cone health

Cone Health Cone Health • 8,600 employees8,600 employees

• Largest private employer in Guilford CountyLargest private employer in Guilford County• 5 hospitals (1,017 beds)5 hospitals (1,017 beds)• 60+ Physician Practices60+ Physician Practices

• Three Urgent Care CentersThree Urgent Care Centers

Greetings From Our Chief Nursing Greetings From Our Chief Nursing OfficerOfficer “Welcome! I am excited as you Welcome! I am excited as you

embark on your new embark on your new professional journey. My wish is professional journey. My wish is that you will sincerely enjoy that you will sincerely enjoy working at Cone Health and will working at Cone Health and will thrive in our practice thrive in our practice environment.”environment.”

Theresa Brodrick , Theresa Brodrick , RN, PhD, CNS, RN, PhD, CNS, CNA CNA Chief Nursing OfficerChief Nursing Officer

VisionVisionCone Health will be

a national leader in deliveringmeasurably superior healthcare.

Strategic Plan Strategic Plan

Our MissionWe serve our communities We serve our communities

by preventing illness, by preventing illness, restoring health and restoring health and

providing comfort, through providing comfort, through exceptional people delivering exceptional people delivering

exceptional care.exceptional care.

Goal: Be in Be in the top 10% nationally for:the top 10% nationally for:

Quality Quality Service Service Cost Cost

Our ExpectationsOur Expectations

To provide the best healthcare possible, we believe that everyone must be committed to the Cone Health Values and our New Operating Principles and Practices.

Our ValuesOur Values

Cone Health Operating PrinciplesCone Health Operating Principles

In caring for our patients, each other and our In caring for our patients, each other and our communities:communities:

• I use evidence based practices to provide safe and exceptional patient care.• I communicate honestly and directly with care and respect.• I include people with diverse backgrounds, experiences, and points of view.• I see it, own it, solve it, do it, and celebrate it!

7

Six New PracticesSix New Practices

• I keep patients safe by practicing the 4 R’s (right patient, I keep patients safe by practicing the 4 R’s (right patient, right place, right time, right service).right place, right time, right service).

• I practice AIDET (acknowledge, introduce, duration, I practice AIDET (acknowledge, introduce, duration, explain, thank you) for every patient interaction. explain, thank you) for every patient interaction.

• I assume the best intention and seek to understand. I assume the best intention and seek to understand. • I do not gossip; I take issues to the person who can do I do not gossip; I take issues to the person who can do

something about it.something about it.• I do what I say, when I say, and communicate. If I can’t I I do what I say, when I say, and communicate. If I can’t I

clean it up. clean it up. • I thank someone every day. I thank someone every day.

• Our philosophy summarizes our beliefs

• Our beliefs are the basis for how we deliver care

• Our Model of Care outlines how we conceptualize our beliefs

• This model is based on theories of caring

Professional Model of CareProfessional Model of Care

Care Delivery ModelCare Delivery Model

• Our Relationship Based Care Delivery Model is how we operationalize our Model of Care and Philosophy

• This model is patient and family centered

Focuses on 3 Key Relationships

• Self• Colleagues• Patient & Families

HIPAA and Corporate ComplianceHIPAA and Corporate Compliance

Special NoteXXX

“xxx” in front of the patient’s name = Strict PrivacyWhen someone asks for that person by name, state, ”There is no record of that person being in the facility.”

HIPAA and Corporate ComplianceHIPAA and Corporate ComplianceReport Privacy Violations

• Reports of a privacy violation are entered into the electronic Safety Zone Portal (SZP).

Safety Zone Portal

Discuss first with your instructor, charge nurse or Cone Health Privacy Officer

HIPAA and Corporate ComplianceHIPAA and Corporate ComplianceGifts from Patients

• • Patients who would like to honor a student should be referred to the Office of Fund Development.

