CLINICAL STUDENT HANDBOOK
DEPARTMENT OF VOLUNTEER SERVICES AND
STUDENT REGISTRATION
www.wrh.on.ca
VOLUNTEER INQUIRIES Metropolitan Campus 1995 Lens Avenue, RM # 1413, Windsor, ON, N8W 1L9 (519) 254-5577 Ext. 52575 Ouellette Campus 1030 Ouellette Avenue, RM# 1-504, Windsor, ON, N9A 1E1 (519) 254-5577 Ext. 33345
CLINICAL STUDENT INQUIRIES
Ouellette Campus 1030 Ouellette Avenue, RM# 1-504, Windsor, ON, N9A 1E1 (519) 254-5577 Ext. 33673
November 2015
Clinical Student Handbook 2
INTRODUCTION
Welcome to Windsor Regional Hospital (WRH)
We at Windsor Regional Hospital (WRH), welcome your interest to serve as a member of our Volunteer and Student Programs, we look forward to having you join our team of enthusiastic and devoted Volunteers, Students and Staff members. Windsor Regional Hospital strives to be patient-centered in every service we provide. Your skills and services will help us in our efforts to provide quality care and service to our patients and their families. Our organization would not be able to provide an outstanding care experience without the commitment of Volunteers and Students like you. We hope that you will find your experience at Windsor Regional Hospital both meaningful and rewarding. This Clinical Student Handbook will help introduce you to the policies and expectations that govern the clinical student internship programs at Windsor Regional Hospital. Together, we will:
share in the responsibility of meeting the needs of our patients
demonstrate our commitment to excellence by providing a safe and friendly environment for those entrusted to our care
provide outstanding care with compassion.
We hope you will be proud of your contribution of time, skill and talents to the patients and staff at Windsor Regional Hospital. Sincerely, Volunteer Services & Student Registration Team
Clinical Student Handbook 3
Section Page
CAMPUS LOCATIONS/VOLUNTEER SERVICES/STUDENT REGISTRATION TEAM 6
Metropolitan Campus/Windsor Regional Cancer Centre 7
Ouellette Campus 7
BECOMING A CLINICAL STUDENT/REGISTRATION PROCESS 8 Becoming a Clinical Student at Windsor Regional Hospital 9
Clinical Student Responsibilities During Placement 10
Attendance 10
Sign in Procedures for Internship Credit and Attendance Records 11
Statutory/Observed Holidays 11
Reference Letters 12
Internship Evaluations 12
Change of Address/Phone/Email/Emergency Contact Number 12
Locker Information 13
Termination 13
Parking Privileges at the Met and Ouellette Campus 14
Cafeteria Services 14
Pre-Registration Paperwork and Orientation Requirements 15
Police Clearances: Vulnerable Persons/Pardon for Sexual Offences 16
Health Requirements 17-18
Mask Fit Testing 18
Post Secondary Student Unpaid Work Placement Insurance Form (WSIB) 19
PROFESSIONAL CONDUCT/ETHICAL GUIDELINES/CONFIDENTIALITY 20
Professional Conduct 21
Ethical Guidelines 22
Confidentiality/Privacy 22-23
TABLE OF CONTENTS
Clinical Student Handbook 4
TABLE OF CONTENTS CONTINUED
SECTION PAGE
POLICIES AND PROCEDURES 24
Policy Library 25
Citizenship Status 25
Smoking 25
Dress Code Policy 25
Foot Wear Policy 26
Fragrance and Scent Policy 27
Identification Badge/Proximity Cards/PALS Alarms 27
Workplace Violence, Harassment and Bullying Policy 28-29
Accessible Customer Service 30-32
Social Media Policy 33-34
WORKPLACE SAFETY 35
Safety Responsibilities/Roles Regarding Safety 36
Responsibilities as a Windsor Regional Clinical Student 37
Safety/Routine Practices 38
1. Infection Control
Hand Hygiene
How to Wash your Hands
4 Moments of Hand Hygiene 2. Personal Protective Equipment (PPE)
Protective Gear
Gloves
Donning and Doffing 3. Proper Sharps Disposal
What is a Sharp
Disposal of Sharps
Need Stick Injury 4. Incident Reporting 5. Precaution Signs throughout the Hospital
38-40
41-42
43-44
44 45
Clinical Student Handbook 5
TABLE OF CONTENTS CONTINUED
SECTION PAGE
OCCUPATIONAL HEALTH & SAFETY/WHMIS 46
Commitment-Policy Statement/Safety Laws/References 47
Workplace Hazard Definitions 48
Workplace Hazardous Material Information Systems (WHMIS) 49
Material Safety Data Sheets (MSDS)/Safety Labels 50
Ergonomics & Proper Back Safety (Bending/Pushing/Pulling) 51
Body Mechanics/Sitting at Computer 51
Body Mechanics/Moving and Lifting Items 52
Lifting and Transferring a Patient/Safety Tips 53
Emergency Codes for Hospitals 54
What to Do in an Emergency – How to Call a Code 55
What to Do Once a Code is Called/Emergency Code Kits 55
The Role of the Student in the Event of an Emergency Code is Called 56
Code Red/Code Red Drills 56
Fire Safety (RACE/PASS) 56
Code Blue (Medical Emergency/Cardiac Arrest/Outside of Building) 57
Code Green (Internal Evacuation) 57
Code Yellow (Level I – Missing Patient, Level II - Infant/Child) 58
Code Black (Bomb Threat – Phone or Mail) 58
Code White (Violent Person) Code White Response 59
Code Brown (Level I, Level II, Level III) 60
Code Pink (Medical Emergency in an Infant) 60
Code Orange (External Disaster) 61
Code Purple (Hostage Situation/Person with Weapon) 62
PATIENT FOCUSED CARE AND SAFETY 63
Patient Bill of Rights/Patient Responsibilities 64
Patient/Client Identifiers 65
Patients In Bed/Additional Patient Safety Factors 65-66
Wheelchair Safety Instructions (Staxi – Stackable Wheelchairs) 67-68
Clinical Experience at Windsor Regional Hospital/Lean on Us 69
Clinical Student Handbook 6
OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
CAMPUS LOCATIONS
VOLUNTEER SERVICES/
STUDENT REGISTRATION
TEAM MEMBERS
Clinical Student Handbook 7
Volunteer Services and Student Registration Team
METROPOLITAN CAMPUS
CANCER CENTRE
OUELLETTE CAMPUS
METROPOLITIAN CAMPUS 1995 Lens Avenue, RM# 1413
Windsor, Ontario, N8W 1L9
Anita Schawillie, Volunteer Coordinator (519) 254-5577 ext. 52343
Carolyn Brown, Student Registrar, Nursing Students
(519) 254-5577 ext. 52563 Fax: (519) 985-2616
Office Hours: 8:30 a.m. to 4:30 p.m.
OUELLETTE CAMPUS 1030 Ouellette Avenue, RM# 1-504
Windsor, Ontario, N9A 1E1
Renee Hopes, Manager Volunteer Services & Student Registration
(519) 254-5577 ext. 33184
Connie Tomalty, Student Registrar, Clinical Students (519) 254-5577 ext. 33673
Fax: (519) 255-2126
Office Hours: 8:00 a.m. to 4:30 p.m.
Allied Health Services
Ambulatory Care & Outpatient Clinics
Emergency Services
Family Birthing Centre
ICU/CCU/Cardiology
Medicine/Oncology/Surgery
OR/PAC/Day Surgery
Pediatrics/NICU
Acute Care Services
Allied Health Services
Cardiology/Cath Lab
Day Surgery
Diagnostic Imaging
Emergency Services
ICU
CAMPUS LOCATIONS
Chemotherapy
Clinical Trials/Research
Lab Services
Prevention Programs
Radiation/Oncology
Screening
Systemic Oncology Programs
Lab Services
Mental Health
Neurology/Neuro Surgery
Outpatient Clinics
Renal Dialysis
Clinical Student Handbook 8
OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
BECOMING A
CLINICAL STUDENT/
REGISTRATION PROCESS
Clinical Student Handbook 9
A “CLINICAL STUDENT” is a valuable position that allows you to demonstrate your hard-work and passion in the field for which you have chosen to study. This opportunity will offer hands on experience and help you to understand the importance of keeping focused on the patient. This opportunity allows you to work as a team demonstrating compassion not only for the patient but for their families providing exemplary care. You will work closely with a professional health care team and gain excellent interpersonal and critical thinking skills. You will be presented with opportunities to network with other health care professionals to focus on career launching opportunities.
The following guidelines in this handbook have been developed for Clinical Students to help facilitate a positive learning experience at Windsor Regional Hospital. All Clinical Students must complete pre-placement registration paperwork and review Windsor Regional Hospital orientation policies and procedures prior to placement. The overall registration process can take 3-4 weeks to complete. Registration paperwork needs to be submitted to the Student Registrar to confirm if the student meets the requirements of Windsor Regional Hospital before a placement can begin.
Clinical Students are expected to follow the guidelines of professional behavior and safety initiatives at all times while on hospital premises. Always keep patient safety and personal safety in mind i.e. good hand hygiene and adhering to all applicable health and safety rules.
Clinical Students are required to sign a Confidentiality Statement/agreement and have Workers Compensation Insurance coverage provided by their educational facility. Students are the direct responsibility of the department manager/supervisor/training delegate assigned to them. Students will be asked to sign in/out at a Kiosk for the duration of their placement. The Kiosk will log your hours for internship credit and for security and for statistical purposes.
Windsor Regional Hospital’s vision and mission statement “Outstanding Care—No Exceptions” Delivering an Outstanding Care Experience Driven by a Passionate Commitment to Excellence” describes our commitment to patients, families, staff, students, volunteers and our medical community partners who provide care and support to all. We are looking forward to helping you to build the necessary skills to be successful in your future endeavors.
“We hope you have a positive learning experience at Windsor Regional Hospital”
BECOMING A CLINICAL STUDENT AT
WINDSOR REGIONAL HOSPITAL
Clinical Student Handbook 10
Clinical Student Responsibilities While on Placement:
Direct any problems concerning your placement to the Student Registrar of the Volunteer Services and Student Registration Department.
Sign in for each shift at the Kiosk. If completing your placement or any placement hours at an off-site location, you are responsible for submitting your off-site hours to the Student Registrar the 1st of each month. Failure to submit your hours on time maybe documented on your evaluation and notification will be given to your Field Placement Coordinator.
Report to your placement with your Windsor Regional Hospital ID badge clearly visible. You are required to return your WRH ID badge to the Student Registrar at the end of your placement along with any proximity access cards.
If you have been issued a security P.A.L.S alarm at the Ouellette Campus, it is your responsibility to return it to the Environmental Services Department at the end of your placement. The department is located in the lower lower level of the hospital. Failure to return your alarm will result in a $75.00 replacement fee.
Submit your student evaluation form to your direct supervisor or training delegate to be reviewed and returned to your placement coordinator at the school.
