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STUDENT NURSING ORIENTATION

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Title: STUDENT NURSING ORIENTATION


1
STUDENT NURSING ORIENTATION
  • NorthShore University HealthSystem

2
A Message from the Chief Nursing Officer
  • Nancy T. Semerdjian, RN, BSN, MBA, FACHE

3
Our Vision
  • for Nursing at NorthShore University
    HealthSystem (NorthShore) is to be recognized
    nationally and locally for our commitment to
    providing the very best quality of care and to be
    a destination for superior nursing care and
    leadership.   We are committed to embracing the
    core values of compassion, excellence,
    collaboration and innovation.

4
Our Goals
  • are to provide a professional environment
    that promotes superior patient care, shared
    decision making, and collaborative practice for
    every nurse at NorthShore.  We are committed to
    the professional growth of our staff through
    continuous learning and evidence-based nursing
    practice.  We hope to establish NorthShore as the
    destination of choice for professional nurses to
    embark on a challenging and rewarding career
    path. The recruitment and retention of
    knowledgeable, highly skilled, motivated nurses
    is critical to our success.

5
Our Journey
  •  to Excellence offers the venue for
    demonstrating our long term commitment to
    excellence to all of NorthShore and to the
    surrounding communities we serve. It is a journey
    that fully supports the NorthShore mission to
    preserve and improve human life through the
    provision of superior care, academic excellence
    and innovative research. 

6
Our Nursing Leadership Team
  • provides the foundation for achieving our goals.
    Nursing Administration promotes the development
    of leaders at all levels through continuous
    learning and knowledge sharing. We create an
    environment that promotes data-based decision
    making, participative management, quality, and
    cost-effective care.

7
Nursing Core Values
  • Excellence
  • Excellence in patient centered care
  • Collaborative Practice
  • Shared decision making that fosters
    accountability, participation, and loyalty
  • Innovative Technology
  • Use state of the art technology to enhance
    innovation

8
Nursing Core Values
  • Education
  • A learning environment that advances nursing
    clinical and administrative leadership.
  • Research
  • Evidence based clinical research that focuses on
    improved outcomes

9
Emergency Codes
  • Color Code Quick Reference Chart

10
Activating a Code
  • Activate the Emergency Code System by dialing
    3199 and announcing the type of emergency and the
    location. All codes will be announced through
    the overhead public address system. Code actions
    are in effect until an all clear is announced
    overhead.

11
Color Code Quick Reference Chart
Code Red Fire
Code Yellow Code Triage Standby
Code Gray Behavioral Dyscontrol
Code Black Severe Weather Condition
Code Green Internal Emergency
12
Color Code Quick Reference Chart
Code Blue Medical Emergency
Code Pink Missing Infant/Child
Code White Bomb Threat
Code Purple Evacuation
13
Color Code Quick Reference Chart
Code Orange Hazardous Material
Code Lavender Facility Lockdown
Code Beige Chemical/Biological/ Radiological
Code Silver Incident Command Activated
14
Pain Management
  • The NorthShore philosopy towards pain and pain
    management is
  • If a patient says he is in pain, we believe him.
  • Every patient has the right to pain management
  • Review the policy in Clinical Practice Manual
    (CP07-1003).
  • The Clinical Practice Manual is located on the
    NorthShore intranet, the Pulse, which may be
    accessed on the clinical unit from any computer.

15
Parking
  • Evanston Hospital On your first day, please park
    in 1000 Central parking garage across the street
    from the hospital. Each student will be asked to
    fill out a parking form and take it to the
    Hospital Parking Office on Girard Street at the
    entrance to the parking structure. Once a
    sticker is issued, students should park in the
    Ryan West lot which is located on Central Street
    just West of Ryan Stadium, but before the Metra
    tracks.
  • Glenbrook Hospital Park in the Employee/Medical
    Office Building Staff parking WEST of the new
    Ambulatory Care Center Building, parking lot
    sections BLUE 1-12 closest to Landwehr Road

16
Parking
  • Highland Park Hospital Parking is available in
    the areas designated for employees. Please note
    that parking in spots designated for handicapped,
    emergency, and patient/visitor parking is
    strictly prohibited.
  • Skokie Hospital Park in the Employee parking lot
    on the west side of the Kenton building off Knox
    Ave. Park only in the yellow outlined spaces
    towards the back. The white outlined spaces are
    reserved for patients and visitors. Parking is
    free.

