Student/ Instructor Orientation
JCAHO and OSHA require that all students and clinical instructors participating in clinical activities at Baptist
Health Paducah or on the hospital campus complete student/instructor orientation.
To fulfill this requirement please take time to:
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Read the enclosed information
Ask your instructor or contact Andrea Williams, Baptist Health Paducah student coordinator, to
explain any information that you do not understand
Complete and return the first four pages to your instructor or Andrea Williams:
1. Validation of Completion
2. Statement of Understanding
3. Clinical Informatics Statement of Understanding – only for those students using clinical
information systems for documentation or medication administration.
4. Evaluation Comments
All Students and Instructors will receive a Baptist Health Paducah badge. Students with instructors in the
building will receive their badge from their instructor. All other students must come to the Education
Department to receive a badge. Students and Instructors must wear the badge at all times.
For questions, please contact:
Andrea Williams, RN, BSN
Education Instructor/Student Placement
Education Department
Baptist Health Paducah
2501 Kentucky Ave.
Paducah, Ky. 42003
270.575.8370 phone
270.575.2251 fax
andrea.wiliams @BHSI.com
BaptistHealthPaducah.com
Validation of Completion / Clinical Student Orientation
Please read all written materials. Ask your instructor to explain any information that you do not
understand.
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Read and sign “Statement of Understanding” (Requires witness signature)
Read and sign “Clinical Informatics Statement of Agreement” (if applicable)
Baptist Health Paducah Mission & Vision Statement
Emergency Codes
Safety Information – General, Fire and Radiation
Fall Risk
Infection Control
Assessing and Managing Pain
Population Specific and Cultural Awareness
HIPAA: Privacy, Security and Confidentiality
Federal False Claims Act
Patient Rights and Ethical Concerns
Dress Code and Artificial Fingernails
Parking Diagram
I have read and understand the Baptist Health Paducah Student Orientation information. All of my
questions have been answered satisfactorily.
Print Name:
Signature:
Date:
School: ___________________________________________________________
Major/Program:
Please Return This Page
Page 1
STATEMENT OF UNDERSTANDING
I, ____________________________________________, by signing this Statement of Understanding, do hereby
represent that I have read and understand the following:
1.
The program in which I am enrolled requires a period of assigned guided clinical experiences in
facilities other than school.
2.
The clinical experiences will be assigned for their educational value. Thus, I will not be entitled
to any wages, workers' compensation or other benefits, either from the School or from the Hospital.
3.
While in the hospital facility, I will conduct myself in accordance with its rules, policies,
procedures and regulations. Further, I will be subject to the supervision of both Hospital personnel and the
School faculty.
4.
I understand that neither the Hospital nor the School is responsible for injuries which I incur
solely as a result of my own negligence. I acknowledge that the School has encouraged me to acquire
personal medical and hospitalization insurance.
5.
I have read and agreed to the School's policies, rules and regulations related to the program for
which I have enrolled.
6.
I understand that information regarding patients or former patients is confidential and is to be
used only for clinical purposes. I agree to maintain permanently the confidentiality of all patient information
obtained during my clinical experience.
7.
I understand that the educational experience in which I am involved will in no way entitle me to
a job at the Hospital.
8.
I understand that any action on my part which is not fully consistent with the above statements
may warrant removal from the clinical experience at the Hospital.
I have read and understand the above statements and accept them as conditions of my enrollment and
participation.
Date: _________________
________________________________
Student
________________________________
Witness
PLEASE RETURN THIS PAGE TO YOUR INSTRUCTOR
PG 2
Baptist Health Paducah
Clinical Informatics Statement of Agreement
Login in username and password:
Your login information including username, password and PIN numbers, as applicable are confidential and
should not shared or used by anyone else. You are not to use another person’s login; doing so will result in
your account being terminate. This applies to instructors and students. This applies to access to all computer
systems. HIPPA and Privacy rules apply to all patient information.
If you are a Baptist Health Paducah employee and attending school, use your school account when functioning
as a student or instructor. Employee accounts are to be used only when working for Baptist Health Paducah.