Cooperate with staff and fellow volunteers/students.
Follow your internship agreement and evaluation forms regarding your duties while on training.
Abide by the policies and procedures of the Hospital and of the Volunteer Services and Student Registration Department as described in this Clinical Student Handbook.
Report any workplace hazards, injuries or illnesses to your supervisor/manager or
training delegate.
Attendance
Be proactive and obtain the correct department phone number, cell phone and email addresses.
Notify your manager/supervisor/training delegate directly when you are unable to make your assigned shift or will be late. Several absences, problematic tardiness and/or leaving your shift early are not acceptable and will lead to the dismissal from your internship assignment.
Inform your manager/supervisor/training delegate of any "planned absences" (i.e., holidays, etc.) in advance and be prepared to make up those internship hours. Missing time should be discussed with your direct manager/supervisor/training delegate immediately
In case of illness, the student should not come to the hospital.
If illness occurs while on placement at the hospital, the student must notify his/her manager/supervisor or training delegate before leaving the hospital.
Clinical Student Handbook 11
Sign-In Procedures for Internship Credit and Attendance Records
Students must sign in before starting their shift and sign out at the end of their shift.
Sign-in procedures for students will be discussed during the registration interview with the Student Registrar. Met/Cancer Centre and Ouellette Campus students will use the designated Kiosk to log their hours.
Students placed at off site for placement or complete hours off-site will be given an individual time record log sheet to record his/her service hours which is required to be emailed or faxed the 1st of each month to the Student Registrar. Students are required to log their hours manually on the clipboard provided when the Kiosk machines are down for Security and attendance purposes and to make sure you receive credit for the day. The clipboards are located on top of the kiosk machine or in the hanging file folder. It is important that students maintain accurate service records for liability, emergency situations and for internship credit. Service hours are presented to the Hospital Administration, Ministry of Health and to the Board of Directors monthly.
Statutory/Observed Holidays
Students are responsible for checking with their Windsor Regional Hospital supervising manager/supervisor/training delegate regarding holidays and other hospital holidays i.e. Family Day. A listing of the holiday calendar year is available, contact the Student Registrar for a copy.
It is part of your responsibility during your internship to sign in and out at the beginning and end of your scheduled shift or submit any off-site placement hours to the Student Registrar the 1st of each month. Consistency is part of your responsibilities while on placement as a Clinical Student at Windsor Regional
Hospital.
Clinical Student Handbook 12
Reference Letters If you would like to receive a letter of reference regarding your placement with us, it is up to you to request one for your direct manager/supervisor or training delegate. Due to the detailed nature and uniqueness of your placement, the Student Registrar is not able to comment on your overall performance but can confirm your attendance, participation and share any comments made by staff regarding your performance with the Human Resources Department. If you require a letter of reference, please request it at least 14 days prior to the end of your placement. It is up to the discretion of each manager/supervisor or training delegate to determine if a letter can be provided. Windsor Regional Hospital is not obligated to complete one on your behalf. You may choose to request that the following information be included in your reference letter:
Area of placement (including campus)
Dates of placement
Specific examples of successes during your placement
Name of direct manager/supervisor or training delegate
Internship Evaluations
It is recommended that you inform your manager/supervisor/training delegate within the first week of your placement that you need an evaluation review completed during your placement. Your performance will be evaluated by the person who is overseeing your placement. Please allow sufficient time for staff to complete your evaluation. It is your responsibility to ensure that your Field Placement Coordinator receives your evaluation in a sealed envelope. Staff will not keep copies of your evaluation review nor is a copy kept in your student file unless a copy is forwarded directly from your manager/supervisor or training delegate to the Student Registrar.
Change of Address/Phone/Email or Emergency Contact Number
Report any changes in your address, home, cell phone or email or emergency contact to the Student Registrar of the Volunteer Services and Student Registration Department to keep your records up-to-date, this information is important in the event of an injury while on placement.
Clinical Student Handbook 13
Locker Information
A limited number of lockers are available for students. If a locker, closet or locked cupboard is not available in your placement area, please ask the Student Registrar for details on the assignment of lockers. It is your responsibility to ensure that personal belongings are in a secure area. Windsor Regional Hospital is not responsible for missing or damaged items.
Termination
The Volunteer Services and Student Registration Department reserves the right to discipline and/or terminate a student as a result of:
Failure to comply with hospital policies, rules and procedures
Problematic attendance
Negative or inappropriate comments and/or conduct
Failure to maintain a clean and professional dress code
Breach of Confidentiality
Any other circumstances, in the judgment of the Volunteer Services and Student Registration Department, where continued service as a student is in conflict with the best interests of the hospital and its patients.
In less severe situations, disciplinary actions may include verbal and/or written warnings and in some cases suspension from your placement. In the event that you choose to discontinue your placement at Windsor Regional Hospital, you are required to notify the following individuals immediately:
Student Registrar of the Department of Volunteer Services and Student Registration
Your direct manager/supervisor/training delegate within the placement area assigned
Clinical Student Handbook 14
Parking Privileges
The following parking options are currently available: Met Campus/Cancer Centre:
Free parking is available in the hospital shuttle parking lot located off of Kildare and Seneca Road in the PSA Quality Systems lot due to limited space in the main visitors parking area.
A shuttle van will pick you up from the shuttle stop and drop you off at the main entrance of the hospital. Upon leaving, the shuttle van will pick you up at the front entrance of the hospital and drop you off at the lot which you parked.
Shuttle service is available Monday-Friday, 6:30 a.m. to Midnight.
If you are scheduled for weekend shifts or holidays, you may park in the Lens Avenue Patient/Visitor Parking Lot. You must show your Windsor Regional Hospital ID badge to exit.
NOTE: The Lens Parking lot is for WEEKEND USE ONLY as it is needed for patient and visitors during regular business hours.
Ouellette Campus:
If you find parking on the residential streets that surround the hospital, you can park there for free. Please note street signage and be respectful of community residents.
Parking is available in the hospital parking garage, entrance off of Erie Street for a fee of $7.00 a day.
A public parking lot is located off of Ouellette Avenue which is pay and display, daily max of $7.00 a day.
A private parking lots are located on Goyeau Street across from the Morris Sutton Funeral Home (68 Giles Blvd) for a flat rate of $4.00 a day which is within walking distance from the hospital, approximately two blocks from the Goyeau Street entrance.
Parking is available in Lot “G” located on the corner of Erie and Goyeau Street for $2.75 1st hour and $1.75 each additional hour, daily max of $7.00.
Tokens can be purchased at the Cashiers Office in packages of 10 for $30.00 and gives you 14 hours of parking privileges.
Cafeteria Services
There are designated eating areas at both campuses. Please use these areas during meal times and breaks. Snacks, beverages or meals are not to be consumed within patient areas.
• Metropolitan Campus, the cafeteria is located on the 1st Floor.
• Ouellette Campus, the cafeteria is located on lower level.
Please Note: Windsor Regional Hospital is not liable for any loss or damage to any vehicle while
parked on Windsor Regional Hospital property. Parking privileges may be revoked in the event that current students use their ID badge for personal visits outside of their student commitment.
Clinical Student Handbook 15
Pre-Registration Paperwork/Orientation Requirements
Clinical Students are required to complete/submit pre-registration paperwork BEFORE their first day of placement. This paperwork is to be given to the Student Registrar at least 4-6 weeks before their start date. The following are Windsor Regional Hospital Registration Requirements:
VULNERABLE PERSON/PARDON FOR SEXUAL OFFENCE POLICE CLEARANCE: Students who have basic Criminal Checks or Ontario Education Student Check (OESC) will be required to obtain a complete vulnerable person check with their local police department which they reside to meet the placement requirements of Windsor Regional Hospital. Contact the Student Registrar for any concerns or questions. See Police Clearances Section for further clarification.
HEALTH REVIEW: 2-Step Mantoux TB skin test (both arms, 7-days apart). If positive, an updated X-
ray will be accepted if it is dated within a year along with medical note giving clearance
Documented proof proving immunity to measles, mumps, rubella and varicella
Passports to health are accepted if dated within one year of start date
Mask fit documentation (if you have not been mask fit tested, contact the Student Registrar for further direction)
See Health Review Section for additional clarification of the health requirements required for placement at Windsor Regional Hospital.
POSTSECONDARY STUDENT UNPAID WORK PLACEMENT INSURANCE CLAIM FORM (WSIB):
Windsor Regional Hospital must receive a letter of confirmation from your Educational Facility/Field Placement Coordinator indicating that your educational facility is providing WSIB coverage for you while you are on placement. This letter must be received before a placement can begin.
Students coming from educational facilities out-of-province or from the United States who reside in Canada are not covered by the Ministry of Training for Colleges and Universities, students are asked to contact the Student Registrar for further clarification.
CLINICAL STUDENT HANDBOOK/WINDSOR REGIONAL HOSPITAL ORIENTATION: Students must read through the “Clinical Student Orientation Handbook” and be familiar with hospital policies and procedures and safety hazards. You will be asked to complete a “Check for Understanding” and submit it to the Student Registrar before your start date. You can find the “Check of Understanding” on the WRH website at www.wrh.on.ca/volunteer services.
CONFIDENTIALITY AND INTERNSHIP AGREEMENT FORMS: Students are required to sign a
Confidentiality and Internship Agreement Form before their placement start date. Preceptors for Physician Assistant Students are required to sign an Acceptance of Responsibility Form for their students before a placement can begin.
KIOSK ID NUMBER: Students will be assigned a Kiosk ID number which will required them to sign
in/out for attendance, internship credit, security and statistical purposes.
WRH ID BADGE/PROXIMITY CARD: Students must wear a Windsor Regional Hospital ID badge
while on placement. ID badges/Proximity cards will be distributed by the Student Registrar once the student has been cleared to start placement. ID badges and proximity cards are to be returned on your last day of placement.
You will be introduced to staff and receive departmental training/orientation including a tour of your floor by your direct manager/supervisor/training delegate. It is the responsibility of staff to provide you with any specialized training and safety hazards related to your area of study.
Clinical Student Handbook 16
Police Clearances: Vulnerable Person Including Pardon for Sexual
Offence
In compliance with the regulations set forth by the Ministry of Community and Social Services, a Vulnerable Persons Records check is a mandatory requirement for all prospective student placements. An enhanced search includes the “Pardoned Sexual Offences”. There are different levels of police clearances, they are as follows:
Criminal Records Check
Police Records Check
Vulnerable Persons Sector Check including the Pardon for Sexual Offence
Other Security Clearances: Ontario Education Student Check (OESC), Back Check, please contact the Student Registrar for further direction
In order to obtain a Vulnerable Persons Check (VPC) from your local police department, you will need to have an agency letter and form. If you have obtained a Vulnerable Person Police Clearance already and it is dated within the past 12 months of your placement start date, please email or fax your report to the Student Registrar for review in advance of your start date to confirm if it is acceptable for placement at Windsor Regional Hospital. You will be required to show your original copy of your police clearance to the Student Registrar on first day of placement.
