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Nursing Student Orientation

This presentation is brought to you by The Schools Of Nursing
by Tracy Blair on 2 June 2014

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Transcript of Nursing Student Orientation

This is just the beginning of your orientation to Children’s Hospital of Wisconsin. Please review this information prior to your first day of clinical. Discuss the information and any questions you have with your instructor or preceptor. The policies and procedures can be found on the CHW Student Placement Website: http://www.chw.org/medical-professionals/education/students/nursing-education/nursing-students/
Let your adventure begin......
Student Nurse Orientation Introduction-
Welcome, we’re glad
you’re here!
Start at the pirate ship's top sail to begin your adventure
A Treasure awaits you..
Please review the policies and procedures prior to your first day of clinical. They can be found on the student website http://www.chw.org/students
If you have any questions please talk with your clinical instructor or preceptor.
Students park in the employee parking ramp located
behind Children’s Corporate Center, 999 N. 92nd St.

On your first day notify the attendant via the intercom
located at the entrance that you are a nursing student.
When you receive your ID badge it will open the gate to
the parking structure. During the dates you are assigned
to Children’s Hospital of Wisconsin. The parking ramp
and lot near the clinics building is reserved for visitors,
families and patients.
Student Nurse Orientation
Dress Code
All students doing a clinical or precepted learning experience in any CHW entity must adhere to the CHW Employee Dress Code Policy. You must read this policy prior to your first day.
Student Nurse Orientation
Milwaukee Regional Medical Center is Smoke Free
Student Nurse Orientation
Negligence in performing job responsibilities which directly impact the health, safety or well being of patients or customers.
Negligence in performing job responsibilities which result in loss, damage or destruction of equipment belonging to the hospital or others.
Insubordinate conduct toward a leader or refusing to carry out the instructions of a leader
Any unprofessional conduct, behavior or appearance
Excessive tardiness or unscheduled absences
Unauthorized use, possession, or reporting under the influence of, intoxicating beverages, narcotics or dangerous drugs on CHW premises
Fighting, gambling, horseplay or using profane, obscene or abusive language on CHW premises
Threatening, intimidating or coercing others on CHW premises or carrying weapons.
Failure to meet TJC & OSHA requirements for compliance, competency &/or education
Student Nurse Orientation
CHW supports the confidentiality, integrity, and availability of all protected health information (PHI) in compliance with the HIPAA security rule. During your student placement at a Children’s Hospital of Wisconsin entity the privacy of patients and their information must be protected:

Do not talk about patients in public places (elevators, cafeteria).
Do not copy any medical records. Remove the identifiers of the patients in any notes that you take for school work.
Anything you hear or see must be confidential. Medical information is shared only with authorized people for the purpose of caring for the child.
Student Nurse Orientation
Cell phones may be used only in designated areas in the hospital
Personal phone calls should not be made on department phones
Hospital Computers should not be used to access or send personal e-mails
Profanity is never acceptable
Student Nurse Orientation
Attendance- You must contact your preceptor or instructor if you are unable to arrive for your clinical placement at the appropriate time, or because of illness, change in schedule, etc.

Review your school’s attendance policy for further instructions.
Student Nurse Orientation
In addition:

School uniforms and a CHW student picture ID tag must be worn at all times when in the hospital. Business casual attire with a lab coat are appropriate in some ambulatory settings.
No visible piercing (except ears), or clothes that reveal skin other than arms are allowed.
Nails should be short and either un-polished or light colored polish. No artificial nails of any kind are allowed.
Children pull on things that dangle. Be careful: do not wear necklaces or large hoop earrings.
If you have long hair it must be pulled back.
Student Nurse Orientation
As a student at Children’s Hospital of Wisconsin, we expect that all care of patients will be shared and supervised by the nurse assigned to the patient and/or your clinical instructor
Never hesitate to ask questions, ask for directions, or ask for help, doing any task or using any equipment that is unfamiliar to you
Review the Nursing Student policy found on http://www.chw.org/students
Student Nurse Orientation
Should a large scale disaster occur in our community, Children’s Hospital of Wisconsin prepares for potential incoming patients.
Contact your clinical instructor or preceptor at this time.
External Disaster
Mass Casualty Response
Student Nurse Orientation
Safety Procedures
Student Nurse Orientation
Safety Procedures
When certain emergency conditions occur, they are announced on the overhead speaker. You can also refer to your Safety Card. Contact your instructor or nurse for further direction.
Student Nurse Orientation
Safety Procedures
If you see a situation at the CHW campus that puts your safety or the safety of others at risk, you need:

To report an urgent safety related issue to Security Services,
Dial 88
from any hospital telephone.

