welcome to advent health orlando nursing student orientation in the beginning advent health began as the florida sanitarium back in 1908. we would take care of tuberculosis patients off our building off the offshores of lake estelle where our current campus advent of orlando lies as you could see we have grown significantly since those early days we have campuses such as advent of orlando avent health altamonte east orlando apopka kissimmee the walt disney pavilion at aventille for orlando avent health celebration the woman's pavilion as well as ivan health winter park furthermore we have grown into freestanding eds those inc are including lake mary winter garden which will soon be another full-fledged hospital waterford lakes lake nona as you could see as the orlando region has grown throughout the years so has advent health so i promise that advent health is to provide whole person care so how is this done so this is done through our mission to extend the healing ministry of christ we are a faith-based organization seven-day juventus and really our purpose is to extend that healing ministry of christ what would christ do our direction this is our vision so with our vision we want to be holistic upon our words of whole person care exceptional connected affordable and viable furthermore our beliefs this is what guides our values so we have values of quality and service excellence we want to be the best healthcare organization there we want to abide to community well-being as you could see advent health is very big in community service whether it's helping through volunteer hours or providing community grants we want to provide a healthy community for all those residents of of aventale health orlando furthermore we want to abide to high ethical standards we want to value integrity furthermore stewardship we want to make sure that we're providing affordable care we do not want to waste products that otherwise could be utilized for something else and ultimately inclusiveness i can't stress enough the the inclusiveness found at advent health for each and every department that you you go in at avon tuff you'll see diversity we our diversity of our workforce signifies the diversity of the patients that we take care of and furthermore we have our service standards so this is how we lift out our mission vision and values of keep me safe love me make it easy and own it over the past couple years these have come to light these are easy ways to remind you of how do i extend that healing ministry of christ so when you think about it i'm going to keep my patients safe i want to provide that best care possible own it if i do make a mistake i own up to my mistakes make it easy as a nursing student you're going to have that opportunity to be able to communicate build relationships with your patients maybe you're providing some patient education and your patient feels a little bit confused has that puzzle look you can make it easy for them and ask them some questions maybe re-guide that education to make it a little bit easier for them to understand and ultimately love me treat each and every patient with kindness and respect so when you think about these service standards could you live these at service standards for each other whether it's amongst your students amongst employees staff so just when you think about how do we live out our our mission of extending the hilly ministry of christ think about our service standards of keep me safe love me own it and make it easy in addition one of the core health philosophies at advent health is creation life within the word creation each letter represents a key principle of our creation life philosophy c is for choice r is for rest e is for environment a for activity t for trash i for interpersonal relationships o for outlook and n for nutrition so let's take a look at each one to see on how we could apply it to our patients as well as our daily lives c is for choice so how many of you have been hospitalized before or maybe you haven't been hospitalized but maybe you've had a family member or taking care of a patient previously do do many patients have much choice in the hospital so with recreation life principle we could encourage choice for our patients maybe they don't like that hospital food maybe we could work with our assigners to call down to the cafeteria to see if there's something else for the patients to eat ours for rest so i don't know about you if i'm not feeling well the only thing i want to do is rest so thinking about our patients they're often interrupted by tests lab work etc so at advent if we want to encourage rest for our patients of course we don't want to delay patients care but however we want to encourage rest to the best of our ability e is for environment so is the room too hot too cold for the patient is it cluttered we want to make sure our rooms are safe for not only our patients but staff members and family members is for activity how could we encourage activity in our patients maybe we could help ambulate them maybe we could you know take them around the unit so always make sure that foster that sense of activity in our patients because early ambulation lets to leads to improve healing for our patients t is for trust do they have a um faith-based belief system what could we do you know as students to encourage that faith base maybe we could speak to our nurse to get the chaplain to speak with our patient maybe we as our student nurse could build that trust with that patient going into the letter i interpersonal relationships how is the family dynamics