Policy

All Nebraska Urban Indian Medical Center staff will work to ensure that all facilities are operated in a clean and safe manner.

Procedure

 See  Disaster Plan Policy and Procedure Manual
 Fire Safety Policy and Procedure Manual  
Tornado Safety Policy and Procedure Manual  
Prescription Pad Policy and Procedure Manual       
Drug Sample Distribution and Storage Policy and Procedure Manual
Accident/Incident Policy and Procedure Manual       
Accidental Exposure to Patient Blood or Bodily Fluids Policy and Procedure Manual    
Disruptive, Emotionally Disturbed, and Inebriated Patient/Visitor Policy and Procedure Manual

 
Disaster Plan Policy and Procedure Manual

 Policy
All clinic staff will work to ensure that all facilities are operated in a clean and safe manner.

 Procedure

1. It shall be the responsibility of all staff members, at the supervision of the Clinic Manager, that all services
   are provided in a facility that complies with city, county, state, and federal building codes, fire prevention codes and occupancy codes. 

2. All appropriate licenses and permits shall be posted in a prominent space in each facility.

3. Lighting levels shall be adequately maintained.

4. Temperature and humidity shall be controlled and maintained.

5. Heating and air conditioning equipment shall be adequate and kept in good working order.

6. The plumbing system shall provide adequate hot and cold water, with proper drainage.

7. Attics, storage areas, and cellars are to be kept safe and free from accumulations of extraneous materials,
    such as refuse.  Combustibles, such as cleaning rags and compounds, are to be kept in closed metal containers.

8. The grounds surrounding the facility are to be kept free from refuse and litter.

9. Every effort must be made to control pests in the facility.  Harborages and entrances for insects and rodents must
    be eliminated.  Garbage and trash must not be allowed to accumulate and must be stored away from food
    or medical supplies.

10. All outside traffic areas must be kept free of ice and snow and other winter traffic hazards.

11. Fire and tornado emergency drill procedures are established and drills conducted monthly. 
     Fire protection equipment, including smoke detectors must be checked on a monthly basis.

Fire Safety Policy and Procedure Manual

Policy

Whenever the fire alarms sound, clinic staff will assist all clients and patients of Nebraska Urban Indian Medical
Center outside and away from the building.

 Procedure

1. STAY CALM!!

2. The receptionist will be responsible for calling 911.

3. All clinic staff will explain to the clients/patients what is happening in a reassuring and calm manner.

4. Staff will help mothers with small children and other clients/patients with mobility issues.

5. Staff will assist everyone outside and away from the building.  Everyone will meet at the southeast corner of the parking lot.

6. Staff will stay with the most fearful patients and provide assistance.

7. All persons will be dissuaded from reentering the building for any reason.

8. Staff members will act as a role model by maintaining a sense of calm.
9.  

 Tornado Safety Policy and Procedure Manual 

Policy

Whenever the sirens for tornados sound, clinic staff will assist all clients and patients of Nebraska Urban Indian Medical Center to the basement break room.

 Procedure

1. STAY CALM!!

2. The receptionist will lock the front door immediately, take the radio and flashlight and go to the basement break room area.

3. The rest of the staff will explain to the patients what is happening in a reassuring and calm manner.

4. The staff members will instruct everyone in the clinic at the time of the siren that there is an area to which all need to proceed to immediately.

5. All persons will be dissuaded about leaving the building.

6. The staff will help mothers carry small children and proceed to the basement break room.

7. If anyone has mobility issues, a staff member will take them in a wheelchair.

8. Transport as quickly as possible but not in a rushed manner.

9. All are to remain in the basement break room until the clear signal is given.

10. Staff will stay with the most fearful patients, and provide reassurance.

11. When all are in the basement break room, staff members will try to maintain a sense of calm, inviting all to listen to the radio or TV if there is electricity.  Staff are NOT to leave the basement break room and will act as a role model by staying calm and not going out the door.

12. When the all-clear signal sounds, staff will assist patients back to the clinic area and resume normal functioning.

Prescription Pad Policy and Procedure Manual 

Policy

Nebraska Urban Indian Medical Center shall keep all prescription pads under lock and key at all times.

 Procedure

1. All prescription pads will be kept only by health care providers (i.e. doctors, mid-levels) and the Clinic Manager and will be kept under lock and key at all times.  If a provider is in the facilities and it is observed that his/her prescription pad is accessible to patients, he/she will be reminded in a professional manner that the prescription pad needs to be secured.  The second time, the provider may be reprimanded according to the NUIMC employee personnel handbook.