Security and privileges are different for students and instructors versus employee privileges.
Any problems accessing the network or clinical applications should be reported to the Help Desk at 2730.
Inform the Help Desk you are a student and to please page the on call Clinical Informatics staff person. You
will receive a call from Clinical Informatics to help you.
All Students:
Agreement Statement
I have received the above instructions. I agree to follow the above instructions. I understand that my account
may be terminated if I allow another student or instructor to use my login or if I violate any of the above
instructions
Name: PRINT _____________________________________
Signature: _________________________________________
Date: ____________
School and Program: ____________________________________________________
Medication Administration – applies only to Nursing and Respiratory Therapy students
Students and instructors will receive a medication administration badge with a bar code. Each badge is specific for one
student. Instructors will pass out badges at the beginning of the shift and collect badges at the end of the shift. Students
are not to take their medication administration badges home.
Neither students nor instructors have the security to verify or create an order. Nursing or Respiratory staff will need to
verify and create all orders.
Neither students nor instructors can administer a non bar coded medication. Staff must administer medications that are
not bar-coded. There is never a reason for a student or instructor to give a non bar-coded medication.
If a medication bar-code does not work or an unusual message pops up, such as “Dose Mismatching”, notify the Help Desk
at 2730 and ask them to page CIT for assistance.
Students cannot be a witness for insulin drug dose calculations and administration. Only exception is during the
120-hour practicum.
I understand and agree to follow the instructions specific to medication administration and use of HARx. _______ (initial)
PLEASE RETURN THIS PAGE TO YOUR INSTRUCTOR
PG 3
Student Orientation Evaluation/ Comments
At Baptist Health Paducah, we want you to have an exceptional clinical experience. We ask that you please
complete the following questions.
What did you like best about the training materials?
What did you like least about the training materials?
What suggestions do you have for improvement?
Are there other topics on which you would like more information?
Please return this page.
Page 4
Mission
The mission of Baptist Health Paducah is to exemplify our Christian heritage of providing
quality healthcare services by enhancing the health of the people and communities we
serve.
Vision
The vision of Baptist Health Paducah is to be nationally recognized as the healthcare
leader in western Kentucky.
Values
Baptist Health Paducah will live out its Christ-centered mission and achieve its vision
guided by:
Respect
Stewardship
Excellence
Integrity
Collaboration
Safety Procedures
Emergency Phone Number: 2111
Security Phone Number: 2644
Summary of Emergency Codes– can be found on the
Multi-colored Safety Kardex located on bulletin boards in areas.
Emergency Code
Emergency Situation
Code Blue
Cardiac and Pulmonary Arrest
Call 2111 when you
are the first to
recognize pulmonary
or cardiac arrest
Code team consists of:
1. Physician
2. RNs from CCU, ICU and Telemetry units.
3. Respiratory Therapists to intubate the
patient as needed.
Medical Emergency Response Team
MET team
Notify staff when
you recognize a
significant change in
the patient
Code STROKE
Patient condition changes and immediate
assistance is needed. The patient is still
breathing and has a pulse.
Notify staff when
you recognize the
signs and symptoms
of stroke
F=Face – Facial droop? Uneven smile?
A=Arms – arm numbness? Arm weakness?
S=Speech – Slurred speech? Difficulty
speaking or understanding?
T=Time – Report findings to staff
immediately
Patient reports chest pain
Cardiac Alert
Notify staff if patient
tells you they have
chest pain
Code Red
Call 2111 and pull
fire alarm when
smoke or fire is
present
The first three
minutes of a fire are
more important than
the next three hours
Code Yellow
External Alert
Overhead page
Code Yellow
External
Stroke
Patient’s condition warrants expert
assessment on acute cardiac syndrome
(ACS)
Fire or Explosion
In a Fire you need to - R.A.C.E.
(Remove, Alarm, Contain, Extinguish)
To use an Extinguisher – P.A.S.S.
(Pull pin, Aim, Squeeze, Sweep)
Classes of Fire Extinguishers
Class A = ordinary combustibles, paper,
cloth or trash
Class B = flammable liquids such as gas, oil
and solvents
Class C = Electrical source
External Disaster
Casualties expected to arrive at the
hospital.