of the for that patient as a student nurse you do have that amazing opportunity to build these relationships with the patient o is for outlook maybe the patient's upset because maybe they're worried about about what's going on maybe they're losing their job because of being hospitalized who's going to be taking care of their dog their family so always be intentional with promoting that positive outlook being that advocate for that patient and finally n is for nutrition we want to encourage healthy nutrition for our patients so as you look at each one of these core tenets and principles of the creation life philosophy these are principles that we ourselves as student nurses nurses as you know people in general we could live out and strive for in order to build that healthy lifestyle in terms of accreditation advent health is accredited by the dmv many of you are familiar with the joint commission that accredits hospitals across the united states over 10 years ago advent health decided to change gears in and have their accrediting body be the dmv one of the core tenets of the dmv is that it helps to regulate government mandates from the centers of medicare and medicaid so basically they help to make sure that we are as an organization abiding to those mandates one of the core principles of the dmv is process improvement so this is done by iso 9001 and and it includes the core tenets of improving the product say what you do prove it and do what you say another element of any hospital is getting eliciting the voice of the customer so this is done by patient surveys so these surveys are completed by the press gainey and are sent upon discharge to several of our patients the one that you might be the most familiar with is with the hcaps based off our age caps we as an organization are able to improve our processes based off patient feedback also the hospital is reimbursed by our patient satisfaction scores so let's talk about some of that feedback that we've obtained via the age caps as well as other feedback tools that we use to elicit feedback at advent health there was a student nurse aaron very helpful and had good side bedside manner they enjoyed visits from student nurses they were both capable and polite all of the nurses were great but special attention goes to student nurse amanda she was wonderful so remember you're not just a student nurse but your patients enjoy your company and satisfaction even throughout their hospital stay let's now talk about communication as student nurses you'll be communicating extensively with not only your patients but also advent health employees as student nurses you'll be excited to enter the clinical arena where you'll be taking care of patients with disease processes and other interventions that you've learned in class however it's important to be mindful when discussing specific patient information because we want to make sure we protect patient information via hipaa so you're going to only discuss any sensitive patient information while in private whether this could be done in the break room or during prayer post conference we want you to be able to share your experiences but always be mindful of who's listening is this something that i want somebody else to be listening to and remember you do not want to take any protected patient information home with you of course you'll probably be assigned to case studies or whatnot your clinical instructor will notify you of how to obtain that patient information while abiding to hipaa how many of you feel comfortable communicating with patients right now many of you might be a little bit intimidated or nervous or even unfamiliar of how to build an authentic connection with patients so at advent health we utilize the eye care communication framework whenever interacting and communicating with our patients i it means introduce so introduce yourself and your role whenever meeting your patient for the first time hi my name is alexis i'll be your student nurse for today c is connect start to build that authentic connection with your patient maybe ask them what do they do for a living do they have family that live close by where are they from build that connection early on as anticipate anticipate the patient's needs maybe acting proactively and asking your patient hey mr smith do you need to use the restroom while i'm here hi miss miss jones do you want me to fill the water basin since i see it's empty r is reinforced reinforce to your patient that you will be back when will you be back and finally as you're exiting the room extend do you need anything while i'm still here so these are key tenets of how to effectively communicate at advent health in healthcare similar to life things might not go away so we might have to utilize key tenants of service recovery at evantelf we utilize the act model when providing service recovery a stands for acknowledge and apologize you want to acknowledge what's the issue at hand you want to ensure understanding of that said issue c is correct what are you going to do to correct that issue and t is for think so how do i utilize this so say for instance you were assigned to patient in room 23 you're super excited to see your patient you knock on the patient's door go in and introduce yourself hi my name is alexis i'll be your student nurse for today and all of a sudden the patient's like where's my payments i've been waiting over an hour for my payments how do you handle that situation first you want to acknowledge the issue on hand i see mr smith that you're in pain i see on your communication board