A

I

D

E

T

Acknowledge

Introduce

Duration

Explanation

Thank You

Patient Care PartnershipPatient Care Partnership

A

I

D

E

T

Acknowledge the patient and visitors. Say “hello.”Introduce yourself and state your business. Why you are there and what you hope to accomplish.Duration- If there is a delay in treatment tell the pt. how long the wait will be.Explanation Tell the pt. why you are doing the treatment and/or giving the medication etc.Thank You- Thank the pt. for allowing you to care for him/her.

Patient Care PartnershipPatient Care Partnership

The Patient Care PartnershipThe Patient Care Partnership Hourly Rounding with a Purpose

8 Behaviors important to Hourly Rounding with Purpose:•Use warm acknowledgement to reduce anxietyUse warm acknowledgement to reduce anxiety•Perform scheduled tasksPerform scheduled tasks•Address the 3 Ps (Address the 3 Ps (Pain, Potty, PositioningPain, Potty, Positioning))•Assess additional comfort needsAssess additional comfort needs•Conduct an environmental assessment of the roomConduct an environmental assessment of the room•Prior to leaving the room, ask, Prior to leaving the room, ask, “Is there anything else I can do for you?”“Is there anything else I can do for you?”•Tell each patient when you will be backTell each patient when you will be back•Document the round on the chartDocument the round on the chart

Hand HygieneThe expectation is that each healthcareworker (including students) will perform proper

hand hygiene with and without wearing gloves

Upon entering and exiting the patient’s room

Infection ContrInfection Controlol

Cone Health policyCone Health policyOnly use alcohol gel / foam provided by Only use alcohol gel / foam provided by

Cone Health, or soap and water.Cone Health, or soap and water.

Cone Health Nursing Policies and Procedures are available Cone Health Nursing Policies and Procedures are available online on the Intranet Homepage under the Resources online on the Intranet Homepage under the Resources tab. The Intranet is available on every department tab. The Intranet is available on every department computer desktop directly or through Citrix.computer desktop directly or through Citrix.

Click on the icons for Citrix or the CH Intranet Homepage.

Policies and ProceduresPolicies and Procedures

CareNotes: Electronic Patient Education Resource

CareNotes provide information in English and Spanish on avariety of topics:

• Medications• Tests• Diagnosis• Labs• Procedures

You can find a link to CareNotes on the Intranet Homepage under Applications.


Computer Training

Faculty should contact the Staff EducationDepartment in order to schedule training(832-8173)

Nursing students and faculty will be given computer instructions and access codes upon successful completion of the training exercise. .


Documentation Standards

Do not shareDo not share computer IDs or passwords.

Do not look atDo not look at information in patient medical records unless you are assigned to the patient. (HIPAA Privacy Laws)

Cone Health Employees must use the computer password assigned as student/faculty for documentation and not their employee password when in the student/faculty role.


CBG Training• Nursing students/faculty will not perform patient glucose testing at this time. • Faculty and/or Students who are Cone Health employees are not permitted to perform the testing while in the faculty/student role. •Students may work with the primary nurse/instructor in order to intervene as necessary r/t blood glucose test results and may chart the results in the patient’s documentation record.


Risk ManagementRisk ManagementAny incident, which may have adverse consequences for patients, visitors, Any incident, which may have adverse consequences for patients, visitors, faculty/student should be reported immediately to Leadership on the faculty/student should be reported immediately to Leadership on the department and a safety Zone Portal entry completed.department and a safety Zone Portal entry completed.

SAFETY ZONE PORTALSAFETY ZONE PORTALEvents that are inconsistent with Cone Health Policies & Procedures, or not part of Events that are inconsistent with Cone Health Policies & Procedures, or not part of routine careroutine care

Goal: Goal: Improve Quality & SafetyImprove Quality & Safety

•Leads to appropriate follow upLeads to appropriate follow up

•Event Event to be documented in patient chartto be documented in patient chart

•Do not document SZP record in patient’s chartDo not document SZP record in patient’s chart


Sentinel EventSentinel EventA Sentinel Event Is:A Sentinel Event Is:•An unexpected occurrence involving death or serious physical or psychological injury or the risk thereof•These events should be reported immediately.•Work with the clinical instructor and the patient’s primary care nurse to report. •See the “Sentinel Event” policy in the Administrative and Patient Care Manual)

•



Red RulesRed Rules• RED Rules RED Rules are requirements that must be followed each

and every time the occasion or situation arises• Because they are such a priority, they are considered

REDRED to signify their importance.

