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Huntsville Hospital Health System

Huntsville Hospital Health System Guidelines for Clinical Instructors of Affiliating Nursing Education Programs Huntsville, Alabama

Patricia J Newberry, Manager, Clinical Nursing Practice 2/8/2017

Huntsville Hospital Health System Guidelines for Clinical Instructors of Affiliating Nursing Education Programs

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Dear Clinical Instructors,

Thank you for partnering with Huntsville Hospital Health System (HHHS) for your clinical experience. We are honored to provide this opportunity for you. This packet will provide the information needed to make your clinical experience here a success.

GENERAL INFORMATION

The clinical instructors must complete these steps prior to the start of clinical and/or prior to students being on the unit. Access the HHHS website at:

www.huntsvillehospital.org/schools-with-clinical-affiliation

Located on the website are 6 required forms or tests that must be completed, signed and placed into the student and Instructor files maintained at your school of nursing.

• Affirmation Statement on Security and Privacy of Information-Affirms that the instructor and student have read and understand the Huntsville Hospital Policy on confidentiality of protected health information.

• Validation Form – Affirms that the student and Instructor have reviewed the online course material, including Care Class, Care Class for Clinicians that Prep &Administer medications, Abuse & Neglect, Suicide, HIPAA Core, HIPAA Clinical and Infection Control. Also lists Policy and Procedures reviewed as well as Guidelines and Brochures. See Appendix A

• HIPAA Clinical and HIPAA Core Test –Tests for HIPAA Core and HIPAA Clinical Core class for instructors to grade. Test key is available in Appendix A

• Employee Occupational Health Policy – Affirms that the student and Instructor have reviewed and will comply with the Infection Control Policy conditions requiring absence from a Clinical/Non-clinical assignment.

• Badge Request Form – Required to receive a student or instructor badge, qualifying access to HHHS facilities.

The following are forms that are to be utilized by the clinical instructors before, during, and after the clinical orientation:

• Instructor Information for Nursing Unit: See Appendix B

• Nursing Student Assignment Sheet –completed by the instructor and provided to the unit to help facilitate assignments. See Appendix C

• Evaluation of Clinical Learning Environment: Students and instructors are encouraged to fill out the

Evaluation of Clinical Learning Environment Survey located in Appendix D

• Clinical Instructor Evaluation: At the end of the clinical rotation, instructors give the nurse manager or their designee, the Clinical Instructor Evaluation form. The nurse manager or their designee will return the completed form to the Clinical Nursing Practice Department. See Appendix E

http://www.huntsvillehospital.org/schools-with-clinical-affiliation


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Annual Tuberculin Skin Test (TST): All students are subject to the same health standards as Huntsville Hospital employees. Schools are required to submit documentation of immunizations, initial and annual TST upon request. This information must also be maintained for six years at your high school. The TST administration is provided at no charge to the students and is administered by the Employee Occupational Health department located in the Blackwell Tower. Their phone number is 256-265-8046 and their hours of operation are Monday – Friday 6:30am to 4:30pm.

Badge Process – Student and Instructor: Acquiring a student or instructor badge takes approximately seven (7) days. • Non-Employee Badge Request Forms must be collected by each school and faxed in a batch to the Clinical

Nursing Practice Department at FAX number: 256-265-1955.

• A typed list of names of the students and instructors requesting a badge must accompany the batched Non-Employee Badge Request Forms.

• Non-Employee Badge Request Forms sent by individual students or instructors will not be processed. We have no way of assuring that the individual requesting the badge is truly a student or faculty member of your school.

• As an alternative to faxing, the Non-Employee Badge Request Forms may be scanned by batch and e-mailed to BOTH [email protected] and [email protected]. The typed list of names must be included with the scanned submissions.

• The Clinical Nursing Department operates from 0800 – 1630 Monday – Friday. Batches of Non-Employee Badge Request Forms received during non-business hours will be processed the next business day.

• Once non-employee badge forms are faxed to the Security Command Center, it takes an additional three days

(3) for the form to be processed and entered into the Security computer system.

• Badges are made by the Security Command Center located inside the Visitor Parking Deck on Gallatin Street. The Visitor Parking Deck is located at the Main Hospital Entrance (to the left of the fountain) on Gallatin. You will be required to sit for a photo.

Student badges are active from the date of issue through graduation. Badges are to be collected by the instructor for all senior/graduating students and returned to the Huntsville Hospital Security office for deactivation. Instructor badges expire each year on AUGUST 31st and must be reactivated. If an instructor needs access to restricted areas (such as Labor and Delivery) the nurse manager of the unit must be contacted to grant access. This request is not processed through the clinical nursing practice department. Students and instructors are required to wear their badges at all times while on hospital property. Badges must be visible and worn above the waist. Computer Access: Students will not be given individual access to our computer systems. Students will be able to pass medications and view charting under the direct supervision of their clinical instructor or nurse on the unit. Contact the Nurse Manager for your clinical unit: See Appendix F for Nurse Manager or unit designee contact information and unit descriptions.

mailto:[email protected]

mailto:[email protected]


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Meeting Areas for Pre-Post Conferences: Nursing students should not gather and meet in the public waiting areas of any of the hospital locations. Space for visitors is limited and waiting areas are designated for patients and families. Nursing students are able to gather and meet in some break rooms – see Appendix F for specific units where this is acceptable.

Parking: Parking Guidelines are not “recommendations,” each student is expected to follow the Guidelines EVERY time they are present for “school related reasons” on the HHHS campus. Students need to add 20-25 minutes to their arrival time to insure they arrive on time to their units for their pre-clinical huddle. See Appendix G for a detailed description of parking guidelines.