2. Any NUIMC staff who remove prescription pads or slips or who assists patients or visitors in removing pads or slips will be subject to disciplinary action which may result in termination.

Drug Sample Distribution and Storage Policy and Procedure Manual

 Policy

Nebraska Urban Indian Medical Center shall keep all drug samples under lock and key at all times.  Drug samples will be obtained from drug company representatives and will be dispersed at the discretion of the health care provider.

 Procedure

1.      Drug samples may be given to patients at the discretion of the health care provider.

2.      Health care providers may choose to give drug samples to patients who are uninsured or have a low household income.

3.      Drug samples will be stored in a securely locked room at all times, not accessible to patients.  Personnel having access to this drug sample room are limited to health care providers and the Clinic Manager.

4.      A list of all drug samples will be maintained in a secure place.  The Clinic Manager will be responsible for maintaining the list.

5.      The list will be reviewed, on a monthly basis, against dispersal records in order to determine if any drugs are not accounted for.

6.      If it is found that drugs are unaccounted for, the Medical Director will be notified immediately.  The Medical Director and the Clinic Manager will review the current policies and procedures for drug sample storage and disbursement and make the appropriate changes.

7.      If it is found that an employee(s) is taking drug samples from the drug sample room without the health care provider’s authorization, the employee(s) will be subject to reprimand in accordance to the NUIMC Employee Handbook, which may include termination.

8.      Drug samples will be distributed according to Nebraska state laws.

Accident/Incident Policy and Procedure Manual

 Policy

An incident report form shall be completed by the appropriate staff involved when an accident or incident occurs at Nebraska Urban Indian Medical Center.

 Procedure

1. An accident or incident will be documented within one working day on an Incident Report Form by the appropriate staff involved or made aware of the situation.  If necessary, supporting documentation, including a treatment plan, will be attached.

2. The Incident Report form, upon completion, will be presented to the Clinic Manager and the Executive Director, for review of the incident, action taken, and any follow-up that is proposed or which may have occurred as a result of the incident.

3. Examples of accidents may include, but are not limited to falls, cuts, and bruises incurred in the facility.  Incidents may include, but are not limited to patient complaints, errors in diagnosis, incorrect administration of medication, disturbed, unruly, abusive or violent patients or visitors.

4. Completed forms will be kept on file for review and reference to possible future occurrences.

Accidental Exposure to Patient Blood or Bodily Fluids Policy and Procedure Manual

 Policy

In the case of an employee’s (or other patient’s) accidental exposure to patient blood or bodily fluids, the incident will be documented on an incident report form and the appropriate action taken.

 Procedure

1.         In the case of an employee’s (or other patient’s) accidental exposure to patient blood or bodily fluids, the Clinic Manager will be notified immediately.  If the Clinic Manager is unavailable, the Medical Director will be contacted.

2.         The Clinic Manager will instruct another nursing support staff member or health care provider to cleanse and dress the wound appropriately.

3.         The appropriate labs will be drawn on the employee (or patient).  These labs may include a Hepatitis C and HIV panel.

4.         The cost of these labs will be absorbed by NUIMC and/or the employee’s (or patient’s) private health insurance.

5.         The incident form will be completed as soon as possible, by the close of the business day.  The incident form will include time, date, incident description, follow-up action, and possible prevention methods for future incidents.  The incident form will be signed by the employee (or patient) and the Clinic Manager, and will be forwarded to the Executive Director.

6.         If a positive diagnostic response is received, appropriate medical action will be coordinated by the Medical Director and the employee.

7.         The incident form will be kept on file for review and reference to possible future occurrences.

 Disruptive, Emotionally Disturbed, and Inebriated  Patient/Visitor Policy and Procedure  

Policy

All facilities will be operated in an orderly and safe manner.  Any behaviors which threaten or place the patients and/or staff in any type of jeopardy will not be tolerated.

 Procedure

1. If a person enters the facility and appears to be inebriated or under the control of a substance, that person will be asked to leave the facility immediately.  Attempts will be made to get the person to leave in a peaceful manner.  If the person is reluctant to do so or does not leave within five minutes, the police will be immediately summoned.  If it is safe, the person will be advised that the call is being made.

2. If the person appears to be disoriented and has a provider, the provider will be called.  If the person does not have a provider, the police will be called.

3. The incident will be immediately reported to the Clinic Manager.

4. The Clinic Manager will complete an Incident Report Form within one working day.

5. In all cases, the health and safety of patients and staff will be considered when determining which action to take.