1. health and fitness

Student Orientation
Manual
2014 Edition
Updated 2/2014
Welcome to Fairfield Medical Center! We hope you find your student experience
with us to be both beneficial to your personal and professional growth, as well as
enjoyable!
Part of our responsibility to you is to ensure your safety and that of our patient’s
and staff before you actually start your student experience. In order to do so, we
have put together this Reference Guide for you to review.
Again, welcome to Fairfield Medical Center! We look forward to meeting you and
having the opportunity to build a personal and professional relationship with you!
Thank you and welcome!
Becky DeVoss, RN
Clinical Education Coordinator
Learning & Development
740-687-8496
rebeccas@fmchealth.org
Table of Contents
Requirements
Application ………………………………………………………….
Orientation post test ………………………………………………..
Liability ……………………………………………………………..
Confidentiality ………………………………………………………
TB test ……………………………………………………………….
Background check ………………………………………………….
Immunizations ………………………………………………………
CPR ………………………………………………………………….
FMC Badge ………………………………………………………….
Clinical Documentation …………………………………………….
Glucose Meters ……………………………………………………..
Page
4
4
4
4
4
4
4
4
4
5
5
General Information
Telephone numbers
……………………………………………….5
Absences ……………………………………………………………. 5
Cafeteria …………………………………………………………….
5
Classrooms ………………………………………………………….
6
Lost and Found ……………………………………………………..
6
Dress Code ………………………………………………………….. 6
Housekeeping ……………………………………………………….
6
Parking ……………………………………………………………… 6,16
Personal Property …………………………………………………..
6
Personal Phone calls ………………………………………………..
6
Smoking …………………………………………………………….. 6
Solicitation …………………………………………………………... 7
Orientation to Standards and Guidelines
Emergency Code …………………………………………………….. 7-10
Patient Identifiers ……………………………………………………. 10
Infection Control ……………………………………………………... 10
Blood Borne Pathogens ………………………………………………. 11
Infectious Waste ……………………………………………………… 11
Hazardous Spill/Code orange ………………………………………… 11
Hazardous Communication Plan ……………………………………. 12
Universal Protocol ……………………………………………………. 12
Interruption Plan ……………………………………………………… 12
Equipment Management ……………………………………………… 13
Center Police …………………………………………………………... 13
Safety Program ………………………………………………………… 13
Customer Service ……………………………………………………… 13
Event Reporting ………………………………………………………... 14&15
Falls ……………………………………………………………………. 15
Patient Rights …………………………………………………………….15
Confidentiality ……………………………………………………………15
Table of Abbreviations ……………………………………………………16
Parking Policy …………………………………………………………….17
Appendix
Appendix A ……………………………………………………………….Application
Appendix B ………………………………………………………………..Liability/Waiver and Confidentiality Statement
Appendix C ………………………………………………………………..Immunization Form
Appendix D ……………………………………………………………… Background Check
Appendix E ……………………………………………………………… Orientation Test
3
REQUIREMENTS
Student
Please complete the application and orientation post test included with this manual. Also, the
notice of privacy, liability statement and confidentiality statement must be signed and returned.
The immunization and background check forms must be completed submitted prior to clinical
rotation.
Application
If you are in a Clinical Rotation or a Health Tech program, you will turn this in to your
instructor. Otherwise, please send completed application directly to:
Learning & Development
Attn: Becky DeVoss
401 N Ewing St
Lancaster, Ohio 43130
rebeccas@fmchealth
Your application must be submitted 3 weeks prior to your clinical rotation/internship or
shadowing experience to allow for time to process and develop a clinical site for your
rotation.
Liability
Confidentiality
These must be signed and turned in with the application
Post-test
Please review the Orientation Manual included and complete the post-test. If you are in a
Clinical Rotation or a Health Tech program, you will turn this into your instructor. Otherwise,
please send your completed post-test directly to Learning & Development.
FMC Badge
All paperwork must be received and your student file complete before a badge will be issued.
Stop by Human Resources between the hours of 7:00am-4:00pm to pick-up an ID badge. A
non-photo “Student” badge will be given to anyone shadowing. For all others, your picture will
be taken and used in providing you a FMC ID badge. The badge is to be worn while here at
FMC. There is a cost of $25.00 for any lost, damaged, or unreturned badge.
TB Test
You need to be able to submit evidence of a two step negative TB Test. If you are in a school
program, they should provide this testing and have it on record. Have the school provide
evidence of compliance. If you have not received a TB test they may be obtained from your
private physician or the health department.
CPR
If you will be involved with any direct patient care, you will need to verify that you have a
current CPR certification. FMC offers CPR classes. Please contact Learning and
Development at 740-687-8491 to register.
Parking Tag
If your student experience will require you to be at FMC more than 8 hours, you will need to
stop in Human Resources between the hours of 7:00am-4:00pm to pick-up a parking tag. You
will need your license plate number.
