Clear Lake Regional Medical Center 500 Medical Center Blvd., Webster , TX 77598

281-332-2511

Revised December 2013

P-922-0183

On behalf of Clear Lake Regional Medical Center, we extend a

warm welcome to you. Thank you for choosing CLRMC for your

clinical rotation. Our goal is to provide meaningful learning

opportunities that will help you gain valuable experience in

your pursuit of a career in healthcare.

--CLRMC Education Department

Above all else, we are committed to the care and improvement of human life. In

recognition of this commitment, we strive to deliver high quality, cost effective

healthcare in the communities we serve.

In pursuit of our mission, we believe the following value statements are essential

and timeless:

•We recognize and affirm the unique and intrinsic worth of each individual

•We treat all those we serve with compassion and kindness.

•We act with absolute honesty, integrity and fairness in the way we conduct our

business and the way we live our lives.

•We trust our colleagues as valuable members of our healthcare team and

pledge to treat one another with loyalty, respect and dignity.

Clear Lake Regional Medical Center is a 595 bed private,

acute facility that opened its doors on March 12, 1972.

Since that time, it has maintained a consistent tradition of

high-quality patient care. Built with the support of the

community, the hospital mirrors the space age environment

of the surrounding area and is dedicated to serving the

medical needs of the local population.

Medical/Surgical ICU Cardiovascular ICU Coronary Care Unit Emergency Department Chest Pain Unit CV Intermediate Units 1 & 2 Surgical Intermediate Care Units Medical Intermediate Care Units Labor & Delivery Ante-Partum Post Partum Newborn Nursery Neonatal Intensive Care Pediatrics Pediatric ICU Oncology Rehabilitation Outpatient Services Discharge Express

Radiology Endoscopy Nuclear Medicine Sleep Lab Respiratory Therapy Laboratory Physical Therapy Occupational Therapy Electrodiagnostics Cardiac Cath Lab Diagnostic Imaging Pharmacy Breast Diagnostic Center

Clear Lake Heart and Vascular Hospital is a free-standing 6 story building

located across from the main hospital at 495 Medical Center Blvd. It

opened its doors in April 2007. All cardiovascular care including CVICU,

CV OR, Cath Lab, CCU, CV Intermediate Units 1 and 2, and Cardiac

Rehab are located in this hospital. In the Spring of 2011, the 5th & 6th

medical floors opened. This represents the near completion of becoming

a hospital with all private rooms.

The Education Department of Clear Lake Regional Medical Center is committed to the educational needs of employees and students throughout the hospital. Students are always welcome to attend hospital in-services and community classes. Call the Education Department at 281-338-3340 if you have any questions regarding the services provided by our department

Privacy and Security of Protected

Health Information

Clear Lake Regional Medical Center requires that ALL students

view the provided HIPAA & HITECH PowerPoint presentation

What is ethical & compliant behavior?

Doing what is right and encouraging others to do the same.

What is HCA’s Code of Conduct?

Our Code of Conduct provides guidance to all HCA colleagues

and assists us in carrying out our daily activities with

appropriate ethical and legal standards. These obligations apply

to our relationships with patients, affiliated physicians, third-

party payers, subcontractors, independent contractors, vendors,

consultants and one another.

How do you report an Ethics and Compliance issue?

Issues can be reported to the ECO, the department director or

manager, human resources or by calling the ethics hotline.

There is no retribution for reporting an issue in good faith.

Every effort will be made to maintain confidentiality.

Who Is our ECO?

ECO: Mark Rozell

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Greet others with a friendly smile and good eye

contact.

Call patients by their preferred name, located

on the white board in the patient room. Never

refer to a patients by their diagnoses or room

number. Using the surname communicates

respect and decreases the likelihood of

misidentifying a patient.

Identify/introduce yourself at the beginning of

all communications – in person, telephone, and

when answering the call bell.

Respect the privacy of patients by pulling the curtain,

knocking on the door before entering, covering the

patients, offering a second gown, etc.

Demonstrate the common courtesy that you were taught

such as saying “please”, “thank you”, and “may I”?

Provide patients, their loved ones and your co-workers as

much information as you can. Use terms they can

understand.

Apologize when necessary – on behalf of the hospital –

even when it wasn’t your “fault”. Take the opportunity for

“service recovery”. This is when something has happened

to the patient and you try to assist with “fixing” the

situation.