Students who live locally and within Essex Country can be provided with these documents from the Student Registrar during your registration process. Students who live outside of Windsor/Essex Country will need to obtain these documents directly from your educational institute and bring them to your local police department prior to starting placement at Windsor Regional Hospital. NOTE: Please keep in mind that the various local Police Departments can take up to 4-6 weeks to process your clearance, please do not procrastinate in obtaining your clearance or your placement start date maybe delayed if you do not have a vulnerable person police clearance handed in to the Student Registrar prior to your start date.
If you live in the London or Toronto area, please allow 6-8 weeks for processing a Vulnerable Persons Check to ensure that you receive it back before you are scheduled to start your placement.
Clinical Student Handbook 17
Health Requirements
A pre-placement health review is required of all prospective students. The health screening process is to ensure the safety of our patients, staff, students, visitors and volunteers within a health care setting. The following must be completed and submitted to the Student Registrar prior to your placement date. If you are unable to submit your pre-health screening requirements before your placement, this may delay your start date.
Two Step Mantoux (Tuberculosis) TB Skin Test (both arms, 7 days apart)
If you have not been tested within 12 months: A 2-Step Mantoux skin test is required.
If you have been tested within 12 months: A one step Mantoux TB skin test is required within 4-weeks of your start date and you are required to provide documented proof of your previous TB tests dated appropriately (signature/stamp/letterhead is required by the administering physician/nurse).
TB tests completed longer than 12 months: If you have had at two negative Mantoux TB skin tests AND you have documented proof of your previous TB tests that include dates and signatures, you will only require one Mantoux TB test within 4-weeks of your start date.
Postive TB Tests: If you had a positive TB skin test, a chest X-ray is required. Windsor Regional Hospital will accept results of a negative chest X-ray within the last 12 months along with a medical note from your physician that indicates that you are free and clear of active disease and are cleared to complete a placement at Windsor Regional Hospital. The note must include the physician’s signature/stamp on the medical note. Any previous results should be forwarded to the Student Registrar if available.
Health Passports: Passport to health completed by your college or university health office are accepted providing that there are dates and signatures on the document, it must be dated within the last 12 months of your start date. If you have an expired passport, you will be required to obtain one updated TB test before your placement start date. Fax or email your passport to the Student Registrar for review prior to your start date for confirmation of your passport.
Immunization Records (Measles, Mumps, Rubella, Varicella)
Students are required to provide serology results proving immunity to Measles, Mumps, Rubella, and Varicella, acceptable documentation includes:
Two documented doses of MMR, one after 1st birthday and one booster dose. A lab report
proving immunity is required.
If born prior to 1970, you are considered age immune to Measles and Mumps but require proof of one dose of MMR after 1
st birthday or lab evidence of immunity to Rubella.
Clear history of Varicella/Shingles is required, lab evidence of immunity is mandatory.
Immunization cards must be signed or stamped by the physician/nurse.
The Influenza Vaccine is recommended between November and April.
Valid Health Card (OHIP).
If you are non-immune to one or more of the immunizations, you must receive an MMR booster vaccine with associated documentation. Please note the following:
MMR booster shots should be given on last day of TB testing and include the date and signature that it was administered.
Varicella vaccines are two shots, 4-weeks apart.
Clinical Student Handbook 18
N95 Respirator Fit-Testing
You are required to submit documented proof of your certified mask-fitting to the Student Registrar. This is part of your health registration paperwork before your start date. A copy will be kept in your student file. If you have not been mask fit tested, please contact the Student Registrar for clarification.
Educational facilities are responsible for fit-testing their students prior to placement. The manufacturer brand and model numbers tested for must coincide with those used by the hospital. Anyone exempt from using a respirator must be approved by the Occupational Health Office.
Only use the size of the respirator that you have been tested for do not use substitutions.
If your educational facility does not provide respirator fit-testing, please contact the Student Registrar for further clarification and direction.
Clinical Students are required to have their certification cards on them at all times while on placement.
Respirator Sizes Available at Windsor Regional Hospital
8210
8110s
9210 + (identical to 1870)
8271
Respirators are latex free
Clinical Student Handbook 19
POSTSECONDARY STUDENT UNPAID WORK PLACEMENT WORKPLACE
INSURANCE CLAIM FORM (WSIB)
Post Secondary Students attending an educational facility in Canada are covered by the Ministry of Education for Colleges and Universities. Students are responsible for ensuring that they have OHIP coverage. You will receive workplace insurance compensation if you are:
A student enrolled in an approved Postsecondary Program
Injured or contracted a disease while on an Unpaid Work Placement; and
Eligible for (WSIB) Workplace Safety Insurance Board as determined by WSIB (Workplace Safety Insurance Board)
Claims under the WSIA are made by submitting the following required documents to WSIB, with copies to Ministry of Training for Colleges and Universities (MTCU)
A WSIB Form 7
The letter of authorization
Postsecondary Student Unpaid Work Placement Workplace Insurance Claim Form signed by the student, The Placement Employer and The Institution
Out-of-Province and Private Educational Facilities: Out of province and private educational facilities are not funded by the Ministry of Education. If you fall in this category, you are to obtain a letter confirming insurance responsibilities from your educational facility. The letter must indicate that they are providing personal injury insurance to you during your placement. A copy of this letter must be submitted to the Student Registrar. The Student Registrar will ensure that an Affiliation Agreement is in place to verify WSIB coverage for all out of province students before a placement can begin. U.S. Educational Facilities: Students residing in Canada that attend an educational facility in the United States where the school does not provide personal liability insurance, this includes cases where students have purchased professional liability insurance. Approval is required by WRH Senior Leadership that the hospital will provide Worker’s Compensation Insurance while on placement and will cover the premiums in the event of an injury. If approval is not granted, you will not be able to participate in a placement program at Windsor Regional Hospital. In the event that this occurs, you and your Field Placement Coordinator will receive notification from the Student Registrar.
Note: It is the student’s responsibility to ensure they have medical and or other insurance coverage while interning as a clinical student. Many schools provide insurance for their students while on placement. If your educational facility does not provide coverage, please contact the Student Registrar immediately for further discussion.
Clinical Student Handbook 20
OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
PROFESSIONAL CONDUCT
ETHICAL GUIDELINES/
CONFIDENTIALITY
Clinical Student Handbook 21
Professional Conduct While on Placement
Your attitude and actions reflect on Windsor Regional Hospital. The following guidelines should assist you while on placement:
At all times, make sure your WRH ID badge is visible and identify yourself as a student.
Act and look professional; conduct yourself with dignity, demonstrate and promote a positive attitude.
Become familiar with the unit and the department’s routine.
Offer assistance to others.
Always answer the telephone professionally and identify yourself a student.
Keep appointments and return calls promptly.
Take the initiative - if unable to help directly, find someone who can.
Always think about the patient and family members and be sensitive to the needs of others.
Ask nursing or medical staff before giving patient something to eat or drink (including water, juice, candy, or food)
Eat/drink within designated areas (i.e. cafeteria, break rooms, outside) NOT IN THE PROGRAM AREAS/FLOORS.
Chewing gum is not appropriate during placement hours.
Windsor Regional Hospital is a NON SMOKING FACILITY, Smoking is only permitted in designated areas off campus.
Cell phones should be turned off or in silent mode during your scheduled shift and TAKING PHOTOS WITH YOUR CELL PHONE IS NOT PERMITTED. Be courteous and respectful to others when using your cell phone in various areas throughout the hospital.
Have consideration for your supervising manager/supervisor/training delegate and RETURN PERSONAL CALLS OR TEXTS ON YOUR BREAK OR LUNCH HOUR.
You must be with your direct supervisor/training delegate when entering patient rooms marked with a precaution sign. Speak to a nurse for additional information and clarification.
Behaviour disturbing or offensive to others shall be subject to disciplinary action up to and including discharge. Examples: shouting, gossiping, coarse language, provoking or a fight.
LEAVE PERSONAL PROBLEMS AT HOME - YOU ARE NEEDED TO HELP OTHERS
PROFESSIONAL CONDUCT
Clinical Student Handbook 22
ETHICAL GUIDELINES
Treat all people with respect & compassion--just as you would like to be treated.
Respect the privacy of others.
Knock on closed or partially closed doors and wait for patient/staff to respond before entering. Do not enter a room when a Physician, nurse/other staff are with the patient (unless directed otherwise by your manager/supervisor or training delegate).
Keep in confidence the many things you see, hear or learn within the hospital.
Respect the cultural and religious values of the patient and their families.
Do not ask the staff/physician for medical advice, medication or have a corridor consultation for your relatives, friends or yourself.
Do not give/receive gifts or money from the patient or their families.
Do not sell or attempt to sell goods or services, request contributions, solicit any written business or distribute political petitions on hospital premises.
CONFIDENTIALITY/PRIVACY
All students are required to sign a “Confidentiality Statement and Agreement Form” as well as an “Internship Agreement Form”. Doing so acknowledges that you understand you will have access to confidential information during your placement with us and you agree to keep this information confidential. These forms will be kept in your student file for up to six years. Access to confidential information may include patient information, family information, applications systems and/or internal hospital business.
Physician Assistant Students will need to have their direct supervisor sign an “Acceptance of Responsibility Form” before they begin placement. This form will also be kept in your file.
Information related to employees, employment and/or compensation, information regarding staff and affiliates, or information about the organization which has not been publicly announced by the organization also falls under this confidentiality agreement.
Every patient/staff/visitor/volunteer and student at Windsor Regional Hospital has a fundamental right to be treated in confidence. Therefore, all information acquired by a student including an individual's personal information (i.e. name, condition, treatment, doctor's name, etc.), any facility related business, staff information, personal or otherwise, is to be held with utmost confidence.
You have a legal and moral obligation to uphold the principles of confidentiality; failure to do so may result in the termination of your student status and/or personal legal action.
ETHICAL GUIDELINES
CONFIDENTIALITY/PRIVACY
Clinical Student Handbook 23
The following are guidelines that students should keep in mind to safeguard an individual's right to confidentiality:
Without exception, you are not to make photo copies or take pictures of any patient information, including your cell phone at anytime.
Avoid casually discussing a patient’s stay at Windsor Regional Hospital with anyone in hallways, patient rooms, elevators, cafeterias, etc.
When you are discussing a patient with someone involved in his/her care, keep in mind where you are and who might overhear.
Speak discreetly when asking personal questions or discussing his/her illness.
Don't take your privileged knowledge about anyone home with you to use as gossip. Become accustomed to saying, "I cannot disclose that information" to avoid any pursuit of the subject.
Windsor Regional Hospital has a legal and ethical responsibility to protect the privacy of patients/families, staff and affiliates and ensures that confidentiality is
maintained.