10 Panel Drug students will need to provide evident of a negative 10 panel drug screen
Screen
Not required of those that are Shadowing
4
Immunizations All students will need to provide proof that they are current on all immunization prior to clinical
rotation. This includes: A 2-step TB skin test and then annual thereafter. We also require
documentation of the MMR vaccine, Varicella and Hepatitis B, or lab work indicating immunity
to these diseases. If your college does not have a copy you may contact your high school for
a copy. If these are not up to date you may go to your family physician or to the health
department for these vaccinations.
Background
Federal background checks will be completed and turned in with application for all students
this does not include those who are shadowing.) If you have not had a background check
completed by your college/university it may be obtained through:
Fairfield County Sherriff’s Department
108 N. High Street
Lancaster, Ohio 43130
The cost is $30.00 and payment is by cash or check – NO debit or credit card
Flu Vaccines
Students must provide proof of the Flu vaccine for the current year. If student has deemed not
to have the flu shot administered said student will need to wear a mask.
Additional training may be requested by your instructor based on the location of your
experience. Please contact the instructor directly to schedule any of the following courses.
Clinical
Documentation
This class is required of any student who will be involved
with charting. All the paperwork required for these classes will be given to you on the
day of your class. There are three different classes, depending on the department:
HSM- All Surgery departments.
HED- ICU, PCU, 3rd, 4th, 5th, 6 South, 6 North, Respiratory
HEC - Emergency Room
Glucose Meters
Nursing students (RN, LPN, NA)with direct patient contact will need to show competency
in the use of a Glucose meter. Testing will occur in the department by your preceptor or
by your class instructor. You will find the necessary paperwork in this manual
5
General Information
IMPORTANT TELEPHONE NUMBERS
Fairfield Medical Center: 740-687-8000
Fairfield Medical Center Police: 740-687-8019
ABSENCES
If you are sick, or will have to be absent for any reason, please notify your instructor and/or
supervisor in advance.
CAFETERIA
You are welcome to eat in the Center cafeteria and you will receive a discount when wearing
your FMC ID badge. The cafeteria is open for lunch from 10:30 am until 1:30 pm and serves
dinner from 4:30 pm until 6:30 pm. Please try to avoid the rush hour between 11:30 am -12:30
pm. This facility is open at other times for coffee and snacks, but cannot be used as a “study
hall” for long periods of time during the day.
CLASSROOMS
Classrooms will be provided for students with the understanding that chairs, tables and
equipment will be returned to their proper places at the end of the class period. Please
remember that conferences and other classes are taking place in the area most of the time
and your cooperation in keeping the atmosphere quiet and conducive to study will be
appreciated. Professional conduct should extend to the classroom area, as well as patient
care areas.
LOST AND FOUND
Fairfield Medical Center is not responsible for lost articles. Articles found on the Center
premises that are not Center property should be submitted to the Patient Representative.
Students who lose personal articles on the Center premises should contact Patient
Representative.
DRESS CODE
Please adhere to the uniform or dress requirements for your particular clinical training
program. In general, uniforms should be kept neat and clean. Recreational clothing and blue
jeans are prohibited while on duty in Fairfield Medical Center. Name badges will be issued by
the Human Resources Department and are to be worn at all times on duty. If lost, replacement
badges will cost $25.00. You are required to turn in your name badge to your clinical instructor
or to Human Resources upon completion of this student experience. Earrings are permitted to
be worn only in your ears, and limited to two per ear. Tattoos should not be visible under any
circumstances unless for a medical reason such as being a diabetic. See personal
appearance policy below.
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HOUSEKEEPING
Please do your best to keep the Center as clean and neat as possible; free of clutter and litter,
which helps to eliminate germs. You will want to follow good housekeeping rules throughout
your health care career. The best time to start is now while you are a student.
PARKING
All students are required to park in the designated student parking. If student is found parking
in employee lots – a ticket from the hospital police will be issued. Three (3) parking violations
will result in the student being asked to leave the clinical site. (Map is included to denote
student parking area.)
There will be a charge of $40.00 per semester for each student. Failure to pay for the parking
will result in loss of clinical hours.
PERSONAL PROPERTY
The Center is not responsible for lost or stolen articles. Please limit the amount of money and
other valuables you bring to the Medical Center. Ensure that these items are either with you or
properly secured at all times. Lockers are available per request and coat racks are located in
each department.
PERSONAL PHONE CALLS
Though it is impossible to completely eliminate all emergency telephone calls, please limit the
use of the telephone to important matters that cannot be handled otherwise. Use of cell
phones or texting in clinical areas is prohibited during your student experience.
SMOKING
Effective July 1, 2006, Fairfield Medical Center became a smoke-free campus. You are not
permitted to use tobacco products, of any kind, on the premise while on or off duty.
SOLICITATION AND DISTRIBUTION
Employees and Non-employees are not permitted to solicit or distribute materials on Center
premises at any time.
Students cannot solicit or distribute any materials to other students or employees on work time.
Examples: Avon, Pampered Chef.
STUDENT RECORDS
Each student will maintain their own hour/daily records. It will not be the responsibility of the
“Center” to maintain those for the student or intern.
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Orientation to Standards and Guidelines
The content below is information that you need to know as required by The Joint Commission,
the Occupational Safety and Health Administration (OSHA) and Fairfield Medical Center.