External Disaster
Casualties are arriving at the hospital
Overhead page
Employee Response
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Call 2111 if you find someone not
breathing. State “Code Blue and
location”
Initiate CPR
See policy: D14.4-WBH: Allow Natural
Death (AND/DNR)
 Report findings to staff IMMEDIATELY
 Staff will call MET team
See policy: M5.1-WBH: Medical
Emergency Team (MET)
 Report findings to staff IMMEDIATELY
 Staff will call Code Stroke
See Policy: C15.3-WBH: Code Stroke
Team
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Report findings to staff IMMEDIATELY
Staff will call Cardiac Alert
See Policy: C1.7-WBH: Cardiac Alert Team
 Do not use elevators.
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Know location of alarm pulls and
extinguishers – alarm pulls by
exits
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Know fire zone(s) for your
department
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Close all doors in area
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Touch a closed door before opening
– if warm or hot to touch – DO NOT
open
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The charge nurse or department
supervisor will give you instructions
if any action is needed.
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The charge nurse or department
supervisor will give you
instructions if any action is
needed.
Code Yellow
Internal
Overhead page
Internal Emergency
A situation that has a negative effect on
patient care. Example: no water or
electricity Building damage during storm
Code Amber
Call 2111 when you
are the first to know
of missing baby or
child
Tornado Watch/
Warning
Overhead page
Baby or Child Abduction
Child is missing.
Tornado
Watch = conditions are right for a tornado
Warning = tornado has been sighted
Code Black
Call 2111 if you
receive the call or
message of a bomb
in the building
Code Grey
(combative person)
Code Silver
(Weapon/workplace
violence)
Call 2111 if you feel
threatened
Code White
Overhead page
System Failure
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Bomb Threat
Be aware of surroundings. Report people
behaving strangely, boxes, bags,
equipment that should not be in area.
The charge nurse or department
supervisor will give you
instructions if any action is
needed.
 All departments observe exits and
stairwells in their area when code
is paged
 Pay attention to all exits and or
unusual behavior.
 Call Security, 2644 for unusual
behavior
 Watch = move away from windows
 Close blinds or curtains on windows
 Close all doors
 Be prepared to seek shelter.
 Warning = Move patients to
internal hall, away from glass.
 Cover patients that cannot be moved
with blankets and pillows, pull
curtain around bed
 Keep caller on phone and get
details.
 Contact Security, 2644.
 Do not touch strange packages,
letters or packages
Security Assistance
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Assistance is needed immediately for the
personal safety of yourself, staff or
patients.
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Call 211, state “Code Silver” and
location if weapon is involved
Evacuation
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The charge nurse or department
supervisor will give you
instructions if any action is
needed.
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Inform charge nurse or
department supervisor of any
problems with systems
Involves the evacuation of an area due to
fire or other disaster.
Electricity, computers, dictation system,
water, phones go out
Call 2111, State “Code Grey and
location for combative person,
patient or visitor
Safety Information
Policies and Procedures listed in this orientation packet can be accessed online. Please ask the
charge nurse or department supervisor to demonstrate how to access Policies and Procedures.
Patient Identification
Always use two patient identifiers
1. Patient Name
2. Date of Birth
 Must have a label, order or computer screen to verify the patient has been identified
correctly
 Room number is never an identifier
Use two identifiers for:
 Documentation – computer and paper forms
 Specimen collection
 Medication administration
 Diagnostic testing
 Transporting to/from other departments
 Treatments
 Adding results, forms, blank orders to chart
 Passing food trays
Patient Arm Bands
Place all armbands on the same arm
White: Patient Identification
Name, birth date, hospital number, admitting physician, admitting
date and time
Red: Allergies
The red arm band will indicate no known allergies (NKA) or
ALLERGIES will simply be stated. The full list of allergies will be in
the EMR.
Purple: Allow Natural Death
Indicates patient is not to receive CPR, intubation or medications in
the event of a cardiac or respiratory arrest. If the patient desires a
limited code, write the limitations on the purple armband.