To request non-urgent assistance from Security Services,
Dial 62552
from any hospital telephone.
Student Nurse Orientation
Safety Procedures
Exposure/Accidents Procedures
For blood borne disease exposure, wash the exposed area immediately; notify your instructor.
Incident reporting procedure available on-line. If you have an accident or exposure, your instructor or preceptor will assist you in completing these forms.
Know your school procedure for exposures/accidents.

Safety Data Sheets
Contain important information about hazardous materials or chemicals.
SDS information can be accessed on the hospital intranet.
Your instructor/preceptor will assist you should you come in contact with hazardous materials.
Student Nurse Orientation
If you have any concerns about your experience here, please share them immediately with your clinical instructor or preceptor. It’s through your feedback that we can improve. The education of health care professionals is a part of our Mission. We’d like you to feel welcomed and valued as a part of the team.
Children’s Hospital of Wisconsin picture ID Badges
must be worn at all times. IDs are dated, so you will
only have access to areas and parking during
the dates of your clinical learning experience.
The ID’s are obtained through the security department
which is located in Suite 150 of
the Children’s Corporate Center.
Your clinical instructor/preceptor
instructor will discuss with you the
Procedure you should use to obtain
your ID badge.
Student Nurse Orientation
The following items would be considered violations of the hospital Code of Conduct:

Falsification or unauthorized altering of records
Unauthorized disclosure of confidential information
Failure to assist in an emergency if assistance is within scope of duties
Refusal to provide care to infectious disease pts
Creating unsafe or unsanitary conditions
Negligence in performing job responsibilities or safety regulations or failure to report unsafe conditions or on-the-job injuries.
Leaving the job without permission during assigned work hours
Sleeping or giving the appearance of sleeping while on duty
Any conduct or behavior which constitutes harassment, dishonesty, disharmony or discourtesy
Stealing or unauthorized use of CHW equipment, this also includes the unauthorized use of information systems, internet access and excessive personal phone use
Student Nurse Orientation
Waste Management
Trash goes in regular clear trash bags
Blood saturated materials go in red trash bags.
Yellow bags should be used for Biohazard or Chemo materials
Recycle whenever possible
Blue recycle bins for plastic/glass
Blue containers without bags for paper

Occupational Health
Body Mechanics- use good body mechanics when moving equipment and patients
Do not lift/move heavy equipment/patients alone
Do not over stuff linen or trash bags.
Student Nurse Orientation

Must be supervised whenever out of crib or bed
Parents lap is often the best place for vitals and assessment.
May not be comfortable with a lot of eye contact until they know you better.
Will understand many more words than they can say.
Student Nurse Orientation
Ages & Stages


Side rails should be up at all times-
assess the need for crib or bed
Still puts everything in the mouth, watch
the size of toys
Latex balloons (not allowed at CHW),
hot dogs, peanuts, popcorn, whole grapes, raisins, and candy are choking hazards
Falls a lot while learning to walk
Not afraid of exploring- gets into everything
Doesn’t understand when in danger-especially near water
Student Nurse Orientation
Ages & Stages


Can learn sign language
Will learn to speak
Respond to simple commands
Can begin to dress self with help
Usually not potty trained
Likes to play near, but usually not with, other children
Often has a special toy or blanket
Often afraid of strangers
Student Nurse Orientation
Ages & Stages


Calming the parent will help to calm the infant.
Parents need to be a part of the plan of care, support the parents to learn their infant’s care.
Help parents to touch and hold their infants as much as possible.
Student Nurse Orientation
Ages & Stages





Control of sound, light, and temperature are important for healing and rest.
Mother’s are encouraged to pump their breast milk, double check breast milk prior to giving to infant.
Never heat breast milk or formula in the microwave.
Use pacifier with Sucrose-Sweetease to improve infant’s comfort.
Student Nurse Orientation
Ages & Stages
Safe Sleep Guidelines http://cupublic.chw.org/media/SafeSleep/safesleep/ie7/index.html?dhtmlActivation=inplace
Position on back or side to sleep (not on tummy) except for special circumstances.
Keep soft objects, toys and loose bedding out of the baby’s sleep area. Do not use pillows.
Can roll off of beds and changing tables: side rails must be up at all times.
Student Nurse Orientation
Ages & Stages





