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THE GERALD P. TURNER DEPARTMENT OF NURSING EXCELLENCE IN NURSING: PASSION FOR PATIENT CARE NURSING STUDENT PLACEMENT HANDBOOK Gerald P. Turner Department of Nursing 600 University Avenue Toronto, Ontario, Canada M5G 1X5 Last Updated: February 2017 1 TABLE OF CONTENTS WELCOME TO THE GERALD P. TURNER DEPARTMENT OF NURSING --------------- 5 NURSING VISION STATEMENT---------------------------------------------------------------------- 6 NURSING PROFESSIONAL PRACTICE MODEL ------------------------------------------------------ 6 CENTRES OF EXCELLENCE --------------------------------------------------------------------------- 7 OUR MAGNET JOURNEY ---------------------------------------------------------------------------- 8 MAGNET RECOGNITION ---------------------------------------------------------------------------- 8 WHY MAGNET RECOGNITION MATTERS ---------------------------------------------------------- 8 WHY MAGNET AT MOUNT SINAI? ---------------------------------------------------------------- 8 WHAT DOES MAGNET MEAN FOR ME? ---------------------------------------------------------- 9 SERVICE WITH HEART -------------------------------------------------------------------- 10 S.T.A.R.T. WITH HEART ------------------------------------------------------------------------- 10 RESPOND WITH H.E.A.R.T----------------------------------------------------------------------- 10 DECLARATION OF PATIENT VALUES -------------------------------------------------------------- 11 GETTING TO MOUNT SINAI --------------------------------------------------------------- 12 INFO MAP AND DIRECTIONS --------------------------------------------------------------------- 12 FREQUENTLY CALLED PHONE NUMBERS -------------------------------------------------------- 13 HOSPITAL FLOOR DIRECTORY -------------------------------------------------------------------- 14 POLICY AND PROCEDURES FOR NURSING STUDENTS ----------------------------- 15 CLINICAL PLACEMENT REQUIREMENTS ------------------------------------------------ 17 CONFIDENTIALITY FORMS ------------------------------------------------------------------------ 17 WSIB FORMS AND INSURANCE ------------------------------------------------------------------ 17 MOUNT SINAI HOSPITAL PHOTO ID ------------------------------------------------------------- 17 MASK FIT TESTING -------------------------------------------------------------------------------- 18 HEALTH & SAFETY CHECKLIST FOR STUDENTS -------------------------------------------------- 18 STUDENT IMMUNIZATION AND SURVEILLANCE POLICY ----------------------------------------- 19 STUDENT GOALS AND OBJECTIVES --------------------------------------------------------------- 20 CLINICAL PLACEMENT EVALUATION ------------------------------------------------------------- 20 DRESS CODE --------------------------------------------------------------------------------------- 20 2 LOCKERS ------------------------------------------------------------------------------------------- 20 ILLNESS REPORTING ------------------------------------------------------------------------------- 20 NURSING STUDENT: ONLINE ELEARNING COURSES--------------------------------------------- 21 HOW TO ACCESS NURSING STUDENT ONLINE ELEARNING COURSES -------- 22 CONFIDENTIALITY AND PRIVACY: GUIDELINES FOR STUDENTS ----------------- 28 BREACH OF PATIENT PRIVACY -------------------------------------------------------------------- 29 ACCEPTABLE USE OF TECHNOLOGY POLICY ------------------------------------------ 31 INAPPROPRIATE USE OF TECHNOLOGY POLICY-------------------------------------------------- 31 ENFORCEMENT OF THE POLICY ------------------------------------------------------------------- 32 WORKPLACE VIOLENCE, HARASSMENT AND DOMESTIC VIOLENCE POLICIES & PROCEDURES ------------------------------------------------------------------------------- 33 PREVENTING INFECTION AT MOUNT SINAI HOSPITAL ---------------------------- 35 HAND HYGIENE------------------------------------------------------------------------------------ 35 ROUTINE PRACTICES ------------------------------------------------------------------------------ 35 ADDITIONAL PRECAUTIONS ---------------------------------------------------------------------- 35 THE MOUNT SINAI HOSPITAL-UNIVERSITY HEALTH NETWORK ANTIMICROBIAL STEWARDSHIP PROGRAM (MSH-UHN ASP) --------------- 38 RISK MANAGEMENT -------------------------------------------------------------------------- 41 GENERAL INFORMATION-------------------------------------------------------------------------- 41 CRITICAL INCIDENTS ------------------------------------------------------------------------------- 41 HUMAN RIGHTS AND HEALTH EQUITY ------------------------------------------------ 42 EMERGENCY CODE AND PREPAREDNESS ---------------------------------------------- 44 EMERGENCY PROCEDURES AT MOUNT SINAI HOSPITAL - 600 UNIVERSITY AVENUE SITE -- 44 3 BEFORE PROVIDING PATIENT CARE----------------------------------------------------- 46 SIDNEY LISWOOD LIBRARY ---------------------------------------------------------------- 47 NURSING CAREERS AT SINAI HEALTH SYSTEM -------------------------------------- 48 EDUCATION ---------------------------------------------------------------------------------------- 48 PRECEPTORSHIP PROGRAM ---------------------------------------------------------------------- 48 SINAI C.A.R.E ------------------------------------------------------------------------------------- 48 TUITION SUPPORT -------------------------------------------------------------------------------- 48 RECRUITMENT AND RETENTION ------------------------------------------------------------------ 49 OPPORTUNITIES FOR EMPLOYMENT ------------------------------------------------------------- 49 FOOD AND OTHER SERVICES -------------------------------------------------------------- 50 FOOD SERVICES ----------------------------------------------------------------------------------- 50 OTHER SERVICES ---------------------------------------------------------------------------------- 50 STUDENT CENTRE----------------------------------------------------------------------------- 51 LEARNING CENTRE FOR STUDENTS --------------------------------------------------------------- 51 RESOURCES ---------------------------------------------------------------------------------------- 51 APPENDICES APPENDIX A: CONFIDENTIALITY AGREEMENT ---------------------------------------------------52 APPENDIX B: HEALTH AND SAFETY CHECKLIST FOR STUDENTS---------------------------------54 4 Gerald P. Turner Department of Nursing 600 University Avenue Toronto, Ontario, Canada M5G 1X5 Welcome to Sinai Health System, Mount Sinai Hospital, Joseph & Wolf Lebovic Health Complex Mount Sinai Hospital, Joseph and Wolf Lebovic Complex; an internationally recognized 442-bed acute care academic health sciences centre affiliated with the University of Toronto, and Canada’s first Magnet designated hospital. In 2015, Mount Sinai amalgamated with Bridgepoint Active Healthcare, and together with Circle of Care and the Lunenfeld Tanenbaum Research Institute, formed Sinai Health System. On behalf of the hospital I would like to welcome you to Mt Sinai. We are very excited that you have chosen to do one of your clinical placements here at our hospital. Every year over 450 nursing students come to Mt Sinai and enjoy a clinical placement at this hospital. As a leading academic health science centre we are incredibly committed to ensuring that you have the most meaningful and transformative clinical experience that you can, one that will really ensure that you are well positioned to be the best you can be as you start your nursing career. You will gain valuable experience working with our nursing staff and collaborating with your interprofessional team. Here you are considered part of our team and our staff work very closely with your faculty to help you develop the professional knowledge, skills, and decision making that is appropriate to deliver the highest quality of patient care. We believe that through this clinical placement you will come to deepen your understanding in the pivotal role that nurses play in the delivery of healthcare, leadership, education, and research. I wish you all the best and I hope that you have an enriching and valuable experience here at Mt Sinai Hospital. I wish you all the best and hope that you will enjoy and value your time here at Mount Sinai Hospital. Sincerely, Nathalie Peladeau Director, Nursing Practice 5 Nursing Vision Statement Patients and families experience the best nursing care in a compassionate, supportive, interdisciplinary environment that embraces and advances professional nursing practice, education, leadership, and research. Nursing Professional Practice Model A professional practice model serves as a foundation for Nursing Excellence. Professional nursing practice is vital to the delivery of safe, quality patient care, and is integral to putting patients first. Our nursing professional practice model depicts how nurses enact their professional role. 6 Centres of Excellence Women and Infant Health Programs Urgent Critical Care Programs Surgical Programs Frances Bloomberg Centre for Women’s and Infant Health Daryl A. Katz Centre For Urgent and Critical Care Christopher Sharp Centre for Oncology Mom & Baby Unit Labour & Delivery Antenatal Inpatient NICU Neonatal Follow Up Clinic Obstetrical Day Unit Post Natal Ambulatory Clinic Special Pregnancy Program (Fetal) Special Pregnancy Program (Maternal) Urodynamics Women’s Unit Center for Fertility and Reproductive Health Marvelle Koffler Breast Centre Intensive Care Unit 10N & 10S Medicine Cardiology Unit Coronary Care Unit 12 S General Medicine Inpatient Psychiatry Psychiatry Day Treatment Psychiatry HIV Clinic Emergency Department Centre for Musculoskeletal Disease Centre for Inflammatory Bowel Disease 11North 11South 14N/Surgical Step Down 14 South 12 North Oncology PAU (Preadmission Unit) EOPS (Elective Outpatient Services) OR (Operating Room) SDA (Same Day