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Mandatory Education Nursing Department Welcome The purpose of this presentation is to meet the required annual education for our Department of Nursing. Directions: read through the presentation. Sign the required forms. Return the forms to the MSU Department of Nursing. MSU Mission The mission of Minot State University is to advance knowledge, critical and creative thinking, and the vitality of community and cultures. MSU Core Values Student Learning first Pursuit of Excellence Responsibility Respect Learning Community Philosophy of the Department of Nursing The Department of Nursing, within the College of Education and Health Sciences of MSU, supports the mission of the University to advance knowledge, critical and creative thinking, and the vitality of community cultures. Department of Nursing Mission The Minot State University Department of Nursing is an integral part of the parent institution and is dedicated to pursuit of higher learning grounded in the arts, sciences, and humanities. The mission of the Department of Nursing is to educate individuals for professional roles in nursing and for graduate education. People The Nursing Department faculty recognizes people are unique, complex, and evolving. Persons interact with a changing environment to maintain life and achieve purposes as individuals and as members of society. The person within the context of nursing is identified as a client. A client may be further defined as individual, family, a group and/or a community. People are dynamic, complex, adaptive, and self determined in achieving a meaningful existence. People utilize their cognitive, affective, and psychomotor capacities to achieve selfactualization. Environment The environment is dynamic, complex, and multidimensional. The environment is further defined as the context, surroundings, settings, foci, or backgrounds within which individuals interact. Health A condition of the life cycle that is dynamic, adaptive, responsive to both internal and external stimuli, and influenced by the behaviors of the person. Health refers to the person’s state of well being at the time that nursing occurs. Health is personal and can range from high-level wellness to terminal illness. Nursing Is defined as an application of scientific knowledge enhanced by artful practice in a socially responsible manner. Nursing Education Nursing education is viewed as process designated to facilitate learning. Students and faculty are active and responsible participants in learning. Nursing education at the baccalaureate level integrates content from the arts and humanities and social and physical science. The key curricular components emphasized within the curriculum are derived from the Dept. of Nursing’s Mission and Philosophy. The Following Threads Are Woven Throughout Our Program Professionalism Research Holistic health Globalization Professionalism Professionalism in nursing includes adherence to professional nursing practice and performance standards. The professional nurse possesses leadership and management skills, is capable of delegation and supervision of health care providers and may practice autonomously within the legal/ethical scope of practice of the licensing organization. The professional nurse assumes a variety of roles including but not limited to provider of client centered care, educator, researcher, leader, manager, evaluator, advocate, and/or counselor. Research Research is a systematic inquiry that uses various approaches to answer questions and solve problems. Nursing research is a process that allows nurses to ask questions to gain knowledge for improving patient care. Holistic Health Nursing supports a holistic view of diverse persons and requires its practitioners to have achieved a substantial knowledge base in the sciences, arts, and humanities. The caring, competent nurse uses self and presence, recognizing the importance of spirituality, diversity, community and social justice in the promotion of health through the life span. Communication of information is critical in educating people toward health and healing. Globalization The baccalaureate nurse is prepared to practice professional nursing in a global society, with an awareness of diversity and varied cultures. Globalization, cont. As members of a global community of nurses, the faculty is dedicated to support the education and professional development of nurses working to improve the health of the world’s people. With a commitment to social justice, the Department of Nursing prepares nurses to confront the issues of people living in poverty and underserved areas. Theoretical Constructs The Department of Nursing’s theoretical beliefs are eclectic in nature with key concepts drawn from the works of Florence Nightingale, Madeleine Leininger, and M. Jean Watson. Faculty embrace these theoretical beliefs as important to nursing and baccalaureate education. Major Theoretical Constructs Nightingale’s (1969) emphasis on environment to optimize health Leininger’s (1978) advocating for cultural care Watson’s (1979) premise that caring is the soul of nursing MSU Nursing Department Specific Information Department of Nursing Committees The Department of Nursing has student representatives on 2 committees. They are: – Student