Imitates sounds and gestures, smiles and laughs
Begins to respond to name and can say short words by 1 year
Cries differently for different needs, fears strangers
Likes mirrors, colors, can begin simple games
(so big, peek-a- boo)
Student Nurse Orientation
Ages & Stages



Makes throaty noises and smacks lips, may smile randomly
Cries when hungry or uncomfortable
Likes to be held; head should be supported
Likes soft music
Student Nurse Orientation
Ages & Stages



High quality, comprehensive health care services to children appropriate for their needs begins with understanding the different developmental and emotional needs of children at different ages.
In this environment, paying attention to the needs of children and their families needs to be at the core of who we are and what we do.
Student Nurse Orientation
Ages & Stages
Clinical Research
Our research institute advances state-of-the-art pediatric health care practice through dedicated laboratory and clinical research. Based on the concept of translational research, the institute is designed to take clinical problems from patients’ bedsides to study in the laboratory. Laboratory discoveries then are converted into new treatments, preventions, therapies and cure for patients.

Regional Centers
Several regional centers are based at Children’s Hospital of Wisconsin. These include the Airway, Digestive and Voice Center; Cancer and Blood Disorder Center; Fetal Concerns Center; Genetics Center; Herma Heart Center, Transplant Center and Wisconsin Poison Center.

Two hospital facilities

The flagship Children's Hospital facility near Milwaukee has 296 beds. Patient care units include a Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, Cardiac Intensive Care Unit, Cancer and Blood Disorders Unit, Epilepsy Monitoring Unit and Short Stay Unit. The Children's Hospital facility in Neenah, Wis., has 42 pediatric beds, including a 22 bed NICU.
2013 FACT SHEET (continued)
Unique in Wisconsin

Children’s Hospital of Wisconsin is one of the nation’s top pediatric facilities. It also is a Level 1 Pediatric Trauma Center verified by the American College of Surgeons. Founded in 1894, Children's Hospital provides primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Care is provided to children from Wisconsin, Michigan, northern Illinois and beyond.

Private, independent

Children’s Hospital of Wisconsin is a private, independent, not-­for­-profit hospital. It is a major teaching affiliate of the Medical College of Wisconsin and is affiliated with more than a dozen schools of nursing. Other pediatric education programs also are associated with the hospital.

Patient Served
Children’s Hospital of Wisconsin is one of the busiest pediatric hospitals in the nation. Last year, 24,085 infants, children and adolescents were admitted and 332,211 were seen in the hospital’s specialty outpatient clinics and urgent care sites. The Emergency Department/Trauma Center treated 61,732 children, and 15,559 surgical procedures were performed at the hospital. An additional 9,292 surgeries were performed at Surgicenter of Greater Milwaukee. In addition, the primary care clinics of Children’s Medical Group suported 241,897 patient visits.

Specialty clinics
More than 70 specialty clinics provide outpatient diagnosis and treatment for a wide variety of pediatric 
disorders. Specialty clinics include asthma/allergy/immunology, birthmarks/vascular anomalies, cancer,, cardiology, dental,  dermatology,
diabetes/endocrinology, ear/nose/throat, gastroenterology, neonatology, neurology,  orthopedics, pulmonary/sleep, sports medicine/concussion  and urology. In addition to clinics on the Milwaukee hospital campus, many of these outpatient services also are available at locations throughout metro Milwaukee and Wisconsin.

A National Leader
In its March 2013 issue, Parents magazine ranked Children's Hospital of Wisconsin #4 in the nation in its Best Children's Hospital Survey. We were also top 10 for all six specialty areas the magazine ranked- with our Preemie and Newborn Care #1 and our Emergency Care #3. The hospital is designated a Magnet hospital by the American Nurses Credentialing Center, a national honor that recognizes nursing excellence.
2013 FACT SHEET



In the March 2013, Issue of Parents Magazine Children’s Hospital of Wisconsin is ranked in 4th of Pediatric Hospitals in the nation.