The Joint Commission - The Joint Commission accredits and certifies nearly 15,000 health
care organizations and programs in the United States. Joint Commission accreditation and
certification is recognized nationwide as a symbol of quality that reflects an organization’s
commitment to meeting certain performance standards.
OSHA - OSHA's mission is to assure the safety and health of America's workers by setting and
enforcing standards; providing training, outreach, and education; establishing partnerships;
and encouraging continual improvement in workplace safety and health
Emergency Codes
The following codes are listed on the back of your identification badge.
Code Red - Fire
Remember:
Close all doors and windows
Leave all lights ON
Do not use elevators
Follow instructions from the manager or supervisor.
If you need to use a fire extinguisher remember PASS – Pull the pin, Aim, Squeeze and
Sweep.
Code Adam – Missing Child
In the event of a missing or abducted child or infant you will notify the Center’s Switchboard
Operator and alert Center Police. The Center Police Officer will be in charge of the situation.
Staff will be directed to check and guard stairwells, elevators, and all entrances to departments
and the facility. Staff will watch for persons not appropriate for their area and observe if they
could be hiding an abducted infant. Remember to remain calm.
Code Brown – Missing Adult Patient
An adult patient is missing from your unit. You will begin an immediate search of your
department and the Center. Notify the Center’s Switchboard, Center Police, House Supervisor,
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Manager, the attending physician, and the patient’s residence. Note a time frame when the
patient was last seen.
Code Green – External Disaster/ Code Yellow – Internal Disaster
External disaster means that the event is occurring outside of the facility. Internal means that
we have multiple victims of a related disaster within our building.
If you hear Level One overhead this means that there is a disaster in progress but the victims
hae not arrived at FMC. You will need to take direction from the manager of the unit you have
been assigned to or from your instructor.
Level 2 means that the victims of the disaster have started arriving in the ED. Again, follow the
instructions of the manager of the unit or your instructor.
Code Gray – Severe Weather
When Fairfield County is affected by severe weather – the Center Police will determine if a
Code Grey needs to be put into effect.
If you hear a Code Grey Option One announced – this means that a Tornado or high wind
“WATCH” has been issued by the National Weather Service for our area.
During a Code Grey Option One you will need to follow the instructions of the manager on the
unit. You will help remove objects from the patient’s window sills, make sure that you know
where the flashlights are and begin closing the blinds and drapes in the patient rooms.
When Option Two has been called – it denotes that a tornado has been sighted or that we
have a high wind WARNING in our area.
You will need to assist the unit staff in closing the blinds and drapes in the patient rooms, close
all doors, including the smoke barrier doors. If asked by the manager of the unit – evacuate
patients to an area that has been chosen by the manager.
Code Blue – Adult Medical Emergency
Code blue is called when a person is unresponsive and does not have a pulse or is breathing.
If you witness or find a patient/person who is unresponsive, without a pulse and breathing you
should call for help and start CPR.
Code Pink – Infant/Child Medical Emergency
Code pink is called when an infant or child is not breathing and has no pulse. You will need to
establish unresponsiveness, call for help and start.
Code Violet – Violent / Combative Person
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Code Violet is used when a person has lost control and immediate assistance is needed in
order to manage their aggressive behavior. If you encounter a person who has lost control –
notify the manager of the unit. They will evaluate the patient and decide the course of
treatment
Code Silver – Hostage Situation or person with a weapon
If you encounter a person who has a weapon or you have been taken hostage – never argue
with the person, do not panic, do what you are told, always face the person and do not try to
be a hero.
If you hear a Code Silver announced – follow the direction of your instructor or the manager of
the unit. You may be asked to assist in closing doors, assisting patients, visitors and staff.
Do not use the elevators and do not transport any patients at this time.
Code Black – Bomb / Bomb Threat
If you would receive a phone call that threatens a bomb do the following:
1.
2.
3.
4.
5.
6.
Remain calm.
Speak in a normal tone.
Keep the caller on the line.
Listen for distinguishing voice characteristics.
Listen for background noise.
Obtain assistance from the manager and/or instructor
You may also be asked to assist with looking for unusual objects that may potentially be a
bomb.
Patient Identifiers
One of the most important tasks that you will do on a daily basis is identifying your patient. At
Fairfield Medical Center we use the:
1. Patient name
2. Patient’s Date of Birth
Do not use the patient’s room number
Always have a document to compare the date of birth and the patient’s name
Infection Control
Universal precautions is treating ALL patients as if their blood and body fluids were potentially
infectious regardless of known infectious disease.
Hand washing is the single most important procedure in Infection Control.
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.
The protection you use to prevent exposure- gloves, masks, gowns, aprons, eye protection are
called Personal Protective Equipment (PPE)
To prevent the event of a needle stick you would not recap needles. If you were to be stuck by
a contaminated needle you would, report this to your instructor and manager of the
department; fill out an incident report, and complete the post exposure management kit of lab
testing. You will report to the Emergency Room and any cost associated will be the
responsibility of the student.
