands are not visibly soiled.

b. Handwashing with soap and water is indicated when hands are visually soiled, or when contact with patients with clostridium difficile.

UTILITIES

In case of electrical failure, the hospital is equipped with a generator. The generator will operate the red electrical outlets located in patient rooms and hallways. Please do not prop closed fire doors to the open position.

Oxygen shut-off valves, for emergency shut off during a fire, are located on the Medical/Surgical Units, ICU and ER units. Staff is trained in the use of these valves.

SEXUAL HARASSMENT

ARH will not tolerate sexual harassment of any nature. All employees have been instructed to report harassment and all reports are fully investigated. Investigations are confidential and employees are protected by a non-retaliation policy.

AMERICANS WITH DISABILITIES ACT

ARH follows the lead of the EEOC. Employees will maintain employment as long as they can perform their job duties in a safe, effective manner with reasonable accommodation. The ADA covers those with HIV, as long as job duties do not put others at risk for contracting HIV from the employee.

ETHICAL BEHAVIORAL EXPECTATIONS

Highlands ARH Regional Medical Center places the highest trust in the fundamental honesty and integrity of each employee/volunteer in his/her daily relationships with patients, physicians, volunteers, the public and fellow workers. The community perceives contractual employees/volunteers to be part of our facility and so therefore ARH expects anyone associated with this facility in a contractual capacity to uphold our standards and maintain public trust. The following actions are considered proper causes for disciplinary action, or removal from clinical rotation at our facility. However these acts are not all the reasons the hospital may take disciplinary action, or removal from clinical rotations at our facility:

1. Falsifying employment records or other company records.

2. Violating ARH policies regarding discrimination or harassment.

3. Soliciting or accepting gratuities from vendors or patients.

4. Excessive absenteeism or chronic tardiness.

5. Sleeping while on duty.

6. Unnecessary or unauthorized use of supplies, including but not limited to personal use of supplies.

7. Reporting to work intoxicated or under the influence of alcohol or non-prescribed drugs, or the illegal manufacture, possession, use, sale, distribution, or transportation of drugs or alcohol.

8. Engaging in fighting on ARH premises or injuring another employee, business partner, visitor or patient through either intentional or reckless conduct.

9. Using profane, foul, obscene, insulting, abusive or crude language, inappropriate jokes, racial slurs, sexual comments even if spoken in non-standard English/foreign language.

10. Theft of property from ARH, its business partners, patients or employees.

11. Possession of firearms on ARH premises or while on ARH business.

12. Disregard of safety or security rules. Failure to perform assignments satisfactorily

13. Insubordination.

14. Unauthorized disclosure of confidential information about ARH, its business partners, patients or employees.

15. Misuse of ARH funds.

16. Conviction of a felony, a high misdemeanor or a crime involving moral turpitude, or the commission of acts of moral turpitude, either at or outside the workplace.

17. Damaging or destroying ARH equipment or property, whether intentionally or carelessly.

18. Failure to perform satisfactorily in critical incidents, including but not limited to incidents regarding patient care.

19. Gambling on duty.

20. Disregard of or refusal to comply with ARH Corporate Bylaws, ARH Board of Trustee Policies and Procedures, ARH System Policies and Procedures, ARH Facility Policies and Procedures, practices proper orders and instructions from duly authorized management employees.

21. Unexcused absences or leaving work without authorization.

22. Excessive use of company telephones for personal matters.

Each person should always bear in mind the effect that his/her actions have on patient care. Every action reflects not only upon the individual, but on their employer/school/company they represent, as well.

ABUSE/NEGLECT/EXPLOITATION

Each patient shall be free from abuse, neglect, mistreatment, exploitation and misappropriation of property. Abuse may include: physical harm, pain, mental anguish, verbal abuse, sexual abuse, or involuntary seclusion from any source.

Patient care and treatment shall be monitored by all staff, on an ongoing basis, to assure patients are free from abuse, neglect, or mistreatment. It is the responsibility of all staff to provide a safe environment for the patients. Staff members, volunteers, students, family members and others should be encouraged to report incidents of abuse, or suspected abuse, and should be assured that they will be protected from repercussions. Abuse can be patient to patient, staff to patient, family to patient, visitor to patient, etc.

SECLUSION/RESTRAINTS

Seclusion or restraints shall be utilized only when all other approaches have been tried and failed. In all cases where seclusion or restraints are applied, patients’ rights shall be respected.

Policies and procedures specify time within which an order must be obtained after each use of restraint or seclusion and the maximum time for the use of either intervention. Periodic observation will be completed, including a maximum of time between observations.

CHEST PAIN ACCREDITATION

Highlands ARH is Chest Pain Center accreditated by the American College of Cardiology. It means that Highland ARH is recognized for providing evidence based standards of care to patients who experience chest pain.

Education is provided to our staff, volunteers, students, and community about the importance of Early Heart Attack Care (EHAC). EHAC asks that everyone becomes familiar with signs and symptoms of heart attack so that they can become an active bystander to save a life—even if it’s yours.

