STUDENT NURSING ORIENTATION

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STUDENT NURSING ORIENTATION

• NorthShore University HealthSystem

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A Message from the Chief Nursing Officer

• Nancy T. Semerdjian, RN, BSN, MBA, FACHE

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Our Vision

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

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Our Goals

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

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Our Journey

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

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Our Nursing Leadership Team

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

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Nursing Core Values

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

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Nursing Core Values

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

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Emergency Codes

• Color Code Quick Reference Chart

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Activating a Code

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

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Color Code Quick Reference Chart
Code Red Fire
Code Yellow Code Triage Standby
Code Gray Behavioral Dyscontrol
Code Black Severe Weather Condition
Code Green Internal Emergency
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Color Code Quick Reference Chart
Code Blue Medical Emergency
Code Pink Missing Infant/Child
Code White Bomb Threat
Code Purple Evacuation
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Color Code Quick Reference Chart
Code Orange Hazardous Material
Code Lavender Facility Lockdown
Code Beige Chemical/Biological/ Radiological
Code Silver Incident Command Activated
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Pain Management

• The NorthShore philosopy towards pain and pain
  management is
• If a patient says he is in pain, we believe him.
• Every patient has the right to pain management
• Review the policy in Clinical Practice Manual
  (CP07-1003).
• The Clinical Practice Manual is located on the
  NorthShore intranet, the Pulse, which may be
  accessed on the clinical unit from any computer.

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Parking

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

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Parking

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

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Rapid Response Team

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

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Rapid Response Team

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

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Rapid Response Team

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

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Rapid Response Team

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

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Rapid Response Team

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

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Rapid Response Team

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

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The SBAR Report

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

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The SBAR Report

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

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The SBAR Report

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

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The SBAR Report

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

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The SBAR Report

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

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The SBAR Report

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