Faculty Affairs – Curriculum Committee Curriculum Committee Deals with course/class concerns and text books. Meets 3rd Friday of month, watch the bulletin board for notices. Student Faculty Affairs Plans for scholarships, handbook changes, policies & parties. Also 3rd Fridays. Check the bulletin board for notices. Student Scholarships Awards Ceremony 24 scholarships – criteria is located in the back of your handbook. ND State Board Loan Board of Nursing Education Loan. – You do not have to pay it back if you work in the state for X years. – Applications can be obtained from the State Board. Deadline is July1. Safety Information Fire Regulations and Emergency Evacuation Plan for MSU Fire alarms and extinguishers are located near each exit door on each floor. In the event of fire, sound the alarm and evacuate the building. Do not use the elevators. At the clinical settings, follow their policy. Policies & Procedures Clinical facilities have their own specific policies & procedures. Faculty will point out their location at the clinical settings. Infection Control The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard, became the Federal law in July, 1992. All hospital/agency policies and procedures directed by this standard are found in the agency’s “Exposure control Plan” and in the Infection Control section of the agency’s policy and procedure manual. Students and healthcare workers are to receive orientation and annual education to comply with these OSHA Standards. The following information is based on OSHA Standards. Standard Precautions Apply to all patients at all times regardless of diagnosis. Standard precautions applies to – – – – Blood Body fluids Secretions Excretions (whether or not blood is present or visible) except with sweat – Non-intact skin and mucous membranes Personal Protective Equipment PPE examples are: – Gloves – Masks – Gowns – Plastic aprons – Goggles with protective shields Hand Hygiene Must take place between patients, after procedures and when in contact with patient equipment, linens, supplies and immediate environment. Hand Hygiene Hand washing with an antimicrobial soap under a running stream of water, applying friction to fingers, hands, wrists for at least 15 seconds; drying hands with paper towel; shutting off the faucet with a paper towel. Soap & Water Soap and water must be used: – When you first get to work – For contact with proteinaceous material – If visibly soiled – Before eating – After using the restroom – When caring for patients diagnosed with spore producing organism, such as Anthrax or Clostridium Difficile. Alcohol Based Hand Antiseptics Foam and gel antiseptics can be used at any other time when in contact with patients, their equipment, linen, supplies and immediate environment. Gloves Must be worn when in contact with blood or other potentially infectious materials, mucous membranes, and non-intact skin. Wear gloves if you the caregiver have non-intact skin. Important! Perform hand hygiene before and after using gloves! Gloves are changed between all client contacts. Fluid Resistant Gowns Must be worn whenever the potential exists for soiling of uniforms or clothing. These gowns are also worn for contact isolation precautions. Masks Must be worn when there is a risk of exposure to spraying or splashing of blood or fluids that contain blood. This is typically a regular surgical mask. (N95) masks are worn only for airborne transmission organisms. Eye Protection Goggles or face shields must be worn for risks of exposure to spraying or splashing of blood. Your own glasses are not sufficient protection unless you use “add-on” side pieces. Eye protection and masks are worn in conjunction with one another. Sharps Must be disposed of in an OSHA approved puncture resistant container. Contaminated needles are NOT to be recapped, bent, broken or other wise manipulated by hand. Safety Devices Agencies use a variety of safety engineered devices and must be used according to their instructions. Examples: needle less IV therapy systems, syringes, venipuncture devices, scalpels, blunted suture needles, lancets and blood collection devices. Biohazard Waste Defined as waste “likely to release infectious material in liquid or semi-liquid form”. Waste contaminated with blood or fluids that contain blood likely to pose a risk of exposure must be red-bagged. Linen Linen should be placed in linen bags at bedside and not on the floor. Linen soiled with biohazard waist need to placed in fluid resistant bags at the point of use. (bedside) Contaminated Equipment Follow your agency policy. Place items in soiled utility rooms for pickup and reprocessing (decontamination, disinfection of sterilization) by Central Processing Unit personnel. Small surgical instruments should be placed in soaking basins containing an enzymatic. Equipment, cont Some equipment may be disinfected on the unit with appropriate disinfectant. Multi-use equipment, such as wheelchairs, BP cuffs, glucose monitoring devices and thermometers, should be disinfected between patient use. Blood Spills Facilities are required by OSHA to have spill kits available for clean up. Blood spills are cleaned up in a two-part process. First wipe up the spill and then disinfect the area with one of the following: – Sodium Hypochlorite (Hilex or Clorox 1:100, with