Really listen to the patient and loved ones. Never

underestimate their knowledge of their bodies and their

health. Appreciate and respect that they can provide

information that will allow you to provide better care.

When discussing an issue with the patient or family, never

blame another staff member or a physician. This can

cause fear and loss of confidence in the hospital as a

whole.

Never tell a patient we are understaffed or that you don’t

have time. Once again, this will cause fear and loss of

confidence.

Always ask patients before touching a part of their bodies.

“May I please have your arm?” “I’ll need to listen to your

heart”.

“Are there any questions

that I can answer for you

at this time?”

“Would another

blanket make you

feel more

comfortable?” “We’re all here to make

sure you have what you

need. Please let us know if

there is anything we can do

for you.”

“I would like you to

be as comfortable

as possible. Let me

do ______ for you.”

“How are you feeling?

Are you having any

pain/nausea/discomfort?”

“Is there anything that I

can do for you before I

leave your room?”

“I understand that you need _____. ______ will be with you very shortly to take care of that.

“He/she is with another patient. Is there something I can do for you?”

“I apologize for

the delay.”

“Many people have concerns about being in the hospital. Is there anything you are worried about?”

“Do you have any fears or concerns that you like to talk about?”

In addition to providing appropriate care to individuals in

at all stages of development providing Culturally

competent care is vital, acknowledging that people of

different cultures have different expectations of

Healthcare.

Development refers to predictable increases in physical,

cognitive, psychological and moral capacities that

individuals acquire to enable them to successfully adapt to

their environment.

Health Care Providers must be able to meet the

distinct needs of patients based on their stage of

growth and development. Each patient, at all

phases of the life continuum, present distinct

clinical challenges. At Clear Lake Regional

Medical Center, we use the following age group

classifications to refer to various age groups:

Geriatric

Adult

Adolescent

child

Infant

Neonate

Be familiar with age-specific characteristics

Identify each patient’s requirements relative

to his/her age specific needs and cultural

background.

Communicate with patients and families in

an age-appropriate manner keeping in mind

cultural expectations.

When age and developmental level or

functional capacity do not match, readjust to

relate to that patient appropriately

Clear Lake Regional Medical Center

Alvin Campus, Clear Lake Campus,

Mainland Campus, Pearland Campus

To improve:

1) effective communication

2) cultural competence

3) patient- and family-centered

care across the care continuum.

The following are a few key terms which will

help you understand Population Specific Care:

Patient-

Centered

Approach Health

Literacy

Cultural

Competence

• Patient-centered care means we take into

consideration each patients:

Age

Preferred language

Ethnicity

Health Literacy

Spirituality/Religion

Understands symptoms

Understands diseases

Understands directions

Asks pertinent questions needed to make

appropriate decisions

Regarding medical information, how well

an individual :

We strive to effectively respond to cultural and

language needs brought by the patient to the health

care setting. As an organization, this begins by

understanding and valuing the population we

serve.

Population by Gender

Inpatient

Mainland Clear Lake

Female 59% 61%

Male 41% 39%

Outpatient

Mainland Clear Lake

Femal

e

63% 66%

Male 37% 34%

Population by Race Must represent > 5% of total patients.

Inpatient

Mainland Clear Lake

White 57% 65%

Hispanic 15% 19%

Black 26% 10%

Outpatient

Mainland Clear Lake

White 50% 62%

Hispani

c

18% 17%

Black 30% 15%

Population by Age

Age

Mainland Clear Lake

Inpatient Outpatient Inpatient Outpatient

<5 5% 7% 18% 10%

5-19 2% 13% 6% 14%

20-44 19% 35% 27% 31%

45-64 29% 25% 20% 27%

>65 45% 20% 29% 18%

Emergency Department Population by Gender

Emergency Departments

Mainland Clear Lake Alvin Pearland

Female 58% 61% 52% 57%

Male 42% 39% 48% 43%

Emergency Department Population by Race Must represent > 5% of total patients.

Emergency Department

Mainland Clear Lake Alvin Pearland

White 57% 65% 63% 20%

Hispanic 15% 19% 29% 20%

Black 26% 10% 4% 55%

Emergency Department Population by Age

Emergency Department

Age

Mainland Clear Lake

Alvin Pearland

<5 9% 11% 15% 16%

5-19 15% 13% 28% 26%

20-44 36% 38% 35% 40%

45-64 23% 20% 15% 13%

>65 17% 18% 7% 5%

Population by Preferred Language

Population by Religious Preference

We are working with IT&S on a report to extract data

from Meditech.