• Student Parking: Students assigned to HH or Women and Childrens will park at First Baptist Church on the St. Clair side. Shuttle service is available upon request by calling 265-6160. Students may park in the Employee Deck after 1400.

• Students assigned to Madison Hospital will park in the parking lot off of Highway 72, in front of the Medical

Office Building . Upon entering Hospital Drive from Highway 72, take the first left and then turn left again into the parking lot.

PULSE Page: The face page for the hospital’s intranet is titled the PULSE page. It is where daily updates are posted. It is also where Clinical Instructors can access hospital Policies and Procedures, Order Sets, The Safety Manual (includes the Emergency Conditions and Basic Staff Response). Other important information is accessed via the Hot List drop down section from any hospital computer. Many of the items listed on the Validation of Clinical Orientation can be found on the Hot List.


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CLASSROOM INSTRUCTOR ORIENTATION 1. It is expected that all instructors review the information on the following website:

www.huntsvillehospital.org/schools-with-clinical-affiliation

prior to attending a one day new instructor orientation. During the orientation instructors will complete the following competency validations:

Restraints, emergency procedures, checking the emergency cart, use of the blood glucose monitor and IV infusion pumps.

Isolation Presentation Point of Care Testing Pyxis EMR – includes review of student documentation and co-signature requirements. Stryker Bed – Zone Alarm, Bed Scales, Overall Operation of Bed Controls

2. Appendix H includes the following miscellaneous items specific to HHHS:

• Points to cover when administering medications to your patient

• How to locate the Lab Test Catalog

• Recommendations for Preventing Catheter Associated UTI’s

• Patient instructions for Bedside Report

3. Complete the following CBL Modules in addition to those classes identified on the HHHS website: o Alaris System with Guardrails Suite MX training – Pump Module 0515 o Online vendor education:

Kangaroo Tube Feeding Pump In-Service Zoll R Series PLUS Defibrillator Module

CLINICAL ORIENTATION The following guidelines will be followed based on orientation needs. 1. For clinical instructors who are:

a. new to the Huntsville Hospital Health System, or, b. have not served in this capacity during the past three years

These instructors MUST complete the requirements of hospital/nursing orientation as outlined: It is recommended that a minimum of 8 hours with a staff preceptor be completed on the assigned nursing unit.

This time should include: unit orientation, review of patient population, familiarization of the floor plan and routine, introductions to the different staff roles and interaction with the staff, patient assignments including patients not to take, who to contact during off hours, process to charge supplies.

2. For clinical instructors who have been at the Huntsville Hospital Health System previously but are assigned to a different clinical unit (did not have students on a newly assigned unit during past academic year) the following is recommended: A minimum of 4 hours clinical orientation on the new unit – covering the same unit specific items as outlined

above.

3. For clinical instructors who are returning to the same clinical unit It is recommended the instructor communicate with the nurse manager/charge nurse to receive an update of

new treatments, processes and protocols being utilized on the unit.

http://www.huntsvillehospital.org/schools-with-clinical-affiliation


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NURSING INSTRUCTOR EXPECTATIONS:

1. Complete the form “Instructor Information for Nursing Units” . See Appendix B 2. Review Parking Guidelines with nursing students.

3. Review Policies and Procedures listed on the Validation Form with nursing students prior to beginning of clinical

rotation. Policies and Procedures are viewable and printable from the PULSE Page.

4. Introduce yourself and students to the Director, the Clinical Education Specialist, the Charge nurse and clinical staff

5. Meet with the unit designee at least weekly to discuss issues/concerns

6. Complete the evaluation of clinical experience – at the end of the semester/clinical experience. Students should complete this also. See Appendix D.

7. Must maintain a professional appearance.

8. Must arrive on time for scheduled clinical to assure students can participate in bedside report.

9. Must maintain professional presence including upholding the HHHS Employee Rules of Conduct and the Mission,

Vision and Values during the clinical rotation. Available via the PULSE Page

10. Utilize AIDET when communicating with all patients. See Appendix I

11. Must notify the unit if the clinical group will not be reporting for a scheduled day.

12. Must provide a formal assignment sheet. This form is provided in Appendix C.

13. Must remain with the students at all times during the clinical rotation unless the rotation does not require faculty on site. Students must know how to contact the instructor at all times.

14. Must sign into Pyxis and observe all medication administration if passing medications with the students. The

instructor will NOT share their passwords with the students.

15. Instructor or staff nurse must pull all medications for the students from the medication Pyxis.

16. Instructors who are also Huntsville Hospital System employees are NOT to use their Employee identification when operating any Huntsville Hospital equipment, i.e. Collection Manager or Pyxis. You are to use your Instructor identification.

17. If you are unfamiliar with any piece of equipment or a procedure, ask the charge nurse for assistance and guidance.

18. Any laboratory specimens obtained by a nursing instructor or student must be documented as having been obtained by a nursing instructor or a student in the EMR.


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NURSING STUDENT EXPECTATIONS: 1. Must complete all required forms and paperwork before the student will be allowed on the unit. 2. Must maintain a professional appearance in compliance with the HHHS dress code. 3. Must arrive on time for scheduled clinical to facilitate bedside report of patient assignment. 4. Must report off to the nurse caring for the patient at the end of duty and when leaving the floor for any reason. 5. Will not copy any portion of the patient’s medical record. All documents with protected health information must be placed in

shred bins at the end of the shift. 6. Must wear a visible nametag at all times. 7. May not pass any high alert medications that require a two nurse independent double check. 8. May not administer any type of blood or blood product. 9. May not accept verbal or telephone orders from physicians under any circumstances. 10. All orders for medications must be taken off and signed by a nurse before a student may administer them. 11. May not administer IV medications in an emergent situation and may not administer any controlled substance by direct

intravenous push.