Admission) PACU (Post Anesthetic Care Unit) Endoscopy 7 Our Magnet Journey Magnet Recognition Magnet is a voluntary recognition process for nursing excellence conducted by the American Nurses’ Credentialing Centre (ANCC). Magnet recognizes the quality of nursing programs within health-care organizations and demonstrates the importance and worth of nurses to the overall success of an organization. Magnet status is one of the highest achievements a hospital can attain. To date, there is not a single organization in Canada that is recognized as a Magnet institution. Mount Sinai Hospital was named the first hospital in Canada to achieve Magnet® recognition, on January 14th by The American Nurses Credentialing Center (ANCC). Why Magnet Recognition Matters Magnet-designated organizations report having a competitive advantage, which includes: outperforming their peers in recruiting and retaining nurses lower burnout rates and higher levels of nurse job satisfaction and commitment maintaining collaborative work environments with collegial interprofessional relationships possessing core values such as empowerment, pride, mentoring, respect, integrity, and teamwork Why Magnet at Mount Sinai? By engaging in the Magnet recognition process we are committing to our staff and to the community that our highest priorities are providing quality patient care and a positive practice environment for staff. Magnet will help elevate standards in practice, enhance the work environment, and improve patient outcomes. It will allow the nurses’ voice to be heard at the unit-level and at all other levels of the organization through nurse participation and engagement. Magnet is a vehicle for developing and implementing nursing-based initiatives and strategies within our own organization and also within health care organizations nation-wide. Magnet is an opportunity for Mount Sinai to celebrate Nursing and its contribution to putting patients first and delivering quality patient care. 8 What Does Magnet Mean for Me? Magnet involves nursing staff participation in decision-making, input into work environment change, and a commitment to and focus on quality patient care. As a nurse at Mount Sinai Hospital, Magnet means having the opportunity to share your thoughts and ideas about nursing and patient care across the organization. It allows you to identify challenges in the work environment and allows you to develop strategies and solutions to enhance your practice, the workplace, and the care you provide; this includes: i. involvement in Unit Nursing Practice Councils and organizational committees ii. developing and implementing unit-based strategies to enhance patient care iii. being a MAGNET champion iv. involvement in evidence-based practice and research initiatives at the unit level For more information visit the Magnet site: http://info2/departments/nursing/magnet/magnetrecognition. 9 SERVICE WITH HEART Service with HEART is a mandatory hospital-wide service excellence program to strengthen our patient-centred approach to care. The program is based on a successful training program developed by the Cleveland Clinic. Mount Sinai Hospital’s Office of Patient Experience and Outcomes in partnership with our Organizational Development Department have customized the training for our Hospital. The Service with HEART program consists of two components: S.T.A.R.T with Heart and Respond with H.E.A.R.T. S.T.A.R.T. with Heart S.T.A.R.T. with Heart is an upfront service and care program. It reinforces the expected behaviours which Mount Sinai has identified as behaviours that lead to the best experiences for patients, visitors, and each other - every day, every time Smile and greet warmly Tell your name and role Active listening & assist Relationship & rapport Thank the person Respond with H.E.A.R.T Respond with H.E.A.R.T. is a tool most often used for service recovery. What is service recovery? Service recovery is “making right what went wrong.” The reason we would like to have a service recovery model is because it: • is the right thing to do • makes your job easier • affects our reputation Respond with HEART: Hear the Story Empathize Apologize Respond Thank 10 Declaration of Patient Values The Declaration of Patient Values was developed in 2010 in accordance with the Excellent Care for All Act. The declaration is a set of commitments that our organization promises to honour when delivering services and caring for our patients. The document also outlines the kind of service that our patients and their families can expect to receive at Mount Sinai Hospital. Through the Service with HEART program, we can all learn new ways to live the declaration and ensure that our patients are satisfied with their experience at Mount Sinai. 11 GETTING TO MOUNT SINAI Info Map and Directions Mount Sinai Hospital is located in downtown Toronto just south of College Street and University Avenue. Our clinics and departments are located in 3 separate sites within the block. Take the Spadina-University subway line to Queen's Park Station (College Street). Or take the College / Carlton streetcar to University Avenue. The Hospital is south of College Street on the west side, at 600 University Avenue. By Train Take VIA Rail or GO Transit to Union Station. You can then walk up University Avenue (about 25 minutes at casual pace) or take the subway from Union Station north to Queen's Park Station. Parking Parking garages owned and operated by independent contractors are located across from the hospital on Murray Street. The icon represents parking close to the Hospital in the map to the right. Alternate parking options include meters on McCaul Street, one block west of Murray, and several lots close to the Hospital: McCaul St., above ground lots between Baldwin and College 525 University Avenue, at University and Elm 393 University Avenue, entrance at 30 Centre St. Bay and Gerrard, above ground lot Sick Kids Hospital, underground lot off Elm Street between University and Elizabeth Toronto General Hospital, Gerrard Street and Elizabeth Street lots 12 Frequently Called Phone Numbers If you are calling a patient from outside the Hospital, please dial 416-586-4800 and the extension you wish to reach. Some frequently called numbers are listed below. Main Hospital Telephone Number 416-586-4800 Department Extension Emergency Department 5054 Patient Inquiry Line 8300 Information/Main Switchboard “0” Human Resources 5040 Lost and Found 5056 13 Hospital Floor Directory 14 POLICY AND PROCEDURES FOR NURSING STUDENTS The instructor and students will follow the Hospital's Standards policy and procedures when providing nursing care. Preceptor/Instructor, NUA, and student(s) are encouraged to utilize the following College of Nurses of Ontario (CNO) documents to support decisions regarding scope of student practice: • Practice Guideline - Supporting Learners • Reference Document - Legislation and Regulation RHPA: Scope of Practice, Controlled Acts Model Safety measures regarding the administration of medications by nursing students are to be followed: The narcotic key will not be given to the student. The instructor may carry the key. The instructor or a Registered Nurse will accompany the students when narcotics are being administered. Narcotic sheet transcription must be checked by RN/instructor and co-signed by the same. Students will not take verbal orders. Any required calculation for fractional dosage is to be checked by the instructor or a Registered Nurse. All medications including IV medications are to be administered according to hospital policy. The Nursing Unit Administrator may restrict the performance of any given procedure to unit staff only. The preceptor/instructor will determine the scope of the pre-graduate and clinical experience in collaboration with the Nursing Unit Administrator. Unsafe performance is the display by a student caring for a patient with: i) a lack of knowledge, skill, and judgment, or ii) disregard for the welfare of the patient, of a nature, or to an extent which indicates that the student is unfit to continue1 in a clinical area. 15 In the event that a NUA and/or preceptor are concerned about the performance of a student the following levels of intervention are provided as guidelines only. The nature and seriousness of the issue will determine the level of intervention implemented. Level One: The preceptor and/or NUA will identify the unsafe performance and discuss the issue with the student. Level Two: The preceptor and/or NUA will notify the clinical instructor of concerns. Level Three: A meeting of the student, clinical instructor, and preceptor will be held. Level Four: The Chair of the Nursing Program will be informed, at which time the educational institution will guide the process. 