Clinical Site Liaisons

Premier Health Center 110 N. Main St. Dayton, Ohio 45402 premierhealth.com

Dear faculty member, Welcome to Student Placement with the Premier Health Learning Institute! As part of our mission to build healthier communities, Premier Health is committed to providing educational experiences that help prepare the next generation of nurses to be successful in the dynamic field of healthcare. This packet is designed to provide you with the information and resources you need to secure placements for your students—and ensure you are prepared to lead your students through their educational experiences at our hospitals. To help you through this process, our clinical site liaisons will partner with you to ensure everything goes smoothly.

Clinical Site Liaisons Atrium Medical Center Miami Valley Hospital Miami Valley Hospital South Good Samaritan Hospital Good Samaritan North Health Center Upper Valley Medical Center

Erin Evans

937-208-9145 [email protected] Anessa Snapp

937-734-2407 [email protected]

If, after reviewing the enclosed materials, you have any questions about our student placement process or what is expected of you, please contact your clinical site liaison for assistance. We look forward to working with you to coordinate clinical and preceptor placements for your students! Sincerely,

Trish Wackler Clinical Education, Director Premier Health

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Table of Contents Student Placement Checklist...................................................................................................................................... 1 Premier Health Student Placement Contacts...................................................................................................... 2 Faculty: Student Training & Competency Guide.............................................................................................3-5 Appendix Forms for Faculty to Complete Student Placement Request Form....................................................................................................................... 6 CARF Form...................................................................................................................................................................... 7 Faculty Waiver Form................................................................................................................................................... 8 Forms for Students to Complete Exhibit A – Student Health & Liability Form............................................................................................ 9-10 Exhibit B – Student Acknowledgement...........................................................................................................11 Handouts HealthStream Learning Center Login Instructions.....................................................................................12 Stericycle Waste Compliance ..............................................................................................................................13 Student Badging........................................................................................................................................................14 Student Parking.........................................................................................................................................................15 Quizzes & Competency Assessments Accu-Chek Inform II™ Initial Certification (Quiz)..................................................................................16-18 Accu-Chek Inform II™ Initial Certification (Answer Key)....................................................................19-21 Accu-Chek Inform II™ Initial Certification (Checklist)................................................................................22 Competency Performance Checklist – Blood Collection Using Fingerstick Technique................23 Lift Competency Checklist (Quiz).......................................................................................................................24 Lift Competency Checklist (Answer Key) .......................................................................................................25

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Placement Checklist Please use the following checklist to ensure timely completion of all required paperwork. Failure to submit required paperwork on time may cause a delay in starting clinical time.

Deadline

School Coordinator Responsibilities

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60 days before student placement

School coordinator submits the Student Placement Site Request form to Premier Health’s clinical site liaison.

15 days before student placement

School coordinator completes and submits the CARF form (this form ensures students have secured access to Pyxis, Epic, HealthStream, etc. when they arrive) to Premier Health’s clinical site liaison.

Deadline

15 days before student placement

Faculty Responsibilities

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Faculty member contacts the unit educator for a unit tour and 4-hour shadow experience to become familiarized with the unit before student placements begin (if faculty member is new to unit). Faculty member schedules student training for Epic. If any students are precepting, the faculty or students contact their assigned unit to obtain the preceptor’s schedule. Faculty member orients their students to the hospital and unit using the Greater Dayton Area Hospital Association (GDAHA) Nursing Student Experience guidelines available on www.gdaha.org. Faculty member collects the following student paperwork and submits to Premier Health’s clinical site liaison*: 1. Exhibit A 2. Exhibit B

Prior to first day of student placement

Faculty member verifies student completion of the following items and submits quizzes and competency assessments to Premier Health’s clinical site liaison*: 1. Fingerstick/glucometer training 2. Lift training Faculty member coordinates the following HealthStream training for students: 1. Epic training 2. Pyxis training Faculty member picks up student badges from security or telecom and distributes to students. Faculty member reviews Premier Health’s Student Placement Policy.

After clinical rotations are complete

Faculty member collects student badges and returns to security or telecom.

*All required documents must be submitted prior to students being on the floor. Students will not be allowed on the floor until all required paperwork has been submitted. 1

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Premier Health Student Placement Contacts Please use the contact information below for assistance setting up your student placements. Note: no faculty or student is to approach the hospital clinical staff, educator or manager to request clinical times or preceptors. All communication needs to go the through the site liaison.

Atrium Medical Center Clinical Site Liaison: Erin Evans, [email protected] To set up Epic training: Hans Oney, [email protected] To obtain glucometers to train your students: Shari Lovelace, [email protected] To book a room: Cyndi Mapp, [email protected] For issues concerning Pyxis Access: Terry LeMaster, [email protected] For issues with Epic: Help Desk, (937) 208-2737

Good Samaritan Hospital & Good Samaritan North Health Center Clinical Site Liaison: Anessa Snapp, [email protected] To set up Epic training: Hans Oney, [email protected] To obtain glucometers to train your students: Pat Kraft, [email protected] To book a room: Anessa Snapp, [email protected] For issues concerning Pyxis Access: (937) 734-1063 For issues with Epic: Help Desk, (937) 208-2737