17
Rapid Response Team
  • Purpose
  • To improve the quality of patient care, provide
    support and mentoring for the nursing staff
    outside of the critical care units in the care of
    patients with a deteriorating clinical condition.
  • Team Members
  • ICU RN
  • Respiratory Therapist
  • Nursing Consultant

18
Rapid Response Team
  • Rapid Response Teams (RRT) reduce incidents of
    cardiac and respiratory arrests and decrease
    mortality rates. The RRT may be initiated by any
    member of the health care team

19
Rapid Response Team
  • When should I call?
  • Acute change in RR lt8 or gt28 breaths per minute
  • Acute change in O2 sat. lt90 despite O2 _at_
    4L/nasal cannula or mask _at_ 50
  • Acute change in heart rate lt40 or gt130
    beats/minute or change in rhythm
  • Acute change in SBP lt90 mm Hg
  • Acute change in LOC and/or seizures
  • Staff concern that something is wrong with the
    patient

20
Rapid Response Team
  • How Do I Call?
  • Dial 3199 and state, The Rapid Response Team
    is needed, (provide the location).
  • The operator will page the RRT there will be no
    audible announcement.
  • The RRT team will arrive within 5 minutes,
    assist the primary nurse in the management of the
    patient and determine if the patient will remain
    on the nursing unit or transfer to the ICU

21
Rapid Response Team
  • What is the responsibility of Primary Nurse
    before the team arrives?
  • Remain with the patient
  • Alert other team members to cover other patients
  • Take vital signs
  • Place patient on bedside monitor
  • Have Jetson brought to the room
  • Have the 12-Lead EKG brought to outside of the
    room to have in the event it is needed.

22
Rapid Response Team
  • What does the Primary Nurse do when the RRT
    arrives?
  • Provide the team an SBAR report
  • Remain in the room with the RRT
  • Continues to function as the Primary Nurse for
    the patient

23
The SBAR Report
  • Before paging the physician
  • 1- Assess the patient head to toe
  • 2- Review the chart for appropriate physician
    appropriate call
  • 3- Know the admitting diagnosis
  • 4- Read the most recent Progress Notes and the
    assessment from the nurse of the prior shift
  • 5- Have available when speaking with the
    physician
  • ? The Epic chart ? Allergies ? Meds ? IVs ?
    Labs/results
  • ? Recent VS you took ? Code Status
  • 6- Text page the physician using the computer.
    Always include your name and so the doctor will
    know who to ask for. Let the concierge know you
    have placed the call

24
The SBAR Report
  • Situation
  • State your name and clinical unit.
  • I am calling about Name Room Number
  • The problem I am calling about is
    _____________
  • I am concerned about
    example BP 200 100 or a change of 30 mm
  • Pulse 140 50 Resp. 5 40 Temp
    96 104

25
The SBAR Report
  • Background
  • Be prepared to discuss the following, especially
    with an on-call/consulting MD
  • Admission diagnosis and date of admission
  • Pertinent medical history
  • Brief synopsis of the treatment to date

26
The SBAR Report
  • Assessment
  • State what you think the problem is changes in
  • ? BP _______ ? Pulse ________ ?Temp._____
  • ? Pain Eval ____ ? O2 Sats ________? O2 ______
  • ? Mental Status ? Respiratory rate/quality
  • ? Heart rhythm ? Breathing ? Neuro Signs
  • ? BP, ? Pulse, rate/quality ? Wound drainage
  • ? GI/GU ? NV ? Diarrhea ? Skin Color

27
The SBAR Report
  • Request/Recommendation
  • ? Pt. seems unstable may get worse. We need to
    do something
  • ? I am not sure what the problem is but the
    patient is deteriorating.
  • REQUEST
  • ?Transfer to a higher level of care ? Come to see
    the patient
  • ? Ask for a consultant
  • ASK Do you need any tests?
  • ? CXR ? ABG ? EKG ? CBC ? BMP ? BNP ? Other
  • Do you want to change?
  • ? Medication ? Treatments
  • What parameters do you want to be called about?

28
The SBAR Report
  • DOCUMENT
  • The change in patients condition, in notes
  • Orders received
  • Physician notification time and report given
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