16 CLINICAL PLACEMENT REQUIREMENTS There are several required items that must be completed in order for nursing students to fulfill their clinical placement hours. All affiliated schools requesting Nursing student clinical placements at Sinai Health System, are aware of the requirements. Please approach your school if you have questions. Confidentiality Forms All students are required to sign a confidentiality form prior to commencing placement (See Appendix A). Forms have also been provided to school program coordinators. Completed forms are to be returned Nursing Administration, Rm 19- 219. WSIB Forms and Insurance The University shall manage claims that may arise. The University will ensure that WSIB and Insurance documents are provided to the hospital at the commencement of the students’ placement. School program coordinators are to complete necessary documents and return to Nursing Administration prior to student placements in order to ensure clinical hours are not jeopardized. Mount Sinai Hospital Photo ID All students and clinical instructors are required to wear Mount Sinai Hospital Photo ID while on placement at Mount Sinai Hospital. Photo ID can be obtained on the first day of your placement in the Human Resources Department located on the Main floor Room 301 during the following days and hours: Monday 08:30 –16:30 Tuesday and Thursday 08:30 – 10:30 and 14:00 – 16:00 Wednesday and Friday 08:30 – 10:30 and 14:00 – 16:00 PHONE NUMBER: Extension 5040 17 NEW Clinical Instructors of Nursing Student Groups MUST contact Human Resources to schedule an appointment for ID photos. Nursing students that are NOT part of a group, can visit HR during open hours to obtain their ID. Mask Fit Testing All students are required to have a valid Fit Test Card prior to starting placement. This is arranged by your school. Health & Safety Checklist for Students Mount Sinai Hospital is committed to providing a safe environment for all staff, patients, students and visitors. We have a number of responsibilities under the Occupational Health and Safety Act. This includes taking every “precaution reasonable” to protect the health and safety of our students. A Health & Safety Checklist for Students (see Appendix B) has been designed to assist preceptors in providing a unit-specific health and safety orientation to new students. It is important to complete all portions of the checklist as soon as possible as a health and safety emergency could arise at any time and it is essential that a student knows what to do. Preceptors/clinical instructors use this checklist to guide the discussion during the student’s first day on the unit. A copy of the completed checklist MUST be given to the unit Nurse Clinician or Clinical Nurse Specialist, and will be sent to the Occupational Health, Wellness and Safety Department for record keeping. 18 Student Immunization and Surveillance Policy All students must comply with the Mount Sinai Hospital Immunization & Surveillance Policy. All students coming into Mount Sinai Hospital are required to comply with the Mount Sinai Hospital Immunization & Surveillance Policy, which is based upon the OMA/OHA Communicable Disease Surveillance Protocols for Ontario Hospitals. Documentary proof of current immunization against specific communicable diseases must be submitted to and maintained by the Student Health Program at the respective college or university in advance of the student placement at Mount Sinai Hospital. Students must provide documentation of tuberculosis screening, as well as proof of immunity to measles, mumps, rubella, and varicella (chickenpox). Hepatitis B, Tetanus, Diptheria, Pertussis and Influenza immunization status must also be documented. Any exceptions to this policy must be approved in writing by the MSH Director of Occupational Health, Wellness and Safety and the Director of Infection Control following the completion of a risk assessment. Tuberculosis: Students must have an initial baseline two-step Mantoux TB skin test in their medical history. An annual (one-step) TB skin test is required thereafter if the results are negative. If a student has a documented positive TB skin test, a chest x-ray is required. For students who have previously been assessed for a positive TB skin test and have a documented CXR on file, there is no need to repeat the CXR on an annual basis unless clinically indicated. Measles - Either one of the following is acceptable: Documentation of receipt of 2 doses of live measles virus vaccine (or trivalent measles-mumps-rubella [MMR] vaccine) on or after the first birthday, with doses given at least four weeks apart, OR Laboratory evidence of immunity (positive titre results). Mumps - Either one of the following is acceptable: Documentation of receipt of 2 doses of live mumps virus vaccine (or trivalent measles-mumps-rubella [MMR] vaccine) on or after the first birthday, with doses given at least four weeks apart, OR Laboratory evidence of immunity (positive titre results). Rubella - Either one of the following is acceptable: Documentation of receipt of 1 dose of virus vaccine (or trivalent measles-mumps-rubella [MMR] vaccine) on or after the first birthday. OR Laboratory evidence of immunity (positive titre results). Varicella (Chickenpox) – Either one of the following is acceptable: Documentation of receipt of 2 doses of chickenpox vaccine, given at least 4 weeks apart, OR Laboratory evidence of immunity (positive titre results). Hepatitis B Vaccine - Highly recommended for any student who might have any contact with human blood or body fluids, or items contaminated with human blood or body fluids. All students must notify their Student Health program of their immune status (e.g. their hepatitis B surface antibody titre so that, if an exposure occurs, protective action can be taken promptly). Tetanus/Diphtheria/Pertussis - Students who have not received a dose of pertussis vaccine as an adult should receive one dose of Tdap (Tetanus/diphtheria/pertussis vaccine for adults) prior to working in the hospital. Subsequently, Tetanus/Diphtheria Vaccine (Td) should be received every 10 years. All students must inform their Student Health program of their vaccination status. Influenza Vaccine - Offered by Mount Sinai Hospital during influenza season and highly recommended for all students annually. If you cannot receive the influenza vaccination you must wear a surgical mask in all patient care areas during influenza season as per the MSH Prevention and Management of Influenza Policy. 19 Student Goals and Objectives All preceptored students are expected to develop written goals and objectives for their placement experience to share with their preceptor. Clinical Placement Evaluation All students are expected to complete a Student Evaluation of Clinical Placement form at the end of the placement experience. Forms are available online. Dress Code The standard uniforms for students are clean scrubs, appropriate footwear, and Mount Sinai Hospital photo ID. As some units have more specific dress requirements, please ask the unit contact person about the dress code for the unit. Lockers Students are provided with lockers at no charge and all personal equipment is to be left in the locker. Personal belongings are to be removed at the end of the placement and anything left in the locker will be discarded. Female lockers and location are available through Human Resource: Main floor, Room 301. Male students should contact Nursing Administration, 19- 219 for information. Illness Reporting Students are required to notify their preceptor if they will be absent for any reason. Students are not come to MSH if they have any infectious illnesses with symptoms including nausea with diarrhea or vomiting, runny nose, scratchy or sore throat, cough, pink eye, swollen/tender lymph glands, rash or fever. If the student is sick with a potentially infectious illness and was working in a clinical area within the past 48 hours, students must also contact the hospital’s SICK reporting line (416-586-4800 ext. 7425) to report to Occupational Health (OH). The sick reporting line is used to help identify outbreaks and prevent transmission of infections. OH will only follow-up as required if investigating a potential outbreak. 20 Nursing Student: Online eLearning Courses All students must complete required courses that will support their placement at the hospital. Students must complete: 1) Mount Sinai Hospital Nursing Student eLearning modules To access these eLearning modules, your school has been given the enrollment key, password and instructions for the Mount Sinai Hospital Learning Management System. You can access the Mount Sinai Hospital Learning Management System here: https://mountsinai.myabsorb.ca if you have any issues or questions please contact [email protected] Instructions for accessing the Learning Management System is on page 22. 2) Mount Sinai Hospital Systems Education Training Schools are responsible for arranging systems education training. Please contact your school coordinator for the date and time of your prescheduled session. NOTE: All online video modules must be completed prior to coming to the hospital for the in class sceanrios. 21 HOW TO ACCESS NURSING STUDENT ONLINE ELEARNING COURSES Before you are granted access to the computer systems at Mount Sinai Hospital you will need to complete a series of courses related to Mount Sinai Hospital policies, clinical standards and use of the PowerChart Electronic Patient Record (EPR). These courses consist of a series of comprehensive online eLearning videos followed by in-class “day in the life” scenario exercises. Please follow steps 1 and 2 outlined below. Step # 1: Complete all online eLearning modules Online eLearning courses can be accessed via the Mount Sinai Hospital Learning Management System (LMS). 1. Log in to the Learning Management System using the following website: mountsinai.myabsorb.ca 2. Click Sign Up 3. Enter your Enrollment Key (Key ID). Your department administrator will provide you with a key. 22 4. Click Sign Up 5. Complete ALL of the required Sign Up fields 6. Click Sign Up 7. The message below will be in your email. Click on the link in your message. The Sinai Health SystemsSinai Health Systems LMS will automatically launch. 23 8. If you have previously had a rotation at Mount Sinai Hospital you will see the screen below letting you know that your Username already exists. In this case, you can now use the Login just to the right. If you have forgotten your password, click the “Forgot Password?” link. When you see this screen, just click Close, any new courses that require completion will have been successfully added to your My Courses. 9. To access your mandatory eLearning modules click My Courses 24 10.Completed courses will have a check mark. Courses that are in progress will have a red arrow icon. 11. Click the Launch button to start a course. Completed Course Click Launch to start the course Course in progress Click here to change the view on this screen. You can view courses by list or by folders. SEARCH FOR SPECIFIC COURSE 12. To find a specific course, click on the Sinai Health System logo to go back to the main dashboard 13. Click on Catalog to search for a specific course 25 14. In the Search Catalog field, type the name of the course you are looking for and click on the magnifying glass. 