12. May not complete a central line dressing change.

13. May not administer chemotherapy. 14. Fractional dosage: All fractional dosages, including insulin, must be checked and verified by a registered nurse for each

administration. 15. Controlled substances: All controlled substances must be supervised and co-signed by a registered nurse. Students may not

receive or sign for narcotics. 16. May not administer oxytocin (Pitocin) to undelivered patients. 17. May not care for patients in Airborne Precautions including TB, chicken pox, shingles, measles, or epidemic influenzas; may

provide care for other isolation patients. 18. Students and clinical instructors are to follow the policies and procedures of their assigned unit. 19. Faculty or preceptor supervision is always required for any invasive procedure performed by a nurse; for example urinary

catheterizations, suctioning, and nasogastric tube placement. 20. Artificial or excessively lengthened nails are prohibited. 21. Cell phone use, including camera and text functions during clinical time , is prohibited. Confidentiality must be maintained

along with maintaining professional boundaries through all social networking systems.


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CLINICAL UNIT EXPECTATIONS: 1. A representative from the unit will provide the clinical instructor with the unit orientation including a tour and

where to post assignments, where not to congregate, where to keep charts, when not to take charts, etc. 2. A representative from the unit will provide clinical instructor codes to all locked areas the students will need to

enter to perform their duties. Room codes may be distributed to students. 3. Should nurses on a unit assume precepting a student, then that nurse will assume responsibility of direct supervision

of student at that time, including supervising all treatments and all medication administration. 4. The staff on unit will be responsive and helpful.


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Appendix A


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Instructors must review (at a minimum) the Policy and Procedures listed below with all nursing students prior to the beginning of each new clinical rotation. The policies may be viewed and printed from the PULSE page of the hospital intranet.

• Confidentiality of Patient, Employee and Proprietary Information • Fall Prevention and Management/Fall Risk Assessment Tool

• Flushing of ADULT Central and Peripheral Lines

• Hazardous Drugs

• HIPAA Privacy and Security Responsibilities Medication Administration: Double Checking Medications and “Hand-offs”

• Identification of Patients • Indwelling Urinary (FOLEY) Catheter Protocol

• Intravenous Infusion, Central Line

• Isolation Policy and Procedure

• Medication Administration, Double Checking Medications and Hand-Offs • Medication Administration by G/NG Tube

• Medication Administration, I.M. Injection

• Medication Administration, I.M. Injection Sites

• Medication Administration, Oral

• Medication Administration: IV Piggyback (Medications or IV fluid bolus) through Saline Lock or Peripheral Continuous IV Fluids

• Medication Administration, IV Push

• Medication Administration, Subcutaneous Injections

• Restraint Guidelines for Non-violent or Non-self-destructive Patients The Emergency Conditions and Basic Staff Response Guidelines are found in the SAFETY MANUAL – also located on the PULSE page.

HIPAA Clinical Quiz Answer

Key

1. E 8. C

2. E 9. A

3. C 10. D

4. B 11. B

5. B 12. C

6. C 13. A

7. A 14. B

HIPAA Core Quiz Answer Key

1. D 6. E 11. B 16. B 21. D

2. C 7. A 12. E 17. B 22. B

3. B 8. F 13. D 18. D 23. A

4. C 9. D 14. B 19. B 24. D

5 .B 10.C 15. E 20. B 25. C


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Brochures to be reviewed: • Hand Hygiene • Huntsville Hospital Skin Care Formulary • Sepsis Core Measures


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Appendix B


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Instructor Information for Nursing Unit

Unit Name

Instructor Name

Contact Information: Home/Cell phone/email

Dates and Times Students will be on Unit (include prep times)


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Appendix C


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Appendix D


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Clinical Learning Environment Survey This survey is designed to assess clinical nursing student and instructor’s perceptions of the clinical learning environment at Huntsville Hospital Health System. Participation in this survey is voluntary. Your responses are anonymous and confidential. Unit: __________________ School: ___________________ Year in School: ________________ Previous Healthcare Experience: Yes No Number of Years: <1 1 2 3 4 >5 For each of the following statements, please choose a number to indicate your level of agreement. 1 = Strongly Disagree 2 = Disagree 3 = Neither Agree or Disagree 4 = Agree 5 = Strongly Agree

1. Staff nurses regularly provide feedback to nursing students for the work that is done. 1 2 3 4 5

2. Staff nurses are interested in supervising students. 1 2 3 4 5

3. Staff nurses are good role models. 1 2 3 4 5

4. Staff nurses are willing to spend time teaching nursing students. 1 2 3 4 5

5. Staff nurses guide nursing students to perform new skills. 1 2 3 4 5

6. Staff nurses show a positive attitude towards the supervision of nursing students. 1 2 3 4 5

7. The unit staff is easy to approach. 1 2 3 4 5

8. The unit staff knows the nursing students by their names. 1 2 3 4 5

9. Staff nurses regard the nursing student as a learner rather than a worker. 1 2 3 4 5

10. I enjoyed my time working on the unit. 1 2 3 4 5

11. I am happy with the experience I have had on this unit. 1 2 3 4 5

12. I look forward to clinical practice.

1 2 3 4 5

13. The experience on the unit makes me eager to become a staff nurse 1 2 3 4 5

14. Nursing students are considered to be part of the unit team.

1 2 3 4 5 Tool modified from: Chaun and Barnett Clinical Learning Environment Evaluation Tool 2012


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After completion, return to the Clinical Nursing Practice Department, FAX: 256-265-1955 What did you like best about your clinical experience? What did you like least about your clinical experience? Please list any staff you would like to recognize from your clinical experience.