Blood Borne Pathogens
Examples of blood borne pathogens are Malaria, Hepatitis, HIV, Syphilis.
You can prevent contact with a blood borne pathogen by treating all blood and body fluids as if
they are potentially infectious. Use gloves, masks and gowns. Always wash your hands
Infectious Waste
Infectious wastes are spread by blood, air, and contact
If you have infectious wastes that are disposable, put in a red biohazard bag
Hazardous Material Spill Code Orange
Hazardous materials are chemical substances which, if released or
misused, can pose a threat to the environment, life or health.
.
Chemical exposure may cause or contribute to many serious health effects such as
heart dysfunction, kidney, lung, and brain damage, sterility, cancer, burns and
rashes. Some chemicals may also be safety hazards and have the potential to
cause fires and explosions and other serious accidents.
The most common types of hazardous spills at Fairfield Medical Center are:
Chemo therapy agents
Blood and body fluids
Chemicals
Radioative
ALL employees should know the location, content, and use of any spill kit in their
department. The spill kit will be used when the spill is larger than 1 cubic foot or more in
volume.
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Hazardous Communication Program
In order to identify hazardous products on the units you are assigned, check for the warning
labels on the container. You can also look for the material safety data sheet which is located
on the intranet or in the Orange and White manual located on the units.
Universal Protocol
It is important in any procedure that is performed at Fairfield Medical Center that 3 processes
are checked prior to the start of the procedure.
1. Verify that you have the correct procedure, the right patient and the correct site
2. Make sure that the patient has gone through a pre-procedure verification process
a. must be completed prior to the procedure – you are verifying that you have all
the proper documents, related information and equipment
3. A time out is conducted before the procedure.
a. completed immediately before starting the procedure
b. it includes: anesthesia, surgeon, circulating nurse or nurse attending
procedure or any other active participants.
Interruption Plan – Power & Telephones
1.
Power Failure
In the event of a power failure, the Center’s generators will automatically start
within10seconds.Hallway lights are equipped with emergency power as well as red outlets,
which include light switches. Nursing floors have emergency power in each of the patient
rooms, as identified by the red wall plate covering.
2.
Telephones
If the Center encounters a telephone outage – cell phones are available on each of the
units
Do not transmit cellular phones in the following areas:
Surgery – behind the line
Cardiac services
ICU
ED
PACU
Cardiac Rehab
PCU
You can find department cell phone numbers in the Emergency and Disaster Manual on
your unit
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Equipment Management
All equipment that is utilized for patient care must have a Bio Med or Plant Engineering sticker
on it and must have been checked with in the past 12 months.
If a piece of equipment fails while you are using it, do the following:
1.
2.
3.
Remove from use immediately!
Inform your Manager / Supervisor.
Place a tag on the piece of equipment noting that it is broken or does not work.
Center Police
The Center has police officers on duty 24 hours a day who are responsible for safeguarding
individuals while they are on the Center premises, as well as for providing security of the
buildings and grounds. If an unsafe situation exists, employees are encouraged to call the
Center Police at 8019 immediately.
In addition, the officers are available to escort employees to their cars in the parking lot.
Safety Program
If you encounter a safety issue, report this to your instructor and manager of the unit.
Customer Relations
It is everyone’s responsibility in the Center to provide great service to our customers. This
means using “good manners” at all times.
Always take a person where they need to go – do not point and give directions.
If someone looks lost, ask if they need assistance
Answer call lights immediately
Ask patients, “Is there anything more I can do for you, I have time.”
If you encounter a patient or family member who has a complaint – contact your instructor,
manager of the unit and Patient Representative at ext. 8555 or (740) 687-8555.
AIDET
Acknowledge—Acknowledge the patient by name. Make eye contact.
Ask: "Is there anything I can do for you?"
Introduce—Introduce yourself, your skill set, your professional certification,
and experience.
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Duration—Give an accurate time expectation for tests, physician arrival,
and tray delivery.
Explanation—Explain step by step what will happen, answer questions,
and leave a phone number where you can be reached.
Thank—Thank the patient for choosing your hospital, and for their
communication and cooperation. Thank the family for assistance and being
there to support the patient
Event Reports (formerly known as incident reports)
ALL incidents that occur on Center property involving patients, visitors, and employees
must be reported. Three different incident reports are available, depending on the situation.
An incident report should never be filed in the patient record or photocopied. All
information must be factual. The incident report is to be completed by the individual at the
time of the incident!
1. Computer Event Report Form
(Open Microsoft Word, click File>New>FMC Forms)
The Event Report Form is used to report incidents involving:
Employees
Physicians
Allied Health Staff
Volunteers
Students
Visitors
When an employee has an incident or is injured on the job, follow these steps:
1.
2.
3.
4.
5.
Report incident to Manager/Supervisor.
Complete the incident report.
If medical attention is needed- seek treatment in Employee Health. The Emergency
Department is for emergencies only and must be authorized by calling the Manager or
House Supervisor on duty.
The Manager/Supervisor will complete an investigation into the incident.
Management will send the completed form to Employee Health within 48 hours of the
incident.
When a visitor has an incident or is injured, follow these steps:
1.