15. Otherwise, click on the list icon to view a list of courses in the Catalog main folders. VIEW TRANSCRIPT 16. To view your complete transcript click Transcript 17. You can see at a glance which courses you have Completed, are In Progress or are Not Started. This list will include any courses that you may have taken during previous rotations at Mount Sinai Hospital. To print your transcript, click Print Transcript 26 Step # 2: Complete the in-class scenario exercise The in-class scenarios allow you to practice some of the skills you have developed after completing the online eLearning videos. Each scenario was designed in conjunction with practicing clinicians to ensure they mirror clinical practice on the unit. Sessions are held in the main Mount Sinai Hospital building, 11th floor, room 11-207. Follow the yellow arrows on the wall to arrive at the classroom. The classroom is open for drop in sessions during the following hours (no appointment required). DAY Monday Tuesday Wednesday Thursday Friday Saturday Sunday HOURS 9-12 & 1-3 Closed Closed 9-12 & 1-3 9-12 Closed Closed In-class scenarios will take approximately 90 minutes to complete. Following the in-class scenario you will receive your login information. 27 CONFIDENTIALITY AND PRIVACY: GUIDELINES FOR STUDENTS Confidentiality and Privacy: Guidelines for Students On November 1 2004, the Personal Health Information Protection Act, 2004 came into force. This Act provides, among other things, rules governing the collection, use, and disclosure of patient health information. As a student learning at Mount Sinai Hospital, you are considered an “agent” of Mount Sinai Hospital under the Act. As an “agent”, the Act provides some rules that you must follow. These guidelines provide more detailed advice as to how to meet your privacy obligations than the Confidentiality Agreement that you signed when you first joined the hospital. As a student, you may be asked to collect and use patient health information. If the nature of the assistance you are providing involves collecting, accessing, or disclosing health information, apply the “need to know” rule. Only collect, access, use, and disclose as much information as you need to in order to be able to perform the task. Never discuss outside of the hospital any patient information you learn at the hospital. Even at the hospital ensure that those with whom you are sharing need to know the information. If you are ever concerned that the nature of the activity you are being asked to perform may breach one of the privacy “rules”, ask your supervising clinician about how the patient’s privacy is being respected or contact the Corporate Privacy Officer. If any non-Mount Sinai Hospital personnel request information about a patient, check with your supervising clinician prior to disclosing any information. If you are provided with access to any application containing patient health information, like PowerChart (the Mount Sinai Hospital electronic patient record), ensure that you never share your password with anyone. Always log out of the application prior to walking away from the computer and keep in mind that your access to electronically stored patient health information may be audited. Do not leave the Mount Sinai Hospital paper health record unattended. This prohibition includes never leaving the record alone with the patient. If a patient wants access to his/her health record, contact the primary care giver to arrange a time when the patient can access the record with a care giver knowledgeable about that patient’s care plan. If a patient asks you for information or has a complaint related to accessing or correcting health information or about how his/her health information has been collected, used, or disclosed, refer them to his/her primary caregiver, the Privacy: A Guide for Patients brochure, and/or the Corporate Privacy Officer. When you are finished with a paper document containing health information that does not belong in the patient’s health record, always place it in one of the “shred-it” bins, don’t place it in a recycling bin. For other media, refer to the “Secure Disposal of Health Information” policy. 28 Breach of Patient Privacy 1. Breach of privacy includes any intentional or inadvertent unauthorized access, use, or disclosure of confidential information and any inappropriate disposal of confidential information. Common examples of breaches of confidentiality include, but are not limited to: the misplacement of a patient record a laptop with confidential information stored on it is stolen a letter addressed to one person is faxed to the wrong number accessing personal health information of family members or friends without authorization documents containing patient health information are left in a public area disclosure of patient information to a police officer without the patient’s consent, a warrant, or a summons 2. It is not a breach of privacy to report patient information in a research study as long as the information is unidentifiable or the patient’s consent or Research Ethics Board approval for the study has been obtained in advance. 3. While every effort will be made to maintain patient confidentiality, the hospital recognizes that in practice, reasonable limits may be placed on the principle of patient confidentiality. Sometimes the provision of quality care or education requires that confidential information be discussed among health care providers in patient care areas where other patients or visitors may be present (i.e. nonprivate rooms, hallways in busy units where patients are being treated, and outpatient clinics). Nevertheless, careful consideration should always be given to how to minimize the compromise to patient privacy in these circumstances. 4. The following steps should be followed in the event a breach occurs: Inform your manager/supervisor and the Corporate Privacy Officer. Identify the extent of the breach i.e. if the breach involves unauthorized disclosure of personal health information, determine what information was inappropriately disclosed, to whom the information relates, and to whom it was disclosed. Take steps to contain the breach i.e. if the breach involves unauthorized access to confidential information stored electronically, take steps to suspend the sign-on facilitating the inappropriate access to the network or application. Ensure that any person not authorized to receive the confidential information did not make or keep copies of the information and get that person’s contact information in case you need to follow up. Note the unauthorized uses and disclosures in or linked to the affected confidential records. If necessary, investigate to determine the cause of the breach. 5. It is the obligation of the Hospital and the care providers involved in any breach to notify the people whose privacy has been breached. People whose privacy has been breached should be told specifically what and how much confidential information was affected and what immediate and long-term steps the hospital and others have taken to rectify the breach. The involved care providers should work with the Corporate Privacy Officer to discharge this obligation. 29 6. Every person working at the hospital has the right and responsibility to report a breach of privacy without fear of reprisal for doing so. Breaches of privacy can be reported to a manager, supervisor, or directly to the Corporate Privacy Officer. 7. Individuals who fail to comply with any part of this policy may be subject to discipline up to and including dismissal or, in the case of medical staff, immediate loss of all hospital privileges. 30 ACCEPTABLE USE OF TECHNOLOGY POLICY Acceptable use of IT resources includes, but is not limited to the following responsibilities: Individuals with Computer IDs must protect the confidentiality of their User ID and password. Confidential information that is in an electronic format should only be stored in secure file shares or a secure technical facility as defined by the Informatics Department. Information not stored in an appropriate manner will be deleted. Use only User IDs or accounts and IT resources which you are authorized to use, and use them for the purposes for which they were intended. Respect the integrity of IT resources and data i.e. do not damage or alter the software of a computer or computing system. Respect and adhere to all local, provincial, or federal law which may govern use of IT resources in Canada. These include, but are not limited to the Criminal Code of Canada and the Ontario Personal Health Information Protection Act. Inappropriate Use of Technology Policy The following categories of use are inappropriate and prohibited: Use that impedes, interferes with, impairs, or otherwise causes harm to IT resources generally or to the activities of others. Use of IT resources in a way that suggests hospital endorsement of any political candidate or party. Use damaging the integrity of the hospital or other IT resources. This category includes, but is not limited to, the following: o o o o o o o o o attempts to defeat system security unauthorized access or use disguised use which includes access to the hospital information system with a User ID other than one’s own User ID, without specific prior authorization from the Informatics Department distributing computer viruses modification or removal of data or equipment without specific authorization use of unauthorized devices commercial use of IT resources for business purposes unrelated to the Hospital use for unethical or malicious purposes use in violation of Hospital contracts and/or external data network policies Certain activities are considered inappropriate use of IT resources. To protect the integrity of the hospital information resources users must NOT: download material from non-trusted internet sites install software on PCs without informing the Informatics Department 31 bring hardware into the hospital that will access the hospital network or be used in conjunction with confidential information without informing the Informatics Department prior to the arrival of such equipment into the hospital, hardware includes, but is not limited to: wireless devices, handheld devices (i.e., Palm Pilots, IPAQ, etc.) network routing devices, and modems move computers and related equipment; moves must be arranged by calling the helpdesk (4357) Enforcement of the Policy MSH has the authority and obligation to monitor, audit, and investigate all technology usage including but not limited to: Patient/Client Chart Access Email Usage Internet Usage Activities in all Applications MSH staff must report inappropriate materials on computers and inappropriate use of technology facilities to the Helpdesk (4357). Unauthorized individuals accessing technology facilities must be reported to MSH Security (5056) immediately. A breach of this policy will be just cause for disciplinary action up to and including termination of employment or affiliation with MSH. If you have any questions or comments, please contact your clinical instructor / education coordinator. 