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After completion, return to the Clinical Nursing Practice Department, FAX: 256-265-1955

Appendix E


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Clinical Instructor Evaluation

Instructor Name:_______________Location/Name of Clinical Unit:___________ Please evaluate the clinical instructor using the following scale: 1 = Strongly Disagree 2 = Disagree 3 = Neither Agree or Disagree 4 = Agree 5 = Strongly Agree Use the comment section to elaborate, particularly when a rating of 3 or lower is given.

1. Contacted the nurse manager prior to clinical to introduce themselves and orient to the unit. 1 2 3 4 5

2. Maintained a professional appearance and conduct.

1 2 3 4 5

3. Arrived on unit in time to make student assignments, complete pre-clinical huddle and allow nursing students to participate in bedside shift report. 1 2 3 4 5

4. Provided Nursing Student Assignment Sheets with clearly defined clinical expectations.

1 2 3 4 5

5. Maintained communication and had good rapport with nurse manager, charge nurse, and staff. 1 2 3 4 5

6. Was readily available to students at all times.

1 2 3 4 5

7. Sought learning opportunities for students. 1 2 3 4 5

8. Handled student issues in a professional manner.

1 2 3 4 5

9. This was an appropriate clinical for this unit. 1 2 3 4 5

10. I would like this clinical instructor back on my unit.

1 2 3 4 5 Comments: After completion, return to the Clinical Nursing Practice Department, FAX: 256-265-1955


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Appendix F


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Huntsville Hospital Main 1GSM 1GNM STICU-Surgical Trauma Intensive Care Unit- Provides care for adolescent, adult, and senior patients requiring advanced assessment and monitoring post surgery; including mechanically ventilated patients, patients with multiple traumatic injuries, sepsis and multiple organ failure. Name of Nursing Unit STICU – No clinical at this time Unit Contact Person, Title and Phone Location for pre-and post-clinical huddle 2E/2W-Internal Medicine/Nephrology: Provides care to adult, adolescent, and senior patients with emphasis on renal, pulmonary, gastrointestinal, diabetes, peritonitis, altered mental status, occluded dialysis shunts, central line thrombosis, and diagnostic procedures or interventions. Name of Nursing Unit 2E/2W Internal Medicine/Nephrology/Dialysis Unit Contact Person and Phone Jana Byrd Unit Director 256-265-8241

or 256-265-2827

Location for pre-and post-clinical huddle Conference room between units, across from Room 252 and Room 271

3E/3W-Cardiology II/III: Provides care for patients with artery disease, hypertension, pacemaker malfunction/failure, cardiac rhythm changes, endocarditis, cardiogenic shock, thrombophlebitis, congestive heart failure, chest pain, post acute MI, post cardiac surgery, pre/post cardiac catheterization. Name of Nursing Unit Cardiology II (3W) Unit Contact Person, Title and Phone Christine Fussell Unit Director 256-265-6601 Location for pre-and post-clinical huddle Cardiology III (3E) breakroom Name of Nursing Unit Cardiology III (3E) Unit Contact Person, Title and Phone Christine Fussell Unit Director 256-265-6601 Location for pre-and post-clinical huddle Cardiology III (3E) breakroom 3N Cardiac Short Stay and Cardiac Cath Lab: Cardiac Short Stay provides short-term care or skilled observation and monitoring of patients receiving cardiac procedures including pacemaker and defibrillator insertion, ablations, angioplasty, stent placement, cardioversion, and cardiac catheterizations. The Cath Lab provides care for patients requiring cardiac interventions such as catheterization, angioplasty, stenting, thrombectomy, temporary and permanent pacemakers, intra-cardiac defibrillators, intra-aortic balloon pump insertion and pericardiocentesis. Name of Nursing Unit Cardiac Short Stay (3N) Unit Contact Person, Title and Phone Kim Fabbri

Mandy Caruso Charge Nurse

256-265-8693

Location for pre-and post-clinical huddle Bank “A” Elevators - Badge Restricted – Third Floor. Former waiting room.

Name of Nursing Unit Cardiac Cath Lab (3N-N) Unit Contact Person, Title and Phone Chris Thornton

Unit Director

256-265-8411

Location for pre-and post-clinical huddle Bank “A” Elevators - Badge Restricted – Third Floor. Former waiting room.

3NE-Ortho Spine: Provides care for patients’ post spinal surgery/procedures, including cervical, thoracic, and


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lumbar fusions with care of drains, dressings, and assisting with physical therapy and ambulation. Name of Nursing Unit Ortho Spine (3NE) (No clinical for Fall 2016) Unit Contact Person, Title and Phone Jennifer Williams Unit Director 256-265-6867 Location for pre-and post-clinical huddle Hospital Cafeteria 3S/3SE/3SW-Behavioral Health/Behavioral Health Geriatric: Provides care for patients with acute and chronic psychological disorders including suicide, depression, anxiety, dementia, and Alzheimer's. Name of Nursing Unit Behavioral Health (3SE) Behavioral Health (3S) Geriatric Psych

(3SW) Unit Contact Person, Title and Phone Brad Bailey Unit Director 256-265-3052 Location for pre-and post-clinical huddle Conference Room 306 4E/4W/4N/4NW-Progressive Surgery I, II, III: Care of adolescent, adult, and geriatric pre/post operative patients including gastric, colon rectal, urological, vascular surgeries and trauma patients, monitoring for complications such as pneumothorax, pneumonia, pulmonary embolus, hypovolemic shock, and electrolyte imbalances. Name of Nursing Unit Progressive Surgery I (4E) Unit Contact Person and Phone Susan Sandt Unit Director 256-265-6656 Location for pre-and post-clinical huddle Solarium at back of the nursing unit Name of Nursing Unit Progressive Surgery II (4W) Unit Contact Person and Phone Amanda Johnson Interim Unit Director 256-265-6816