Miami Valley Hospital & Miami Valley Hospital South Clinical Site Liaison: Erin Evans, [email protected] To set up Epic training: Kathy Fellows, [email protected] To obtain glucometers to train your students: Connie Cable, [email protected] To book a room: Shannon Conley, [email protected] For issues concerning Pyxis Access: Alicia Ricks, [email protected] For issues with Epic: Help Desk, (937) 208-2737

Upper Valley Medical Center Clinical Site Liaison: Anessa Snapp, [email protected] To set up Epic training: Hans Oney, [email protected] To obtain glucometers to train your students: Susan Behm, [email protected] To book a room: Susan Behm, [email protected] For issues concerning Pyxis Access: Tarlesa Delcamp, [email protected] For issues with Epic: Help Desk, (937) 208-2737 2

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Faculty: Student Training & Competency Guide To ensure your students are ready to be begin their clinical experience as scheduled, the following must be completed prior to the first day of student placement:

Epic Training (Offsite and Onsite Training) and Access Epic training is comprised of Computer Based Training (CBT) modules that all students are required to complete prior to their first day of student placement. Students will not be able to begin their clinical experience until Epic training is complete. Offsite Epic Training (Prerequisite for Onsite Epic Training Session) • All students are required to complete all CBT Epic modules prior to attending the onsite Epic training session. Epic CBTs are accessible in HealthStream (see HealthStream Login Instructions). Curriculum for Onsite Epic Training Session • 1-hour guided practice that will cover all content necessary to comfortably navigate Epic • Fingerprint enrollment for BioLogin. - If network accounts are not prepared, fingerprinting will be delayed. You can call 734-7979 to have IT bring a mobile device to you while students are on the unit. • If Premier Health student IDs are available, students will log in to production to ensure correct Epic access.

Faculty Responsibilities 1. Communicate CBT Requirement to Students It is the faculty’s responsibility to ensure students understand CBT requirements. All students must complete required CBT Epic modules prior to attending the onsite training session. 2. Schedule Onsite Epic Training at least 2 Weeks in Advance of Student Placement Training calendars fill up quickly—and we want to provide you with your first choice of time. Note: you do not need to send student names to schedule training, just the anticipated number of students that will attend training. To schedule training, please contact:

Site Atrium Medical Center Good Samaritan Hospital Good Samaritan North Health Center Upper Valley Medical Center Miami Valley Hospital Miami Valley Hospital South

Epic Trainer Hans Oney [email protected] Kathy Fellows [email protected]

3. Verify Completion of Required CBT Modules It is the faculty’s responsibility ensure students complete CBT requirements. Students should be instructed to print certificate of completion and turn it in to you for your own records. 4. Attend Onsite Epic Training with Students Faculty are required to be present for the onsite Epic training session.

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Pyxis Training & Access Pyxis training is comprised of Computer Based Training (CBT) modules that all students are required to complete prior to their first day of student placement. Students will not be able to begin their clinical experience until Pyxis training is complete.

Faculty Responsibilities 1. Communicate CBT Requirement to Students It is the faculty’s responsibility to ensure students understand CBT requirements. All students must complete required CBT Pyxis modules prior to their first day of student placement. CBT Pyxis modules are accessible in HealthStream (see HealthStream Login Instructions). Once students have completed their CBT, you can assist them with logging in at any Pyxis station. 2. Verify Completion of Required CBT Modules It is the faculty’s responsibility to ensure students complete CBT requirements. Students should be instructed to print certificate of completion and turn it in to you for your own records.

Glucometer Training & Competency Validation Glucometer training for students is comprised of faculty-led training and competency validation. Students will not be able to begin their clinical experience until Glucometer training is complete.

Faculty Responsibilities 1. Attend Onsite Glucometer Training and Competency Validation (New Faculty Only) New faculty are required to attend onsite glucometer training prior to student placements. Upon completion, you will be assigned an Accu-Chek code and associated student ID codes. 2. Complete Glucometer Competency Validation (Returning Faculty) Returning faculty are required to complete glucometer competency validation annually. Upon completion, you will be assigned an Accu-Chek code and associated student ID codes. 3. Provide Training and Competency Validation for Students After training your students, please validate competency by administering the enclosed quiz and completing the enclosed competency performance validation checklists with each student. Note: competency validation checklist with test score must be completed and signed by instructor. To obtain a training meter, please contact:

Site Atrium Medical Center Good Samaritan Hospital Good Samaritan North Health Center

Lab Coordinator Shari Lovelace [email protected] Pat Kraft [email protected]

Miami Valley Hospital Miami Valley Hospital South

Connie Cable [email protected]

Upper Valley Medical Center

Susan Behm [email protected]

4. Submit Competency Validation Checklist with Test Score for each Student to your Clinical Site Liaison (listed above) Faculty are responsible for submitting documentation of each student’s competency before student placement begins. Codes are deactivated at the end of the semester. 4

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Lift Class Competency Validation Lift Class Competency for students is comprised of faculty-led training and competency validation. Students will not be able to begin their clinical experience until their Lift Class Competency is validated.

Faculty Responsibilities 1. Provide Training and Competency Validation for Students After training your students, please administer the enclosed competency performance validation checklist with each student. Note: competency validation checklist must be completed and signed by instructor. 2. Submit Competency Validation Checklist with Test Score for each Student to your Clinical Site Liaison Faculty are responsible for submitting documentation of each student’s competency before student placement begins.