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OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
POLICIES &
PROCEDURES
Clinical Student Handbook 25
Citizenship Status
For insurance and liability reasons, we ask that students provide documented proof that they have the legal status to complete a placement in Canada.
Smoking
Windsor Regional Hospital is a non-smoking facility. There are limited exceptions for patients in designated areas, the areas are as follows:
Met Campus:
Corner of Byng and T2B Way
Corner of Kildare and T2B Way
Ouellette Campus: Outside of the Emergency Department on Goyeau Street
Southeast corner of parking lot “F”
Dress Code Policy
You are expected to maintain a neat, clean and conservative appearance. The way you dress should promote professionalism amongst visitors, patients and staff. Your attire may be casual, yet professional. These guidelines are in accordance with standards for health and safety of workers and our patients.
Uniforms must be worn at all times if the staff in your area is required to wear them please follow the same requirements (i.e. lab coats, scrubs, etc. business attire) you maybe asked to leave if you do not wear a uniform or respectable business attire.
Jewelry should be kept to a minimum (no large earnings or long necklaces).
Socks or hosiery may be required in certain departments, please consult your department manager/supervisor/training delegate for further clarification.
Blue jeans, yoga pants or form fitting tights are not appropriate business attire.
No shorts or short skirts/dresses, cut-offs, tight-fitting clothing, tank tops, sweats, shirts and tops exposing the midriff (stomach)
Shoes are to be comfortable, low-heeled, and closed toe in patient care areas. Clean running shoes are acceptable. Sandals, clogs or the like are not permitted.
HOSPITAL POLICIES
Policy Library: All policies and procedures can be found via the Policy Library on the Windsor Regional Intranet which is accessible via the Kiosks at the Met and
Ouellette Campus.
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Footwear Policy
Examples of appropriate footwear in patient care areas/lab include but not limited to:
Crocs must be closed over the foot (no holes) and the strap must be placed around the back of the ankle. This type of footwear may not be worn in the Lab and any other areas where the potential for exposure to physical, chemical and/or biological contaminants is high.
Examples of unacceptable footwear in patient care areas/lab include, but are not limited to:
Clinical Student Handbook 27
Fragrance and Scent Policy
Due to health concerns arising from exposure to scented products, you should limit strong perfumes, colognes, hand-lotions, soaps and hairspray while in the workplace. Adhere to the Scent Sensitive Alert and Scent Sensitive Environment signs posted in the identified areas. The aim is to provide a healthy environment for all employees, patients, visitors and volunteers and students.
Identification Badge
As a student, you are required to wear a Windsor Regional Hospital ID badge while on duty. Students should not wear their hospital issued ID badge once off duty.
ID badges are distributed through the Student Registrar of the Volunteer Services and Student Registration Department only NOT THROUGH THE SECURITY OFFICE.
When your student placement is complete, your ID badge should be returned to the Volunteer Services & Student Registration Department either at the Met or Ouellette Campus. Drop boxes are available at both campuses.
Proximity Cards
Ouellette Campus
Swipe proximity cards are to be distributed by the Student Registrar.
Students are responsible for returning the proximity card to the Student Registrar at the end of your placement not to the Security Office.
Met Campus When requesting proximity cards for areas at the Met Campus, the supervising
manager/training delegate is required to email the Student Registrar to request in writing the area(s) that are required and the proximity card will then be distributed by the Volunteer Services Office. All requests and proximity card numbers need to be recorded in the students file. Students are responsible for returning the proximity card to the Volunteer Services Office not the Security Office.
P.A.L.S. ALARMS P.A.L.S. Alarms are not issued by the Volunteer Services/Student Registration Department. If the
area which you are placed requires that you have a P.A.L.S alarm at the Ouellette Campus, it can be issued by the Environmental Services Department which is located in the lower level of the hospital. Failure to return your alarm will result in a $75.00 replacement fee.
Jane Smith CLINICAL STUDENT
Met/Ouellette Campus
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Workplace Violence, Harassment and Bullying
The Occupational Health & Safety Act states that an employer has the obligation to keep workers safe from Workplace Violence and address Workplace Harassment. Windsor Regional Hospital is committed to providing a safe and secure work environment, free from violence, threats, bullying, intimidation and harassment. Threats, threatening behavior or acts of violence against employees, members of medical/dental professional staff, patients, visitors, residents, affiliates (including students and volunteers) or other individuals on Windsor Regional Hospital property will not be tolerated. Windsor Regional Hospital Workplace Violence/Harassment Response Protocol Policy provides more information on what workplace violence, harassment, and bullying are and the protocol for addressing these issues. Guiding Definitions of Workplace Violence & Harassment:
WORKPLACE VIOLENCE
The exercise of physical force by a person against a worker, in a workplace, that causes or could cause physical injury to the worker.
An attempt to exercise physical force against a worker, in a workplace, that could cause physical injury to the worker.
The threat of physical force by a person to a worker in a workplace that cause or could cause physical injury to the worker.
WORKPLACE 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.
WORKPLACE BULLYING
Conduct which is known or ought reasonably to have been known, would undermine another individual’s self-esteem and damage that individual’s self confidence, examples include:
Sudden and unpredictable angry outbursts Rude or abusive comments or conduct Unjust, persistent criticism of a person, especially in the presence of others Belittling of a person’s opinions, especially in the presence of others Yelling at or using profanity towards someone Spreading false and malicious rumors, gossip or innuendo Purposefully excluding or isolating someone from normal work-related
interactions required to perform the job
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Things You Should Know and What to Do What to Do If You Experience Workplace Harassment/Bullying
Immediately report any threatening/violent behavior to your supervising manager/supervisor/delegate, the most responsible person (MRP) on the unit and the Student Registrar. Domestic Violence
Resources are available to assist you. If Windsor Regional becomes aware or ought to reasonably be aware of domestic violence that would likely expose a worker, student or volunteer to physical injury in the workplace, we will take every precaution reasonable to protect you. What to Do if you Experience Domestic Violence
If you are experiencing Domestic Violence, in order that we can assist keeping you and all staff/others safe while in our hospital, please report to your supervising manager/supervisor/training delegate so that we can work with you to devise a “safety plan”. You may also contact our Domestic Violence Program at 254-5577 ext. 52772. Provide Information to a Worker (Includes Volunteers and Students)
By law, employers are obligated to provide information to a worker to protect their health & safety including information about individuals they may encounter in the course of their work that may be violent and/or expose the worker to physical injury. Right to Refuse Unsafe Work
A worker may refuse to work or do particular work when they have reason to believe workplace violence is likely to endanger them. Promptly report any such circumstances to the most responsible person (MRP) and complete a RL6 report. While they investigate the circumstances, you will remain in a safe place that is as near as reasonably possible to your assigned work area. Confidentiality
Windsor Regional Hospital understands the sensitivity and confidential nature of the information gathered when reporting an incidence of violence, harassment or bullying and has developed confidentiality procedures that recognize and respect the privacy of all parties involved.
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Accessible Customer Service
Ontario’s Accessibility for Ontarians with Disabilities Act (AODA) requires all service providers to remove barriers faced by people with disabilities when accessing their services. What does this mean for WRH?
• Create policies and procedures
• Provide education to all staff, students and volunteers
• Allow people with disabilities to be accompanied by their service animal or support person, unless prohibited by law
• Provide notice when facilities/services are disrupted
• Establish a feedback process for how services are provided to people with disabilities, along with how to take action on any feedback
Providing Accessible Customer Service and what you can do?
• Always put the person first e.g. say “person who is blind” instead of “blind person”
• Give person time to carry out tasks
• Offer assistance in completing forms, etc.
• Put yourself at the same level – never push a wheelchair unless asked
• Let the person know about accessible features e.g. ramps, washrooms
• Don’t make assumptions about the person’s abilities
• Utilize multiple forms of communication e.g. verbal, written, pictures
• Be patient, calm and flexible
Service Animals
When is an animal considered a service animal?
• It is apparent the animal is used by the person for disability related reason
• The person possesses a letter from a medical professional but you can not ask to see the letter, you are to assume the person has it in his/her possession.
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Providing Customer Service to a Person with a Service Animal
• Service animals are not pets – they are working animals. Do not touch, feed or speak to the animal without permission
• A service animal may accompany a person with a disability anywhere the public is allowed to go, except where excluded by law
• If excluded by law, alternative ways to access services must be provided e.g. bringing services to the person, offering a safe location where the animal can wait
• The person with the disability is responsible for the supervision and care of the animal . Assisted Devices What is an Assistive Device?
• Device/technology that increases mobility, vision, hearing and communication capacities. Examples of Assisted Devices at WRH include:
• TTY (teletypewriter) phones – Hooked up to a phone/jack; allows for the typing of messages back and forth between telephones (available in the ED and at the Welcome Desk)
• Braille Augmented Keyboards – Mimics every key on a full standard keyboard; can be connected to the keyboard port on a computer (available via Switchboard)
• Elevators, crutches/canes/walkers, courtesy wheelchairs, call bells at bedsides, shower chairs, mechanical patient lifts, portable oxygen, photocopiers, etc.
Support Persons What is a Support Person?
• Someone whose presence at an activity is justified by the support and assistance he/she provides exclusively to the person with the disability.
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Providing Customer Service to a Person with a Support Person
• Support persons are allowed to accompany the person with a disability in any area open to the public or third parties
• Discuss ahead of time whether the person with the disability wishes to have the support person present during confidential discussions
• In some situations, the support person may need to agree to requirements of service, just as the person with the disability does e.g. group counseling services
• Appropriate behaviour should be expected of a support person, just as it is of the person with the disability and all other persons
What to do when a person with a disability is having difficulty accessing services
• Always ask “how may I help you?”
• Offer assistance – If the person accepts your offer, allow him/her to explain how best to help them
• Provide adequate notification of alternate access to services e.g. parking lot construction, front entrance closure, etc.
• Seek alternative resources e.g. Canadian National Institute for the Blind (CNIB), Canadian Hearing Society (CHS), etc.
Call the Patient Representative at the Met Campus at ext. 52317 and for the Ouellette Campus ext. 34404 for any issues/questions
Interpretalk Translation Services
• Language Services provides direct interpretation of over 50 languages.
• The service is available using any regular telephone at any site.
• Further information is available on the Intranet/Telecommunications.
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Social Media Policy WRH supports the use of social media and recognizes the benefits of social media for communication purposes. However, actions outside of the workplace can affect the reputation of WRH, members of staff, and/or patients. Disclosing information on social media may affect the employment, internship opportunity or appointment and privilege relationship. Any hospital staff (professional staff, volunteer, clinical students, employee or associate) that violates this policy may be disciplined under the Hospital’s disciplinary process up to and including dismissal. This policy is intended to clearly outline the privacy, confidentiality, legal and ethical issues that all employees and affiliates have in regard to the use of social media. This policy will also aid in protecting the reputation of employees, colleagues, patients and affiliates of Windsor Regional Hospital (WRH). This policy applies to all staff (professional staff, volunteer, clinical students, employee or associate). For the purposes of this policy, “social media” means any facility for online publication and commentary, including without limitation blogs; wiki’s; social networking sites such as, but not limited to, Facebook, LinkedIn, Twitter, Flickr, newspaper/media blogging sites, letters to the editor and YouTube.