Identify:

• Preferred language

• Communication impairment

• Patient race & ethnicity

• Required assistive devices

• Additional needs affecting his or her care

Communicate:

• Unique patient needs to the care team

• Inform patients of their rights.

Identify and Act:

•Patient communication needs

•Patient’s health literacy

•Patient’s cultural, religious, or spiritual beliefs or

practices that influence care.

•Dietary needs or restrictions that affect care.

Communicate:

•information about unique patient needs to the

care team.

Monitor changes in communication status.

Involve patients and families in the care & education

Match informed consent process to health literacy

Accommodate patient cultural, religious, or spiritual

beliefs and practices.

Monitor changes in dietary needs or restrictions that

may impact the patient’s care.

Communicate information about unique patient

needs to the care team.

• Monitor changes in the patient’s communication

status

• Involve the patient’s surrogate decision-maker and

family

• Identify patient cultural, religious, or spiritual

beliefs and practices related to the end of life

• Make sure the patient has access to his or her

chosen support person and or clergy

• Engage patients and family in discharge and

transfer planning.

• Discharge instructions that meet patient needs.

• Identify follow op providers that meet patient

unique needs.

• Interpretalk

• Use Interpretalk Phone: 2 handsets to conference call

• Plug the Interpretalk phone in phone jack

• Follow instructions for the phone

• Listen for the dial tone

• Press the Interpretalk button

• Press the Code button

• When greeted by coordinator provide:

• Department /unit

• Your Last and First name

• Your patient’s Medical Record Number (bring patient sticker with you)

RESOURCES…..

• Request the language needed

• Coordinator will inform you when interpreter is “on

line” and give you the interpreter ID number

• Explain the objective of the call to the interpreter

• Speak directly to the non-English speaker in the first

person

• Upon completion of the call, all parties should simply

hang up

• Your time will be automatically recorded

RESOURCES…..

Click on

“Links” Choose Quality

Interactions

Resource

1

2

3

http://www.jointcommission.org/assets/1/6/ARoad

mapforHospitalsfinalversion727.pdf

http://www.cahealthliteracy.org/

http://www2.massgeneral.org/interpreters/bits.as

p

I have the right to be treated as a living human being until I

die.

I have the right to express my feelings and emotions about

my approaching death in my own way.

I have the right to be free from pain.

I have the right to die in peace and with dignity.

I have the right to maintain a sense of helpfulness, however

its focus may change.

I have the right to participate in decisions concerning my

care.

I have the right not to die alone.

I have the right to discuss and enlarge my religious and

spiritual experiences, regardless of what they may mean to

others.

At Clear Lake Regional Medical Center, we are committed to preserving the rights

of the dying.

It has been estimated that as many as one

hospital patient in ten acquires a

nosocomial infection

Estimates of the annual healthcare cost

range from $4.5 billion to $11 billion and

up

A majority of these infections could be

eliminated through good hand washing

technique and following infection control

policies.

Hand Hygiene is critical to

infection prevention

Under nails

Between fingers

3 inches above wrist

Friction for 15 seconds

Soap and Water

Visibly soiled

Before & after:

gloving

Eating

Toileting

C-diff

Alcohol hand foam •Not visibly soiled

•Adjunct to soap and water, wash

with soap/water after 4 foam used

3- 4 times

Antimicrobial Soap

High risk areas such

as: •Surgery

•Neonatal nurseries

•Critical care areas

All

Patients

All the

time

Use disposable equipment - Appropriate

disposal of Red Bag Waste

Don appropriate apparel - Remove gowns,

etc. prior to leaving the room

Check Isolation sign on door: Airborne,

Droplet, Contact, or Special Contact

Keep door closed

Check the Isolation sign for specific instructions

Students are not allowed to care for patients with TB in

Airborne Isolation. Students are not fitted for the

required N95 Mask.

Use caution in cases of confirmed or

suspected communicable diseases such as:

Chicken Pox, Measles, Conjunctivitis, the

FLU

Do not attend clinicals at CLRMC if you

suspect you may have an illness that could

be spread to others. Notify your instructor

or the department/unit to which you are

assigned.

Be Careful – use ALL available safety features

If an injury occurs:

Immediately bleed the injury (if appropriate)

Wash the area

Notify CLRMC Employee and Instructor

immediately

Complete Occurrence Report

Get emergency care per school policy

Follow-up care-Student responsibility per

school policy

SAFETY ON THE JOB is everyone’s responsibility.

