Date: **/**/****

Target Audience: All Staff

Presenter: Department Heads/Managers

Learning Objectives/Course Description:

1.All staff must fill out a stop and watch form if there is a change for a patient (This includes abnormal vital signs, new onset of respiratory symptoms, any change in functionality, or any change in toileting, appetite, etc.) This form should be completed and given to the Unit Manager or a nurse.

2.Abnormal vital signs are to be reported immediately to a provider and a progress note is to be written

3.Any new onset of respiratory symptoms should be reported immediately to a provider and a progress note is to be written. Also the patient door should be closed until orders received from provider.

4.All required PPE is to be worn at all times within the facility.

5.If a staff member is having any symptoms as indicated on the facility screening form please do not come to the facility and report immediately.

1. Essential for assisting staff to achieve, enhance, or maintain competence to do their assigned job. Related to patient population, nature of care/service, healthcare advances, findings from performance appraisals, new equipment/technology, etc.

2. Required by an external accreditation, regulatory, or licensing agency (as required by JCAHO, OSHA, or State).

3. Related to findings from the hospital’s Performance Improvement Program indicating that a problem is related to staff knowledge or performance. (Findings from committees, peer review, etc.)

4. Driven by internal organizational standards or requirements. (Policies/procedures, job description, etc.).

Instructional

Lectures

Teleconference

Strategies:

Role-playing simulation

Self-study packet

(check all

Audio Tape

Skills Demo

that apply)

Computer Assisted Instruction

Video Tape

Evaluation of Program Effectiveness (i.e. changes noted as a result of this program:

.

I acknowledge that I have attended the above titled In-service presented by the instructor

Printed Full Name:

Signature:

Job Title:

License # (if applicable)