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Instructions to log on to HealthStream Learning Center (HLC) Offsite 1. In the address bar of your browser type in http://www.healthstream.com/hlc/php The screen should appear similar to the one below.

Figure 1

2. Login to HLC by typing in your UserID and Password and clicking on Login. UserID: the letter ‘T’ followed by your Student ID (example T12345678) Password: Password1 3. The page will open to the default My Learning tab. The page will appear with the modules you need to take. Proceed viewing each module and make sure the system records you have successfully completed each module’s test. TROUBLESHOOTING HEALTHSTREAM The browsercheck is set to run whenever a user brings up our HealthStream login page. If their system does not meet the recommend setting a yellow bar will appear at the top of the page with a link to check what is wrong with their browser. HealthStream will not work in the Firefox browser. Internet Explorer is the only browser that records progress in a course correctly back to HealthStream. Other browsers may work but are not reliable all the time in recording back to HealthStream. In new versions of Internet Explorer the user may need to click on the Compatibility View Icon (a piece of paper with a jagged line through it usually located near the address bar in the browser) or click on “Compatibility Mode” or “View” under the Tools menu of the browser to have the links work in HealthStream. Pop-Up blockers need to be turned off under the Tools menu of the browser to allow Pop-ups.

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT

Student Placement Request Form Please fill in the following to request floors for your student groups for winter/spring semester 2016. IMPORTANT: Once a clinical day and time is assigned it cannot be changed without prior approval from your Clinical Site Liaison. If you need to schedule a makeup day, your Clinical Site Liaison can help arrange this for you. For AMC, MVH & MVHS placements, please contact Erin Evans with any questions at 937-208-9145 or [email protected]. For GSH, GSNHC & UVMC placements, please contact Anessa Snapp with any questions at 937-734-2407 or [email protected].

School:

Winter 2016

Hospital:

Please list each clinical group seperately. Floor:

Faculty

Year of students

Class name

Day requesting

Dates of clinicals

Times of clinicals

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT

Premier Health CARF Form This form is used to request access to Healthstream, Epic, Pyxis & Accucheck. Student Placement Coordinator or School Representative: Please complete this form in its entirety; one form per class section. Return the completed form via email to the Clinical Site Liaison for your requested facility as listed below. This form must be received 2 weeks prior to clinical start time to allow time for processing.

A delay in receipt of this document may cause a delay in starting clinical time. Clinical Site Liaison/Contact Person for GSH, GSNHC & UVMC:

Anessa Snapp

[email protected]

Phone: (937) 734-2407

Clinical Site Liaison/Contact Person for AMC, MVH & MVHS:

Erin Evans

[email protected]

Phone: (937)440-4924

University/College: Program Type: Clinical Coordinator Name(s): Clinical Coordinator’s E-mail Address: Clinical Instructor Last Name: Clinical Instructor Middle Initial: Clinical Instructor E-mail Address: Hospital Name: Clinical Location/Units: Clinical Day of Week & Clinical Hours: Clinical Dates (first date - last date): Student Last Name

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Submit to TES ¨

Student First Name

DOB:

Clinical Coordinator’s Phone Number: Premier Employee?

First Name: Last 4 SS#:

Clinical Instructor’s Phone Number:

Student Middle Initial

School Issued Student Student Date of Birth: ID #:

Submitted to CARF Admin ¨

Healthstream login

Submit for HLC Account ¨

Is EPIC Training Needed?

As a student nurse, has student had Epic access at Premier?

Pyxis Assigned ¨

Unit Assigned for Precepted Students Only

Accucheck Assigned ¨

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Premier Health Faculty Waiver Form Please complete this form and submit to your clinical site liaison if your students will not be using glucometers or Pyxis during their student placement this semester.

Waive Glucometer Testing Faculty Name:_________________________________________________________________________ School: ______________________________________________________________________________ Date: ________________________________________________________________________________ My group will NOT be using glucometers for this semester, signed: _________________________________

Waive Pyxis Use Faculty Name:_________________________________________________________________________ School: ______________________________________________________________________________ Date: ________________________________________________________________________________ My group will NOT be using the Pyxis for this semester, signed: _________________________________

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Premier Health Student Health & Liability Form - Exhibit A USE INK AND COMPLETE EVERY BLANK Each student must complete this form and submit it to the Hospital representative at least one week prior to the commencement of the educational experience at Hospital. Print Name_________________________________________ Ohio License #_____________________ (If student is licensed)

School_____________________________________________________________________________ Educational Period _________________________________to_________________________________ Faculty Members Name (if applicable) ____________________________________________________ Sign________________________________________________

Date__________________________

HEALTH REQUIREMENTS I have had a physical examination within twelve months of the beginning of the educational experience that revealed that I am in good health. The exam included the tests below. List the DATE and RESULTS of each test. PPD (or Chest x-ray if Hx of + PPD)

Date of test________________________________ (Within last 12 months)

Results____________________________________ Annual Influenza Vaccination

Date of Vaccination___________________________ Proof of Exemption if Applicable_________________

Verification of the above dates and/or results are on file at: _________________________________________________________________________________________ School or Doctor’s Office or Place of Employment

OTHER REQUIREMENTS HEALTH INSURANCE: Name of Company __________________________________________________________ Policy Number _____________________________________________ Expiration Date ___________________ Student Signature ___________________________________________ Date ___________________________ Information on a student is to be maintained on file in the department in which the student is practicing, as required by the Ohio Department of Health, JCAHO, and Office of the General Counsel.