Children’s Hospital of Wisconsin
is a magnet hospital by the American Nurses Credentialing Center.
The policies and procedures you must review prior to starting your learning experience can be found on the Children’s Hospital of Wisconsin website: http://www.chw.org/students
Nursing Student Policy:
http://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/Nursing%20Students.pdf
Dress Code:
http://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/Dress%20Code.pdf
Privacy-Confidentiality/Patient Information:
http://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/Patient%20Privacy.pdf
Student Placement Policy:
http://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/Student%20Placement%20Program.pdf
Safety:
http://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/SafetyGeneral%20%20CHW.pdf
Policies and Procedures
C.A.R.E.
Provide high quality, comprehensive health
C
are services to children appropriate for their needs.
Provide leadership, experience and expertise as a community, state and regional resource to
A
dvocate for the health and well-being of children.
Support
R
esearch and training activities that increase the knowledge and understanding of the health care needs of children.
Be a center for the
E
ducation of health care professionals in the care of children.
OUR MISSION
The Children’s Hospital of Wisconsin
Growth and Developmental Considerations in the Pediatric Population
The Joint Commission “National Patient Safety Goals”
Infection Prevention and Control
Safety and Security Procedures
The Student Role and Responsibilities
Code of Conduct- HIPAA
Patient Experience
In this presentation you will be introduced to:

The purpose of the Student Nurse Clinical placements is to provide student nurses the opportunity to learn to care for children in a developmentally appropriate way while gaining clinical experience in pediatrics.

The following presentation is one way to meet the compliance requirement that you must complete prior to beginning your student placement at Children’s Hospital of Wisconsin.
Student Nurse Orientation- Introduction
Children’s Hospital of Wisconsin – Main Campus
9000 W. Wisconsin Avenue
Milwaukee, WI 53226
(414) 266-2000




No drawstring closures at the neck or necklaces (unless of cultural importance)
Puts everything in their mouth- make sure no items are smaller than their fist
Must travel in a car seat (facing rear) in the back seat
Walkers are dangerous and not recommended
Student Nurse Orientation
Ages & Stages


Values and guiding behaviors:
Purpose
- We act in service of children and families.
Collaboration
- We work together to care for children and families.
Integrity
- We build confidence and trust in all interactions.
Health
- We are at our best.
Innovation
- We commit to breakthrough solutions with continuous learning.
OUR VISION
Isolation Precautions Signs
Identify the type of isolation, located on the wall outside of each room.
Implemented for the safety of everyone.


Use of Personal Protective Equipment (PPE)
Wear gloves, gowns, masks, etc. when required.
PPE is located either in the isolation cart next to the room or the patient’s room.
Remove and dispose of PPE garments properly.
Student Nurse Orientation



Includes:
Isolation Precautions Signs
Personal Protective Equipment
Basic Patient Contact Tips
Student Nurse Orientation


Report any safety concern that happen to you or your patient to the nurse assigned to your patient and to your clinical instructor. Report any safety concern that could have happened (for example: the IV fluid sent for the patient did not match the order, but you caught it before you gave it) to the nurse assigned to your patient and to your clinical instructor. Children’s Hospital of Wisconsin tracks all safety concerns through an online database. Tracking problems can eliminate or lessen the risk of future concerns by trying to change any systems that contributed to them.
Student Nurse Orientation

Clean Hands Save Lives
C4K: Clean 4 Kids

Children’s Hospital of Wisconsin works to decrease the spread of nosocomial infection by following the CDC recommendations for hand hygiene:
Clean your hands before and after entering the patient's room.
Use soap and water when hands are visibly soiled or after using the restroom.
There is NO tolerance for staff who do not comply with the policy.
Student Nurse Orientation
TJC Safety Goals
Notify the child’s nurse and obtain and place a new band

Children are active and bands come off or are removed for many different reasons
If you find the child you are caring for does not have an ID band on you MUST
Student Nurse Orientation
TJC Safety Goals
Improve the accuracy of
patient identification

Must use two identifiers to identify
the patient (one of them cannot be the room
number) whenever taking blood samples,
administering medications, any procedures, dietary needs or administering blood.

The primary patient identifiers are:
First and last name of patient
Date of birth
“Right patient” is verified by 2 not 1 identifier
Student Nurse Orientation
TJC Safety Goals
Children’s safety risks increase in the hospital

TJC is an organization that sets up standards for all
hospitals to follow. The purpose of the National Patient Safety Goals is to improve patient safety. The goals focus on problems in health care safety and how to solve them.
Identify patients correctly
Improve staff communication
Use medications safely
Prevent infection
Identify patient safety risks
Prevent mistakes in surgery
Student Nurse Orientation
The Joint Commission Safety Goals