256-265-6639 Location for pre-and post-clinical huddle Solarium on 4E between rooms 480 and 490 Name of Nursing Unit Progressive Surgery III (4N/NW) Unit Contact Person and Phone Susan Sandt Unit Director 256-265-6656 Location for pre-and post-clinical huddle 4 Northwest Conference Room across from 442 4MST/4NE MICU-Medical Intensive Care Unit-Provides care for critical patients including suicide, overdose, gastrointestinal bleeds, chronic respiratory requiring pulmonary monitoring and/or ventilation. Name of Nursing Unit MICU (4MST/4NE) Unit Contact Person, Title and Phone Jeff Johnson Resource Nurse 256-265-8649 Location for pre-and post-clinical huddle 4MST-Next to Nutrition Room and Near Bed 16

4NE-Behind Medication Room 5E/5W-Respiratory Care/Medical Progressive Care: Patient population includes acute and chronic pulmonary diseases, tracheostomy care, patients requiring mechanical ventilation and stepdown care for patients transferred from MICU/AICU. Name of Nursing Unit RCU (5E/5W) Unit Contact Person, Title and Phone Chris Swanson

Heather Tolbert Charge Nurse 256-265-8499

Location for pre-and post-clinical huddle Rear hallway between rooms 581 and 590 or Hospital Cafeteria 5MST/5NE/5NW-Ortho Trauma/Joint Camp/Orthopedics: Care of patients’ pre/post surgical intervention of


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hip, knee, extremity fractures, complex and blunt trauma injuries, total-joint arthroplasties, and spinal surgery. Name of Nursing Unit Joint Camp (5NE) Unit Contact Person, Title and Phone Linda Thompson

Catherine Brown Charge Nurse Unit Director

256-265-8343 256-412-5980

Location for pre-and post-clinical huddle 5NE End of hallway Pre- The physical therapy room, across from Room 503 Post- Cafeteria or End of hallway across from 515

Name of Nursing Unit Orthopedics (5NW)– (overflow of spine, joint and trauma) Unit Contact Person, Title and Phone Victoria Donaldson

Catherine Brown Charge Nurse Unit Director

256-265-6683 256-412-5980

Location for pre-and post-clinical huddle Break room across from room 543 Name of Nursing Unit Orthopedic Trauma (5MST) Unit Contact Person, Title and Phone Jennifer Williams Unit Director 256-265-6867 Location for pre-and post-clinical huddle End of hallway next door to room 1551 6NE/6NW CCU1/CCU2– Coronary Care Unit– Provides care to patients with cardiac rhythm changes, chest pain/acute myocardial infarction, dissection aortic aneurysm, digoxin toxicity, pacemaker failure, pulmonary embolus, pericarditis, hypertension, CHF, pulmonary edema, and cardiogenic shock. Name of Nursing Unit CCU1- (6NE) Unit Contact Person and Phone Donna Wilson

Pam Crabtree Charge Nurse 256-265-8645

Location for pre-and post-clinical huddle Breakroom, located behind the nurses station Name of Nursing Unit CCU2 – (6NW) Unit Contact Person, Title and Phone Liz Scrivens

Anne Marie Strickland

Charge Nurse 256-265-8644

Location for pre-and post-clinical huddle Breakroom, located behind the nurses station 6E-CVICU-Cardiovascular Intensive Care Unit-Provides care to patients post cardiac/thoracic surgery, acute and chronic cardiac diseases requiring pressors and rhythm regulating drips, ventilator assistance. Name of Nursing Unit CVICU (6E) Unit Contact Person, Title and Phone Julie Carlyle

Tiffany Peel

Division Director Clinical Nurse Specialist

256-265-8600 256-656-4539 256-265-2236 256-698-1984

Location for pre-clinical huddle Break Room in CVICU Location for post-clinical huddle 6B Classroom or Unit Break Room


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6W-Progressive Cardiovascular (PCV): Provides care for the adolescent, adult, and senior pre-operative and post-operative cardiovascular and thoracic surgery patients, medical cardiology patients, and cardio vascular related medical-surgical overflow patients. Name of Nursing Unit PCV (6W) Unit Contact Person, Title and Phone Julie Carlyle

Tiffany Peel

Division Director Clinical Nurse Specialist

256-265-8600 256-656-4539 256-265-2236 256-698-1984

Location for pre-clinical huddle Break Room in PCV Location for post-clinical huddle 6B Classroom or Unit Break Room 6N/6MST-Cardiology I/IV: Provides care for patients with artery disease, hypertension, pacemaker malfunction/failure, cardiac rhythm changes, endocarditis, cardiogenic shock, thrombophlebitis, congestive heart failure, chest pain, post acute MI, post cardiac surgery, pre/post cardiac catheterization. Name of Nursing Unit Cardiology I (6N) Unit Contact Person, Title and Phone Jamie Fortenberry Unit Director 256-265-6878 Location for pre-and post-clinical huddle Breakroom across from Room 627 Name of Nursing Unit Cardiology IV (6MST) Unit Contact Person, Title and Phone Jamie Fortenberry Unit Director 256-265-6878 Location for pre-and post-clinical huddle Breakroom behind Front Desk 7N/7NE/7NW/7W-Family Practice/General Medicine: Provides care to adolescent, adult, and senior patients with medical/surgical conditions with an emphasis on diabetes, infectious processes, respiratory disease, chronic heart disease, gastrointestinal disease, thrombosis, bleeding disorders, pancreatitis, sepsis, renal failure, and altered mental status. Name of Nursing Unit Family Practice (7N,7NE,7NW) Unit Contact Person and Phone Linda Chester Clinical Education