Example: No intubation – this indicates that the patient wants to
have CPR and medications, but no intubation.
Yellow: Risk for Falls
Indicates patient is at risk for falls and requires assistance with
ambulating. Attach a “star” to the room door by a magnet
indicating the patient is at risk for falls. Two stars on the door
indicate the patient in bed two is at risk for falls.
Pink: Blood
Indicates lab work has been drawn for the patient to receive blood
products.
Material Safety Data Sheet (MSDS)
 You have the right to know about all chemicals and other hazards in your work area.
 Material Safety Data Sheets (MSDS) are available for all chemicals used in the hospital.
 The MSDS contain information about how stable the chemical is, hazardous
ingredients, spill or leak procedures, special protection needed, fire or explosion
data, health hazards and special precautions.
 The MSDS are available on the Intranet.
 Please ask the charge nurse or department supervisor to demonstrate how to access
the MSDS database.
Security Department -- Ext. 2644
 Notify the Security Department of any suspicious activity or security concerns.
 Security can provide the following services:
 Escort to vehicles
 Jump batteries
 Air flat tires
Visitor Safety
 Notify Security of any accidents by visitors. Call extension 2644.
 Do not tell visitors to go to the Emergency Room, it is their decision, not yours, to
decide if they need emergency care
Smoking
 Smoking is not permitted except for designated outside areas.
 Notify staff if patients or visitors violate this policy
Laboratory/Medical Equipment
1. Use of laboratory/medical equipment requires the Practitioner to:
a. Know the capabilities, limitations and special application(s) of equipment
b. Know basic operating and safety procedures for equipment use
c. Know emergency procedures in the event of equipment failure
d. Know process for reporting Medical Equipment Management problems, failures
and user errors
2. Problems with laboratory/medical should be reported to the charge nurse or department
supervisor. The equipment will be tagged with an orange sticker and Biomedical
Engineering will be notified of need to repair.
3. An incident report must be completed if an actual injury or a potential for injury exists
due to failure of the equipment (potential FDA reporting as part of the Safe Medical
Device Act).
Reporting and Investigating Incidents and Accidents
Risk Manager: Meri Curtis, ext. 2228
Patient Safety Officer: Randy Perrin, ext. 2980
Environmental Safety Officer: Sheena Richardson, ext. 2556
Communication between caregivers has been determined the Number 1 cause of incidents and accidents in the hospital
setting. Open, honest and respectful collaboration between caregivers is expected and fosters a culture of patient safety.
The Risk Manager and/or Hospital Safety Officer review and investigate accidents that cause, or have the potential to
cause: injury (patients, visitors or staff), property damage or harm to the environment. Investigations may be conducted
singly or with assistance from directors, supervisors or a committee of experts. Incident and accident data is collected and
reviewed monthly to identify cause and trends. There are four forms to report problems, failures and incidents. Ask the
charge nurse or department supervisor to obtain these forms when needed.
1.
2.
3.
4.
Potential Risk/Hazard Report: used to report hazards in the workplace
Risk Occurrence Report: used to report incidents involving patients, such as falls or injury from medical devices.
Medication Event Report: used to report incidents that involve medications or equipment that delivers medication.
Employee Incident Report: used to report body fluid exposures. Baseline testing will be provided at the time of
exposure.
Contact Hospital Risk Manager to discuss unplanned events during patient hospitalization. Early investigation and
determination of the root cause of the event takes place for serious or critical events. The Risk Manager will work with
the physician to assure the patient is aware of the event and the investigative process.
A root cause analysis is performed at the direction of BHS Counsel and Baptist Health Paducah Defense Counsel in
order to maintain attorney client privilege. Initially after an event, the risk investigation occurs with the participants
singly. After statements are obtained, the individuals involved in the event will meet together to identify the issues
and determine appropriate measures to prevent future occurrences.
A root cause analysis answers questions such as:
What area/service was impacted?
What are the steps in the process?
What human factors were relevant to the event?