Knock when entering the room, ask for permission to examine teen
Try to find a way to incorporate their friends into the treatment plan.
Encourage visits and calls from family and friends
Student Nurse Orientation
Ages & Stages


Understands abstract thought
and theories
Shows interest in dating
Very peer focused
Lots of need for privacy and respect
Very idealistic
Participates in sports and hobbies
Student Nurse Orientation
Ages & Stages



Keeping up with schoolwork is important
Hospital-based schoolroom with teachers who can coordinate with child’s school needs
Like to participate in discussions and decisions about their plan of care
Student Nurse Orientation
Ages & Stages







Must wear a seat belt, may still need a booster seat
Understands that things may be dangerous but still will participate
At risk for sports and bike injuries as well as fireworks, burns and firearms
Should not be left alone for long periods of time
Student Nurse Orientation
Ages & Stages
Student Nurse Orientation
Ages & Stages




Develops reading, writing and math skills
Understands time
Understands and enjoys humor
Likes to learn and do things by themselves
Likes to play with friends
Clothes and appearance are important

Car seat or booster seat required in a car
Water remains a hazard
May still put things in mouth, ears, or nose
Must be supervised whenever out of crib or bed
Assess for Fall Risk- and need for side rails
Student Nurse Orientation
Ages & Stages




Language explodes to 900 to 1200 words
Can count and sort and understands simple explanations, asks “why”
Likes to do things for themselves, but still needs a lot of supervision
Loves to tell “jokes”
Loves to press elevator buttons
Student Nurse Orientation
Ages & Stages
Follow safe guidelines:
Always put side rails up when you leave a bedside
Do not place restraints on a patient, if necessary, your patient’s nurse will do this task
Do not leave choking/suffocation hazards near children
Cables should be routed to keep them out of patient’s reach and out of traffic flow areas
Student Nurse Orientation
Basic Patient Contact Tips

Always wash hands before and after patient contact
Alcohol stethoscope off between patients
Follow posted infection control guidelines
Remind others who enter the patient’s room that hand washing is required.
Student Nurse Orientation
Remember!
You are responsible for your own infection control safety. If you do not have the proper equipment - ask your preceptor or clinical instructor where to obtain the equipment
Student Nurse Orientation
Improve the safety of high risk medications
Review the “Medication Management” to review all medications that need two RN double checks (chart at the end of the policy). In Epic all medications need to be co-signed immediately.
Student Nurse Orientation
TJC Safety Goals


Seat belt required. Car accidents are a huge risk
May be over-daring when with friends
May become sexually active
May experiment with smoking, alcohol and drugs
High risk for firearm and sports injuries
Student Nurse Orientation
Ages & Stages
Student Nurse Orientation
Ages & Stages


Pre-school children have issues about body integrity.
Band-aides are very important: keep some in your pocket, draw happy faces on them.
Incorporate play into visit or check up. The child may not talk to you, but they may talk to a puppet or toy.
CONGRATULATIONS!
You have located the treasure.
The wealth of knowledge you have learned from reviewing this information is PRICELESS.
Welcome
Investing emotionally.
•Seek opportunities to be friendly.
•Treat every interaction as if it were the first.
•Take time to listen.
•Be sincere.
Providing a welcoming and safe environment.
•Acknowledge and greet everyone.
•Adhere to safety and security policies.
•Protect privacy and confidentiality.
Showing respect and value in each interaction.
•Treat others as they wish to be treated.
•Be sensitive to others points of view.
•Recognize diversity and appreciate individuality.
Understanding and helping others.
•Recognize when help may be needed and offer assistance.
•Communicate in an understandable and timely manner.
•Explain what to expect, what will be done, and why.
•Accept perception and the story behind the story.
We deliver Service Excellence by…
Everything we do shows our passion for children. Employee competence is critical to the safe, high quality family-centered care and services we provide. Core Competencies define the skill foundation for all positions within CHHS and are part of the annual performance review.

SAFETY
Eliminates or lessens risks that could harm employees or the children and families we serve.
Maintains knowledge of CHHS safety practices and related skills.
Reports actual and potential safety events.
Fixes situations that place children, families or employees at risk.
Communicates safety risks beyond one’s immediate influence.

SERVICE EXCELLENCE
Places children and families at the center of care and service design and delivery. Serves internal and external customers with respect and appreciation. A customer is anyone who receives the results of your work.
Partners with children and families to make decisions and plan care and/or services.
Invests emotionally.
Provides a welcoming and safe environment.
Values and shows respect for others in each interaction.
Understands and helps others.
Uses the L.E.A.D. (Listen, Empathize, Apologize, Do-something) service recovery model when customer expectations are unmet.