32 WORKPLACE VIOLENCE, HARASSMENT AND DOMESTIC VIOLENCE POLICIES & PROCEDURES Mount Sinai Hospital does not tolerate any type of violence or harassment, either within the workplace or at work-related activities. All employees and students are required to know about the following policies: Workplace Violence Prevention Policy Diversity & Human Rights Policy which includes workplace harassment Domestic Violence Policy Policies can be accessed on the MSH Intranet site. The policies contain: Definitions of workplace violence, harassment and domestic violence & incident reporting procedures Describes the supports available for employees and students Outlines consequences for violent and harassing behaviours Protections under the policies for confidentiality and no reprisals Students should also review: Prevention of BBP exposure and Blood Borne Pathogen Exposure Protocol which can be found on the MSH Intranet site. Definitions: Workplace Violence: “Exercise, attempt, or threat of physical force by a person (statement or behaviour) against a worker in a workplace that causes or could cause physical injury to the worker”. Sources for violence could include: patients, clients, coworkers, former employees, strangers, general public, and domestic violence. Harassment: “Engaging in a course of vexatious comment or conduct against a worker in a workplace that is known or ought reasonably to be known to be unwelcome.” Examples include: demeaning remarks/jokes/taunts/racial slurs, sexually suggestive behaviour, insults, practical jokes, bullying, exclusion, and disruptive behaviour (yelling/swearing). Domestic Violence: Threatening or extremely coercive behaviour perpetrated by one partner in a current or formerly intimate relationship. This includes physical, sexual, emotional, psychological, and financial abuse. 33 What to do if you experience workplace violence, harassment or domestic violence? Workplace Violence, Harassment, and Domestic Violence training is required for all new students and is available through eLearning in the Mount Sinai Hospital LMS. 34 PREVENTING INFECTION AT MOUNT SINAI HOSPITAL Mount Sinai Hospital has developed an Infection Control Program which prevents infection in patients and staff. Our goal is to maintain a safe environment for everyone. For all questions or concerns please page us through locating at ext. 5133. Hand Hygiene Consistent hand hygiene is the most important measure to protect your and your patients from infection. Alcohol hand rub is more effective than soap and water, as long as hands are not visibly dirty. Hands should be cleaned: before contact with any patient or their environment before any aseptic procedure after contact where there has been the potential for blood/body fluid exposure after contact with the patient or their environment Routine Practices Routine practices are the standard at MSH to protect staff and patients from transmission of infection. Routine practices requires all health care workers to consider all body substances (blood, body fluids, secretions, excretions, drainage) from all patients as potentially infectious. Routine practices mandate that, in addition to hand hygiene: Use protective equipment measures based on the procedure being performed and the level of risk involved. Gloves should be worn when there is a risk of contact of your hands with mucous membranes, non-intact skin, moist body substances, and undiagnosed rashes. Gowns, masks, and/or face shields should be worn if you are at risk of being splashed with moist body substances, or exposed to respiratory droplets (e.g. during suctioning, intubation, or bronchoscopy) Additional Precautions Tb: All patients with risk factors for TB (lived in an endemic area for TB, hemoptysis, night sweats, exposure to TB etc.) must be placed in airborne precautions until this diagnosis can be ruled out. Significant Travel: Patients with a recent travel history to high risk countries(Cambodia, China, Egypt, Indonesia, Thailand, Vietnam, Iran, Iraq, Turkey, Saudi Arabia, Israel, Yemen, Syria, United Arab Emirates, Jordan, Lebanon, Palestinian Territories, Oman, Kuwait, Bahrain and Cyprus) must be placed in airborne/droplet/contact precautions while the Nasopharyngeal (NP) swab is being processed. Influenza: All patients with respiratory symptoms during flu-season must be placed in droplet/contact precautions. Precautions may be discontinued once NP swab negative. No additional precautions needed once flu season is over. Antibiotic Resistant Organisms (AROs): Adherence to additional precautions prevents the transmission of organisms such as MRSA, VRE, C-Diff, and ESBL. Precaution signs are used to remind staff and visitors of the precautions needed before entering the patient’s 35 environment. Please follow the instructions posted to maintain a safe environment for patients as well as other staff members. The table below contains information about the patients who most often require additional precautions at MSH, and what different constitutes different types of precautions. Precautions Patients who most often need these precautions Room Protective equipment for room entry Airborne Patients who may have pulmonary tuberculosis may be patients with: Private, negative pressure, door closed Fit-tested N95 respirator (perform seal check) pneumonia and risk factors for TB o exposure to a patient with TB in the past o lived in a TB endemic area ; Africa, SE Asia, India, Eastern Europe o concomitant HIV infection known prior TB evidence of old granulomatous disease on CXR, weight loss, night sweats, hemoptysis failure to respond to antibacterial therapy. Chickenpox/Measles Patients suspected of having Private, chickenpox, disseminated zoster, negative measles pressure, door closed Droplet-contact Patients with respiratory symptoms during flu-season , meningitis, Group A streptococcus or pneumonia Airborne/droplet/con Patients with febrile respiratory tact illness and a significant travel history ie Cambodia, China, Egypt, Indonesia, Thailand, Vietnam, Iran, Iraq, Turkey, Saudi Arabia, Israel, Yemen, Private Not required, but susceptible staff may not enter room Face shield Gloves Gown Private, negative pressure, door closed Fit-tested N95 respirator (perform seal check) Gown Gloves 36 MRSA VRE/C. difficile Syria, United Arab Emirates, Jordan, Lebanon, Palestinian Territories, Oman, Kuwait, Bahrain and Cyprus Face shield Private Patients colonized or infected with MRSA; Roommates who have been exposed to someone with MRSA; Patients who have been admitted to US hospitals in last 2 year Surgical mask Patients with known or suspected Private C. difficile, patients colonized or infected with VRE; Roommates who have been exposed to someone with VRE; patients who have been admitted to US hospitals in last 2 yrs Page Infection control Gloves Gown Gown Gloves Cleaning of portable equipment (eg. stethoscope) 37 THE MOUNT SINAI HOSPITAL-UNIVERSITY HEALTH NETWORK ANTIMICROBIAL STEWARDSHIP PROGRAM (MSH-UHN ASP) The Mount Sinai Hospital-University Health Network Antimicrobial Stewardship Program (MSH-UHN ASP) is a multidisciplinary and collaborative program which has been in existence since 2009. The MSH-UHN ASP has the primary objective of “Getting patients the right antibiotics when they need them and only when they need them”. The program uses an innovative, evidence-informed approach to research, education, and clinical practice to improve the local, provincial, national, and international use of antimicrobials. Clostridium difficile infection (CDI) is a significant patient safety concern in our institutions. In response, the ASP collaborated with multiple stakeholders across MSH & UHN to standardize care related to the diagnosis and management of patients with CDI. The MSH-UHN CDI Management Algorithm was launched in November 2014 after extensive consultation with interdisciplinary stakeholders, including primary care nurses and nursing leadership. The CDI algorithm eLearning module was developed to assist clinicians and can be accessed through the Mount Sinai Hospital Learning Management System. Nurses play a pivotal role in the optimal management of patients with CDI and completing the eLearning module and self-assessment tool supports providing optimal care for these patients. What role do RNs have in the algorithm? One of the main goals of the algorithm is to empower RNs or Patient Care Coordinators to oversee the algorithm in practice and offer guidance in some important aspects of clinical decision making. In following the algorithm, RNs or Patient Care Coordinators will be able to continue to assess and re-assess the patient when appropriate and ensure that all clinicians involved in the care of the patient are continually engaged. 