• RED Rules RED Rules are rules that CANNOTCANNOT be broken.• They are few in number and easy to remember.• They are associated with processes that can cause

serious harm to patients.

Policies and ProceduresPolicies and ProceduresCone Health Red Rule #1Cone Health Red Rule #1

• A time out A time out is completed before all invasive is completed before all invasive procedures.procedures.

• Invasive procedures are described in policy number Invasive procedures are described in policy number IV-P-39 located in the Administrative Policy Manual.IV-P-39 located in the Administrative Policy Manual.

Cone Health Red Rule #2Cone Health Red Rule #2• All inpatients receiving medication or blood

products, or undergoing any procedure, will have an identification band in place and identification will be confirmed.

Patients in Cone Health are identification by both:

NameAND

Medical Record #


Ethical IssuesEthical Issues

•Cone Health offers Ethics Consultation for patients, families, medical staff and ancillary staff involved in patient care.

•The patient’s primary nurse and your instructor can contact Pastoral Care to request an Ethics Consult


The American Nurses Association (ANA) Code of Ethics for Nurses provides guidelines for practice.

Rapid Response Team (RRT)Rapid Response Team (RRT)Provides early and rapid intervention for patients outside the ICU setting whose condition is deteriorating. Critical Care team responds to a call for critical care expertise to the patient’s bedside to assist with stabilizing and transferring to a higher level of care as needed

CONDITION HELPCONDITION HELPA Safety Net Program for Patients and Families

• WHAT- Ability for patients and families to activate a Rapid Response Team to come to your room to work with your current healthcare team to address your concerns.

HOW - CONDITION HELP – Dial 2-1666 from any hospital phone


CONE HEALTH EMERGENCY CODESCONE HEALTH EMERGENCY CODES

CODE SITUATIONRED Fire

YELLOW Bomb Threat

ORANGE Internal/External Spills*PINK Infant/Child Abduction

TRIAGE Disaster

GRAY Restricted Area

BLACK Bioterrorism

Code Gray Code Gray – Restricted Access Emergency CodesEmergency Codes

What is Code Gray?• Response to an incident of civil unrest within

Cone Health that threatens the safety of patients, visitors and staff.

• Potential reasons to activate Code Gray include, but are not limited to:

– Heightened emotional or behavioral response, even after de-escalation attempts

– Visible weapons– Physical altercations– Hostage situations– Communication of threats

Emergency CodesEmergency Codes

Code Gray Code Gray – RESTRICTED ACCESS

When a “Code Gray” is announced:When a “Code Gray” is announced:• Ancillary services and support staff avoid the area Ancillary services and support staff avoid the area

until “Code Gray – All Clear” is announceduntil “Code Gray – All Clear” is announced

• All staff authorized to enter the restricted area must All staff authorized to enter the restricted area must present appropriate identificationpresent appropriate identification

•

Code Pink Code Pink – Abduction Emergency CodesEmergency Codes

When Code Pink is announced, some departments have specific assignments. All other available employees should:

• Come into the hallways and stairwells.

• Keep an eye on any nearby exits.

• Call Security to report any activity that seems suspicious.

Cone Health is a Certified Chest Pain & Stroke Center

Heart Attack SymptomsHeart Attack SymptomsHow to RecognizeHow to Recognize

&&What to DoWhat to Do

Chest Discomfort May Be Chest Discomfort May Be a Sign of a Heart Attacka Sign of a Heart Attack

• Pressure, heavinessPressure, heaviness• Squeezing, tightnessSqueezing, tightness• BurningBurning• Lasts more than 2 minutesLasts more than 2 minutes• May come & goMay come & go

Sometimes Heart Attacks only cause Pain in …Sometimes Heart Attacks only cause Pain in …• One or both arms. Back. NeckOne or both arms. Back. Neck