Specialist 256-265-9277

Location for pre-and post-clinical huddle 7NE classroom if available, if not then the hallway at the end of the hall on 7NE

Name of Nursing Unit General Medicine (7W) Unit Contact Person, Title and Phone Tabatha Peterson

Brett Pate Charge Nurse 256-265-8175

Location for pre-and post-clinical huddle Conference Room across from room 751 or 770 7MST/7E: Oncology/Stem Cell: Provides care to adolescent, adult, and senior patients receiving chemotherapy, radiation therapy, and administration of blood products and pain management. Care is also provided to patients with complications from chemotherapy, radiation, cancer, and cancer treatments. Name of Nursing Unit Oncology (7E) Unit Contact Person, Title and Phone Cheryl Smith

Teresa Elliott Danielle Bates-Ford

Charge Nurse 256-265-8862 Unit ext. 52741

Location for pre-and post- clinical huddle

Solarium - Adjoins room 779


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Name of Nursing Unit Oncology (7MST) Unit Contact Person, Title and Phone Cheryl Smith

Teresa Elliott Danielle Bates-Ford

Charge Nurse 256-265-8862 Unit ext. 50750

Location for pre-and post-clinical huddle Family Lounge – Across from room 750 – around the corner 8MST/8NPCU-Neuro Spine/Neuro Progressive Care: Provides care to individuals recently suffering from transient ischemic attacks, ischemic or hemorrhagic strokes, traumatic brain injuries, brain tumors, aneurysms, seizures, individuals with neuromuscular disorders, spinal surgery, or spinal cord compression. Name of Nursing Unit Neuro spine – Neurosurgery (8MST) Unit Contact Person, Title and Phone Mark Walden Unit Director 256-265-8869 Location for pre-and post-clinical huddle Lounge on the southeast corner of the unit Name of Nursing Unit Neuro Progressive Care (8N PCU) Unit Contact Person, Title and Phone Lee Collins Unit Director 256-265-8344 Location for pre-and post-clinical huddle NICU Consult Room outside of NICU (if not in use by grieving

family). If Consult Room in use will need to use Hospital Lobby 8NE NICU-Neuro Intensive Care Unit-Provides care for patients needing advanced assessment and monitoring due to stroke, trauma head injury/bleed, acute spinal cord injury, post neurological surgery and neuromuscular disorders requiring mechanical ventilation. Name of Nursing Unit NICU (8NE-M) Unit Contact Person, Title and Phone Jenny Mitchell Unit Director 256-265-2706 Location for pre-and post-clinical huddle If not in use can use the consultation room across the hallway

from the unit entrance Wound Clinic- Our clinic cares for wounds that have resisted healing, such as: •Skin ulcers caused by poor blood circulation in the veins and arteries •Open lesions on the toes and feet (often a complication in patients with poorly controlled diabetes) •Wounds from a surgical incision that have not completely closed •A pressure sore over a bone, often caused by prolonged bed confinement •Wounds occurring in skin made delicate or thin by disease or medication •Traumatic wounds that have failed to heal. Name of Nursing Unit Wound Clinic 420 Lowell Drive, Suite 500 Unit Contact Person, Title and Phone Mary Hopper Wound Care Specialist 256-265-3052 Location for pre-and post-clinical huddle 420 Lowell Drive, Suite 500 or across from Room 431 at the main

hospital


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Huntsville Hospital for Women and Children Name of Nursing Unit Pediatric ER Unit Contact Person, Title and Phone

Alicia Wright Clinical Education Specialist

256-265-2619

Location for pre-and post-clinical huddle 4 Northwest Conference Room across from 442 2SE-Antepartum: Care of patients experiencing preterm labor, premature rupture of membranes, pre-eclampsia, placenta previa and high risk antepartum patients. 2E Labor and Delivery– Care of patients experiencing active labor, providing monitoring and assessment of mother and baby during labor and delivery process. Name of Nursing Unit Antepartum /Labor and Delivery/ Unit Contact Person, Title and Phone Tammy Baer Clinical Education


Location for pre-and post-clinical huddle L&D Conference Room, If unavailable then use LDR #20 2WE- Maternal ED Name of Nursing Unit Unit Not Open Unit Contact Person, Title and Phone Location for pre-and post- clinical huddle

3E Neonatal Intensive Care Unit-Provide care of premature neonates requiring intensive monitoring, assessment and treatment including ventilation, hydration, temperature management and feeding. Name of Nursing Unit RNICU Unit Contact Person and Phone Greta Simmons Clinical Education


Location for pre-and post-clinical huddle No clinical groups, only individual Students 3WSE-Women’s Surgical-Care of patients requiring general gynecological, GYN oncology, ENT, robotic surgeries, plastic surgery, pain procedures, postpartum complications including perinatal loss through miscarriage, ectopic pregnancy, fetal demise, still birth, and adoptive process. Name of Nursing Unit 3WSE Unit Contact Person, Title and Phone Heather Thacker Clinical Education


Location for pre-and post-clinical huddle Ground Floor, Cafeteria 4SE-Pediatrics-Care of infant, child, and adolescent with respiratory illnesses, seizures, traumas, infections, gastrointestinal disorders and cardiac conditions. The surgical patient presents a variety of specialties including ear, nose, and throat surgery, general surgery, orthopedics, neurology, urology, and cardiology. Name of Nursing Unit Pediatrics Unit Contact Person and Phone Kim Griggs