2.
Offer immediate First Aid and call the House Supervisor or your Manager.
The Incident Report should be completed by the person who witnessed or found the
visitor
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2.
Patient Event Report Form (Tan Color Form*)
(Note: Patient Incident Reports may also be completed on the AS 400, under QA Incident
Report)
You would fill out a patient incident report when an incident occurs that is not within the norm
for patient, such as:
When a patient falls
Performing the wrong procedure on a patient
Performing the procedure on the wrong patient
This form must be completed immediately after the incident and care of the patient. It should
be reviewed by your instructor before submission to the nurse manager.
3. Medication Event Report Form (Salmon Color)
Whenever a medication incident or potential medication incident occurs, even if the error does
not reach the patient. Be sure to fill out the form as completely as possible. Turn into your
instructor for review and then to the manager of the unit.
Falls Program
You will know if a patient is at High Risk for Falling when you see a yellow dot on patient’s
chart and on name card on patient’s door; High Fall Risk label at head of bed below patient’s
name; Yellow wrist band on the patient.
Patient Rights and Responsibilities
All patients and family members need to know where the patient rights and responsibilities are
located. It is you responsibility as a healthcare provider to assist them. There are patient rights
brochures on each unit.
Confidentiality / HIPAA
All students and employees have the legal and ethical responsibility to keep all
information about patients and their families confidential and private. Patient
information may only be discussed with other healthcare providers who need that
information in order to do their job.
Safety Issues
If you note a safety issue at Fairfield Medical Center you should call the safety hotline at 687-8988
15
TABLE OF DANGEROUS ABBREVIATIONS & SYMBOLS
The following list of abbreviations and symbols has compiled by the Pharmacy and
Therapeutics Committee due to their potential for error. Please do not use these dangerous
abbreviations or symbols.
Abbreviation/Symbol
MgSO4
Intended Meaning
Magnesium sulfate
Misinterpretation
Morphine sulfate
Correction
Use “magnesium
sulfate” or “mag
sulfate”
Magnesium sulfate
Use “morphine” or
“morphine sulfate”
Magnesium sulfate
Use “morphine” or
“morphine sulfate”
mg
Use “mcg”
Read as a 0 or 4
“unit” has no
causing 10-fold
acceptable
overdose, 4U seen as abbreviation. Use
“40” or 4u seen as “44” “unit”
Misread as IV
Use “international
(intravenous)
units” or “units”
Misread as “U” or “00” Use “ml”
MSO4
Morphine sulfate
MS
Morphine sulfate
ug
U or u
Microgram
Unit
IU
International units
cc
Cubic centimeter
Zero after decimal point
(1.0)
1mg
Misread as 10mg if
decimal point is not
seen
No zero before decimal
point (.5mg)
0.5mg
Misread as 5mg if the
decimal point is not
seen
QD, qd
Daily
QOD, qod
Every other day.
Misread as QID or
QOD
Misread as QD or QID
Do not use terminal
zeros for doses
expressed in whole
numbers
Always use zero,
before a decimal point
when the dose is less
than a whole number
Use “daily”
Use “every other day”
16
FAIRFIELD MEDICAL CENTER
Subject: Parking Regulations
Students must park in the student lot located on South Ewing street across from Anchor
Hocking. This is for day shift. Evening shift students will parking in the J lot.
Parking in the garage is completely prohibited.
Students are not to use the Valet parking.
Tickets will be issued to those that do. – Greater than 2 tickets for any reason will result in
removal of student from their clinical at Fairfield Medical Center
17
FAIRFIELD MEDICAL CENTER Subject: Personal Appearance EMPLOYEE HANDBOOK HUMAN RESOURCES POLICY
& PROCEDURES Supersedes: June 20, 2011 Effective: August 1, 2011 Page 1 of 2
POLICY
It is the policy of Fairfield Medical Center (FMC) that each employee’s dress, grooming, and personal hygiene
should be appropriate to the work situation and in a professional manner that inspires confidence and trust among
patients and visitors and presents a professional, positive and consistent image to those we serve.
PURPOSE
This policy is the Center-wide Personal Appearance policy. Minimally, each department will adhere to these
standards and may require a more restrictive dress code based on operational, infection control, and safety needs.
More restrictive requirements must be reviewed and approved by Human Resources and will be communicated,
interpreted, and enforced by the manager. Employees in the Patient Services Division should refer to the Patient
Services Dress Code Policy for further details.
PROCEDURE
I. Employees are expected to present a professional, businesslike image to customers and the public at all times.
Clothing must be clean, neatly pressed, in good repair, properly fitted, not revealing and appropriate for the type of
work performed. Acceptable personal appearance is an ongoing requirement of employment with the Center. Radical
departures from professional dress or personal grooming and hygiene standards will not be permitted unless
authorized by the appropriate Chief Officer or the department requesting the variance.