that you were you were next due for morphine about 45 minutes ago c correct tell the patient what are you going to do to correct them as a student you can administer narcotics per se but maybe you could tell mr smith hey mr smith i will speak with your nurse susie and we will work on a plan to administer your pain medicine and t is for think thank you mr smith for bringing this to my attention or maybe thank you mr smith for being patient with us as we rectify this issue and another tool that we utilize at advantel for communication is today's plan this plan is printed at the start of each and every shift and it's used to enhance communication a list of the physician physicians on the case as well as any outstanding test or new medications ordered are provided on this tool furthermore there is a space for questions from my doctor this is a great tool to utilize with your patient because maybe your patients anxiously awaiting to see their physician for the day and as a student they may have asked you several questions that you can't answer per se but you as the student could write down those questions for the doctor so the patient can't forget to ask those questions when the physician does arrive another key element of the today's plan is what's the most important thing i could do for you today i love this component of the today's plan because it really provides that personalized care for that patient another thing that we do at advent health is to provide the hourly visit so each and every hour either the nurse or the patient care tech rounds on the patient and kind of addresses these five key components that we like to call the five piece pain potty position periphery imparting these are the five most common reasons why patients press the call light and if you haven't been hospitalized just imagine pressing on the call lay maybe the the care team responds in two minutes but as the patient those two minutes could seem like two hours so when we're proactively meeting the patient's needs they don't have to wait on that call light and they're able to get that rest they so so desired let's talk about espar so whenever communicating with other members of the inter professional team we utilize s bar and in your nursing curriculum you'll soon grow accustomed to s bar so each letter represents a different key component of when we're communicating so s is for situation why why are you calling what is the most important thing i need to tell the physician the oncoming nurse about this patient b is background what's any pertinent patient diagnosis medical information that they need to know about a's assessment why is why i'm calling so important what is that background information let's include a full head to toe physical assessment pertinent vital signs labs and ours for recommendation what do you as the nurse recommend for your patient interpreter services so many of you may be blessed to be multilingual however at advent health you cannot translate for physicians or anybody else for that moment only certified interpreters may translate into the patient's birth or native language however all patients have the right to receive health care information in their birth language so we do have face-to-face interpreters but also we do have as you see on the screen the stratus interpreter it's similar to a facetime you could say where each and every unit has this stratus interpreter device that is wheeled to the bedside and the interpreter with the nurse physician as well as the patient are able to effectively interpret and communicate for any medical procedures consultation etc so let's now talk about safety and infection prevention because as we know safety first patient identification so this becomes super important to use at least two patient identifiers whenever providing patient care treatment or services so we utilize patient name and birthday so you're going to ask your patient could you verify your name and date of birth and we're going to double check that with the patient's wristband just to make sure we have the correct patient but what happens if we have a patient that is confused and says their name is santa claus and we know for sure that patient isn't santa claus so how do we verify that this is the correct person if you said let's verify with their patient armband as well as the patient chart you are correct so we always want to be intentional because you could accidentally go into that wrong patient's room and provide services that wasn't appropriate for that patient now let's talk about safe medication administration throughout your clinicals you'll be able to provide medications but it becomes really important to follow the guidelines whenever providing a medication as students you will only be giving medications with your clinical instructor or your practicum preceptor when that time arises so let's say for instance you're assigned to nurse susie and she's like hey alexis do you want to pass meds with me you unfortunately cannot pass me physically past meds with susie without your instructor being present however we do encourage you to observe the process because observation is equally as important as doing when you're learning clinical skills so how do you provide safe medication administration as a student nurse at advent health you're going to first verbally notify the patient's rm prior to administering medications so your clinical instructor might assign you to past medications in room 16. you're going to let that assign nurse let's say it's susie know that hey i'm going to be passing the morning medications