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Title: Mandatory Education


1
Mandatory Education
  • Nursing Department

2
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.

3
MSU Mission
  • The mission of Minot State University is to
    advance knowledge, critical and creative
    thinking, and the vitality of community and
    cultures.

4
MSU Core Values
  • Student Learning first
  • Pursuit of Excellence
  • Responsibility
  • Respect
  • Learning Community

5
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.

6
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.

7
  • The mission of the Department of Nursing is to
    educate individuals for professional roles in
    nursing and for graduate education.

8
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.

9
  • 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
    self-actualization.

10
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.

11
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 persons state of well being
    at the time that nursing occurs. Health is
    personal and can range from high-level wellness
    to terminal illness.

12
Nursing
  • Is defined as an application of scientific
    knowledge enhanced by artful practice in a
    socially responsible manner.

13
Nursing Education
  • Nursing education is viewed as process designated
    to facilitate learning. Students and faculty are
    active and responsible participants in learning.

14
  • 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
    Nursings Mission and Philosophy.

15
The Following Threads Are Woven Throughout Our
Program
  • Professionalism
  • Research
  • Holistic health
  • Globalization

16
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.

17
  • 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.

18
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.

19
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.

20
  • 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.

21
Globalization
  • The baccalaureate nurse is prepared to practice
    professional nursing in a global society, with an
    awareness of diversity and varied cultures.

22
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 worlds 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.

23
Theoretical Constructs
  • The Department of Nursings 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.

24
Major Theoretical Constructs
  • Nightingales (1969) emphasis on environment to
    optimize health
  • Leiningers (1978) advocating for cultural care
  • Watsons (1979) premise that caring is the soul
    of nursing

25
MSU Nursing Department Specific Information
26
Department of Nursing Committees
  • The Department of Nursing has student
    representatives on 2 committees. They are
  • Student Faculty Affairs
  • Curriculum Committee

27
Curriculum Committee
  • Deals with course/class concerns and text books.
  • Meets 3rd Friday of month, watch the bulletin
    board for notices.

28
Student Faculty Affairs
  • Plans for scholarships, handbook changes,
    policies parties.
  • Also 3rd Fridays. Check the bulletin board for
    notices.

29
Student Scholarships
  • Awards Ceremony
  • 24 scholarships
  • criteria is located in the back of your handbook.

30
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.

31
Safety Information
32
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.

33
Policies Procedures
  • Clinical facilities have their own specific
    policies procedures.
  • Faculty will point out their location at the
    clinical settings.

34
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 agencys Exposure control Plan
    and in the Infection Control section of the
    agencys policy and procedure manual.

35
  • 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.

36
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

37
Personal Protective Equipment
  • PPE examples are
  • Gloves
  • Masks
  • Gowns
  • Plastic aprons
  • Goggles with protective shields

38
Hand Hygiene
  • Must take place between patients, after
    procedures and when in contact with patient
    equipment, linens, supplies and immediate
    environment.

39
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.

40
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.

41
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.

42
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.

43
Important!
  • Perform hand hygiene before and after using
    gloves!
  • Gloves are changed between all client contacts.

44
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.

45
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.

46
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.

47
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.

48
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.

49
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.

50
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)

51
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.

52
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.

53
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 1100, with
    Dispatch, or Vesphene.

54
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.

55
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.

56
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

57
  • 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

58
  • 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)

59
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.

60
Blood Exposure, Cont.
  • Results will be returned to you. Follow-up
    testing or treatment will depend on the test
    results.

61
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.

62
HBV
  • The vaccine is recommended for students but is
    not mandatory.

63
Hepatitis C
  • There is no prophylaxis for Hepatitis C.

64
Isolation Precautions
  • Tier 1 Standard Precautions
  • Tier 2 Transmission-Based Precautions

65
Standard Precautions
  • Used for the care of all persons regardless of
    their diagnosis or possible infections.

66
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.p
    df

67
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.

68
Change
  • Per the 2007 Guidelines, the term Airborne
    Infection Isolation Room (AIIR) replaces
    Airborne Precautions

69
New Elements Include
  • Respiratory Hygiene/Cough etiquette
  • Safe Injection Practices
  • Masks for Special Lumbar Puncture Procedures

70
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.

71
Elements of Respiratory Hygiene/Cough Etiquette
  • 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.

72
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.

73
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.

74
Transmission Based Precautions
  • There are 3 categories, which are used in
    addition to Standard Precautions.
  • They are
  • Airborne
  • Droplet
  • Contact

75
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

76
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 isnt 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

77
Airborne Transmission, cont.
  • Examples
  • Varicella (chicken pox)
  • TB
  • SARS
  • Measles (rubeola)

78
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

79
Droplet Precautions, cont.
  • Examples
  • Diphtheria
  • Myoplasma pneumonia
  • Pertussis
  • Mumps
  • Rubella
  • Streptococcal pharyngitis
  • Scarlet fever in children

80
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 clients
    environment.

81
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)

82
Contact Precautions, cont.
  • Examples
  • Certain Gastrointestinal and respiratory
    illnesses
  • Wound infections
  • Colstridium difficile
  • Impetigo
  • Shigella (dysentery)
  • RSV

83
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.

84
  • HIPAA sets up strict guidelines that define a
    patient or residents 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

85
  • 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

86
  • 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

87
  • 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

88
  • 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.

89
  • 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.

90
  • 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.

91
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.

92
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
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