II. All employees are required to wear their Center ID badges facing forward while working.
III. Any employees who work in an office setting, and/or have regular contact with the public must comply with the
following personal appearance standards:
A. Employees are expected to dress in a manner that is acceptable to the established standards of the Center and
requirements of their department. Employees should not wear suggestive attire including backless tops, tank tops or
spaghetti straps, jeans, sports clothing, shorts, sandals, flip flops, slippers, T-shirts, novelty buttons, non-approved
hats, sleeveless shirts, blouses or dresses unless worn with a jacket or sweater and similar items of casual attire that
do not present a professional appearance.
B. All employees are required to be well groomed, practice appropriate personal hygiene and use good judgment in
dressing appropriately for their position, within the requirements of this policy.
C. Hair should be clean, combed, and neatly trimmed or arranged. Unkempt hair is not permissible, regardless of
length. Sideburns, moustaches, and beards should be neatly trimmed.
D. Tattoos (except for medical alerts) and body piercings, other than two earrings per ear, cannot be visible.
FAIRFIELD MEDICAL CENTER Subject: Personal Appearance EMPLOYEE HANDBOOK HUMAN RESOURCES POLICY
& PROCEDURES Supersedes: June 20, 2011 Effective: August 1, 2011 Page 2 of 2 E. Artificial nails are not to be worn by
employees performing clinical tasks. Natural fingernail tips are to be kept less than ¼ an inch long by employees
performing direct clinical tasks. Nail polish, if permitted and worn, should be free of chips.
F. Employees attending training classes at the Center must wear business casual attire (No backless tops, tank tops or
spaghetti straps, jeans, sports clothing, shorts, sandals, flip flops, slippers,
T-shirts, sleeveless shirts, blouses or dresses unless worn with a jacket or sweater).
IV. Employees who do not regularly meet the public should follow basic requirements of safety and comfort, but
must still be as neat and professional as working conditions permit.
V. Certain employees may be required to meet special dress, grooming and hygiene standards, such as wearing
uniforms or scrubs, depending on the nature of their job. These requirements are specified by individual department
policies.
A. Specifically, for Patient Services, there is a color requirement in uniforms for four main reasons: patient
satisfaction, patient safety, hospital image, and professionalism. These requirements are in place for the purpose of
improving safety, quality, and patient satisfaction; other employees may not be dressed in like manner.
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1. RNs – navy scrub pants, scrub top, and lab jacket (as needed).
2. Clinical Nurse Leaders – white pants, scrub top, lab jacket (as needed), & shoes.
3. Clinical Coordinators – navy pants, white shirt, white lab jacket (as needed), & white shoes.
B. Couriers and other employees that work outside may wear hats (FMC Logo only) outside FMC facilities and in
their vehicles to protect themselves from temperature extremes and from sun exposure.
VII. At the Center’s administrative discretion, employees may be permitted to dress in a more casual fashion than is
normally required. On these occasions, employees are still expected to present a neat appearance and are not
permitted to wear ripped or disheveled clothing, athletic wear, or similarly inappropriate clothing. Human Resources
will give advance notification of what type of casual wear, e.g. hospital T-shirts or college sweatshirts, may be worn
and the times that such clothing will be permitted.
VII. Any employee who does not conform to the standards of this policy will be sent home and required to change
clothes that meet the acceptable established guidelines of this policy. Hourly employees will not be compensated for
any work time missed because of failure to comply with this policy. Violations of this policy may also result in
disciplinary action up to and including termination for repeated failure to follow the policy.
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Student Verification Agreement
Student Name______________________________________
School____________________________________________
I, ________________________(representative from school) do consent and verify that
__________________________(Student’s name)has received the following: (Please check all
that apply)
_____
Criminal background check
_____
Current TB test(within the current year)
_____
Immunizations to include; MMR, Varicella and Hepatitis
_____
5 Panel drug screen
_____
Flu Vaccine
_____
Current CPR Card , if applicable
That his or her record meets the Fairfield Medical Center permissible standards. Fairfield
Medical Center honors the partnerships and maintains that integrity with all programs and
students who use the Fairfield Medical Center facilities. Signature on this record substanciates
that the school/college/university maintains current and accurate records of the above. That
FMC may contact an individual institution and request copies of the records.
**If the school program cannot verify that this student has received the above then
the student must provide Fairfield Medical Center with a copy of those items required for their
application
Signature ____________________
(Representative from school)
Title _______________ Date_________
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TO BE SIGNED BY EACH STUDENT AS A CONDITION OF PARTICIAPTION IN
ANY STUDENT/INTERN/SHADOW EXPERIENCE
CONFIDENTIALITY STATEMENT
I understand that as a student completing my internship/shadowing experience at Fairfield Medical
Center, I may be exposed to confidential information regarding patients and financial information
produced by or held by Fairfield Medical Center. During the term of my visit with Fairfield Medical
Center and any related activities, or any time thereafter, I shall not directly or indirectly, make or cause
to be made, any disclosure or other use not authorized by Fairfield Medical Center of any confidential
information acquired during the course of my experience at Fairfield Medical Center unless such
information is or becomes otherwise legally available to the public. For purposes of this agreement, the
term “confidential information” means any business, medical or financial information not generally
known to the public at large regarding the business and operations of Fairfield Medical Center and its
patients, employees and physicians. Any breach of confidential information by me shall constitute
grounds for immediate termination from my internship/shadowing experience at Fairfield Medical
Center and can further be grounds for any legal action taken by the offended parties.