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT STUDENT ACKNOWLEDGEMENT Participation in the educational experience is prohibited unless this statement is signed by the Student. Student Signature___________________________________________________________________________ Print Name__________________________________________________________ Date__________________ Home Address______________________________________________________________________________ Home Phone____________________________________Cell Phone___________________________________ Email Address______________________________________________________________________________ University Contact Person_____________________________________________________________________ Contact Person’s Phone_______________________________________________________________________ Contact Person’s Email Address_________________________________________________________________

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Acknowledgment - Exhibit B Each student must complete this form and submit it to Anessa Snapp and Erin Evans, Center of Nursing Excellence at least two weeks prior to the commencement of the educational experience at any of the Premier Health Facilities. Affiliate/School Name:_______________________________ Faculty name: ______________________________ Hospital Dept:_______________________________________________________________________________ Clinical Specialty Area/Unit:_____________________________________________________________________ Term of Educational Experience: _______________________________ to ________________________________ I, the undersigned student, do hereby acknowledge that I have read and understand the following statements. I agree to abide by and be bound by the following statements in return for Good Samaritan Hospital allowing me to participate in an educational experience on its premises. 1. I will conduct my educational activities at a Premier Health Facility only under the supervision of a Premier Health employee or affiliated faculty member. 2. I will comply with all Premier Health rules and regulations and Premier Health policies and procedures. 3. I affirm that I have met immunization requirements, including (but not limited to) immune status for Hepatitis B, Rubella, TB, and annual Influenza vaccination and understand that proof of this status will be provided upon request by the clinical facility. 4. I understand that Premier Health retains the right to remove any student at any time in its sole discretion. 5. I acknowledge that I am not an employee of Premier Health for purposes of this educational experience. 6. I understand that I am responsible for the cost of any medical care that I receive from Premier Health for any reason. 7. I acknowledge my responsibility and liability regarding the confidential nature of all information that I have access to at Premier Health by virtue of my participation in this program. 8. I understand that I may not participate in the program until I have received an orientation that includes, but is not limited to, confidentiality, fire, safety and area specific requirements. 9. I will obtain written permission from Premier Health before publishing any material related to my educational experience at Premier Health. 10. I acknowledge that I have read and signed the GDAHA passport agreement. 11. I have working knowledge of the Pyxis and/or have completed the tutorial of the Pyxis.

Participation in the educational experience is prohibited unless this statement is signed by the Student.

STUDENT SIGNATURES

STUDENT SIGNATURES

Date of Signatures:____________________________ 12

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Stericycle RX Waste Compliance Service Nursing Fact Sheet Narcotics shall be disposed of per hospital policy! 1. R  ed Sharps Container: Sharps that do not contain any medication: - Empty syringes (oral and intravenous) - Empty ampoules 2. R  ed Bags (Regulated Medical Waste) - Blood saturated materials - Biohazardous waste 3. Blue RX Container (no code) Any items that has the possibility of leaking must first be put into a ZIP LOCK bag. No free fluids allowed in container. (NO SHARPS!!) - Partial IV bags and bottles, partial medication vials - Tablets - whole, broken or partial - Partial Topical Ointments 4. B  lack 2 Gallon Sharps Container: - Medication left in a syringe or ampoule 5. 8  Gallon Black Compatible Container: (BKC and PBKC) - Any leftover medication in IV bag, bottle or vial coded as BKC or PBKC (NO SHARPS!!) 6. S  end Back to Pharmacy (SP, SPO, SPS, SPLP) - Items labeled as SP, SPO, SPC need to be returned to pharmacy for proper disposal. Examples may include aerosols, unused silver nitrate sticks and ammonia inhalant. No free fluids allowed in any containers. Please put all IV bags, bottles and ointments which are not capped into a zip lock bag before disposal.

Pharmaceutical Waste Compliance IV Disposal Guideline Drain Disposal Allowed Provided there are no medications instilled in the IV, drain disposal is permitted in any of the following solutions: • Saline solution • Dextrose solution • Glucose solution • Electrolytes including Potassium • Lactated Ringer Pharmaceutical Waste (Blue Container) (No Code) - Represents 93% of hospital medication. Any leftover IV with non-controlled substance instilled in it and does not have a code. Compatible Hazardous (Coded as BKC or PBKC) Any leftover IV with hazardous, non-controlled substance instilled in it. These items will be coded with a BKC or PBKC. Witnessed Disposal - Controlled Substances Controlled substances should be disposed of per current pharmacy/hospital policy.

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Badging Student badges are activated for the duration of the clinical experience and provide students with access to primary entrances, the nursing unit breakroom, nutrition center and med prep areas; badges are also used for parking access. Student MUST wear their badge forward-facing along with their Student ID.

Faculty Responsibilities 1. Pick Up Student Badges To pick up student badges, please go to:

Site

Badge Pick Up Location

Badge Drop Off Location

Atrium Medical Center

Security

Security

Good Samaritan Hospital

Security

Clinical Site Liaison

Good Samaritan North Health Center

Security

Clinical Site Liaison

Miami Valley Hospital

Security

Security

Miami Valley Hospital South

Security

Security

Upper Valley Medical Center

Telecom

Telecom

2. Distribute Badges to Students Please make sure each student has received a badge prior to being on the unit for student placement. 3. Collect Student Badges and Return to Premier Health Please collect all student badges at the end of the clinical experience and return to the drop off location listed above. In the event that multiple groups will be rotating through the clinical site during the semester, you may collect and redistribute badges for each group. You MUST notify the clinical site liaison when badges are reassigned. Lost badges will be assessed a $20 replacement fee. 4. Contact Clinical Site Liaison with any Badging Problems Issues with badges that are not functioning properly should be discussed with the clinical site liaison. Students should not be directed to go to security to ask for a badge revision/reissue.