on room 16. next you're going to be supervised administering those medications by your rn faculty instructor or advent health rn preceptor while administering those medications you want to utilize the five rights of medication administration and all documentation must be performed in the electronic medical record and authenticated by the rn that's directly supervising and your clinical instructor will provide you with further information on how that process looks and once you administer those medications you want to verbally notify the patient's rn after administering the medications as you can see on this slide there are certain medications that you as a student at advent health cannot administer some of these medications include narcotics chemotherapy tpn however this is only just a sliver of the many medications that we that you as a student could administer while you're completing your clinicals here whenever interacting with patients you want to make sure that you're abiding to the five moments of hand hygiene this has become even more important since the coronavirus has spread so you're always going to wash your hands any time before touching a patient before any clean or aseptic procedure after any body fluid exposure risk such as emptying out a foley after touching a patient and after touching patient surroundings so whenever performing hand hygiene you want to be thorough by utilizing the alcohol-based foam found at the entrance of each and every patient room as well as within each and every patient room so you might be in a rush and just say hey i'm just going to go and put on gloves that's fine gloves of hand hygiene equates to clean hands however gloves without hand hygiene you're only 70 percent effective do i want to be 70 effective prior to entering that patient's room do i want to transmit those germs right then in there furthermore in addition to providing adequate hand hygiene you also want to buy to ppe ppe signage will be posted at the entry of each and every patient room your patients will be either on contact precautions which will warrant the yellow gown with gloves droplet precautions which is a green sign which you will be wearing a surgical mask with gloves or airborne precautions where you will be wearing an n95 mask as well as gloves so be conscientious whenever entering a patient's room to see if they're on precautions or not so how to prevent bloodstream infections so at ethan health we do not want our patients to receive eclapsy which is a central line associated bloodstream infection this is a never event so how do we prevent these infections from occurring any time that you're accessing an iv line whether it's to give antibiotics or to flush a saline flush you want to always make sure to wash your hands and glove up you want to scrub the iv catheter for at least 10 to 15 seconds using an alcohol wipe as well as utilizing when needed alcohol impregnated caps called curos caps the green caps that you see on this slide and also remember we're very intentional with preventing clapsy that all central line dressings will be changed every 96 hours and when those dressings are changed everyone including the patient in the room must wear a mess this is important to help prevent this the spread of the spread of infection to that central line another thing that we're very conscientious at advent health is preventing urinary catheter infections known as caudies so throughout the duration of a urinary catheter we want to make sure that we're intentional at every step from insertion to discontinuation that we're abiding to clean sterile procedure with our insertion we make sure that all patients are given a hibiclens pericare chd foam as you see on the slide prior to inserting the urinary catheter during the insertion we abide to sterile procedure while caring for patients and maintaining patients with urinary catheters we want to make sure that we are providing um chd pericare every 12 hours so once a shift to our patients and furthermore we want to remove these urinary catheters as soon as possible and we have a nurse driven protocol in which nurses have the authority to remove urinary catheters in most circumstances in an effort to combat the influenza virus you have one of two options to choose from during flu season you're able to first receive the flu vaccination and you'll receive a sticker to place on your student badge similar to the one shown on the screen or you're able to decline the flu vac vaccine however with this you're required to wear a surgical mask at all times and while in a patient care area or when transporting a patient from the months of december to march let's talk about waste streams while in clinicals you might be asked to dispose of certain wastes while while providing patient care sharps disposal so each and every patient room as well as the med room and soiled utility rooms will have a sharps box this is where you're going to be disposing of any used sharps syringes etc next we have the propobox known as the hazardous waste pharmaceuticals this is where you're going to be disposing of any used ivy piggy bag tubing furthermore these boxes are found only in the med room as well as the soiled utility room next we have the yellow box this is where any trace chemo agents go so if you do see yellow just be mindful that you do need to have special training since chemo does require additional training in terms of safety and finally we have the red bag so this is where any blood or blood saturated items are going to be disposed in virus so which patient population