Actions outside of the workplace can affect the reputation of Windsor Regional Hospital, members of staff and/or patients.
Clinical Student Handbook 34
In order to protect Windsor Regional Hospital staff, volunteers, clinical students, clients and partners, the following procedures are in effect regarding participation by employees in social media facilities:
1. Before publishing any material online, remember that what you post online is legally considered public material and as such each staff member of WRH is personally responsible for his her publications.
Do not publish materials that are insulting, demeaning, or offensive to our
patients and families, WRH, our staff, or any community partners, or that dames their respective reputations in any way;
Do not reveal any confidential information related to our patients, WRH, our staff, our clients and families, or any community partners.
Do not reveal or describe the treatment or care provided to patients on social media.
Do not ask anyone to identify themselves as a WRH patient in any type of social media forum;
Do not publish any photo on social media that is a photo of a patient, the hospital facility itself, you and/or a fellow staff member while working or attending WRH.
2. Do not involve, either directly or through links to other sites or web domains, the
unauthorized use of WRH’s intellectual property in your communications as specific permission is required to use the logos, trademarks, and images owned by WRH or by another company to reproduce the materials of WRH.
3. Do not identify the Hospital as your employer or include any information that
enables a reader to associate you with WRH unless WRH approves, in advance, you doing so.
4. Do not use company resources or time to blog or to participate in social networking groups, unless authorized to do so.
5. Contact the President and CEO or the Public Relations department before proceeding if you are concerned about whether publishing a specific type of content would be in violation of this policy.
6. The only exception to any of the above is publications by Windsor Regional Hospital in its own intranet or social media site after it has obtained the specific written consent of the patient, family and/or staff member in advance of publication.
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OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
WORKPLACE SAFETY
Clinical Student Handbook 36
Roles and Responsibilities Regarding Safety:
The definition of worker in Ontario workplaces has been recently updated to include “unpaid learners” or students that may perform work or supplies a service. Workers in Ontario, including students, have three (3) basic rights to help protect their health and safety while at work.
1. THE RIGHT TO KNOW or the right to be informed about, actual and potential dangers in the workplace
2. THE RIGHT TO PARTICIPATE in the workplace health and safety training or activities through Joint Health and Safety Committee (JHSC) or as a worker health and safety representative, and
3. THE RIGHT TO REFUSE UNSAFE WORK where a worker must truly believe what they are being asked to do could harm them or another person
Work refusals are somewhat limited in healthcare settings – where a worker cannot refuse work that may
have a negative impact on patient care, if the work is part of the workers normal task and the worker has
the appropriate tools and training to conduct the work in a safe manner.
Workers, as well as students, also have legal obligations that they must fulfill in the workplace
including:
Working in compliance with Occupational Health & Safety acts and regulations
Using personal protective equipment and clothing as directed by the employer
Reporting workplace hazards and dangers, and
Work and use workplace equipment in a safe manner
Both the employer and management staff also have legal obligations to ensure a safe workplace. They
both must do everything reasonable in the circumstances to protect a worker.
Employers must:
Inform workers of workplace hazards
Ensure supervisor understands health and safety on the job
Provide information and instructions to do jobs safely
Make sure everyone knows and follows health and safety procedures
Ensures that personal protective equipment is provided in the workplace
Supervisor will make sure:
Workers are informed of workplace hazards in their area of work and how to work with those
hazards safely
Workers follow the law and workplace policies and procedures for safety
Workers wear the appropriate personal protective equipment
The Joint Health and Safety Committee also help to ensure a safe workplace. Their main role is to identify workplace hazards and recommend corrective action to address these hazards. Workplace hazards are often identified through regularly scheduled workplace inspections conducted by the Joint Health and Safety Committee.
SAFETY RESPONSIBILITES
Clinical Student Handbook 37
Safety Responsibilities as a Clinical Student:
Each healthcare provider, student and volunteer plays a vital role in infection prevention and control strategies which are designed to protect patients, staff and the community.
Students are not to lift patients UNLESS supervised by their supervising manager/supervisor/training delegate. Please refer to page 53 of the handbook for additional safety tips regarding proper transferring and lifting techniques.
Use all machinery and equipment the way you were trained to use them and do not make changes to any equipment or take shortcuts. If in doubt when asked to do something, seek out the advice of your manager/supervisor/training delegate. If you have not received training on a piece of equipment, inform your manager/supervisor/training delegate.
Students are NOT allowed to operate or assist staff with using a portable lift, to lift a patient, due to lack of proper training with the equipment.
Students are to ask their supervising manager/supervisor/training delegate for a demonstration of how to use the Staxi (stackable) wheelchairs before operating the wheelchair to ensure the safety of the patient.
You have the responsibility to report any hazard to your manager/supervisor/ training delegate as soon as possible
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Routine Practices at Windsor Regional Hospital Routine Practices are workplace practices that are used to protect staff, students and volunteers from exposure to blood and other potentially infectious materials. They include:
1. Infection Control/Hand Hygiene 2. Personal Protective Equipment (PPE) 3. Proper Sharps Disposal 4. Incident Reporting 5. Precaution Signs throughout the Hospital
1. Infection Control Windsor Regional Hospital believes that infection Prevention and Control is vital for our patient safety. As a result, the hospital has adopted a hand-hygiene campaign supporting the fact that hand hygiene is the single most effective way to prevent health care-associated infections and the spread of antibiotic resistant organisms. All visitors, staff, students and volunteers are asked to clean their hands when entering the hospital. The primary purpose of infection control in hospitals is to prevent our already sick patients from developing additional acquired infections. Hand hygiene is the single most important means in preventing the spread of infectious germs. Thus, it is important that you follow the guidelines below regarding "How to Wash Your Hands." If proper hand washing techniques are not practiced, you may be responsible for transmitting infections from you to the patient, from patient to patient, and from the patient to you. Hand Hygiene There are two methods of performing hand hygiene. This can involve washing with soap and water or using the Alcohol-Based Hand Rub (ABHR). You may not think you need a lesson on anything as simple as hand hygiene, but proper hand hygiene is the single most important thing we do to prevent the spread of disease. There are germs all about us, but most are very quickly destroyed with the use of ABHR (Alcohol-Based Hand Rub) if your hands are not visibly soiled. If your hands are visibly soiled, use soap and water for 15 seconds
SAFETY PRACTICES
Clinical Student Handbook 39
How to Hand Wash: Method to be Used if Hands are Visibly Soiled:
Remove all jewelry (can harbour micro organisms)
Wet hands with warm running water
Apply soap
Lather soap for 15 seconds
Rinse thoroughly under running water
Pat hands dry with a paper towel to avoid recontamination
Turn off water using paper towel, (Faucets are considered dirty).
How to Use Alcohol-Based Hand Rub (ABHR) - Preferred Method:
Remove all jewelry (can harbour micro organisms)
Apply a loonie sized amount of produce to the to palms of dry hands
Rub palms together, especially between the fingers and on the fingertips
Rub hands for 15 seconds until product is dry
Do not use paper towels
When to Wash your Hands:
Before and after your shift
Before eating, drinking, preparing, or handling food
After using the toilet, blowing your nose, sneezing, or coughing
Before and after contact with each patient, including hair, face, etc. If you have you come in contact with blood, body fluids, or contaminated objects such as elevator buttons, doorknobs, phones, debit machines, bank machines, etc.
Before putting gloves on and after removing your gloves
After handling money and newspapers
Clinical Student Handbook 40
When Hand Hygiene MUST be Performed – 4 Moments for Hand Hygiene Windsor Regional Hospital also follows the Ontario Ministry of Health Initiative of “4 Moments for Hand Hygiene”. Regular hand hygiene audits are conducted throughout the hospital to ensure that all healthcare providers (including students and volunteers) are maintaining a safe environment for our patients.
REMEMBER A quick passing of the hands under running water is not proper hand hygiene and only gives you a false sense of security. In addition to hand hygiene using soap and water or ABHR, you are required to do the following:
Complete a 2-step Mantoux skin test
Do not come in if you have a cold, infection, fever, cold sores or diarrhea as the simplest virus may be fatal for a patient.
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2. Personal Protective Equipment (PPE)
Personal Protective Equipment (PPE) include gowns, masks, hair nets, rubber gloves, latex gloves dust masks, hearing protection, safety boots, and/or goggles.
Standard precautions are workplace practices that are used to protect staff, students and volunteers from exposure to blood or other potentially infectious materials. By assuming that each patient is infected with a communicable disease, you can prevent the spread of illness or injury to yourself or others by following these routine practices. Protective Gear You may see staff wearing protective gear such as masks, eye, goggles or gowns. These items help protect the workers from splashing or soiling. Gloves Gloves are located in all patient care areas and should be worn whenever there is a rash of contact with blood or body fluids. Gloves should be worn when your hands are chafed and/or inflammation of the skin, hangnail or small cut is present. Disposable gloves are single patient use only and should be removed and discarded before leaving the patient environment. Wash your hands after removing gloves. Gloves are located in patient rooms or at the nursing units. Latex Sensitivity/Allergies Symptoms of a latex allergy include dry, flaky or itchy skin, a rash or hives. Advise your manager/supervisor or training delegate immediately if you experience symptom any
symptoms of a latex allergy. A list of latex containing produces within the hospital is available through the Material Management Department.
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Donning and Doffing - Personal Protective Equipment (PPE) Continued
Use PPE before handling any new product. Protect yourself when using WHMIS or Non-WHMIS products, information regarding use of personal protective equipment is available on the product’s Supplier Label (i.e. Precautions) and the Materials Safety Data Sheet (MSDS).
For infection control purposes, the required Personal Protective Equipment (PPE) is outlined on each of the isolations signs.
The following is also a preferred way for donning and doffing (removing) PPE:
DONNING (PUTTING ON) PPE DOFFING (REMOVING) PPE
1. Perform Hand Hygiene
1. Remove Gloves (outside of gloves is contaminated) avoid touching the outside of gloves when removing
2. Put on Gown
2. Remove Gown
3. Put on Mask or N95 respirator
3. Perform Hand Hygiene
4. Put on Eye Protection (goggles or face shield)
4. Remove Eye Protection (goggles or face shield)
5. Put on gloves
5. Remove your Mask or N95 respirator
6. Perform Hand Hygiene
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3. Proper Sharps Disposal What is a Sharp? A Sharp is defined as anything capable of cutting or penetrating the skin or any part of a worker’s body (i.e. needles, knives, scissors, broken glass).