Clinical Site Liaisons Miami Valley Hospital Miami Valley Hospital South Atrium Medical Center

Erin Evans 937-208-9145 [email protected]

Upper Valley Medical Center Good Samaritan Hospital Good Samaritan North Health Center

Anessa Snapp 937-734-2407 [email protected]

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Parking Atrium Medical Center

d Roa op o sL

Ca m pu s

Atrium Dr.

Cam pu

All students and faculty are to park in the employee parking lot. Maps of the hospital campus and facility may be retrieved from: https://www.atriummedcenter.org/Locations/Campus-and-Building-Maps/

Lo op

122

Roa d

H

Atrium Medical Center

am

Medical Center

s Loop Rd. pu

NORTH ENTRANCE

N

SOUTH ENTRANCE

Campus Loop Road

Union Road

Employee Parking

Dr.

map not to scale

Market Ave.

C

Medical Center Dr.

Commerce Drive

Good Samaritan Hospital All students and faculty are to park in the employee parking lot (Hepburn Lot). Entrances are located across from the hospital driveway from southbound Philadelphia Avenue and from east and west bound lanes of Salem Avenue. Maps of the hospital campus and facility may be retrieved from: http://www.goodsamdayton.org/Locations/Campus-and-Building-Maps/ Sherwood Drive

Employee Parking Main Garage Visitor Parking

Philadelphia Drive

1

Sa lem

Benson Drive

MAIN ENTRANCE Employee Parking

Emergency Parking

Philadelphia Drive

Employee Parking

Av en ue

N

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Parking Good Samaritan North Health Center All students and faculty are to park in the 8900 N Main Street lot (by the ER, lot not shown on map). Maps of the hospital campus and facility may be retrieved from: https://www.goodsamdayton.org/Locations/Good-Samaritan-North-Health-Center/Maps-and-Directions/

Patient Parking

Emergency Parking

Lake

MAIN STREET ENTRANCE CANCER CENTER ENTRANCE

Good Samaritan North Health Center

LAKESIDE ENTRANCE EMERGENCY ENTRANCE

H

Heathcliff Road

Staff Parking

N

AMBULANCE ENTRANCE

Mount Calvary Lutheran Church Parking Lot

Patient Parking

Garber Road

Main Street (RT. 48)

Education Center Parking

Miami Valley Hospital

Students and faculty may park at the Main Street lot. This lot is located at the corner of N. Main and Apple Street, but accessed on Stout St. If this lot is full, the overflow lot is located on Vine St. A hospital shuttle is available. Note: 2nd and 3rd shift may park in garage 2 or 3. Maps of the hospital campus and facility may be retrieved from: http://www.miamivalleyhospital.org/Locations/Campus-and-Building-Maps/ Stout Street Vine Street

E. Foraker Street

t ree l St Hil

Main St. Lot

treet ker S E. Fora Foraker St. Lot

Brady Street

Vine St. Lot

Physician Office Garage

Apple St. Lot

Apple Street

MVH Child Care Center

AppleWarren Lot

Weber Center

Visitor Garage Magnolia Colby Ln.

Fairgrounds

Street

Berry Women’s Center

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Student Parking Miami Valley Hospital South All students and faculty are to park in the employee parking lot. Maps of the hospital campus and facility may be retrieved from: https://www.miamivalleyhospital.org/Locations/Campus-and-Building-Maps/ Wilmington Pike

I-675

Parking Parking

C

C

Parking

B

Cancer Center and 2300 Physician Office Building Entrance

2350 Physician Office Building Entrance

Main Entrance Parking

Mia mi Va lley Drive

A

Emergency Walk-in Entrance Maternity Entrance Parking

Wilmington Pike

Bed Tower Entrance

D

N

Employee Parking Emergency Drive

South Campus Boulevard

Clyo Road

Upper Valley Medical Center All students and faculty are to park in Lot E. Maps of the hospital campus and facility may be retrieved from: https://www.uvmc.com/Locations/Campus-and-Building-Maps/