• Shortness of breath. Shortness of breath. Breaking out in a cold sweatBreaking out in a cold sweat• Nausea, vomiting. Light headednessNausea, vomiting. Light headedness• Extreme weakness, fatigueExtreme weakness, fatigue

Other Signs of a Heart Attack Other Signs of a Heart Attack

If a guest or employee has symptoms of a If a guest or employee has symptoms of a heart attackheart attack:

- Notify an RN or other healthcare providerNotify an RN or other healthcare provider- Assist him into a wheelchair- Assist him into a wheelchair- Take him to the Emergency Department- Take him to the Emergency Department- If there is no ED available, call 911 for emergency - If there is no ED available, call 911 for emergency carecare

If a patient has symptoms of a heart attack:- Notify the patient’s nurse or medical caregiver Notify the patient’s nurse or medical caregiver immediatelyimmediately

A Stroke Looks Like…Stroke Signs and Symptoms: Stroke Signs and Symptoms:

•Numbness or weakness of the face, arm Numbness or weakness of the face, arm or leg…especially on one side!or leg…especially on one side!

•Trouble seeing in one or both eyes!Trouble seeing in one or both eyes!

A Stroke Looks Like…Stroke Signs and Symptoms: Stroke Signs and Symptoms:

•Trouble walking, loss of balance Trouble walking, loss of balance or coordination!or coordination!

•““The Worst Headache of my Life” The Worst Headache of my Life” with with no known cause!no known cause!

WHAT SHOULD YOU DO IF YOU THINK A PATIENT OR VISITOR IS HAVING A

STROKE?

You can make a difference in a stroke You can make a difference in a stroke patient’s life! patient’s life!

REMEMBER…

EEyesyesDoubleBlurred

Balance

FFacialacialDroop

AArmrmLeg

Weakness

SSpeechpeech TTIMEIME!

Cone Health is participating in the statewide Cone Health is participating in the statewide program to implement standardized armband program to implement standardized armband colors for improved safety.colors for improved safety.

Banding Together for Patient SafetyBanding Together for Patient Safety

BLUE: BLUE: Blood Bank BraceletBlood Bank Bracelet

Banding Together for Patient SafetyBanding Together for Patient Safety

The blood identification bracelet is now a blue blue armband. The armband will continue to have a patient identification number.

Patient identification is done by the white arm band.

Safe Patient HandlingSafe Patient Handling

POLICYPOLICY: All patient transfer/ lifting will be done safely : All patient transfer/ lifting will be done safely and appropriately to protect the employee and patient and appropriately to protect the employee and patient from injuryfrom injury.•All patient lifting, shifting, or transferring will be completed based on assessment, utilizing mechanical lift equipment and/or other approved patient handling aids.•Consult with the Patient’s Primary Care Nurse and your nursing instructor for guidance.

Safe Patient HandlingSafe Patient Handling

Tubes/ SlidesTubes/ Slides•Tubes & slides reduce friction and provide a safer, more comfortable move for patientsand caregivers. •BlueBlue or OrangeOrange TUBE - Lateral transfer - bed to stretcher•MAXI SLIDE – boost patient in bed

•Students refer to clinical instructor and patient’s primary nurse for questions/instruction

Safe Patient HandlingSafe Patient Handling• Maxi Move- Lifting and transfer device for the Maxi Move- Lifting and transfer device for the

totally dependent individualtotally dependent individual

• Able to lift from floor, bed, chair, toilet/bathing area and other areas

• Safe to use as a transportation device throughout the facility

• Able to double-task procedures - weigh individual during lifting and transfer activities

• Has selection of standard sized slings from x-small to x-large and various specialty slings (e.g. amputee slings)

• Refer to clinical instructor and patient’s primary Refer to clinical instructor and patient’s primary nurse for questions/instruction.nurse for questions/instruction.

• Only approved abbreviations may Only approved abbreviations may be used. be used.

• The list is found in Citrix / The list is found in Citrix / Resources / Policies & Procedures Resources / Policies & Procedures / Approved Abbreviations List./ Approved Abbreviations List.