Examples of incorrect practices that may result in needle stick injuries include:
Not properly securing the safety cap
Losing track of a needle (i.e. on a patient’s bed)
Not immediately placing a used sharp in the sharps container
Disposing a sharp into a sharps container that is full
Needles must never be recapped
Disposal of Sharps:
BIOHAZARDOUS SHARPS NON-BIOHAZARDOUS SHARPS
1. Discard the sharp immediately after use into the closest available sharps container. Containers must be replaced when ¾ full; DO NOT OVER FILL.
1. Place broken glass in a cardboard box
2. Full sharps containers should be placed in the grey tote in the Dirty Utility Room; Replace with empty container IMMEDIATELY.
2. Label the box and seal with tape.
3. Housekeeping placed the full tote in a refrigerated bio-hazardous materials storage area.
3. Place the box next to the regular garbage.
NOTE: New sharps containers are available from Materials Management. New totes are available from Housekeeping.
NOTE: Broken glass should NEVER be thrown into the regular garbage. Small pieces of glass can be placed in a sharps container.
If you find a sharp that has been inappropriately disposed of do not try and dispose of this yourself, immediately isolate the area and get assistance. Your manager/supervisor or training delegate should be alerted to the improper disposal of any sharps immediately.
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Needle Stick Injury Protocol
1. If the skin is broken, let the wound bleed freely, DO NOT APPLY DIRECT PRESSURE on the site.
2. Clean the wound with antiseptic or soap and water. Apply a band aid on small wounds.
3. Notify your staff manager/supervisor or training delegate to obtain medical attention and COMPLETE A RL6 REPORT.
4. IMMEDIATELY get medical attention, go to the Emergency Department if necessary.
5. Consult with your manager/supervisor or training delegate for COMPLETION OF AN INCIDENT INVESTIGATION.
6. Notify the Student Registrar of the incident, a copy of the incident report along with the Post Secondary Student Unpaid Work Placement Insurance Claim Form (WSIB) which needs to be sent to your educational facility Field Placement Coordinator within 24-48 hours.
4. Incident Reporting
In the event of an accident or incident (patient or personal) while on duty as a student at Windsor Regional Hospital, notify your manager/supervisor/training delegate as well as the Student Registrar so the educational facility can be contacted and if necessary, fill out the Student Unpaid Work Placement Insurance Form and submit the report
within 24-48 hours.
If you are injured, you will be medically assed by an Occupational Health Nurse and, if necessary, directed to the Emergency Department or a nearby clinic. In addition, the Windsor Regional Hospital supervising staff member is responsible for reporting the accident/injury in RL6 by the end of the shift on the day of the incident.
An accident/incident or hazardous situation is any unplanned event that results in, or has the potential to results in harm to any employee, patient, student or volunteer.
Examples Include: Falls, needle-stick injuries, medication errors, strains and sprains.
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5. Follow Precaution Signs throughout the Hospital
Students are advised not to enter a patient’s room marked with an Isolation/Precaution Sign unless directed or supervised by a Windsor Regional Hospital staff member. On the Paediatric Unit, students should ask the charge nurse about rooms with isolation signs and whether or not they should enter the room. The charge nurse will educate you about additional precautions that should be taken.
Acknowledge and Adhere to Signage in the Hospital
Adult Has Passed Away
Child Has Passed Away
Safety Bulletin Boards: Look for important OH&S information and resources on bulletin boards at the Met, Cancer Centre and Ouellette Campus in the staff rooms, The Human Resources Department or main traffic hallways.
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OCCUPATIONAL
HEALTH & SAFETY/WHMIS
OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
Clinical Student Handbook 47
Commitment/Policy Statement
Windsor Regional Hospital is committed to worker’s health and safety which is demonstrated through maintaining a healthy and safe work environment and ensuring measures are in place to protect workers from the risk of injury or illness. It is an expectation that all workers comply with all health and safety rules and procedures.
The success of the Occupational Health and Safety Program relies on the Internal Responsibility System, which is a philosophy that everyone (the employer, management and workers) work together, sharing the responsibility to maintain a safe and health workplace.
Laws
There are laws in place to help ensure a safe workplace is maintained. The Occupational Health and Safety Act came into effect in 1978 and were written to protect Ontario workers from injury or illness in the workplace and sets out general duties for workplace parties, such as the employer, supervisor and worker.
Additional Safety Resources
To find out more information about Workplace Safety, visit these websites:
Ministry of Labour
www.labour.gov.on.ca
Workplace Safety and Insurance Board
www.wsib.ca
Workers Health and Safety Centre
www.whsc.on.ca
Health and Safety Ontario
www.healthandsafetyontario.ca
COMMITMENTS TO SAFETY
Clinical Student Handbook 48
Workplace Hazards Definations
A Hazard is defined as any condition or practice that may have the potential to cause harm to people or damage to equipment, materials or the environment.
Workplace Hazards are categorized into two common types:
Safety or Physical hazards – cause injuries
Health Hazards – cause illnesses
Some examples of safety hazards that cause injuries at Windsor Regional Hospital include:
Strains/Sprains from patient handling
Slips, trips and falls
Repetitive strain injuries or musculoskeletal injuries from material handling
Body parts getting caught in or struck by objects
Some Health Hazards that may cause an illness to Windsor Regional Hospital include:
Exposure to blood or body fluids
Needle stick injuries
Exposure to influenza during an outbreak
1. It is important to be fully aware of the hazards in the workplace.
2. Be sure to ask your Windsor Regional Hospital manager/supervisor/ training delegate of the risks that you maybe exposed to that are specific to the department you are placed.
3. Never be afraid to ask questions about your safety or that of a patient. 4. Make sure you receive orientation to the department which you are
placed.
Clinical Student Handbook 49
In keeping with Ontario Legislation, all students and volunteers are provided instruction regarding W.H.M.I.S. It is important to keep in mind that we are in an environment where potentially hazardous materials and substances exist. We all have a responsibility to be cautious and knowledgeable of potentially hazardous materials.
The following WHMIS symbols help to identify potentially hazardous materials if a chemical/material is not handled properly. Before handling any product, check the label for potential hazard symbols and safe handling instructions.
SYMBOL MEANING DEFINITION
Biohazardous and Infectious Material (i.e. used needle stick)
Organisms or its toxins that have been shown, or believe to cause, disease in humans.
Oxidizing (i.e. linseed oil)
Materials that cause other materials to ignite or burn.
Compressed Gas (i.e. Oxygen tank)
Any material, product or substance contained under pressure. Contents may explode if heated or dropped.
Flammable or Combustible (i.e. gasoline)
Material which is easily ignited when exposed to a flame or other ignition source. May ignite spontaneously.
Dangerously Reactive
(i.e. bleach & ammonia)
Materials which may have unexpected reactions when mixed with another product.
Materials Causing Other
Toxic Effects (i.e. asbestos)
Products that have the potential to cause long term serious health problems due to repeated exposures over a long period time.
Corrosive Material (i.e. acid)
Materials that can destroy the skin or eat through materials.
Materials Causing Serious & Immediate Toxic Effects
(i.e. bleach)
Products that can cause death or immediate injury when a person is exposed to small amounts.
WORKPLACE HAZARDOUS MATERIALS INFORMATION SYSTEM
W.H.M.I.S
Clinical Student Handbook 50
Material Safety Data Sheets (MSDS)
MSD’s are available for all controlled products used and/or stored at Windsor Regional Hospital. These sheets contain safety information such as product ingredients, first aid, safe handling
instructions, etc. There is a master listing of all MSDS’ on the WRH Intranet under WHMIS.
Safety Labels
All controlled products must have one of two WHMIS labels: A Supplier Label or a Workplace Label.
SUPPLIER LABELS WORKPLACE LABELS
Attached to product by supplier Has distinctive hatched WHMIS border
Must contain: 1. Product identifier 2. Supplier identifier 3. MSDS statement 4. Hazard symbols(s) 5. Risk Phrases 6. Precautions 7. First aid
Required if: Existing supplier label is faded/illegible Product is decanted
Must contain: 1. Product identifier 2. Safe handling instructions 3. MSDS statement
If a worker contracts an illness or disease while at work that is serious to be eligible for WSIB
entitlements, it may be considered an occupational illness.
Unlike safety hazards, occupational illnesses may not appear immediately. In fact, some illnesses may take weeks, months, even years to materialize. This is what is referred to the
latency period.
MATERIAL SAFETY DATA SHEETS:
Supplied by the manufacturer of the product
Details the safe handling, use and storage of hazardous materials used in the work area
Must be updated every 3 years
TWO TYPES OF MSDS INVENTORIES:
Master Inventory: This is the most up-to-date inventory and is found on the WRH Intranet under MSDS (includes all products used within the hospital). Students can access this inventory on the hospital intranet from the staff Kiosks.
Departmental Inventory: Located in Departmental Binders (contains only products found in the department) Accessible only to those departments without computer access (i.e. Food & Nutrition, Housekeeping)
MS
DS
Clinical Student Handbook 51
Ergonomics & Proper Back Safety
Body Mechanics: Sitting at a Computer
Bending To bend safely, kneel down on one knee Bend your knees and hips, not your back When learning forward, move your whole body
Pushing/Pulling Stay close to the load, don’t lean forward Use both arms You can push twice as much as you can pull, so push rather than pull when possible
Head is upright Top of screen is at or
below eye level
Screen is arm’s length
away
Wrists are in
neutral position
Bring frequently used items
to you – avoid reaching!
Feet are flat on the floor
Shoulders are
relaxed, no slouching!
Forearms are
parallel to floor
Back of chair supports lower
back
Adjust chair so that thighs are
parallel to floor
Clinical Student Handbook 52
Body Mechanics: Moving and Lifting Items
FOLLOW THE STEPS AS OUTLINED FOR SAFETY PRACTICES:
1 Assess the weight of the object – gently nudge with foot and only lift if physically able, ask for assistance if needed
2 Get a firm grip on object (two hands)
3 With feet shoulder width apart, use your legs to lift the object:
Avoid twisting
Keep the object close to your body
Keep your head up (don’t look down)
4 Using your legs, keep a straight back and lower the item to the ground
1
2 3
4
SAFETY IS IMPORTANT TO EVERYONE
Windsor Regional Hospital recognizes health and safety as a vital component in achieving its vision, mission and values.
Safety in the workplace is a priority and critical to the well-being of employees,
students and volunteers of Windsor Regional Hospital.
Clinical Student Handbook 53
Safety Tips When Lifting and Transferring a Patient
LIFTING AND TRANSFERRING A PATIENT SAFELY
Never Lift or Transfer a Patient Alone
Get Assistance from a Trained Staff Member
Students are required to receive the proper training for patient transfer and lifting techniques from their supervising manager/supervisor/training delegate and are never to attempt to lift or transfer a patient alone. Always have direct supervision to ensure safety to the patient and to you.
An injury is easy if you do not carefully follow specific lifting techniques which have been put into place for each patient; techniques are based on each patient’s ability to stand and assist with the transfer.