38 First Episode Clostridium Difficile Infection (CDI) Management Algorithm 39 40 RISK MANAGEMENT General Information Office Hours: Monday to Friday, 8:00 am to 4:00 pm Risk Manager: Kimberlee Parker Telephone: (416) 586-4800, extension 2885 Email: [email protected] The mandate of the risk management team is to identify risk to the hospital and its patients, visitors, and staff, analyze it, reduce it, and prevent it. Some of the tools used to achieve this mandate are safety reporting and trending, risk reduction strategies, emergency response procedures, and risk prevention activities. The Risk Manager is responsible for responding to both internal and external crises to ensure the safety of the Mount Sinai Hospital community. One of the most important functions of the Risk Manager is the management and investigation of Critical Incidents. Critical Incidents A critical incident is defined as an incident involving a serious, undesirable, and unexpected outcome or event which involves actual or potential loss of life, limb, or function for the patient that does not result primarily from the patients’ underlying medical condition or from a known risk inherent in providing the treatment, or has a significant potential to adversely affect public perception and confidence in the hospital. Critical incidents must be reported immediately and students share the same responsibilities as employees or professional staff members who witness or discover a critical incident. The appropriate staff member, preceptor/ manager/supervisor must be informed immediately. Once informed of the critical incident it is the responsibility of that staff person to take the next steps. For further information on critical incidents please visit the hospital’s intranet site to review: http://info2/policies/generalmanual/sectionvi/vij3542. 41 HUMAN RIGHTS AND HEALTH EQUITY All employees, physicians, volunteers, patients and visitors at Mount Sinai Hospital have the right to be treated equitably and with respect regardless of race, sex, sexual orientation, gender identity, colour, ancestry, place of origin, ethnic origin, marital status, age, disability, citizenship, family status or religion. Through training, policy development, complaint resolution, and reviews of systems and procedures, the Human Rights & Health Equity (HR&HE) Office works to ensure that the Hospital environment is free from discrimination and harassment and that hospital services are accessible to the whole community and delivered in an equitable manner. 1. Why is Equity Important? Mount Sinai Hospital was founded to welcome practitioners and patients who were excluded from other medical facilities. Today, through its ongoing commitment to human rights and health equity, the Hospital continues this legacy. A workplace that is healthy, fair, and welcoming and that is free from discrimination and harassment and a workforce that is aware of and equipped to address the barriers to healthcare faced by marginalized groups will result in the best possible health outcomes for all patients regardless of their personal characteristics. Quality health care is equitable health care. 2. Policy Development The HR&HE Office develops, promotes and administers policies that promote best practices and ensure compliance with the Ontario Human Rights Code and the Occupational Health and Safety Act. The Diversity and Human Rights Policy lists and defines the rights and responsibilities of all members of the hospital community as they relate to harassment and discrimination. The Policy also outlines the complaint resolution processes available to those who believe their rights under the Policy have been breached. MSH is committed to accommodating needs related to one’s race, sex, sexual orientation, gender identity, colour, ancestry, place of origin, ethnic origin, marital status, age, disability, citizenship, family status or religion so that all individuals have equal access to employment opportunities, services, goods and facilities. The Accommodation Policy explains which needs are to be accommodated, sets out the responsibilities of both the person requesting accommodation and the person receiving the request, and outlines the general steps of the accommodation process. MSH is committed to providing an environment where trans, intersex and two-spirit individuals are welcomed, treated with dignity and respect, and encouraged to be active members of the Hospital community. The Gender Identity Policy identifies the rights and responsibilities of members of the hospital community, including the right to be identified and referred to as the gender with which one identifies, the right to have personnel records changed if one is undergoing or has undergone a transition process, and the right to be assigned a patient room according to the gender with which one identifies. In 2010, the Occupational Health and Safety Act was amended to require employers to protect employees from domestic violence. The Domestic Violence Policy outlines the steps that MSH will take to support and protect victims of domestic violence from their current or former partner while at work. Over 60% of female homicides in Canada are due to domestic violence. 74% of domestic violence victims are harassed while at work; this puts victims and all people present at the workplace at risk. 42 3. Complaint Resolution Members of the hospital community who believe that they have experienced discrimination or harassment at MSH may address the issue directly, bring the matter to the attention of their supervisor or manager, or contact the HR&HE Office. The Office can provide advice and resources, facilitate a discussion between the parties, or conduct a formal investigation into the complaint. 4. Education and Training The HR&HE Office delivers a variety of training aimed at ensuring as healthy, inclusive, and equitable a workplace as possible; including Giving and Receiving Feedback, Conflict Resolution, Addressing Disrespectful Behaviour, and Accommodation and Disability Management. In addition, the Office works to raise awareness of human rights issues as they relate to health care. As an example, the “Are You An ALLY?” campaign empowers employees to recognize overt and covert discrimination, interrupt instances of discrimination with respect and compassion, and take responsibility for comments or behaviours that are identified as hurtful or discriminatory. The campaign focusses on five marginalized groups: people with mental health issues; people who are lesbian, gay, and bisexual; people who are trans, intersex, and two-spirit; people with disabilities; and people who are racialized. The Office also organizes numerous educational events to commemorate Lunar New Year, Black History Month, Pride, International Day for the Elimination of Racial Discrimination, Trans Day of Remembrance, National Day of Remembrance and Action on Violence against Women, National Aboriginal Day, International Day of Persons with Disabilities, and others. 5. Reviews of Systems and Procedures Often, disparities and inequities in employment or the provision of health care services are not the result of conscious decisions to exclude and discriminate. Instead, they are the result of systems and processes that have not been designed with everyone in mind. The HR&HE Office regularly engages in system reviews to identify and address these issues at MSH. In 2013, for example, the Hospital conducted a Workforce Census that collected qualitative and quantitative organizational data on the 5,029 physicians, employees and volunteers at MSH. The census included 10 demographic questions relating to language, age, disability, dependants, racial/ethnic identity, education, religion/spirituality, gender/gender identity, and sexual orientation. The census also included 8 inclusion questions related to employee awareness of rights and responsibilities for accommodation and a respectful, accessible and safe workplace environment; perceptions of fairness; and experiences of harassment from patients and colleagues. Similarly, the Accessibility for Ontarians with Disabilities Act (AODA) Committee works to ensure that staff members, patients, visitors, and other hospital users do not encounter any barriers to receiving service. The Committee responds to emerging accessibility concerns as identified by hospital users, and provides training on the AODA Customer Service Standard which is now part of hospital orientation. 43 EMERGENCY CODE AND PREPAREDNESS Emergency Procedures at Mount Sinai Hospital - 600 University Avenue Site Emergency policies and procedures have been developed to assist staff so that they know how to respond to any unexpected emergency event at the hospital site. The goal of these policies is to ensure staff, student, patient, and visitor safety and the potential for positive outcomes. In case of an emergency call … Switchboard/ Locating at extension 5555 The location and type of emergency must be specified when the call is made. The three most important pieces of information to share are: your name your exact location/ location of the emergency the nature (type) of the emergency Mount Sinai Hospital uses a color code system to identify emergency situations in the hospital. Hospital staff members are trained to respond to the situation as indicated in our emergency procedures plan. The response occurs when an overhead announcement is made indicating the type of Code (the color is identified), followed by the location of the Code. When you hear this type of announcement, please refer to your Emergency Procedures binder or to the Emergency Procedures website found on the main hospital intranet page for further direction. Emergency Codes used at the Mount Sinai Hospital 600 University Avenue site are as follows: CODE What it Means / Important Things to Know Adult Cardiac Arrest BLUE used for a medical emergency , cardiac or respiratory arrest in an adult notify Switchboard of the location of the Code Blue when you call 5555 clear the way and way find for the emergency response team to enter and assist with the response PINK used for a cardiac or respiratory arrest in an infant calls the Code Pink Team to the