Early signs and symptoms include: feeling of fullness, pain that travels down one or both arms; jaw pain, excessive fatigue; anxiety; chest pressure, squeezing aching, or burning; back pain or shortness of breath. Women typically have different symptoms than men. They often delay seeking immediate medical care and are more likely to die. Women may feel completely exhausted, drained, dizzy or nauseous. They may feel upper back pain that travels up into their jaw. They may think their stomach pain is the flue, heartburn, or an ulcer.

What do you do if you encounter someone with these symptoms?

|In Hospital |In Community |

|Cardiac Arrest |Remain calm |

|Call Code Blue, Dial extension “3333” |Have the person lie, or sit down |

|Initiate CPR |Call “911” (provide location, signs/symptoms) |

|Non-Cardiac Arrest Situation |Follow 911 instructions which may include administration of 2 (81|

|Patient |mg) or 1 (325 mg) Aspirin chewed |

|Notify the primary nurse caring for the patient immediately |If Some Collapses |

|Call Rapid Response Team by calling extension “3333” |Call “911” for help |

|Visitor |Perform Hands-Only CPR if needed |

|Stop what you are doing, or find someone to help immediately |Find and deploy and Automatic External Defibrillator (AED) |

|Find a wheelchair and take the person to the Emergency Room | |

STROKE ACCREDIATION

Highlands ARH is affiliated with the Norton Healthcare/UK Healthcare Stroke Care Network. This networks shares information and practices to ensure quality stroke care. Highlands ARH is an Acute Stroke Ready facility which means that we are equipped to evaluate, diagnose, stabilize, treat with thrombolytics (blood thinners) and transfer patients with acute stroke.

Be familiar with signs and symptoms of a stroke and notify a staff member immediately if they are observed. Remember the acronym BEFAST when thinking stroke symptoms.

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VOICING A COMPLAINT

We hope that your experience is positive. We understand, however, if you feel there has been a certain aspect of care observed that could be improved upon. ARH encourages this feedback as we view it as useful in making our hospital better. We encourage you to contact us directly if you have a complaint or concern about services at our facility and its staff. If you have a complaint, please contact the Education Department at (606) 886-7490, or the department supervisor.

You also have the right to contact the state hospital agency of licensing and regulations instead of, or in addition to, using the internal complaint process. In Kentucky, complaints can be made by contacting the Office of Inspector General, Southern Enforcement Branch and asking for the complaint coordinator at (606) 330-2030. Or you may contact DNV online at , or my phone at (866) 523-6842.

POLICIES/PROCEDURES – available upon request

• PARKING – Must follow Highlands ARH employee policy

• COMMUNICATION SYSTEMS (Telephone/Voice mail, Internet, etc.)

• PATIENT RIGHTS – available in the Patient Guest Book

• CELL PHONES

• DRESS CODE

Student Parking

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Students are instructed to park near the Cancer Center, or Helipad denoted (circled on map) on the map above.

Contract staff may park in employee parking located at the rear of the Medical Center, or in the employee parking area near Human Resources.

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ORIENTATION ACKNOWLEDGEMENT FORM

The orientation packet coupled with any verbal orientation received from the Department Supervisor in the department in which your are working or by the Education Coordinator is designed to ensure that each person working within our facility is given necessary information while in association with our facility. This information is provided so personnel will be able to comply with the rules, regulations, and standards of Highlands ARH Regional Medical Center and Appalachian Regional Healthcare, Inc. After reading the information in the orientation packet please complete the acknowledgment and agreement below:

I _____________________________ have read the information in the orientation

(Please Print)

packet. I understand that Highlands ARH Regional Medical Center admits patients with infectious diseases, uses hazardous materials in the prevention, diagnosis, and treatment of diseases. I further understand that special policies and procedures are necessary to maintain the safety of patients, visitors and employees. I agree to comply to the best of my ability with the policies that have been outlined in the packet. I understand that if I have questions or require additional education in any area I am to contact the Education Department at (606) 886-7490 or the Administration Department (606) 886-7602.

HIPAA PRIVACY AND SECURITY

By signing below:

1. I certify that I was trained on HIPAA Privacy and Security.

2. I certify that I under the material and laws

3. I agree that I will abide by and comply with the ARH HIPAA Privacy and Security and Confidentiality policies and procedures.

4. If the content of the HIPAA Privacy and Security, as well as confidentiality is not understood, I agree to contact a manager for guidance.

5. I understand that this form will be maintained.

I acknowledge understanding in all areas listed in this packet.

Signature Company/School Date

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Signature of ARH Representative

For Students Only:

Date of Birth: ________________________ Rotation Location: ____________

Begin Date of Rotation: ________________ End Date of Rotation: _________

Home/Shared/Education/2020 Orientation Packet/2020 Student Contract Orientation Revised 12.2019

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HIGHLANDS ARH REGIONAL

MEDICAL CENTER

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