When you are caring for patient in a hospital, it is imperative to know how to proper lift and move a patient and move them from one position to another.
Proper lifting techniques prevent you from incurring unnecessary injury; it also prevents you from injuring the patient.
Back injuries are the most common among health care workers, yet they are the most easily prevented. Once you hurt your back, it is more susceptible to further injury in the future.
SAFETY TIPS/REMINDERS
Always evaluate the patient’s mobility/capabilities before assisting them. Have the patient do as much as they can safely on their own.
Regardless of how much the patient weighs or his/her ability to assist with the lift, you always need to lift with your legs rather than your back. Always keep your back straight, bend at the knees and as you lift the patient, do so with the strength of your legs.
The same is for when you lift a patient up into bed. Keep your back straight and avoid slouching. Though you have to bend, keep your head and neck in alignment with your spine, your feet shoulder width apart for balance and your knees bent. As you proceed to pull the patient up into bed, pull with your legs, not your back.
Communicate with your lifting partner, such as “on the count of three”
Make a conscious decision before lift or transferring a patient THINK SAFETY FIRST.
Never be timid about asking for assistance.
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Emergency Codes at Windsor Regional Hospital:
CODE RED FIRE
CODE BLUE CARDIAC ARREST
CODE GREEN INTERNAL EVACUATION
CODE YELLOW MISSING PATIENT
CODE BLACK BOMB THREAT OR SEARCH
CODE WHITE VIOLENT PERSON
CODE BROWN CHEMICAL SPILL
CODE PINK NEO-NATAL ARREST
CODE ORANGE EXTERNAL DISASTER IN THE COMMUNITY
CODE PURPLE HOSTAGE SITUATION OR PERSON WITH A WEAPON (COLOUR OF BRUISING)
CODE GREY INFRASTRUCTURE LOSS OR FAILURE/EXTERNAL AIR
CONTAMINATION IS CURRENTLY UNDER DEVELOPMENT
Hospital Emergency codes can be found via the hospital intranet, Kiosk’s are available at the Met and Ouellette Campus.
REMEMBER YOUR CODES!
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Emergency Codes Kits
At the Met Campus, each unit/department has an Emergency Code Kit. For the Ouellette Campus, ask your training manager, supervisor or training delegate where to
locate the Emergency Code Kit. Make sure you know where to locate this kit in your work
environment. This kit includes valuable information/supplies required during an emergency such as the following:
Code reference sheets
Documentation forms
Departmental floor plans
Hazmat (spill mats)
Green Tape
What to do in an Emergency - How to Call A Code
Alert Switchboard: To alert Switchboard of a Code situation, staff at Met, Cancer Centre, and Ouellette Campus should do the following:
1. Dial 3-3-3-3, to alert Switchboard of a code 2. Provide the following information:
Name of the CODE (i.e. CODE RED)
Campus (i.e. MET)
Exact location (i.e. Department or Room #)
At all other off-site programs dial 9-1-1 to report a code
What to do Once a Code is Called
Switchboard will announce the code overhead 3 times
Response teams are put into action
Staff members in affected areas will respond
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The Role of the Student in the Event of an Emergency Code:
CODE RED: Fire in the Hospital
Code Red DRILLS: A Code Red is called over the pager system to alert hospital personnel to the
detection of smoke or fire. To ensure that all employees know what to do in an actual emergency situation, Code Red Drills are held on a frequent basis. If a Code Red Drill is called in your area, all employees, volunteers/students must respond appropriately (i.e. close doors, windows, clear hallways of equipment, etc.)
Most Responsible Person (MRP) completes the Report of Code Red Drill form
Form is forwarded to Security and becomes part of the official record required by the Fire Prevention Officer under the Fire Code
Feedback from these forms is used to determine if follow-up or further training is required.
Follow the Acronym R.A.C.E. If the fire alarm sounds, students are to stop what they are doing and report to their manager/supervisor of their area to wait for further instructions. If the alarm sounds while you are away from your area, return immediately to your assigned area to be accounted for and to help as directed. Do not use elevators or phones during a fire alarm. In an effort to contain a potential fire, most doors will close automatically as the alarm sounds.
FIRE SAFETY
E
C
A
R RESCUE (Remove)
Remove person from immediate area (if necessary)
Re-assure patients/visitors in area
ALARM (Assess)
Pull the nearest fire alarm
Remain calm
Call switchboard (x3333) Met/Ouellette
Dial 911 at all other sites
CONFINE
Close all doors and windows
Fire doors close automatically via magnetic release
Instruct patients/visitors to remain in their rooms
Clear hallways of obstructions
EXTINGUISH (Evacuate)
Fight fire if possible using the appropriate extinguisher
Code Green – code for internal evacuation
May involve horizontal or vertical evacuation
FIRE EXTINGUISHERS
ABC fire extinguishers contain a dry chemical or halon and can be used for all types of fires. Think of P A S S to help you remember how to use a fire extinguisher:
Pull…the pin
Aim …the nozzle at the base of the fire
Squeeze…the handle
Sweep …sweeping motion side to side
Only attempt to fight a fire if:
It is small and contained You are not alone You know how to use a fire
extinguisher You have a clear path to exit
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CODE BLUE: (Medical Emergency/Cardiac Arrest)
Met and Ouellette Campus, Dial 3-3-3-3, all off-site locations should call 9-1-1, for medical emergencies, staff should aid in directing EMS upon arrival. The Code
Blue Team at each site will bring the crash cart to the scene and take charge of any announced Code Blue. If you are working in an area that has a Code Blue emergency, stop what you are doing and ensure that the pathway for the crash cart is clear by moving carts and other items out of the way. Also, ask people (i.e. family) to stand aside for the Code Blue Team to come through.
CODE BLUE OUTSIDE OF BUILDING: Met and Ouellette
Upon discovery of an unresponsive person on hospital property (but outside of the physical structure of WRH), notify Switchboard by dialing 3-3-3-3
Switchboard will contact EMS and announce the Code overhead. The Code Blue Team will determine the appropriateness of responding based on personal safety, hospital responsibilities, distance from the hospital, etc.
CODE GREEN: (Internal Evacuation)
A Code Green refers to internal evacuation of the health care facility. It may result from either an internal or external event. This cause of treat may require immediate actions such as a gas leak, explosion or reapidly spreading fire OR action may be required in the near future, such as a response to a toxic spill in the community. In the case of a Code Green, students should report to the Volunteer Services and Student Registration Department.
CODE GREEN LEVEL ACTIONS Level 1- Horizontal Evacuation
Evacuate all affected persons beyond the fire separation door to adjacent safe area on the SAME FLOOR.
Level II - Vertical Evacuation
Evacuate all affected persons to another floor, preferably two floors down.
Level III - Total Evacuation
Upon order from the Fire Department, CEO or Medical Officer of Health evacuates all persons from affected building outside or to another building.
NOTE: During an evacuation, staff will place green tape (found in the Emergency Code Kits at Met Campus, confirm with the department manager at the Ouellette Campus) across a door
jam to indicate that the room has been checked and is vacant and that the “room is all clear”:
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CODE YELLOW Level I: Missing Patient/Resident
Call Switchboard 3-3-3-3 and provide a full description of the mission person, time, and location last seen.
A search for the patient/resident will be conducted by Security and Staff on the specific unit/area involved.
Staff will document in RL6 even if the person is found.
If the person has not been located, a more in-depth search will be conducted by ALL staff – search results will be forwarded to Administration.
Staff will be asked to check their voicemail for a description of the missing person. Anyone without voicemail should ask their MRP for information.
CODE YELLOW Level II: INFANT/CHILD: Missing Infant/Child Code Amber (or Amber Alert) is the emergency code now used to signify a missing infant/child. In the case of a Code Yellow Infant/Child, the most responsible person will provide a description of the alleged abductor and child to Switchboard, brief all staff on the unit, and organize a search of the entire unit.
CODE BLACK: Bomb Threat
Threats by Phone:
Remain calm, listen carefully, make notes, do not interrupt, and DO NOT hang up
Call 3-3-3-3 or 9-1-1 (off-site only) with details of the threat
Complete any campus specific forms
Switchboard notifies Security, Facilities, CEO and Police Threats by Mail
Immediately tell the most responsible person about the document and avoid handling the item as much as possible.
Search Procedures:
Once a Code Black is called, all staff are to TURN OFF PAGERS and CELL PHONES
Permission must be given by the Incident Commander before turning back on any devices
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CODE WHITE: Violent Person
This emergency code is used to signify that the behavior of an individual is deemed to be out of control or at risk of becoming out of control. Windsor Regional Hospital is committed to providing a safe and secure work environment, free from violence, threats, intimidation and harassment. Threats, threatening behaviour or acts of violence against employees, affiliates, patients, visitors, residents or other individuals on WRH properties will not be tolerated.
A Code White Policy has been developed in conjunction with the Workplace Violence Response Policy to provide an effective and efficient method of responding to many forms and degrees of workplace violence. It is recognized that some behaviours on the part of patients are symptomatic of their illness and requires a response that balances the need for control and protection with an appropriate therapeutic response.
CODE WHITE RESPONSE: Call a Code White if you witness or are involved with any individual who is not responding to de-escalation intervention and is:
Threatening, harassing or being verbally abusive to another individual
Attempting to harm themselves or others
Attempting to destroy property
Displaying threatening behavior that is escalating
Refusing to leave hospital property when required
What to Do in a Code White:
MET
CANCER CENTRE OUELLETTE
Remove yourself and others from immediate danger if the offending party cuts off efforts at communication.
Contact a staff member to appoint a person to dial 3-3-3-3
OFF-SITE LOCATIONS
Remove yourself and others from immediate danger if the offending party cuts off efforts at communication.
Contact a staff member or call for help and if necessary call 911
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CODE BROWN: Chemical Spill
Level I - Departmental Response
Small spill easily cleaned up with soap and water or departmental spill kit
Contents are identifiable and pose no threat of irritation to skin, eyes or lungs
DO NOT call a Code Brown
The department that experienced the spill is responsible for cleaning it up. Housekeeping can be requested to assist with the cleanup if available.
Level II - Code Brown Team Response
Dial Switchboard 3-3-3-3
Large spill that requires special clean-up procedures or is unidentifiable and may be hazardous
Code Brown Team will respond Level III - External Response
Dial Switchboard 3-3-3-3
Health/Fire/Environment hazard
Requires special clean-up procedures
Fire Department responds
CODE PINK: Medical Emergency in an Infant: Birth – 1 month
Met
Dial 3-3-3-3 to notify Switchboard
The Code Pink Team will respond
Cancer Centre
Dial 3-3-3-3 to notify Switchboard
Staff should meet the Code Pink Team at the entrance to the Cancer Centre and direct them to the Code location
Ouellette Campus
Dial 3-3-3-3 to notify Switchboard
The Code Blue Team will respond
NOTE: The most responsible person (MRP) of the area of the spill will complete the incident report in Risk Monitor Pro (Met Campus) RL6 (Ouellette Campus) AND any appropriate documentation for all Level II and Level III CodesChecklist for all Level II and Level III Codes.