Annie Thorpe Charge Nurse 256-265-7944

Location for pre-and post-clinical huddle Cafeteria or Lobby


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4SEE-PICU-Pediatric Intensive Care Unit-Comprehensive care of children with surgical ear, nose, and throat surgery, general surgery, orthopedics, neurology, and urology surgery; children that require advanced assessment and monitoring for care/treatment of disease processes. Name of Nursing Unit PICU Unit Contact Person, Title and Phone Stephanie McLaughlin

on maternity leave until 2/2017

Clinical Education Specialist

256-265-7944

Location for pre-and post-clinical huddle Contact Danielle Armstrong – Unit Director at 256-265-7134 until Clinical Education Specialist Returns

4NE AICU -Adult Intensive Care Unit—Provide care for patients post OB-GYN surgery, ENT surgery, critical gynecology patients, mothers with complications post delivery, and other medical-surgical patients requiring intensive monitoring and assessment. Name of Nursing Unit AICU Unit Contact Person, Title and Phone Heather Thacker Clinical Education


Location for pre-and post-clinical huddle Ground Floor, Cafeteria 5MBE - Mother Baby- postpartum vaginal or cesarean section care; postoperative care. Name of Nursing Unit Mother/Baby Unit Contact Person, Title and Phone Jeanette Atkinson Clinical Education


Location for pre-and post-clinical huddle End of South Hall (near rooms 515-516) 5- Well Baby Nursery–. Care of well neonate, circumcision care, neonatal feeding, and hyperbilirubinemia. Rooming-in is encouraged as much as possible with quiet time dedicated from 1-3 daily so Moms can get rest. Name of Nursing Unit Well Baby Nursery Unit Contact Person, Title and Phone Jeanette Atkinson Clinical Education


Location for pre-and post-clinical huddle End of South Hall (near rooms 515-516)


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Madison Hospital Name of Nursing Unit Madison Emergency Department Unit Contact Person, Title and Phone Christy Plemons Clinical Education


Location for pre-and post-clinical huddle Pre- Clinical : Cafeteria or Main Hospital Atrium Post-Clinical: Boardroom or classroom. Call Betty Madison at 256-265-5010 to schedule

2W/E -Mother Baby, Well Baby Nursery– Care of well neonates, circumcision care, neonatal feeding, hyperbilirubinemia, postpartum vaginal or cesarean section care, postoperative care, and transitional infants up to 4 hours of life. Name of Nursing Unit Madison OB (2E/W) Unit Contact Person, Title and Phone Renee Colquitt

Samantha Abercrombie Lead Coordinator Clinical Education Specialist

256-265-5187 256-265-5188

Location for pre-and post-clinical huddle Main Lobby or Cafeteria 1st floor 2W/W Labor and Delivery– Care of patients experiencing active labor; providing monitoring and assessment of mother and baby during the labor and delivery process. Name of Nursing Unit Labor and Delivery Unit Contact Person, Title and Phone Renee Colquitt

Samantha Abercrombie Lead Coordinator Clinical Education Specialist

256-265-5187 256-265-5188

Location for pre-and post-clinical huddle Main Lobby or Cafeteria 1st floor 3E/W Medical Surgical: Provides care to adolescent, adult and senior patients with medical/surgical conditions. Name of Nursing Unit Medical Surgical Unit Contact Person, Title and Phone Brenda Styles Clinical Nurse


Location for pre-and post-clinical huddle PT/ Classroom 3rd Floor (outside of the ICU doors) 3I E/W Medical Surgical ICU- General Adult ICU-Provides care for critical patients including suicide, overdose, gastrointestinal bleeds, chronic respiratory requiring pulmonary monitoring and/or ventilation. Name of Nursing Unit Medical Surgical ICU Unit Contact Person, Title and Phone Brenda Styles Clinical Nurse


Location for pre-and post-clinical huddle PT/ Classroom 3rd Floor (outside of the ICU doors) 4E/W Surgical Care Unit– Provides care to adolescent, adult and senior patients with medical/surgical conditions. All total-joint patients recover on this unit. Name of Nursing Unit Surgical Care Unit Unit Contact Person, Title and Phone Brenda Styles Clinical Nurse


Location for pre-and post- clinical huddle

4th Floor Break room or Cafeteria


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Appendix G


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Huntsville Hospital Instructor and Student Parking Guidelines (Revised 8/9/2016)

Welcome to Huntsville Hospital Health System (HHHS). These Parking Guidelines are provided to inform students of where to park when present on the Huntsville Hospital, Women and Children’s and Madison Hospital campuses. Parking Guidelines are not “recommendations,” each student is expected to follow the Guidelines EVERY time they are present for “school related reasons” on the HHHS campus. Students need to add 20-25 minutes to their arrival time to insure they arrive on time to their units for their pre-clinical huddle. Instructor Parking: All instructors may park on the top deck of the Employee Garage. Access is obtained via the faculty badge. M-F after 5:00 and all weekend days/nights faculty may park on levels 3&4 of the Blackwell Medical Tower. Students precepting or in clinicals on the Huntsville Hospital campus M-F, 7a-7p should use the following instructions:

• Huntsville Hospital Main: o Enter student parking from St. Clair Street directly behind 1st Baptist church located on Governors Drive. Students

should park in the furthest spots on the east side closest to the hospital. o Students can walk 1.5 blocks east towards the main hospital and tram station. For a ride back to cars in the

afternoon call 256- 265-6660. o For safety/traffic reasons, students are asked to use the sidewalk and all crosswalks. o For any emergency requiring our Security Department, please call 256-265-6660. Shuttle service is only available

for large groups. Security must be called at a minimum of 15-20 minutes in advance. • Women and Childrens (WCH):

o Park in the same parking lot as indicated above for Hunstville Hospital Main. The Tram is the quickest way to travel from the Huntsville Hospital Main (HHM) to WCH. Follow the signs to the Tram station. It is located on the second level of HHM, one floor above the cafeteria. There are two Trams; the Tram on your right is an “express” (stopping only at WCH) and the TRAM on your left is a “local” stopping at each building between HHM and WCH. Take the Tram on your right, the express.