How could equipment performance affect the outcome?
What controllable factors directly affected the outcome?
Were there uncontrollable external factors? (i.e. power outage / lightening/ flooding)
Is staff properly qualified and currently competent for their responsibilities?
How did actual staffing compare with ideal levels?
When the root cause(s) of the event is determined, quality indicators are determined, implemented, and monitored for
effectiveness.
Fire Safety
Prevention – Good housekeeping is the best guarantee against fires. Be vigil for fire hazards and report
immediately. Always keep corridors, doorways, entrances and exits clear of obstructions. Do Not wedge
doors open. Carts and other items in the hall must be on the same side.
Preparation – Know the location of all fire extinguishers. Know the location of all fire alarm pull stations.
Know the location of all exits from the facility.
Response – Activate the nearest fire pull station when a fire is identified. Call 2111 and announce a Code Red
and location. Alarm system will automatically signal the Fire Department.
Plan Easy – Evacuate only per supervisors direction. Always evacuate horizontally and then vertically per
instructions.
Remember:
 Panic is the greatest danger in most fires.
 Feel for heat before opening doors. If heat is present, do not open door!
 Avoid alarming patients and families with excited motions.
 Never shout fire!
 Appear calm but efficient, and move with assurance since patients and families look to you for
protection and information.
 The first 3 minutes of a fire are more important than the next 3 hours.
R.A.C.E. Into Action
Remove anyone who might be in immediate danger
Activate alarm at pull station.
Confine fire and control ventilation
Extinguish using proper extinguisher
P.A.S.S. The Fire Extinguisher
Pull the pin.
Aim at the base of the fire.
Squeeze the handle on the extinguisher
Sweep back and forth at the base of the
fire
Types of Fire Extinguishers
Class A Extinguishers will put out fires in ordinary combustibles, such as wood and paper. The symbol on
the extinguisher will look like one or both of these.
Class B Extinguishers should be used on fires involving flammable liquids, such as grease, gasoline, oil, etc.
The symbol on the extinguisher will look like one or both of these.
Class C Extinguishers are suitable for
use on
electrically energized
fires. The presence of the letter “C” indicates that the extinguishing agent is non-conductive. The symbol on
the extinguisher will look like one or both of these.
Multi-Class Extinguishers: Many extinguishers available today can be used on different types of fires and
will be labeled with more than one designator, e.g. A-B, B-C, or A-B-C. Make sure that if you have a multipurpose extinguisher it is properly labeled.
Symbols may be crossed out it not applicable. Be familiar with the capabilities of each fire extinguisher in
your department.
Baptist Health Paducah
Radiation Safety
1. Baptist Health Paducah has ONE radioactive materials license.
 The license is for all radioactive materials used at this facility.
To maintain the license, we must agree to follow the regulations provided by the Kentucky Cabinet for
Health Services, which is the agency that issues the radioactive materials license.
2. Radioactive material is used in the following areas:
 Nuclear Medicine, Radiation Oncology, 6C, Outpatient, 2C, Cardiology and Surgery departments.
Radioactive materials are stored in:
 The Nuclear Medicine hot labs--There is a hot lab in the hospital and one in the heart center.
 The HDR room used by Radiation Oncology
 The isotope closet in Radiation Oncology
 The decay storage closet located in the stairwell beside the Smoking Area in the vicinity of Radiation
Therapy.
Some radioactive materials are sterile when received on site; others are not and have to be sterilized in:
 Central Sterile Processing
Patients containing radioactive material are cared for in:
 Rooms on 2C, 6C (patients with radioactive sources or I-131) and in the Outpatient Department. They
will have radioactive material signs posted on their doors and charts.
Machines that produce radiation can be found in:
 Radiation Oncology, Radiology, Surgery, Endoscopy, Cardiac Cath Lab and ER. Portable units may be
used in various areas of the hospital.
3. Hazards associated with working with radiation falls into two categories:
 External exposure from radioactive sources or radiation producing machines.
 Internal exposure from contamination ingested from radiopharmaceuticals.