Dispatch, or Vesphene. MSDS Sheets Material Safety Data Sheets – OSHA requires the various clinical settings to maintain these sheets on chemicals. Examples: cleaning solutions, copy machine toner, paints. Exposure Control Plan Clinical facilities are required to have Exposure control Plans. We will point the location of these out to you when we get to the clinical settings. – Application examples: safety devices for injections or for IV starts. Blood Exposure Incidents Examples: needle stick injuries, cuts with a scalpel or blood splashes. Wash area Notify your instructor Seek medical treatment immediately Fill out an incident report Report to the ETC immediately. Receiving HIV prophylaxis may prevent as many as 80% of healthcare workers infections. – Risk of HIV after an exposure to an positive patient is 0.4% – Risk of HBV (Hepatitis B) is 6-30% Rapid HIV testing is done to determine results of source patient within 2 hours. Subsequent testing or treatment as the result of exposure (positive source patient) will be at the student expense (Trinity policy, other agencies may have a different policy) Blood Exposure, cont Tests will be completed based on agency policy. Patient results are to be kept confidential. It is a Class C Felony to breach this confidentiality to individuals who have no involvement in their care. Blood Exposure, Cont. Results will be returned to you. Follow-up testing or treatment will depend on the test results. Hepatitis B Vaccine (HBV) What is it? – A series of three injections given to prevent Hepatitis B, a liver disease. The 1st is given initially, 2nd in one month, 3rd in six months. – Contraindications include allergy to yeast, and mercury. If you are pregnant seek the advise of an obstetrician. How it works: – Production of antibodies is 96% – A test for antibody response should occur in 1-2 months post vaccination. – If negative response, one repeat series is recommended with a subsequent antibody test (AntiHBs) If a negative response continues, further vaccination is not recommend. HBV The vaccine is recommended for students but is not mandatory. Hepatitis C There is no prophylaxis for Hepatitis C. Isolation Precautions Tier: 1 Standard Precautions Tier 2: Transmission-Based Precautions Standard Precautions Used for the care of all persons regardless of their diagnosis or possible infections. New Elements of Standard Precautions (CDC 2007) Protection of patients – Infection control outbreak investigations indicated the need for new recommendations or reinforcement of existing infection control recommendations to protect patients. Siegel JD, Rhinehart E, Jackson M, Chairello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, June 2007 http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf Changes or clarifications in terminology The term nosocomial infection is retained to refer only to infections acquired in hospitals. The term healthcare-associated infection (HAI) is used to refer to infections associated with healthcare delivery in any setting (i.e., hospitals, long-term care facilities, ambulatory settings, home care). – This term reflects the inability to determine with certainly where the pathogen is acquired since patients may be colonized with or exposed to potential pathogens outside of the health care, or may develop infections caused by those pathogens when exposed to the conditions associated with delivery of healthcare. Change Per the 2007 Guidelines, the term “Airborne Infection Isolation Room (AIIR)” replaces “Airborne Precautions” New Elements Include Respiratory Hygiene/Cough etiquette Safe Injection Practices Masks for Special Lumbar Puncture Procedures Respiratory Hygiene/Cough Etiquette This strategy is targeted at patients and accompanying family members and friends with undiagnosed transmissible respiratory infections, and applies to any person with signs of illness including cough, congestion, rhinorrhea, or increased production of respiratory secretions when entering a healthcare facility. Elements of Respiratory Hygiene/Cough Etiquette 1. 2. 3. 4. 5. Education of healthcare facility staff, patients, and visitors Posted signs in languages appropriate to the population served, with instructions to patients and accompanying family members or friends Source control measures (e.g., covering the mouth/nose with a tissue when coughing and prompt disposal of used tissues, using surgical masks on the coughing person when tolerated and appropriate Hand hygiene after contact with respiratory secretions Spatial separation, ideally >3 feet, of persons with respiratory infections in common waiting area when possible. Covering sneezes and coughs and placing masks on coughing patients are proven means of source containment that prevent infected persons from dispersing respiratory secretions into the air. Safe Injection Practices Adhere to basic principles of aseptic technique for the preparation and administration of parenteral medications. – These include the use of a sterile, single-use, disposable needle and syringe for each injection given and prevention of contamination of injection equipment and medication. Whenever possible, use of single-dose vials is preferred over multiple-dose vials, especially when medications will be administered to multiple patients. Practices for Special Lumbar