Students precepting or in clinicals on the Madison Hospital campus M-F, 7a-7p should use the following instructions:

• Madison Hospital - Students assigned to Madison Hospital will park in the parking lot off of Highway 72, in front of the Medical Office Building . Upon entering Hospital Drive from Highway 72, take the first left and then turn left again into the parking lot.

Instructions for Nights and Weekend Student Parking: o Huntsville Hospital Main - on the top level of the Employee Parking Garage, located behind the McDonald’s

Restaurant o Women and Childrens - on the top level of the Medical Office Building(MOB) close to Women and Childrens

Hospital o Madison Hospital – Park in the parking lot off of Highway 72, in front of the Medical Office Building . Upon

entering Hospital Drive from Highway 72, take the first left and then turn left again into the parking lot.

Escort: If at any time a student feels insecure in walking to a parking area at any of the three campuses, a Security escort can be arranged. Call the internal number of 5-6660 to arrange for a Security officer to escort you to your vehicle. Consequences for NOT following Student Parking Guidelines: Detailed parking guidelines are provided so students will avoid having a wheel lock placed on their cars and being fined. If student Parking Guidelines are not followed, students will be subject to a parking fine for each occurrence ($50.00-$250.00) Paying for parking in a non-designated student parking area does not exclude a car from being wheel locked. Not following Parking Guidelines could result in a student no longer being able to use Huntsville Hospital as a clinical site. Thank you for your cooperation. We have tried to think of the fairness to each student when creating these Guidelines. There are several schools and many students present at our facility, often at the same time. We have made it our priority to be sure parking is safe and available to all students.


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Appendix H


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Points to cover when administering medications to your patient

This is a guide for your use to ensure you cover the important aspects of administering meds and to ensure your patient has the knowledge they need regarding their medications. Use your own words, however you wish, the point is to cover all aspects for the safety of the patient.

Points to cover: • Introduce yourself, if the patient has visitors tell the patient you are going to be administering their medications

and will be reviewing the medications. Ask the patient if they would like for you to ask the visitors to step out. • Identify the patient (2 identifiers), ensuring the 5 rights • List the meds (name, strength, indication) • Ask if this is the first time they have taken the medication. If it is the first time they have had the medication,

explain the side effects and offer them a medication carenote printout. • Ask if there is anything they need or if they have questions.

How to Locate the Lab Test Catalog

• Go to Pulse page • Click on Departments • Select Operation 1 • Select Laboratory Services • Select Test Catalog • Type in test name

Recommendations for Preventing Catheter-associated UTIs

Nearly all patients who need urinary catheters develop high levels of bacteria in their urine, and the longer the catheter is in place, the higher the risk for infection.

• Catheterize only if absolutely necessary • Use aseptic technique on insertion • Never break the closed system, i.e. remove the foley catheter from tubing • Keep drainage bag off floor and below bladder level • Don’t let the outlet tube on drainage bag touch anything when emptying the drainage bag • Don’t allow tubing to loop below the bag • Get the Foley out ASAP-protocol • Use a Securement Device (StatLock) • Do not Pre-test balloon when placing Foley Catheters


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Patient Instructions for Nurse Bedside Shift Report

At Huntsville Hospital we conduct nurse bedside shift report to keep you better informed about your plan of care, medications, tests and progress while you are here. Bedside shift report is a process where nurses share patient care information at the bedside so that you can be more informed about your care. With your permission, a family member or friend may stay to listen to your report.

When is nurse bedside shift report?

Nurse bedside shift report occurs at each shift change, lasting approximately five minutes.

What should I expect?

Your nurses will:

• Introduce themselves and write his or her name and phone numbers on the patient communication board in your room.

• Invite you and/or your family or friends to take part in the report.

• Talk with you about your health, including the reason you are in the hospital and information about your plan of care.

• Check your medicines, IVs, injuries and bandages.

• Follow up on any tests or lab work that were ordered.

• Encourage you to ask questions and share your concerns and goals.

What should I do?

• Listen. You are an important part of the health care team. We want to make sure you have complete and timely information about your care.

• Speak up. If you have questions or concerns, nurse bedside shift report is the perfect time to discuss them.

• Ask questions if something is confusing. If the nurses use any words or share any information you don’t understand, feel free to ask them to explain.


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Appendix I


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AIDET

Fundamentals for providing excellent Customer Service

Acknowledge

First impressions count. Making eye contact is the first step in forming a relationship with your patients. Always greet them by name and in a positive manner — displaying a warm and friendly smile. Attitude is everything!

Introduce

Introduce yourself politely. Tell the patient your name, state your role and let them know how you are going to help them. Inform your patient of the purpose for each encounter.

Duration

Talk to your patients. Keep in touch to ease waiting times; set expectations for tests, physician arrival, tray delivery and how long you plan to visit their room. Manage the patient’s expectations and apply Service Recovery methods when needed.

Explanation

Talk. Listen. Learn. Let your patient know step-by-step what will happen during the treatment or service you are providing. Ensure that you explain things in a way they can understand. Consistently use the key words for safety and excellent care.

Thank You

Foster an attitude of gratitude. Thank your patients for waiting, providing information and choosing Huntsville Hospital Health System for their care.

Remember to speak with passion and commitment so that our patients are confident they made the right choice by coming to our hospital.

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