Long term exposure to radiation could cause the development of cancer, cataracts and cell mutation that
could affect future offspring. However, when materials and machines are used properly by employees and
when appropriate rules and regulations are followed, either type of exposure to hospital employees should
be very low.
4. If you do not work with radiation producing machines or use radioactive materials:
 There are no radiological safety procedures with which you need to become familiar
Never tamper with any radiation producing machines or any materials labeled as radioactive.
Recognize This Sign And What It Means!
5. If your job requires you to work on or around any of these machines or material, practice these three
techniques to reduce your radiation exposure while working:
 Time- Complete your task around radiation as quickly and safely as possible.
 Distance- Stand as far from the source of radiation as is reasonable to do your job.
 Shielding- To protect you from external exposure, wear lead aprons when being exposed to scattered
radiation. If you are working very close to the machine beam or source of radiation, wear a thyroid
collar and leaded glasses. Consider using barriers such as the control booths in the x-ray rooms,
portable shields and walls as additional means to shield you from radiation exposure.
All individuals working with or around radiation or radioactive materials are required to wear a dosimeter (in
addition to any personal protective equipment required such as a thyroid collar and lead apron). Dosimeters
are required by the State of Kentucky per 902 KAR 100:019 Standards For Protection Against Radiation. This
regulation applies to students and faculty. Wearing a dosimeter badge does not protect you from radiation. It
records the exposure you actually receive.
Schools assigning student dosimeters should instruct students to wear dosimeters during clinical
rotations on the Baptist Health Paducah campus. Baptist Health Paducah is not responsible for
supplying, monitoring, or tracking student dosimeters. If the school does not provide a dosimeter to the
student, the student will not be allowed to work with or around radiation or radioactive materials while
on the hospital campus, which includes the Baptist Imaging Center (BIC). The hospital does supply
personal protective equipment for student use when on hospital campus.
A student dosimeter is required for student access to the following areas/procedures/patients:
 BIC and Radiology routine exam and fluoro rooms
 Nuclear Medicine procedure areas including Nuclear Stress Testing in Cardiology
 Speech Therapy dysphasia studies
 Radiation Oncology treatment rooms, High Dose Rate Afterloader (HDR) room and Outpatient I-131
therapy
 Endoscopy, Cardiac Cath, or Surgery procedures requiring imagining or the use of radiation or
radioactive materials
 Any radioactive posted area including but not limited to the Nuclear Medicine hot labs, the Oncology
source closet and the decay storage closets.
 Inpatients with radioactive implants containing I-131 or Cs-137.
 Patients requiring manual assist ventilation with a Ambu bag during imagining procedures
6. KAR regulations state that you may not eat, drink, or apply cosmetics (including lotions) in any area where
radioactive material is being used.
7. If an emergency situation exists in any of the areas where radioactive materials or machines are or have
been used:
 Distance yourself as much as possible from the machine or materials
 Report the condition to the area supervisor and your supervisor, if different
8. As a student you have an obligation to report any unsafe or suspected unsafe conditions or practices as
they relate to radiation safety. These may be reported to the Radiation Safety Officer (RSO) or designee
(Radiation Safety Consultant) either directly or through your supervisor. If you are not certain whether a
condition or practice is unsafe, contact the RSO or designee to evaluate the situation.
9. Notices, copies of pertinent regulations, and copies of pertinent licenses and license conditions (including
applications and applicable correspondence), as required by regulation 902 KAR 100:165 are located in the
Radiation Safety Office located in Radiation Oncology. The Radiation Safety Officer (RSO) is Robert Gandy
and his phone number is 575-2763, ext. 2763. The Designee, Radiation Safety Consultant Renee’ Balkey, is
also located in Radiation Oncology at ext. 7132, phone number 415-7132.
10. ALARA means as low as reasonably achievable. This is a concept that applies to radiation safety. Our
facility is required to practice ALARA principles in our procedures involving the use of radioactive
materials or radiation producing machines. It means that we are to do everything reasonable to keep
radiation exposures as low as possible.