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CODE ORANGE: External Disaster
In the case of an external disaster, Windsor Regional Hospital would refer totheir Disaster Plan which provides:
Assistance to staff in situations where the potential incoming patients may overwhelm available resources, both human and physical including equipment and space
Assurance that patients arriving from a disaster can be managed in the most efficient and effective manner
Strategies for dealing with increased responsibility and workload
If you are in the building and hear the overhead paging announcing “Code Orange Confirmed Level II”, you should STOP what you are doing and immediately report to your assigned department, students may be assigned other duties to assist in an emergency situation.
CODE ORANGE ADVISORY CODE ORANGE ALERT
The “Code Orange Advisory” is considered a precautionary state and is called when events have taken place that increases the likelihood that a disaster will occur in the community
The hospital has been notified that a disaster has occurred in the community but no causalities arriving yet
CODE ORANGE LEVEL I, II, II
Hospital is receiving less than 4 casualties: Level I: Less than 4 Level II: more than 4, Level III: many more then 4
Departments immediately affected will be involved i.e. Emergency. All staff should stand by for further direction
Specific areas will be set-up for media, family, discharges, Treatment
CODE ORANGE DOWNGRADED
Hospital is no longer receiving casualties
Staff will continue to care for current casualties and complete duties as assigned
Staff may return to their department when indicated by MRP in designed area(s)
The Code Orange Operations Report should be completed
CODE ORANGE DECONTAM
May be used to indicate that the situation includes a chemical, biological, and/or radioactive disaster requiring implementation of lockdown and/or decontamination procedures
The response levels and actions remain the same as outlined in the Code Orange Policy (Code Orange Alert Decontam, Code Orange Confirmed Level I-III, Downgraded)
Decontam will require special actions from Emergency, Security and Facilities
Examples: Tornadoes and other natural disasters, fires and explosions, toxic spills and motor vehicle accidents.
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CODE PURPLE: Hostage Situation or Person with a Weapon
A Code Purple is called in the event of a situation where any person is forcibly confined or held against their will, with the threat of a weapon or threat of violence. What to do if you witness a hostage taking situation or use of a weapon: 1. Dial 9-1-1 immediately if you witness a hostage taking situation or use of a weapon at
Met, Cancer Centre or Ouellette Campus or any off-site location and provide the operator with the following information:
Location of hostage taking
Visible signs or mention of weapons
Number and description of hostages
Number and description of hostage takers
Whether or not hostage takers are contained within a specific room or area
2. Ensure safety of patients and visitors in the immediate area. If there is any sign of actual danger or violence, DO NOT attempt any action. STUDENTS ARE NOT TO PLACE THEMSELVES AT RISK.
3. Dial 3-3-3-3 and notify Switchboard that you have a Code Purple Situation, provide
the location of the incident (Campus Building/Floor/Unit) and confirm if you have contacted the police. For Windsor Regional offsite locations, contact MET Switchboard at (519) 254-5577 ext. 0.
4. Wait for Security and police to arrive. 5. Do not initiate conversation with the hostage taker(s) but do answer if spoken to. 6. Note any demands or actions.
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Commitment to Excellence
PATIENT
FOCUSED CARE
OUR VISION: Outstanding Care - No Exceptions! OUR MISSION: Deliver an Outstanding Care Experience Driven by a Passionate Commitment to Excellence
Clinical Student Handbook 64
Patient Bill of Rights:
Have the right to be treated with consideration, courtesy and respect in a way that fully recognizes their dignity, individuality and cultural background.
Have the right to privacy in care for their personal needs. Have the right to information concerning their medical condition, in terms they can
understand. Have the right to participate in decisions regarding their care. Have the right to an explanation about their treatment and tests including benefits, risks
and alternatives. Have the right to give or refuse consent for treatment, including medication and to be
informed of the consequences of giving or refusing treatment. Have the right to confidentiality of all information. Have the right to know the identity and profession of those responsible for their care. Have the right to express any concerns without fear of negative results. Persons with special needs or handicaps have the right to reasonable accommodation in
accordance with the law. Have the right to be heard and receive a response should they want to express their
opinion about the care they have received.
Patient Responsibilities:
We believe that patients have the responsibility to:
Participate with all caregivers in their treatment and rehabilitation. Provide accurate information regarding their care. Accept the responsibility for the consequences of refusing treatment. Be considerate to all those providing care and to other patients. Observe hospital rules and regulations. Be responsible for all personal property. Actively participate in discharge planning. Accept the responsibility of all uninsured financial obligations. Voice any concerns first to the health care provider or the Patient Representative if
necessary.
PATIENT CARE AND SAFETY
“What people think believe and experience at Windsor Regional
Hospital may depend on their interaction with you”
Clinical Student Handbook 65
PATIENT/CLIENT IDENTIFIERS
Patient Safety is Important to Windsor Regional Hospital One of Windsor Regional Hospital’s key indicators is patient safety. Failure to correctly identify a patient/client can result in a range of adverse events such as medication errors, testing errors, wrong person procedures and the wrong patient/client and the discharge of infants to the wrong family. Utilizing a two-patient identifier is a required organizational practice at WRH. To reinforce this process, Windsor Regional Hospital has launched the “It takes 2 to know it’s you” campaign. Clinical Students at Windsor Regional Hospital must check the armband and chart of the patient. It is the responsibility of your supervising staff member to review the correct procedure with you and your responsibility to ensure that you have been informed of this protocol.
PATIENTS IN BED Some patients are positioned in bed for a specific reason. If they ask you to rearrange the pillows or raise/lower the bed, check with the nurse first. Please do not sit on, lean against, or joggle a patient’s bed. Many patients have incisions or dressings, are positioned in a special way, or have equipment attached below or over the bed. Students should not transport patients with IV’s unless they are supervised/assisting a nurse or other medical professional staff member.
Grip the rear bottom of the pole to propel
Watch height when going through doorways
If blood backs-up into the tube, call a nurse
Clinical Student Handbook 66
Additional Patient Safety Factors
• Food and drink become very important in the hospital. Measurements of intake and output are essential for diagnostic study. NEVER GIVE A PATIENT ANYTHING TO EAT OR DRINK WITHOUT PERMISSION FROM THE NURSE. Do not accept the patient’s word.
• NEVER GIVE ANY SORT OF MEDICATION TO A PATIENT.
• Never leave a Paediatric (child) patient unsupervised if he or she is involved with materials that could be dangerous. Check with the nursing staff if in doubt.
• NICU/pediatric staff will direct you on whether or not you are permitted to lift or carry a child.
• DO NOT ENTER A PATIENT’S ROOM MARKED WITH A PRECAUTION SIGN ON THE DOOR. Please seek advice from the nurses’ station regarding these signs.
• Always ask questions when in doubt. Never assume. You learn by asking questions.
• CALL WHEN HELP IS NEEDED. If in the room, push the patient’s call button. If you cannot reach the call button, and it is an emergency situation, call out loud for “HELP!”
Call When
Help Is Needed
Always Be Aware of
Caution Signs
Learn By
Asking Questions
Clinical Student Handbook 67
Wheelchair Safety Instructions
• Inspect the chair thoroughly before getting the patient; inspect the wheels, brakes, back, seat, footrest, etc. PUT BRAKES ON before assisting a patient from the wheelchair.
• Ask their manager/supervisor/training delegate for a demonstration of how to use standard and Staxi wheelchairs before operating the wheelchair to ensure the safety of the patient. (See next page for instructions on how to use the Staxi Wheelchairs).
• MOVE FOOT RESTS OUT OF THE WAY before a patient gets into or out of a wheelchair.
• Ensure tubing/IV pole is free of pull.
• After the patient is seated, put footrests down and make the patient comfortable. If there is only one footrest on the chair, properly position the patient’s foot and cross the other leg over the resting foot.
• UNLOCK BOTH BRAKES AND ANNOUNCE TO THE PATIENT THAT YOU ARE BEGINNING TO MOVE.
• Ensure that the pathway is clear of obstacles, approaching intersections, doors, and corners. Be cautious and maintain a safe speed.
• Keep your body erect and close to the chair and keep both hands on the wheelchair handles.
• ALWAYS BACK DOWN A RAMP, turning slightly to the side, putting one foot behind the other as a supportive brace.
• Wheelchairs are to be BACKED INTO ELEVATORS AND BACKED THROUGH CLOSED DOORS so as not to injure the patient’s legs.
• When getting the patient out of the chair put on brakes and put up the foot pedals.
• Be sure the patient’s elbows are out of the way so they are not bumped.
• NEVER LEAVE A PATIENT ALONE.
• Report any physical distress of patient to the Charge Nurse.
• After a patient has used the wheelchair, remember to use wipes and rubber gloves to SANITIZE THE WHEELCHAIR by wiping down the arms, seat and the back of the chair for the next patient.
• A Hospital Transporter should be called for any patient that requires an over-sized wheelchair.
Clinical Student Handbook 68
Staxi (stackable) Wheelchairs
The Staxi is also available for transporting patients at Windsor Regional Hospital and are available in the main lobbies of the Metropolitan, Cancer Centre and Ouellette Campus. Please refer to the following diagrams and safety tips before operating the Staxi and be sure to ask your manager/supervisor or training delegate for a demonstration of how to use the Staxi before transporting a patient.
`
Getting into the Staxi
Moving the Staxi
Getting out of the Staxi Chair
Safety Tips
Occupants must enter this chair from the side.
Occupants must be able to sit upright unassisted and have upper truncal control.
Attendant must stay with chair when occupied.
Do not overload the chair, weight limit is 500 lbs.
To avoid tip-overs and falls from the chair. Do not attempt a ‘U’ turn or a 360 maneuver on a slope, ramp or incline.
Always use seatbelts (if installed)
Use caution when maneuvering the chair between, walls or door edges. Watch the positioning of the occupants feet.
Clinical Student Handbook 69
`
Windsor Regional Hospital
Metropolitan/Cancer Centre and Ouellette Campus
We Hope You Enjoy Your Learning Experience!
Questions regarding your internship, please contact the Student Registrar: Connie Tomalty, Ouellette Campus at (519) 254-5577 ext. 33673
Email: [email protected]
Visit our website at www.wrh.on.ca or email us at [email protected] to recruit a family member or a friend to Volunteer for Windsor Regional Hospital.
Applicants must be a minimum of 16 years of age.
Click on “Programs and Services”, “All Departments”
Click on “V” for Volunteer Services/Student Registration
Click on “How to Apply” to obtain an “Application Form”
Contact the Met or Ouellette Campus for more information Met/Cancer Centre (519) 254-5577 ext. 52343
Ouellette (519) 254-5577 ext. 33345