TEAMWORK
Collaborates effectively with team members. Teams can be permanent or temporary groups that may include co-workers, children, families, volunteers and/or community members.
Adopts a positive attitude toward team membership.
Acts as a partner to team members.
Communicates in ways that build team trust.
The Healthiest Kids in the Country
Neonates:
Birth to 4 weeks
Infant:
4 weeks to 1 year
Neonate & Infant Safety:
Neonate &Infant safety
Neonate &
Infant Considerations:
Neonate and
Infant considerations:
Toddlers: 1 to 3 years
Toddler safety
Toddler considerations:
Preschool: Ages 3 to 5
Pre-school Safety
Pre-school considerations:
School-age: 6 to 12 years
School-age Safety
School age considerations:
Teens: 12 to 18 years
Teen Safety
Teen considerations:
Safety and Quality
Safety and Quality
Safety and Quality
Safety and Quality
Safety and Quality
Safety and Quality
Safety and Quality
Safety and Quality
Student Role
Code of Conduct
Code of Conduct
Code of Conduct
Code of Conduct
Code of Conduct
Code of Conduct
Code of Conduct
Code of Conduct
Identification
Parking
In Summary:
Everything we do shows our passion for children
Children's has joined:
Solutions for Patient Safety (SPS)

The SPS network includes 78 children’s hospitals across the country.
50% of all U.S. pediatric admissions are in these hospitals.

SPS Mission:
Working together to eliminate serious harm across all children’s hospitals in the United States

Expected Safety Behaviors include:
Everyone makes a personal commitment to safety.
Everyone is accountable for clear and complete communication.
Everyone supports a questioning attitude.


High reliability organizations (HROs):
Operate under very trying conditions all the time.
Manage to have fewer than their fair share of accidents despite these conditions.
Operate to make systems ultra-safe by decreasing the probability of an accident (or harm).
The goal in these organizations is to achieve zero harm.
Managing the Unexpected (Weick & Sutcliffe)

Identify activities we can’t afford to have go wrong.
Focus on what’s happening on the front line.
Be deliberate about asking questions.
Develop methods to detect, contain, and bounce back from events.
Take advantage of the unique skills of all.


Key Elements of a High Reliability Culture

. . .In that order

1. Keep me safe.
2. Heal me.
3. Be nice to me.

Reliability from a Patient and Family Perspective

Safety Tools for High Reliability:
AIDET Teach-Back
STAR Handoffs
SBARR ARCC

Use AIDET for communication with children, families, and staff:
A
cknowledge: Start with a smile. Greet them by name.
I
ntroduce: Tell the person who you are, your role, and your training.
D
uration: Describe how long it is going to take (for visit, results, etc.).
E
xplanation: Explain what you’re doing, why, and what happens next.
T
hank you: Thank children and families for choosing Children’s. Thank staff for collaborating with you.

AIDET
S
top: Pause to focus your attention on the task at hand.

STAR is a self-checking tool. Think of it as a mental time out that helps you focus on details. It stands for:
T
hink: Understand what is to be done, plan your actions, and decide what you’ll do if the unexpected occurs.

R
eview: Verify that you got the expected or desired results.

A
ct: Carry out the planned task.
R
esponse: Collaboration resulting in a plan of action.

S
ituation: What is going on right now? (Be concise.)
R
ecommendation: What should we do to respond to the situation? (Recommended action.)

A
ssessment: What do I think the issue is? Why am I concerned? (An analysis of the situation.)

B
ackground: What is the background? How did we get to this point? (A brief, relevant history.)
SBARR is a communication tool you can use when a decision is needed. It stands for:


SBARR
Teach-back is using your own words to repeat directions or information you’ve just received.
We use teach-back when we check for understanding with patients and their families.
Using teach-back with co-workers serves the same purpose.

Teach-Back
Handoffs are a critical part of patient safety. Successful handoffs include:


Handoffs
A
sk: First ask a question.

C
hain of command: If this does not work, follow the Chain of command and inform your leader immediately to prevent an event.

C
oncern: If the team member still does not modify their plan, express your concern about the situation.
R
equest: If the team member does not modify their plan, ask for a change.
ARCC is a technique you can use to help a team member prevent a safety event. It stands for:


ARCC
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