N MAIN ENTRANCE

KOESTER PAVILION

EMERGENCY ENTRANCE MATERNITY ENTRANCE AMBULANCE ENTRANCE Rd. 25-A County

COMMUNICATIONS BUILDING DIALYSIS CENTER FARM HOUSE INPATIENT BEHAVIORAL HEALTH

EMPLOYEE PARKING

Par k Lot ing E PHYSICIAN OFFICES

To Ho spit al

UVMC Main Campus Entrance

HUMAN RESOURCES & SUPPORT SERVICES DETTMER

Par k Lot ing B

OUTPATIENT BEHAVIORAL HEALTH

CANCER CARE CENTER

Par k Lot ing D

U ME PPER DIC VA AL LLE CEN Y TER

MATERNITY

Par k Lot ing A

To Ho sp ita l

I-75

Par k Lot ing C

H

To Hospital Ambulance Entrance only

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PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Accu-Chek Inform II™ – Initial Certification TRUE/FALSE ______1. Personal protective equipment must be worn when performing blood glucose testing and when cleaning /disinfecting the meter. ______2. The test strip is placed in the test strip slot with the yellow target area or test window facing up and the end with the gold bars inserted into the meter. ______3. When the meter displays “LO or HI” this means the patient’s glucose is outside the reportable range (10-600 mg/dl) and a sample should be sent to the Clinical Lab to receive a numerical result. ______4. The AccuChek Inform II meter should be docked in the base unit when not in use because the base unit/cradle charges the battery. ______5. There can be significant differences in glucose levels (as much as 70 mg/dL) determined by sample type, site, and time frame between testing. ______6. The comment codes “Procedure Error” and “Do Not Use” prevent a patient result from being reported to the patient’s electronic medical record. MULTIPLE CHOICE ______7. Control vials must be marked with an open date and an expiration date. Controls expire_________ from the date the vials were opened or the Manufacturer’s expiration date, whichever comes first. a. 2 months b. 30 days c. 3 months d. 4 months ______8. QC must be performed: a. Every 24 hours of testing b. If a meter is dropped c. If patient results contradict clinical symptoms d. All of the above ______9. If the wireless network is down: a. Communication of the AccuChek Inform II is not affected b. The meter must be docked in a designated connected base unit c. The Inform II will not be able to be used for testing d. Results will still appear in Epic as soon as the test is completed at bedside _____10. What types of blood cannot be used with the AccuChek Inform II meter and test strips? a. Neonatal heel sticks b. Cord blood c. Capillary d. Venous e. Arterial 18

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT MULTIPLE CHOICE ______11. A capillary (fingerstick) sample should not be used for patients who: a. are in shock b. have peripheral perfusion problems (ex. extreme bleeding) c. are in diabetic ketoacidosis (DKA) d. have a very high hematocrit of >65% e. All of the above ______12. If your meter malfunctions and you are not able to troubleshoot it you should: a. Take the meter out of service and call the Point of Care office. b. Use a different meter or send a sample to the Clinical Laboratory to get a result. c. Take the meter out of service and call Clinical Engineering. d. Letters a. and b. ______13. Which of the following is FALSE when the yellow sample window is underfilled? a. May cause the error message “Type Bad Dose” to display. b. Can happen if you do not apply the blood sample to the front edge of the AccuChek Inform II test strip. c. There is no affect on the test results. d. The comment “Procedure Error” or “Do Not Use” should be added to the result ______14. Which of the following sample sites is approved for glucose testing with this analyzer? a. Toe b. Forearm c. Earlobe d. Fingers/Heels ______15. Self-testing and/or testing of a co-worker a. Is against hospital and POC policy. b. Is ok, if you use the ID of “00000000” c. Is considered testing without a physician order. d. Letters a. and c. ______16. You have a patient who may be in Diabetic Ketoacidosis. Which of the following is FALSE? a. You should not perform a POC glucose test because the result may actually be much higher. b. You should send a sample to the Clinical Lab for testing. c. It is OK to test the patient in the POC setting, the results will not be affected by Diabetic Ketoacidosis (DKA.) d. The AccuChek meter is unreliable for DKA patients.

19

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT MULTIPLE CHOICE ______17. You tested your patient’s blood glucose and got a critical result. What should you do? a. Consider retesting with the meter b. Notify the appropriate care giver of the critical result c. Document critical result notification in EPIC d. Attach the appropriate comment code e. All of the above ______18. Which is NOT appropriate if a patient is experiencing symptoms which are not consistent with the blood glucose result? a. Repeat the test. b. Accept the result the meter is always correct. c. Perform controls to check the analyzer’s performance. d. Send a specimen to the clinical laboratory for analysis. ______19. When performing Accu-Chek glucose testing what statement is FALSE for patient ID? a. If a patient can be identified and does not have a valid, current armband, enter the patient’s name and date of birth as patient ID. b. If a patient cannot be identified, for example a trauma patient, enter the patient ID 91100000 and depending on hospital enter/edit the result in EPIC or call the POC office with information. c. You have scanned the patient’s armband and the patient’s name and DOB does not appear. Since you have scanned the armband you can continue testing. d. Stickers/labels are not to be scanned for patient ID. e. Patient ID for the Accu-Chek Inform II is the CSN. _______20. Select the statement that is TRUE. a. Finger stick Accu-Chek glucose results should always be the same as laboratory results. b. It is not necessary to wipe away the first drop of blood after performing the finger stick. c. The Accu-Chek Inform II procedure is found in MedPolicy. d. Since Accu-Chek test strips are not affected by moisture/environment you can use strips that are found outside the strip vial. _______21. How often does the meter need to be cleaned and with what is the meter cleaned/disinfected? a. Once a day, with soap and water b. After every patient, with the purple topped Sani-Wipe product. If isolation patient with C. Diff, use Clorox wipes. c. When visibly dirty, with alcohol d. It is not necessary to clean the meter. ________22. Select the statement that is TRUE. a. The flashing drop must be visualized on the screen before applying sample to strip. b. After entering a comment you must press the √ button to save the comment with the result c. “NURSE AWARE” is the only comment that posts to the patient’s chart with results. d. All the above 20

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Accu-Chek Inform II™ – Initial Certification

ANSWER KEY

TRUE/FALSE T ______1. Personal protective equipment must be worn when performing blood glucose testing and when cleaning /disinfecting the meter.