Most accidents are a result of carelessness,

thoughtlessness, fatigue, or neglect.

Most accidents can be prevented through proper

care and maintenance of equipment and facilities,

alertness on the job, and good housekeeping

procedures.

Unauthorized use of equipment is prohibited. If you are injured while

at Clear Lake Regional Medical Center, immediately report the

accident to your instructor who must complete an Occurrence Report

within 24 hours. The instructor should notify the supervisor or

director of the department where the student is assigned and the

Education Department.

Avoid hazardous patient handling and movement tasks

whenever possible. If unavoidable, assess them carefully

prior to initiating the transfer or movement.

Use mechanical lifting devices and other approved patient

handling aids for high-risk patient handling except when

alternative methods are absolutely necessary, such as in a

medical emergency.

Use mechanical lifting devices and other approved patient

handling aids in accordance with instructions and training.

BE SAFE - Use good Body Mechanics

REMEMBER that your back is your RESPONSIBILITY

A fall is a sudden unplanned downward displacement of the body to the ground or lower level, excluding falls resulting from violent blows or other purposeful actions.

An un-witnessed fall occurs when a patient is found on the floor and neither the patient or anyone else knows how he or she got there.

Medications: sedatives, hypnotics, anti-

hypertensives, diuretics, bowel preps, anti-

seizure medications, etc…

Assist devices: canes, walkers, wheelchairs

Cognitive impairment (age, developmental

delay, substance abuse, dementia/alzheimers

Educate patient and family

Safe environment:

remove trip hazards

slip hazards

sharp edges

Patient Safety Rounding: 4P’s

Safe exit side

Determining a patient’s potential fall risk: *NOTE: if ≥ 3 are met, patient is “high risk for falls”

• 70 years old

• Confused or disoriented

• Hx of Falls

• Impaired judgment, memory,

gait/transfer dysfunction

• Generalized weakness

• Hx of syncope/orthostatic BP

changes

• Altered elimination

• Sensory/perceptual deterioration

• Special meds: Narcotics, Sedatives,

Tranquillizers, Psychotropics,

Cardiovascular, Diuretics, Laxatives

Anticonvulsives, Antidepressants.

• Immediate Post Op period

• Blind or severely impaired vision

Universal Fall Interventions

Critical Conversation w/patient and family

Signage

Yellow Armband

Non-skid blue socks/footwear

Bed alarm if patient confused/gait dysfunction

Stay with patient in bathroom or bedside commode

• Age: ≥ 85

• Bones: Ortho Problems, Arthritis, Gout, Osteoporosis, Dystrophic Disease, Fractures, Contractures, Amputations, Deformities

• Coagulation: Anemia, Blood Dyscrasia, Clotting Disorder, Sickle Cell Anemia, Hemophilia, Hx of Transfusion Reactions, Anticoagulation

• Surgery: Immediate Post-Op

• This subgroup of patients are at risk for serious injury or even death if they fall. They are identified by:

*NOTE: if 1 or more criteria is met, patient is “at risk for injury”

ABCS

• Universal Fall Interventions

• Critical conversation w/patient and family

• Yellow falling star with red band aid signage

• Yellow socks

• Yellow blanket

• Evolution Bed, low to ground also is air mattress for better skin integrity

• Assess sitter needs

• Stay with patient in bathroom or bedside commode if confused, gait dysfunction, or weak

Universal Interventions

High Fall Risk Interventions

PLUS

Yellow gown

Bed alarm at all times

• Review “Fall Prevention Guidelines for Patient and Family” with every patient.

• Use “Fall Prevention Guidelines for Patient and Family” to have a critical conversation with patient/family if the patient is at High Risk for falls.

• “Critical Conversation for Preventing Falls with Injury” is reviewed if the patient is identified as at Risk for Injury.

Notify Director (or AOS) immediately.

Fall Debriefing must occur with a huddle on the same shift of the fall.

Use audit tool during fall debriefing to collect all pertinent info regarding fall.

Determine what could’ve been done better/ what could’ve prevented the fall.

Include what action steps will be taken to keep your patients safe.

Bed/Chair Alarms: Must be used for high fall risk AND at risk for injury OR if your patient is confused or has gait dysfunction.

Rounding appropriately: Including the 4 P’s during safety rounding and staying with the patient when toileting will help prevent falls and keep our patients safe.