location where the Code Pink has occurred clear the way and way find for the emergency response team to enter and assist with the response Infant Emergency Mother/ Fetal Emergency 77 used for any emergency situation that involves a pregnant mother and her fetus/newborn that requires support from specific members of the Code Pink and Code Blue Teams Massive Blood Transfusion CODE OMEGA Ω used in situations where a coordinated multi-professional team response is needed to care for a patient who is experiencing, or who is perceived to be experiencing, an out of control bleeding state requiring rapid access to blood or blood products CODE BETA Urgent Infant Transfusion • used in situations where a coordinated multi-professional team response is needed to care for an infant who requires rapid access to blood or blood products. β Violent or Threatening Behaviour WHITE used in situations where a person requires assistance to manage any individual(s)who is/are posing a threat, displaying threatening behaviours or who is/are causing harm to self or others 44 should you encounter this type of situation, attempt to leave the immediate area and call for help Bomb Threat BLACK • verbal or written threat or suspicious package is used to make a bomb threat or a potentially dangerous situation (like a suspicious object) is identified • pay close attention to overhead announcements, follow any directions given and report any suspicious activity, items or person(s) immediately Missing Adult Patient YELLOW used when an adult patient is missing from an inpatient unit, Day Surgery, or the ER activates a Hospital-wide search pay close attention to overhead announcements, follow any directions given, and report any suspicious activity/person(s) immediately it is essential you participate in the search process a description of the missing person can be found on the Hospital intranet site under Code Yellow Missing Child or Infant AMBER used when a child or infant is missing from his/her department without being accompanied by hospital staff or a parent/guardian includes a visiting child who has gone missing pay close attention to overhead announcements, follow directions given, and report any suspicious activity/person immediately Fire or Smoke Situation RED • called for any situation in which smoke or fire is detected • pay close attention to overhead announcements, follow any directions given, and report any visual signs of smoke or fire immediately Evacuation GREEN • used in situations where evacuation of a single area/unit, level, or the whole hospital is required • pay close attention to overhead announcements, follow any directions given overhead or by your department, or Fire Marshal, and report any problems immediately Hazardous/ Unmanageable Spill BROWN • involves a situation in which there is an unmanageable spill • includes the spill of a hazardous or unknown substance • pay close attention to overhead announcements, follow any directions given, avoid the contaminated area (remove persons at risk), check your local environment and report any problems immediately Internal Disaster GREY • used for any situation that occurs within the Hospital that requires immediate response (communication failure, power failure, noxious smells, clean water flood, etc.) • report to your Supervisor any related issues that may arise in your department External Disaster ORANGE used for external events/disasters that have the potential of overwhelming resources within the Emergency Department and/or throughout the whole hospital (i.e. mass casualty incidents) pay close attention to overhead announcements and follow any directions given immediately report to your Supervisor for further details Code Orange - CBRN Event involves patients arriving who have been exposed to a Chemical, Biological, Radiological or Nuclear substance staff in areas where response is required have been trained and have specialized equipment to manage these events Hostage Situation PURPLE • used for any situation that involves a hostage taking of staff, patient, or visitor • pay close attention to overhead announcements, follow any directions given, avoid the area of the incident, and report any suspicious activity/person(s) immediately 45 Before Providing Patient Care Prior to performing any patient care procedure, please review the appropriate policy and procedure. Policies and procedures are available electronically from any computer on the nursing units. Once in your clinical area, go to the Intranet and click on Policies and Procedures. 46 SIDNEY LISWOOD LIBRARY The Sidney Liswood Library is located on the NW corner of the 18th floor in room 18-234. The Library features a multipurpose space that is accessible 24 hours a day, 7 days a week. The bring-your-owndevice workspace (located next to the 18th Floor auditorium) provides access to thousands of electronic books and journals, as well as a secure electronic charging station. Hours for library services: 08:30 am-6:00 pm Monday to Friday, closed weekends and stat holidays. Our staff can customize training for you, whether it is for basic or advanced searching in electronic information resources such as Medline, or using information management software tools such as EndNote. We can also conduct bibliographic searches for your research question, or participate in clinical teams as a resource for finding information to facilitate evidence-based practice. Online resources include the following: The library catalogue Medline, PsycInfo, CINAHL ClinicalKey, Access Medicine, e-CPS and ACP Pier Over 200 e-books and hundreds of e-journal titles Contact Information Intranet: http://info2/library/ Internet: http://www.mountsinai.on.ca/education/library Email: [email protected] Phone: 416-586-4800 x4614 Fax: 416-586-4998 47 NURSING CAREERS AT SINAI HEALTH SYSTEM, MOUNT SINAI HOSPITAL, JOSEPH & WOLF LEBOVIC HEALTH COMPLEX Mount Sinai Hospital is an internationally recognized health science centre and a leader in pioneering health-care advances. It is dedicated to both discovering and delivering the best patient care possible and proudly provides opportunities for nurses to assist in the development of innovative approaches to effective health care. Education Paid education days are available to all full and part time nurses and tuition support is available to nurses who wish to pursue advanced degrees in nursing. Preceptorship Program Preceptorship for new staff is a priority at Mount Sinai Hospital. It begins with a structured and purposeful teaching and learning experience which blends classroom and guided clinical experience. In recognition of the importance of preceptorship, preceptors of new hires and of students are acknowledged with special receptions and celebrations. Sinai C.A.R.E The Department of Nursing’s on-site learning centre provides over one thousand days of education annually to Mount Sinai Hospital nurses. Sinai CARE courses are available at no cost to Mount Sinai Hospital staff nurses and to students on placement (as space permits). Courses are available and the course calendar can be viewed at www.mtsinai.on.ca/sinaicare. Tuition Support The Department of Nursing at Mount Sinai Hospital was the first in Ontario to provide tuition support for nursing education. Nurses currently receive financial support for ongoing formal academic preparation, paid seminar attendance, and specialty certification. Nurses in specialty areas attend certificate courses prior to beginning work in the ICU, CCU, ER, and step down units. The Nursing Education Fund Guideline Policy outlines specific details of reimbursement for continuing education pathways. 48 Recruitment and Retention Active recruitment & retention activity in the department of nursing ensures that more than seventy percent of nurses are working in full time positions. The department of nursing is comprised of eleven hundred nurses, as well as service assistants and clerical staff to support the functioning of the patient care units. A comprehensive General Hospital Orientation program welcomes new staff into the organization and for newly hired nurses this is followed by the Nursing Preceptorship Program. Duration of the preceptorship experience varies from program to program. Opportunities for Employment Opportunities for nursing employment exist in both the inpatient and the ambulatory care environment and new graduates are welcomed. 49 FOOD AND OTHER SERVICES Food Services RioCan Food Hall Located on the main floor Monday to Friday 6:30 am – 2:30pm Second Cup: Located in the main lobby just inside the University Avenue entrance Monday to Sunday 6:00 am – 9:00 pm Other Services ABM Machine: Located in the main lobby just next to the Second Cup Rexall: Located in the main lobby just inside the University Avenue entrance Monday to Friday 8:00 am – 8:00 pm Saturday & Sunday 11:00 am – 6:00 pm Indigo Books & Music Inc.: Located in the main lobby just inside the University Avenue entrance Monday to Friday 8:00 am – 8:00 pm Saturday & Sunday 11:00 am to 5:00 pm 50 STUDENT CENTRE Learning Centre for Students The Sydney and Florence Cooper Family Centre is a beautifully designed inter-professional learning centre. It provides facilities for health professional trainees placed at Mount Sinai Hospital to use including: computer lab, lounge, and study/seminar areas. All students placed at Mount Sinai Hospital are welcome in the centre. The Sydney and Florence Cooper Family Centre is located across the street from the back Murray Street entrance of Mount Sinai Hospital in the Joseph and Wolf Lebovic Centre, 60 Murray Street, 3rd floor, telephone 416-586-4800 ext. 8389. The Centre is open Monday – Friday, 08:00 – 18:00. If you require access after 18:00 or on the weekend you can contact [email protected] to obtain and access card. Resources College of Nurses of Ontario Practice Guideline - Supporting Learners http://www.cno.org/docs/prac/44034_SupportLearners.pdf College of Nurses of Ontario Reference Document - Legislation and Regulation RHPA: Scope of Practice, Controlled Acts Model http://www.cno.org/docs/policy/41052_RHPAscope.pdf College of Nurses of Ontario for Nursing Students http://www.cno.org/for/students.html 51 APPENDIX A CONFIDENTIALITY AGREEMENT During my association with Mount Sinai Hospital (the “Hospital”), I acknowledge that I will have access to: (a) confidential or proprietary information relating to the Hospital, its functions, employees and all persons affiliated with the Hospital; and/or (b) health information relating to the Hospital’s patients. As a condition of my association with Mount Sinai Hospital, I hereby agree and acknowledge the following: 1. I shall keep in strict confidence and agree not to inappropriately access, disclose, copy, remove, use or give to any person or organization information of any nature related to the Hospital which the Hospital designates in writing as confidential or which a reasonable person would consider confidential, except in accordance with my Hospital duties, with its specific prior written authorization or as permitted or required by law. 2. At all times, I shall respect the privacy and dignity of patients, employees and all persons affiliated with the Hospital and shall only collect, use and/or disclose personal information relating to these individuals as required by the performance of my legitimate hospital duties under the terms of my association with the Hospital and in accordance with the laws of Ontario and Canada. 