KE Y

T ______2. The test strip is placed in the test strip slot with the yellow target area or test window facing up and the end with the gold bars inserted into the meter. T ______3. When the meter displays “LO or HI” this means the patient’s glucose is outside the reportable range (10-600 mg/dl) and a sample should be sent to the Clinical Lab to receive a numerical result.

T ______4. The AccuChek Inform II meter should be docked in the base unit when not in use because the base unit/cradle charges the battery. T ______5. There can be significant differences in glucose levels (as much as 70 mg/dL) determined by sample type, site, and time frame between testing.

MULTIPLE CHOICE

ER

T ______6. The comment codes “Procedure Error” and “Do Not Use” prevent a patient result from being reported to the patient’s electronic medical record.

SW

c ______7. Control vials must be marked with an open date and an expiration date. Controls expire_________ from the date the vials were opened or the Manufacturer’s expiration date, whichever comes first. a. 2 months b. 30 days c. 3 months d. 4 months

AN

d ______8. QC must be performed: a. Every 24 hours of testing b. If a meter is dropped c. If patient results contradict clinical symptoms d. All of the above b ______9. If the wireless network is down: a. Communication of the AccuChek Inform II is not affected b. The meter must be docked in a designated connected base unit c. The Inform II will not be able to be used for testing d. Results will still appear in Epic as soon as the test is completed at bedside b _____10. What types of blood cannot be used with the AccuChek Inform II meter and test strips? a. Neonatal heel sticks b. Cord blood c. Capillary d. Venous e. Arterial 21

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT MULTIPLE CHOICE e ______11. A capillary (fingerstick) sample should not be used for patients who: a. are in shock b. have peripheral perfusion problems (ex. extreme bleeding) c. are in diabetic ketoacidosis (DKA) d. have a very high hematocrit of >65% e. All of the above

KE Y



d ______12. If your meter malfunctions and you are not able to troubleshoot it you should: a. Take the meter out of service and call the Point of Care office. b. Use a different meter or send a sample to the Clinical Laboratory to get a result. c. Take the meter out of service and call Clinical Engineering. d. Letters a. and b.

ER

c ______13. Which of the following is FALSE when the yellow sample window is underfilled? a. May cause the error message “Type Bad Dose” to display. b. Can happen if you do not apply the blood sample to the front edge of the AccuChek Inform II test strip. c. There is no affect on the test results. d. The comment “Procedure Error” or “Do Not Use” should be added to the result

SW

d ______14. Which of the following sample sites is approved for glucose testing with this analyzer? a. Toe b. Forearm c. Earlobe d. Fingers/Heels

AN

d ______15. Self-testing and/or testing of a co-worker a. Is against hospital and POC policy. b. Is ok, if you use the ID of “00000000” c. Is considered testing without a physician order. d. Letters a. and c. c ______16. You have a patient who may be in Diabetic Ketoacidosis. Which of the following is FALSE? a. You should not perform a POC glucose test because the result may actually be much higher. b. You should send a sample to the Clinical Lab for testing. c. It is OK to test the patient in the POC setting, the results will not be affected by Diabetic Ketoacidosis (DKA.) d. The AccuChek meter is unreliable for DKA patients.

22

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT MULTIPLE CHOICE

KE Y

e ______17. You tested your patient’s blood glucose and got a critical result. What should you do? a. Consider retesting with the meter b. Notify the appropriate care giver of the critical result c. Document critical result notification in EPIC d. Attach the appropriate comment code e. All of the above

b ______18. Which is NOT appropriate if a patient is experiencing symptoms which are not consistent with the blood glucose result? a. Repeat the test. b. Accept the result the meter is always correct. c. Perform controls to check the analyzer’s performance. d. Send a specimen to the clinical laboratory for analysis.

SW

ER

c ______19. When performing Accu-Chek glucose testing what statement is FALSE for patient ID? a. If a patient can be identified and does not have a valid, current armband, enter the patient’s name and date of birth as patient ID. b. If a patient cannot be identified, for example a trauma patient, enter the patient ID 91100000 and depending on hospital enter/edit the result in EPIC or call the POC office with information. c. You have scanned the patient’s armband and the patient’s name and DOB does not appear. Since you have scanned the armband you can continue testing. d. Stickers/labels are not to be scanned for patient ID. e. Patient ID for the Accu-Chek Inform II is the CSN.

AN

c _______20. Select the statement that is TRUE. a. Finger stick Accu-Chek glucose results should always be the same as laboratory results. b. It is not necessary to wipe away the first drop of blood after performing the finger stick. c. The Accu-Chek Inform II procedure is found in MedPolicy. d. Since Accu-Chek test strips are not affected by moisture/environment you can use strips that are found outside the strip vial. b _______21. How often does the meter need to be cleaned and with what is the meter cleaned/disinfected? a. Once a day, with soap and water b. After every patient, with the purple topped Sani-Wipe product. If isolation patient with C. Diff, use Clorox wipes. c. When visibly dirty, with alcohol d. It is not necessary to clean the meter. d ________22. Select the statement that is TRUE. a. The flashing drop must be visualized on the screen before applying sample to strip. b. After entering a comment you must press the √ button to save the comment with the result c. “NURSE AWARE” is the only comment that posts to the patient’s chart with results. d. All the above 23