Alert the staff when a high risk patient is getting out of bed

Any manual method, physical or mechanical device,

material, or equipment that immobilizes or reduces the

ability of a patient to move his or her arms, legs, body

or head freely.

Examples:

• Tucking in sheets very tightly

• Use of side rails x 4

• Holding a patient to prevent movement

• Geri chairs, side rails, mittens when

they have the effect of restricting a

patient’s movement and cannot be

easily removed by the patient

• A medication used to control behavior

that is not a standard treatment, or not

in a dosage used for the patient’s

medical or psychiatric condition would

be considered a restraint.

Two types of restraints

Violent-patient ‘s behavior poses

an immediate and serious threat to

himself or others

Non-violent- primary reason for

use directly supports an identified

treatment plan

Goal: Minimize the use of restraints

Consider alternatives to restraints

Use the least restrictive restraint for the shortest amount of

time. RESTRAINTS SHOULD BE A LAST RESORT.

Restraints should only be applied and monitored by trained

staff. STUDENTS MAY NOT APPLY OR REMOVE RESTRAINTS.

Maintain and monitor a patients safety, rights, and dignity 3

times per hour

RN shall be responsible for the assessment and care of

restrained patient initially and every 2 hours thereafter.

All restraints must be accompanied by a doctor’s order & must

include a second tier review. NO PRN ORDERS

The patient a family should be educated about the reason for

restraints and the criterion for restraint removal.

On admission or during pre-admission, the patient

will be taught the pain scale utilized to measure pain

and how to communicate his or her pain

The patient will be informed that pain management

is included in the plan of care.

The patient and family will receive education on pain

medication control methods, and non-medication

techniques to control pain.

The patient has the right to know the potential

limitations and side effects of the pain medications

given.

The patient should understand the importance of

effective pain management.

PAIN – is an unpleasant sensory and emotional

experience associated with actual or potential

tissue damage

PAIN – has both physical and emotional elements.

It is “whatever the experiencing person says it is

and exists whenever he/she says it does”.

PAIN is the 5th vital sign. Every patient will be

provided appropriate pain management, and staff

will respect and foster the patient’s sense of

dignity and involvement in their own care.

Fear of Pain, especially postoperative pain,

ranks 2nd only to the fear of death

Acute pain

Rapid onset

1 second – 6 months

Autonomic nervous system

Tends to be more responsive to analgesic meds

Chronic pain.

Persistent or episodic in nature

>6 months duration

Habituation of autonomic response

Tends not to be as responsive to analgesic meds

May exhibit signs of depression

Crying, Grimacing, Moaning, Guarding,

Restlessness, Repositioning,

Holding extremely still – Especially in the

elderly you may also see: Hitting, Anxiety,

Sighing, Fright, Making demands, Rubbing

Tachycardia

Hypertension

Tachypnea

Dilated pupils

↑ muscle tension

Pain intensity

Location

Quality of pain, patterns of radiation (if any), character

Onset, duration, variation, and patterns

Alleviating and aggravating factors

Present pain-management regimen and effectiveness

Pain management history

Effects of pain

Patient’s pain goal

Physical exam/observation of the site of pain

Pain reassessment will occur

within 1 hour of pain

medication administration

Pain is assessed using a 0-10 Scale, with “0” representing

No pain and “10” representing the worst pain possible.

Code Type Meaning

Red Fire

Code Blue or Code Blue/Pedi Cardiac/Respiratory Arrest

Rapid Response Team(RRT) ICU Nurse/Respiratory Therapist Responds

Code Neuro Patient having signs and symptoms of stroke

Code Yellow Disaster

Code Gray Emergency Security Assistance

Code Pink Infant/Child Abduction

Code Green Chemical Spill

Code Orange Bioterrorism Attack

Code White Active Shooter (armed Intruder)

Code Black Bomb Threat

Preventing fires and knowing what to do in case of fire is the

responsibility of all hospital employees. A Fire Manual and

Code Red cards are located in each department and nursing

unit.

Know the location of fire extinguishers near your individual

work area;

If a fire is discovered, activate the closest fire alarm signal by

pulling down on the handle of the Local Fire Alarm. Proceed

with the individual fire duties, as designated on the Code Red

cards.

Fire drills are conducted in all areas. Be prepared to

participate.

You must know fire procedures for your area and the

responsibilities you have when a fire occurs in other areas.