Puncture Procedures Use masks for insertion of catheters or injection of material into spinal or epidural spaces via lumbar puncture procedures (e.g., myelogram, spinal or epidural anesthesia. Transmission Based Precautions There are 3 categories, which are used in addition to Standard Precautions. They are: Airborne Droplet Contact Airborne Transmission Used in addition to Standard Precautions Per the 2007 Guidelines, the term “Airborne Infection Isolation Room (AIIR)” replaces “Airborne Precautions” For clients with known or suspected illnesses that are transmitted by airborne droplet nuclei smaller than 5 microns Airborne Transmission, cont Private room with negative air pressure, 6-12 air exchanges per hour, air discharge to outside or have a filtration system for the room air. If private room isn’t available, room with a client with the same illness Wear a respiratory device (N95 respirator) Limit movement in room. Place mask on client when transporting out of room Airborne Transmission, cont. Examples: Varicella (chicken pox) TB SARS Measles (rubeola) Droplet Precautions Used in addition to Standard Precautions Used for clients with illnesses transmitted by particle droplets larger than 5 microns. – Private room Or with a client with the same illness – Wear mask if working within 3 ft of client – Limit movement in room Client must wear a mask if transported out of room Droplet Precautions, cont. Examples: – – – – – – – Diphtheria Myoplasma pneumonia Pertussis Mumps Rubella Streptococcal pharyngitis Scarlet fever in children Contact Precautions Used in addition to Standard Precautions. Used for clients with known or suspected serious illnesses transmitted by direct client contact or by contact with items in the client’s environment. Contact Precautions, cont. – Private room If not available, with a client with the same microorganism – Wear gloves Change gloves after contact with infectious material Remove gloves b/4 leaving room Cleanse hands immediately after removing gloves. (antimicrobial agent) – Wear gown, remove in room – Keep equipment in room (B/P cuff, thermometer) Contact Precautions, cont. Examples: – – – – – – Certain Gastrointestinal and respiratory illnesses Wound infections Colstridium difficile Impetigo Shigella (dysentery) RSV HIPAA HIPAA is the Health Insurance Portability and Accountability Act of 1996. Each facility is required to inform the people they care for (patients or residents) about this law. It is your responsibility to understand what information HIPAA rules and regulations protect. You could be held legally accountable if you reveal patient or resident information. HIPAA sets up strict guidelines that define a patient or resident’s protected health information and who has the right to know or access this information. HIPAA defines Protected Health Information (PHI) as personal medical information that includes: demographic information-name, address, phone number, birthdates, religious affiliation, etc. medical history diagnoses tests and diagnostic procedures treatments and surgical procedures medications charging and billing information insurance carrier or third party payer any other information specific to that patient or resident HIPAA also states that part of PHI is Highly Confidential Information. There are even more rules about who may have access to this information. Highly Confidential Patient Information includes information about: mental health and developmental disabilities services alcohol and drug abuse prevention, treatment and referral HIV/AIDS testing, diagnosis or treatment venereal disease(s) genetic testing child abuse and neglect domestic abuse of an adult with a disability sexual assault The facility is allowed to use protected health information in order to treat the person or obtain payment for services provided. The facility can also use PHI for internal administration and planning or to improve the quality and cost effectiveness of care. For example, PHI may be used to evaluate the quality and competence of health care workers. PHI may be disclosed to certain individuals in the facility to resolve complaints. The facility may disclose PHI: So another health care provider can treat the patient, receive payment for services they provide, or conduct their health care operations. For public health activities. To report abuse, neglect or domestic violence. To ensure compliance with the rules of government health programs such as Medicare or Medicaid. For organ, eye or tissue procurement, banking or transplantation. To units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances. The patient or resident has the right to ask to inspect their medical record file and billing records. They may request copies of the records. They may also ask the facility who has received their PHI. Student Responsibility You (student) will need to print the verification form after completing this education program. It is located on the next slide. – Sign the form and give it to your course instructor. The form will be kept in your Nursing Department file. Verification Form You have completed your Annual Mandatory Education Requirements for MSU Department of Nursing. Name: ____________ Date: ____________ – – Turn in to your course instructor. Instructor will give to department secretary Yearly Education07