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Accu-Chek Inform II™ – Initial Certification NAME: ______________________________________________ DATE: __________________________ UNIT: ________________________________________________ OPERATOR ID: ___________________

EXPECTED BEHAVIORS

MET

NOT MET

Demonstrates maintenance and quality control requirements: A. Cleans meter as required B. Verbalizes battery charging requirements C. Performs quality control and verbalizes frequency of use D. Verbalizes how to label controls and when they expire E. Verbalizes action to take if results are not within range Demonstrates procedure in performing patient AccuChek Inform II glucose testing: A. Wears the proper personal protective equipment C. Verbalizes finger puncture correctly D. Fills yellow target area completely E. Enters the appropriate ID numbers F. Verbalizes reportable/critical ranges for AccuChek glucose results and actions to take G. Disposes of lancet, contaminated materials and gloves properly H. Documentation of patient results I. Demonstrates Scanner use J. Enters appropriate comment codes Miscellaneous A. Has located and read the AccuChek Inform Glucose procedures on intranet B. Verbalizes reagent storage requirements C. Completes the corresponding competency exam Passing score of 90% I verify the above person has demonstrated the expected behaviors in performing glucose measurement with the AccuChek Inform meter. ____________________________________________________________________________________ Trainer Signature

Date

I, the undersigned, understand and have demonstrated the expected behaviors in performing glucose measurements on the AccuChek Inform meter. ____________________________________________________________________________________ Signature

Date

24

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Clinical Laboratory COMPETENCY PERFORMANCE CHECKLIST BLOOD COLLECTION USING FINGERSTICK TECHNIQUE NAME: ______________________________________________ UNIT: __________________________ EMPLOYEE #: ________________________________________________ DATE: ___________________

PERFORMANCE CRITERIA

MET

NOT MET

COMMENTS

Check Physician orders. Positively I.D. patient. Use the 2 JCAHO required identifiers. Put on gloves. Select the puncture site on the lateral aspect of the finger. Position the finger in an independent position and massage toward the fingertip. For older adults and patients with poor circulation warm the site for about 10 minutes before attempting blood collection. Make sure POCT instrument is in the ready mode with all required information entered. Cleanse the site using a 70% alcohol pad. Allow the area to dry completely. Position the sterile lancet firmly against the skin perpendicular to the puncture site. Push the release switch allowing the needle to pierce the skin. Lightly squeeze the patient’s finger above the puncture site until a droplet of blood has collected. Wipe away the first drop and gently squeeze again to form another droplet. DO NOT apply over repetitive pressure (milking) to the site. Proceed with patient testing. Using a gauze pad gently apply pressure to the puncture site. Document POCT results. Discard test strip and lancet when test is finished. Gently wipe table with damp tissue if needed. Remove gloves and wash hands. ____________________________________________________________________________________ Signature and Date

Validator

25

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Lift Class Competency Check To complete this evaluation, visit the homepage of the Premier Health Intranet and type “Lippincott” in the search bar at the top of the page. Once you’re in Lippincott, select “Nursing.” Type “Gait Belt Use” in the search bar at the top of the page. 1. Name three things that you need to know about the patient before you plan a lift or transfer.

a.) ______________________________________________________



b.) ______________________________________________________



c.) ______________________________________________________

2. To prepare the environment for a safe transfer you should make sure that the ________________ are untangled and on the correct side of the bed and that the ____________________ is positioned correctly.

3. Describe the safety advantage of using a gait belt. ___________________________________________ ___________________________________________________________________________________

DEMONSTRATE CORRECT TECHNIQUE: Skill

Competency Demonstrated Y or N

Reviewer Initials

Gait belt placement Rolling Scooting Stand pivot Squat pivot

____________________________________________________________________________________ Participant signature

Date

____________________________________________________________________________________ Instructor signature

Date

26

PREMIER HEALTH LEARNING INSTITUTE | STUDENT PLACEMENT Lift Class Competency Check

ANSWER KEY

KE Y

To complete this evaluation, visit the homepage of the Premier Health Intranet and click “Policies.” Find the hospital you will be at for your student placement, click “Lippincott Procedures,” and then select Nursing. In the query box at the top of the page, type “Gait Belt Use”. 1. Name three things that you need to know about the patient before you plan a lift or transfer. Cognition, Confusion, ability to follow direction a.) ______________________________________________________

Activity order/ level of mobility b.) ______________________________________________________

Presence of any indwelling drains, tubes, location of wound/incision c.) ______________________________________________________

2. To prepare the environment for a safe transfer you should make sure that the lines, IV tubing, O2 tubing are

ER

untangled and on the correct side of the bed and that the bed or chair is positioned correctly.

3. Describe the safety advantage of using a gait belt. Provides a safe method to support the patient by avoiding pulling on their arm/shoulder. Provides improved body mechanics for patient and caregiver during transfers. Prevents falls while providing proper support to the patient.

SW

DEMONSTRATE CORRECT TECHNIQUE:

Skill

Competency Demonstrated Y or N

Reviewer Initials

Gait belt placement Rolling

Scooting

Stand pivot

AN

Squat pivot

____________________________________________________________________________________

Participant signature

Date

____________________________________________________________________________________ Instructor signature

Date

27