WAIVER OF LIABILITY/RELEASE WITH ASSUMPTION OF RISK
AND INDEMNIFICATION
In exchange for the agreement of the Hospital to permit participation in any student/intern/shadow
experience, I hereby voluntarily assume the risk of injury and waive, release, and agree to hold
harmless and indemnify the Hospital, its employees and agents from any and all liability, arising from
negligence or otherwise, and all damages in any way resulting from participation in any student/intern/
shadow experience at the Hospital, including but not limited to bodily, personal, or mental injury.
The undersigned, has read the above carefully, understand its significance, and voluntarily agree
to all of its terms.
NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT
By signing below, I acknowledge that I am in receipt of Fairfield Medical Center’s Notice of Privacy Practices.
Date: ______________________
____________________________________
Student Signature
____________________________________
Student Name (printed)
If student is under 18 years of age, the student’s parent or guardian must also sign this statement:
Date: _______________________
____________________________________
Parent Signature
___________________________________
Parent Name (printed)
Student Application- Fairfield Medical Center
21
PERSONAL
Student Name _______________________________
Phone # ________________________
Address____________________________________
Cell # __________________________
City/State/Zip ________________________________
Email __________________________
If under 18 yrs of age, please check _______
Please complete:
REQUEST
# Hrs _________ Clinical Rotation______ Shadowing_______ Internship________
Department(s)_______________________________Dates_____________________
Have you made contact w/this department? Y
N
Dept.
Contact Name ___________________
Are you currently employed/volunteer or have you ever been employed/volunteered at
SCHOOL
FMC Fairfield Medical Center or any of its affiliate in any capacity? Y N
If yes, date____________________ and department
School Name __________________________________
__________________________________
Instructor _____________________________________
Instructor Email_________________________________ Phone____________________________
Program
Graduation
Date____________
In consideration
of of
myStudy_______________________________
student experience at Fairfield Medical Center, I agree to Expected
conform to the
rules and regulations
of this facility. I
understand that my experience can be terminated at any time and for any reason, at the option of either the facility, the school or
myself. I understand that this student experience does not enter me into an agreement of employment with this facility. I hereby affirm
that the information provided on this application (and accompanying resume, if any) is true and complete. I understand that any false or
misleading representations or omissions may disqualify me from this student experience and further disqualify me from consideration
for employment. I hereby authorize persons, school, and employers named in this application (resume, if any) to provide this facility
with any relevant information regarding my student experience, and I release all such persons from any liability regarding the provision
or use of such information.
Signature ______________________________________________
Date _____________________________
My typed name above shall have the same force and effect as my written signature.
Your signature verifies that you have read and understood all that is contained
In this packet and hereby agree to adhere to the standards
Email to Becky DeVoss at rebeccas@fmchealth.org or by mail to:
Becky DeVoss, Staff Development
Fairfield Medical Center
401 North Ewing Street
Lancaster, Ohio 43130
Fairfield Medical Center
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Student Orientation Post Test
Name: _______________________
School: ____________________
Date: _______________
For questions 1-10 write the letter which matches the proper emergency code.
1. ____ Code Red
2. ____ Code Blue
3. ____ Code Black
4. ____ Code Green
5. ____Code Orange
6. ____Code Violet
7. ____Code Silver
8. ____Code Grey
9. ____Code Brown
10. ____Code Adam
A. Stay Away – Violence of hazard
B. Missing Adult
C. Large influx of patients, Emergency plan activated
D. Fire
E. Medical Emergency
F. Child Abduction
G. Severe weather
H. Person with weapon
I. Combative person
J. Bomb Threat
11.If there is an emergency in the hospital what number would you dial? _____________
12.What do the initials PASS mean?
P ___________________________________________________
A___________________________________________________
S___________________________________________________
S___________________________________________________
13. As part of the hospitals commitment to the “Patient’s First” ethic, you must respect a patient’s religious
and cultural belief’s or practices unless safety or medical necessity dictates otherwise?
True ___
False___
14. The type of event report that is used for visitors is? __________________________________
15. What is an example of a blood borne pathogen? ____________________________________
16. What color denotes that the patient is at high risk for falling? _________________________
17. List 3 dangerous abbreviations. _________________, ________________, _______________
18. We have the responsibility to report any suspected signs of abuse. No individual reporting abuse shall be
criminally liable for any report required or authorized by law unless it can be proven that a false report was
made and that the person knew that the report was false. True__________ False__________
19. It is the responsibility of any employee or student to keep all information about our patients and their
families confidential. True _________ False______________
20. Who is responsible for providing customer service for our patients and their families?
a. Physicians
b. Nurses
c. No One
d. Every One
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21. What are Universal Precautions? _________________________________________________________
22. If you have lost your coat at Fairfield Medical Center who would you go see to help locate it.
____________________________________________________________________________________
23. You are allowed to wear jeans and sandals at Fairfield Medical Center?
True_________ False ________
24. As a student you are allowed to park in the parking garage. True ______ False________
25. Are students allowed to use their cell phones on units that have patients? Yes____ No _____
26. You are allowed to smoke in the bathrooms at Fairfield Medical Center? Yes ______No _______
27. As a student, selling Avon while you are on duty is considered solicitation. Yes _____ No _______
28. What is the number to call the Center Police? ________________________________________
29. What is the Safety Hotline Number? ________________________________________________
30. A piece of equipment that you are using breaks. You should tell your instructor, manager of the unit, mark it as
broken and take it out of service. Yes______ No _______
31. In the event of a power failure the generators start up in how many seconds. ___________
32. _____________________ is the single most important procedure in Infection Control.