do you think fall the most in the hospital do you think it's the young population the middle age or the elderly if you said the middle age you are correct so upon a study it was determined that patients between the ages of 40 to 65 for the most in the hospital so you might be wondering why is that so thinking about this patient population these are the ones that are often not at the hospital they're often caregivers so they might not know their limitations they might be become weaker during their hospital stay maybe due to their illness maybe they're under the effects of anesthesia maybe they're just simply unaware of their surroundings how many of you stayed at a hotel you wake up in the middle of the night to go to the restroom and you're confused on where you're at the same thing could happen to our patients so it's really important that that you treat each and every patient as a fall risk so as you could see we utilize the yellow socks in the hospital to identify our high fall risk patients but we other we have other safety devices at the hospital that you'll utilize such as bed alarms bed belts to ensure the safety of our patients so now let's play a quick game of do you know the codes so the first one is a megaphone to represent an overhead speaker if you said active shooter of violence you are correct code red would indicate a fire what about a code pink that would indicate a child abduction so what would happen it will be overhead paged code pink and a brief description of the child including any clothing patient age will be will be paged overhead at that point all staff members will be proceed to all the exits and blocking the exits and screening any patients or family members going in and out of the hospital what about a code blue so with our code blue that will be for any cardiac arrest or respiratory rest and they will specify code blue adult or code blue pediatric as well as the specific room number where that code blue is occurring code black will be a bomb threat code yellow will be prepared to evacuate code green will be evacuation and code aren't just hazardous materials so with this being said it is super important if these codes should be heard overhead page or announced overhead that you work with your clinical faculty to ensure that your safety but also the safety of the patients let's talk quickly about code red which is fire safety so let's say for instance all of a sudden you're walking down the hallway and you see a fire and a code red is called so you as a nurse as a student are able to attend to that fire so there's two um acronyms that we want you to know when ever dealing with fire safety race and pass so let's say for instance all of a sudden you see a fire first thing you want to do is our rescue so close those doors next alarm pull that fire alarm see confined close the doors let staff know that there is a fire and e is extinguished so how do you utilize that fire extinguisher you're gonna p pull the pin a aim at the base of the fire s squeeze the handle and s squ sweep side to side you have only one race you have to win so i know we've been through quite a bit but you probably want to know how do i get started for clinicals at advent health so you'll be issued an advent of orlando badge in computer app id this computer app id is your login in order to access our computer charting system so be mindful that you'll be on receiving this badge at a later date and this batch must be worn at all times while on any of our ivantel orlando campuses during your clinicals computer access so how to log in so on the main login page you'll be typing in your app id as your username and then type in your initial password as your op id in all caps plus lowercase q1 so if your app id was let's say one two three four five six your initial password would be one two three four five six the lowercase q one from there is going to prompt you to create a new password and of course as we're familiar with with with computer data and safety it must be at least eight characters long and contain three at least three of the four character types uppercase lowercase number special characters if you do run into any issues um you're able to call our it department at 407-303-8000 again that number is 407-303-8000 and they're accessible 24-7 so we do have different resources at your fingertips i know throughout your nursing program you might be told this is refer to your hospital policy and procedure and really in relation to a specific protocol maybe foley insertion so as a student you do have access y clinicals to access all our policies and procedures to see what advent health stance is on certain um and policies just be mindful you won't be tested on the adventist specific policies referred to your nursing school specific ones for testing purposes in terms of parking you'll generally park in the same location as employees so just be mindful of any notification that you will be receiving from your clinical instructor on the start of your clinical um rotation just because parking does switch from campus to campus just and especially with construction occurring at many of the campuses so in closing i really like this quote from maya angelou that says people forget what you said people will forget what you did but people will never forget how you made them feel so as a student nurse you're entering an amazing profession where you're able to really connect and bond with the patient so without further ado i appreciate your time and we hope that you enjoy your clinical experience here at advent health thank you so much