• Also Also ‘Do Not Use’‘Do Not Use’ list can be list can be found on MD Order Sheet.found on MD Order Sheet.

Cone Health GuidelinesCone Health GuidelinesCone Health Approved Abbreviations

Team Communication ToolsSBAR – Effective communication tool. Consistent and organized to promote patient safety

Gather information prior to communicationGather information prior to communication•Situation•Background•Assessment•Recommendations

General General GuidelinesGuidelines

Team Communication Tools

HAND-OFF / HALL PASS •Internal and external transfer of care

– Shift Report– Coverage for lunch / breaks– Critical Lab and Radiology Results

•Uninterrupted time–Requires ability to ask questions

General GuidelinesGeneral Guidelines

General GuidelinesGeneral GuidelinesStudent Parking

Carpooling is strongly encouraged on each campus.Carpooling is strongly encouraged on each campus.Moses Cone Hospital – Students and faculty are required to part in the Wendover and Church Street parking lot.

Wesley Long Hospital – Students must park in the employee parking lot located off N. Elam and Friendly avenues. *May have temporary modifications; confirm with Instructor*

Women’s Hospital – Students may park in the Women’s Education Center parking lot. Turn onto Lendew Avenue from Green Valley Road. Park in the lower area of the parking lot.

Annie Penn Hospital – Students may park in the employee parking lot located adjacent to the South Main Street exit of the hospital lot.

Behavioral Health Hospital – Students must park in the upper middle lot and to the left of the building.


MealsThe Moses H. Cone Memorial Hospital • Wesley Long HospitalThe Moses H. Cone Memorial Hospital • Wesley Long Hospital

Women’s Hospital • Annie Penn HospitalWomen’s Hospital • Annie Penn Hospital

Moses Cone Behavioral Health HospitalMoses Cone Behavioral Health Hospital

LibrariesMoses Cone Hospital • Wesley Long Hospital

Women’s Hospital • Behavioral Health Hospital


Dress Code• Dress professionallyDress professionallyNo tank tops, revealing clothing, sweat pants, biking shorts,

jeans, capris, shorts or flip flops

• Follow the dress code policy of your schoolFollow the dress code policy of your school and Cone Health. and Cone Health.

• Wear your school uniform.

• Lab coats are to be worn over your street clothes.

• Your photo ID must be worn at all timesYour photo ID must be worn at all times•Mid Chest or above with no obstructions

General GuidelinesGeneral GuidelinesDress Code

Cleanliness and Scents•Good personal hygiene must be maintained. Good personal hygiene must be maintained. Avoid obvious and natural odors.

•Scented products- Scented products- e.g. perfumes, fragrances or after-shaves are not allowed.

Tattoos- must be covered at all times.

Nails- must be neat, clean and short. •No artificial nails, nail applications or overlays, nail enamel or polish are allowed for direct bedside caregivers.Jewelry –Minimal while providing patient careMinimal while providing patient care.

•No more than one ring on one hand

•Earrings- no more than 2 earrings per earlobe. Not greater than 1½ inches in diameter or length.

o No open gauges No open gauges and none greater than ½ inch in diameter.o No other visible piercing is acceptable.

General GuidelinesGeneral GuidelinesPhones/Valuables

• Personal phone calls should be limited to emergencies.

• Personal cellular phones are to be turned off and not used in clinical settings.• Storage is limited for personal belongings.

• Valuables cannot be secured.

General GuidelinesGeneral GuidelinesTobacco UseTobacco Use

Tobacco Use is Prohibited on any Cone Health Campus

In the interior and exterior of any CH property. This includes:• Vehicles parked on CH property• Parking decks and lots• Sidewalks on or adjacent to system property• Balconies and picnic areas.

THANK YOUTHANK YOU

We wish you the best at We wish you the best at Cone Health. Cone Health.

Please sign the Orientation Please sign the Orientation Acknowledgement Form and give Acknowledgement Form and give

it to your Instructor for safe it to your Instructor for safe keeping.keeping.

cone health

Documents

exceptional care

exceptional patient

patients patients

careour model of care

cone health values

rs right patient

philosophythis model

patients safe