33. The two patient identifiers we use here at Fairfield Medical Center.
________________________ ________________________________________
34. Tattoos may be seen by our patients? No ____ Yes_____
35. How many piercings are you allowed to have when you work at Fairfield Medical Center. ________
36. What does TJC stand for? ____________ ________________________ _______________________
37. Personal Protective Equipment includes: select as many as apply
____ Goggles
____ Gloves
____ Gowns
____ Masks
38. – 40 I have read the student manual and will comply with the rules and regulations set forth. Non -compliance
may lead to dismissal from the Center.
_______________________________
Signature
______________________
Date
Signature ______________________
Date__________________
24
FAIRFIELD MEDICAL CENTER
STUDENT
SECURITY REQUEST FORM
(If Applicable)
Last Name
First Name
School/College/University
Medical Field
Middle Initial
FOR CLINICAL EDUCATION COORDINATOR TO FILL OUT
Security Access required for the following Applications ( Student Coordinator will approve and submit request)
Systems
Network Login
CPOE
Single Sign-On
Portal
Other_____________
Clinical Documentation
Inpatient Documentation (HED)
HSM - surgery
Other _________________________________________-
Clinical Education Coordinator ___________________________________Date________________________
SYSTEMS ACCESS SECURITY AGREEMENT(If Applicable)
I, __________________________________________________ have read, understood, and will comply with the following:
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(Last name, First name, Middle initial)
I am the only person authorized to use my password(s) and user ID(s).
I will not disclose my password(s) or user ID(s) to anyone.
I will not attempt to learn another person’s password(s)/user ID(s).
I will not attempt to access information by using a password(s) or user ID(s) other than my own.
I will retrieve or attempt to retrieve from the computer system only medical data that is directly related to the treatment of patients with whom I
have a clinical relationship or those patients for whom I have been asked to provide a consultation or for approved educational or research
purposes. I agree to maintain the confidentiality of all such patient data. I will access patient data only as required by my employment or medical
staff responsibilities or for approved educational or research purposes.
It is my responsibility to logout of the system. I will not, under any circumstances, leave a computer terminal to which I have logged in
unattended.
If I have reason to believe that the confidentiality of any of my password(s)/user ID(s) has been compromised, I will contact the Systems
Department immediately so that my password(s)/user ID(s) can be deleted and a new password(s)/user ID(s) assigned to me.
I will immediately report any known or suspected breach of the confidentiality of the system or records/data obtained from it to the Medical
Information Services manager.
I understand that my password(s)/user ID(s) will be deleted from the system when I am no longer employed or have privileges at this institution
or when my job duties do not require access to the medical record database. I will immediately report any such status change to the Systems
Department.
I understand my access will be automatically deactivated after 90 days of non-use.
I understand that medical records confidentiality is required by law, and that there are statutes specifically mandating the confidentiality of,
among other areas, mental health, HIV, and drug and alcohol-related treatment records.
I understand that any fraudulent application, violation of confidentiality or any violation of the above provisions may result in disciplinary action
from termination of access to the system or appropriate medical staff or University disciplinary measures up to and including termination of my
employment with the University or the hospital.
I understand that the Systems department maintains an audit trail of accesses to patient information that records the user, date, and patient
identification of all accesses to electronic medical records.
I understand that my access rights are subject to periodic review, revision and annual renewal.
NEW FOR 2012:
I will not attempt to connect any personal laptop, PC, or hand-held devices to the private hospital wired or wireless networks.
I will not attempt to alter any security software, filters, policy, or configuration on any hospital devices.
I will not load, install, or remove any software on a hospital device or on the Common Desktop without assistance or approval from the FMC
Systems department. (This includes screensavers and Internet toolbars).
I understand that I am absolutely liable for all activity that takes place under my credentials.
I understand that if I do not accept these restrictions of access I may be denied access or have access terminated to relevant computer systems and
networks.
Applicant Printed Name_____________________________________________________________________________________
Office/Department/Unit: _______________________
Title/Position:__________________________
Telephone Number: _____________________
For Students: Start Date______ __End Date________
Physician Preceptor______________________
E-Mail Address: _____________________________
________________________________________
Signature
_________________
Date
Supervisor or Office Manager of Person Approving Issuance of this Account:
Name___________________________________
________________________________________
Signature
Position______________________________
Telephone Number_________________________
__________________
Date
SYSTEMS ACCESS SECURITY AGREEMENT
26