3. This Confidentiality Agreement does not apply to information I previously and independently developed alone or with others prior to my association with the Hospital that I can substantiate by written records or to information in the public domain. 4. I shall maintain the secrecy of my systems User ID(s) and Password(s) that enable me to access the Mount Sinai Hospital and/or Samuel Lunenfeld Research Institute network and applications and acknowledge that I am responsible for all actions taken and access carried out under them. 5. I understand that the Hospital will conduct periodic audits to ensure compliance with this Confidentiality Agreement and will act on any issues of concern uncovered by an audit. 6. I acknowledge the Hospital issues policies and procedures that relate to the confidentiality of Hospital and patient information and that compliance with the terms of these policies are a material term of my association with the Hospital. These policies include, but are not limited to: The Appropriate Use of Information Technology Policy; Confidentiality of Information and Data Security Policy; Health Records Release of Information Policy; Secure Disposal of Confidential Information Policy; and Other department specific policies. I understand that it is my responsibility to familiarize myself with the terms of these policies and to keep myself informed of any changes to them or of any new policies issued to replace or supplement them. If I have any questions about any policies, including their applicability to me and their impact on the performance of my hospital duties, I may contact my Manager or the Privacy Office (at extension 2101 or [email protected]) for answers. 52 7. Regardless of any changes that may occur to my title, duties, status and/or other terms of my employment or association with the Hospital, I understand and agree that the terms of this Confidentiality Agreement will continue to apply. 8. I understand and agree to abide by all the conditions outlined above. I further understand and agree this Confidentiality Agreement will remain in force when I no longer have an association with the Hospital, no matter what the reasons. 9. I also understand that should any of these conditions be breached, I may be subject to corrective action. If I am an employee of the Hospital or an associated employer, this may include termination. Date: ____________________________________ Signature: Name: ____________________________________ (Please print) Department: ____________________________________ 53 APPENDIX B Health & Safety Checklist for Students New and young workers in Ontario are four times more likely to be injured during the first month of employment than at any other time and it is important to communicate the health and safety prevention programs we have in place to ensure their safety. Mount Sinai Hospital is committed to providing a safe environment for all staff, patients, students and visitors. We have a number of responsibilities under the Occupational Health and Safety Act. This includes taking every “precaution reasonable” to protect the health and safety of our students. To meet our requirements, we have implemented a comprehensive approach. Firstly, students are expected to declare completion of required online training courses (WHMIS, Worker safety awareness training, Workplace Violence Prevention, Emergency Codes), their immunity status requirements and a N95 respirator fit test prior to starting their placement at MSH. More information is also provided to students in the NURSING/INTERPROFESSIONAL STUDENT HANDBOOK. This checklist is designed to assist preceptors in providing a unit-specific health and safety orientation to new students. It is important to complete all portions of the checklist as soon as possible as a health and safety emergency could arise at any time and it is essential that the new student knows what to do. How to use the checklist 1. Preceptors/clinical instructors use this checklist to guide the discussion during the student’s first day on the unit. Answer any questions that the student may have with respect to health and safety matters. Contact OHWS at extension 3907 if any questions arise that you need assistance with. 2. Once the checklist is complete, the student and preceptor are required to sign and date the bottom of the checklist. The student should keep a copy of checklist for their reference and the original should be sent to OHWS (via internal mail, fax, or scan to [email protected]). Item Calling in sick √ Details Students are required to notify their preceptor if they will be absent for any reason. Students are not come to MSH if they have any infectious illnesses with symptoms including nausea with diarrhea or vomiting, runny nose, scratchy or sore throat, cough, pink eye, swollen/tender lymph glands, rash or fever. If the student is sick with a potentially infectious illness and was working in a clinical area within the past 48 hours, students must also contact the hospital’s SICK reporting line (416-586-4800 ext. 7425) to report to Occupational Health (OH). The sick reporting line is used to help identify outbreaks and prevent transmission of infections. OH will only follow-up as required if investigating a potential outbreak. Unit-Specific Hazards The preceptor should orient student to unit-specific hazards and safety practices in place to address these. For example: o physical environment of the unit – slip and trip hazards o where to find information about potential aggressive patient behaviours and how to get support to provide safe patient care o chemical and biological hazards (e.g. hazardous drugs, procedures prone to Blood Borne Pathogen exposures and how to follow-up if exposed, anesthetic gases) o patient/material handling – including the safe use of patient lifts and transfer devices on the unit if applicable o Other hazards as required (e.g. Xray, laser, MRI, radioactive materials, temperature extremes, working with electrical equipment, etc) 54 Reporting workplace incidents and illnesses If first aid treatment is required, the student is to report to the Occupational Health Clinic (60 Murray Street, 1st floor) for assessment and treatment. The clinic is open from 7:30 am to 3:30 pm, Monday to Friday. If the Occupational Health clinic is closed or if major medical attention is required, the student should visit the Emergency Department. A Mount Sinai Employee Incident Report (found on the Employee Safety intranet page) must be completed for all work-related incidents/illnesses as well as a hazardous situations or hazards identified in the workplace. This includes reporting any workplace harassment, threats of violence or issues related to domestic violence in the workplace. Personal Protective Equipment (PPE) PPE General Requirements: Footwear in Clinical areas and Operating Rooms: shoes with closed toes, nonperforated upper part and supported heels are required. Eye-Face Protection: disposable face shields must be used when performing tasks where there is a possibility of splashes of liquid material or penetration of solid particles. Additional PPE (e.g. gloves, gowns, etc.) may be required for specific jobs and tasks in the clinical area and students should be aware and follow these requirements. o o o All PPE must be inspected daily before use and students must report any malfunctions to their preceptor. The preceptor should acquaint the student with the location where PPE is stored. If the student has been fit tested to a N95 respirator that is not stocked on your unit, please have the student contact OHWS to schedule a fit test. Emergency Procedures Acquaint the student with the following: o Location of the MSDS binder o Location and how to use eyewash stations/safety showers o Phone stickers with emergency contact information for the department o Location of the fire pull stations/emergency exits/stairwells o Evacuation procedures for unit and the building o If a student requires assistance during an evacuation they must have a personal emergency response plan in place. Please ask the student to contact OHWS to set this up. Scent-Sensitive Environment Policy No wearing or use of scented personal products when coming to MSH. My preceptor/clinical instructor has provided me with a basic health and safety orientation to the unit where I will be doing my student placement at MSH and I am aware of all the information stated in this document. Student Name (please print clearly): Student Signature: Date: Student School: Preceptor Name (please print clearly): Date: Preceptor Signature: 55