RACE

R-rescue

A-alarm

C-contain

E-extinguish PASS

P-pull the pin

A-aim the nozzle

S-squeeze the handle

S-sweep from side to side

at the base of the fire

Code Red

TEXAS: It is a crime NOT to report suspected

abuse/neglect of children and elders

Clear Lake Regional Medical Center provides

for the protection of all patients by making

hospital staff aware of signs, symptoms, and

physical indicators of abuse and/or neglect

and how to report the suspected abuse.

Students should immediately report any

suspected abuse to your instructor and the

charge nurse.

Please see the policies for abuse and neglect

for details.

Bruises, welts, lacerations, or puncture wounds

Dehydration or malnutrition

Multiple injuries or fractures in various stages of healing

Injuries inconsistent with explanation

Difficulty walking or sitting; Torn, stained or bloody

clothing

Complaints of pain or itching in the genital area

Bruises or bleeding from external genitalia

Venereal disease, particularly, in a child <14 years old

Signs of over-medication; Burns; Poor hygiene

Lack of medical attention

24-hour Abuse hotline: 1-800-252-5400 to

report abuse

The patient has the right to be informed of his/her rights in

language he/she understands.

The patient has the right to participate in the development

and implementation of his/her plan of care and to make

informed decisions regarding his/her care.

The patient has the right to be able to request or refuse

treatment.

The patient has a right to give informed consent prior to

the start of a procedure and/or treatment.

The patient has the right to know the identity and

professional status of individuals providing service to

him/her, to know the name of the person responsible for

any procedures and/or treatment, and to know which

physician or other practitioner is primarily responsible for

his/her care.

The patient has a right to refuse to participate in research

and his/her refusal will not compromise his/her care.

The patient has the right to have a family member or

representative of his/her choice and his/her own physician

notified promptly of his/her admission to the hospital.

The patient has the right to include his/her family in care

decisions and/or to delegate decision-making to specific

person and/or appoint a surrogate to make healthcare

decisions on his/her behalf (to the degree permitted by

State Law).

The patient has the right to formulate advance directives

and to have hospital staff and practitioners who provide

care in the hospital comply with these directives.

The patient has the right to appropriate assessment and

management of pain.

The patient has the right to personal privacy.

The patient has the right to security and to receive care in

a safe setting.

The patient has the right to be free from all forms of

abuse or harassment.

The patient has the right to access protective services.

The patient has the right to be informed of any restrictions

(i.e., patient visitors, mail, telephone calls, or other forms

of communication).

The patient has the right to be free from seclusion and

restraints of any form that are not medically necessary

and/or are imposed as a means of coercion, discipline,

convenience, or retaliation by staff.

The patient has the right to respective and supportive

treatment and service at all times and under all

circumstances with recognition of his/her person dignity.

The patient has a right to receive pastoral counseling.

The patient has a right to be involved in resolving dilemmas

about care decisions

The patient has a right to complain.

The patient has the right to the confidentiality of his/her

clinical records

The patient has the right to access information in his/her

clinical records within a reasonable timeframe.

Regardless of the source of payment for his/her care, the

patient has the right to request and receive an itemized and

detailed explanation of his/her total bill for services

rendered in the Hospital.

The patient shall be accorded impartial access to

treatment or accommodations that are available

within the Hospital’s capacity, its stated mission,

and applicable law and regulation. Regardless of

the reason a patient seeks medical/hospital

care, patients with the same health problem

shall receive the same level of quality care

throughout the organization.

The care of the dying patient provided by Clear

Lake Regional Medical Center will optimize the

comfort and dignity of the patient.

Standards – Students will be held to the

standards of competent professionals when

performing all duties.

Uniform – Each student must wear appropriate

uniform, school picture ID and badge provided by

Education Dept while on Hospital property AT ALL

TIMES. Students are expected to follow other

dress code policies of the hospital. The hygiene

and appearance of healthcare professionals has a

significant effect on the confidence our patients

and visitors have in us.

Calling in if unable to report to duty – The student is

expected to call their instructor or the specific unit or

department assigned to him/her if they do not have an

instructor present during their clinical rotation. Please

call at least 2 hours before the shift and provide the

following information: name, school, unit, instructor’s

name and reason for absence.

Transcription of Doctor’s Orders – Students may NOT

transcribe doctor’s orders. The nurse or employee taking

care of the patient is responsible for transcribing the

doctor’s orders and communicating new orders to the

student. The student may not receive verbal or telephone

orders from a physician.

No eating or drinking in areas outside the

cafeteria or break rooms. (You cannot eat

in the lobby)

Cafeteria – The student will receive a discount on meals

purchased in the Cafeteria while they are at this facility

during a clinical rotation.

Elevators – The back “service” elevators should be used

for transporting patients and/or equipment from one area

to another. The front elevators may be used when

discharging patients.

Parking – See the last page of this booklet for approved

parking areas. Carpooling is highly encouraged due to

the high volume of students. The student may be asked to

move their vehicle if they are parked in an unapproved

area.

Handling of Narcotics –

A student nurse may be allowed to administer narcotics under

the supervision of his/her instructor or employee preceptor.

Narcotics will be dispensed from the PYXIS Medication System.

The instructor or employee will enter the system with an

access code and a secure password. Medications are then

documented in eMAR.

The instructor or nurse will check all medications prior to

student administration. Medications are dispensed via the

PYXIS medication cabinet or the Robot system.

IV Therapy/Phlebotomy – Students may perform IV therapy and

phlebotomy techniques following instruction and skills practice

in their academic program. Students may obtain blood using

butterflies, needle and needle holder and start cathlon IV’s.

They may also change IV tubing and bags; hang medications

(IVPB); and monitor drip rates as set forth by their school

guidelines.

DO NOT

ATTEMPT

MORE THAN

2 IV STICKS

Students will work in conjunction with the

CLRMC employee to give patient care. When

reporting on duty, the student will communicate

his/her responsibilities for patient care to the

assigned employee. When reporting off duty,

the student will provide the hospital employee

with completed documentation forms for each

patient, along with a verbal report. The

instructor must be present if the student has not

attained clinical competency in a procedure.

At the department level: Staff will work with the

students on their assigned unit to become

familiar with pertinent unit-specific policies and

procedures.

When discharging a patient, the student must

have the Primary Nurse co-sign the discharge

summary sheet. (Remember to give the

patient the “patient copy” of the form).

Students may not take discharged patients

to the patient pick up area alone. They

must be accompanied by a CLRMC

Employee.

VERY IMPORTANT!

Students may NOT hang blood or blood

products.

Students may NOT ‘pick up’ blood or blood

products from the Blood Bank.

When supplies are issued to a patient, the caregiver is

responsible for ensuring that the supplies given are scanned

and accounted for. Supplies are scanned for two reasons. One

is for inventory control. When an item is scanned out to a

patient, it is deducted from inventory and our central supply

department will know when supplies need to be restocked.

The second reason an item is scanned it to charge the patient.

Some items are “chargeable” to the patient and some are not.

If an item is not patient chargeable, the department will be

charged.

**Please make sure you scan ALL items that are taken out of

the supply or POU room.**

This is used to transport specimens between the Nursing units and

Laboratory as well as to transport medications from the Pharmacy to

the Nursing units. The CTS bins are kept locked. A key is available on

each nursing unit, AOS, Engineering and Pharmacy.

ITEMS NOT APPROVED FOR TRANSPORT IN CTS

24 hour urines

Empty blood bags

Blood components

Ice

Drinks or food items

Contaminated supplies

Money/checks

Sharps

Patient valuables

Non-leakproof containers

containing liquids

Formalin or other hazardous

chemicals

Chemotherapy drugs

Narcotics

Albumin/immune globulin

Vaccines

Home medications

Colony Stimulating Factors

TPA

PACKAGING

Potentially infectious items must be

contained and transported in a manner that

prevents breakage, leakage or contamination

of the system. In accordance with Standard

Precautions and OSHA Bloodborne Pathogen

regulations, all blood and body fluids must

be handled as potentially infectious. A

combination of ziplock bag, Zip-N-Fold

pouches, and foam liners will be used to

immobilize and package items.

The TIGR System is our patient education Video on Demand

system. These videos are stored in a computer database that can

be accessed 24 hours a day to educate patients on various topics

such as cardiovascular, diabetes, mother-baby, and other

pertinent health care topics related to their needs.

The TIGR system can be easily accessed on the bedside phones at

extension 2983. The phone will give you prompts to pick one of

the 60 programs with its 3 digit codes. There are bright orange

flyers on the units with program selection guides.

It is important to know that none of these patient video services

cost the patient any fees. The costs are included in their room

charges.

Students

may park

For additional information including updated

approved parking locations, please contact

the Education department.

Education Department

281-338-3340