At Baptist Health Paducah, the management, the Radiation Safety Committee (RSC) and the RSO are
committed to implementation of the ALARA concept. If at any time, you have a concern about whether or
not ALARA principles are being applied, you may contact the RSO or a member of the RSC about these
concerns. If your concerns are not sufficiently addressed after contacting a committee member and the
RSO, then your next step is to contact the Radioactive Materials Section of the State Cabinet for Health
Services.
Members of the Radiation Safety Committee (RSC):
Teresa Cash
Robert Gandy
Mike Tutor
Dr. Shields/Dr. Adams
Dr. Locken/Dr. Triplett
Mary White
Kim Cromwell
James Waters
Director Cardiac Cath
Radiation Safety Officer
Director of Radiology
Radiologists
Radiation Oncologists
Clinical Manager, 2C Medical Oncology
Surgical RN
Regional Executive Service Line Development
11. Exposure of pregnant occupational workers is of special interest. This is because the human fetus and
small children are more susceptible to the harmful effects of radiation.
Occupational workers are those workers who work with radiation and are considered having the possibility
to receive enough exposure from their work to require monitoring by wearing a dosimeter badge and/or
ring badge.
At Baptist Health Paducah, if an occupational worker declares her pregnancy in writing to the RSO, the RSO
or designee will:
 Give the worker an inservice concerning pregnancy and working with radiation.
 Assign a dosimeter badge for monitoring the fetus.
 Review the worker’s dosimeter readings monthly to determine the exposures to the declared pregnant
worker does not exceed 50 mRem/month or 500 mRem for the term of the pregnancy.
Declaration of pregnancy in writing is the prerogative of the occupational worker and is not mandated by
any regulations pertaining to radiation safety or radioactive materials use. However, if the pregnancy is not
declared in writing, the state does not require the pregnant employee be monitored and exposures
reviewed.
Fall Prevention
All patients should be considered a falls risk upon admission and Standard Fall
Precautions should be implemented. When a patient has been identified to be at risk for
falls based upon nursing assessment, physician’s evaluation or other supporting clinical
documentation, High Risk Fall Precaution strategies should be considered.
Comprehensive interventions should be included in the individualized plan of care.
DEFINITIONS:
 A fall is a sudden, uncontrolled, unintentional, downward displacement of the body to
the ground or other object, excluding falls resulting from violent blows or other
purposeful actions.

A near fall is a sudden loss of balance that does not result in a fall or other injury. This
can include a person who slips, stumbles or trips, and is eased to the floor, bed, chair,
etc. by staff or family members.

An unobserved fall occurs when a patient is found on the floor and hospital or medical
staff does not witness the event or when the patient reports a fall not observed by
anyone.
PROCEDURE:
1. Ensure patient needs can be communicated (i.e. HOH, speech deficiencies, etc.) and
provide alternatives whenever possible.
2. All hospital patients are considered to be at risk for falls and are to be placed on the
following Standard Fall Precautions:
a. Orientation to room and call light use.
b. Bed in low position, wheels locked.
c. Room free of clutter and spills.
d. Personal items within reasonable reach (telephone, call light, bedside table, water,
eyeglasses, urinal).
e. Adequate lighting.
f. Encourage patient to call for assistance when help is needed.
g. Patient/family education on falls precautions: The program is explained to the
patient and/or family and documented using the Logicare teaching sheets. A copy is
given to the patient and/or family for signature and placed in the patient chart. A
second copy is given to the patient/family.
h. Document fall precautions teaching/ education.
3. Nursing should screen all conscious patients for High Risk Fall Precautions utilizing the
Falls Risk Assessment Tool on admission, upon transfer to another unit, change in
patient status, and at least every 24 hours thereafter.
4. The Falls Risk Assessment Tool consists of two sections:
a. Section I has 4 indicators for strict fall precautions: Rehabilitation, Falls, Mental
Status, and Mobility. If “yes” is selected on any one category in Section I it would
qualify a patient for High Risk Fall Precautions and nursing does not need to
complete Section II of the Falls Assessment tool. If nothing is selected in Section I
then Section II must be completed.
b. Section II consists of 4 secondary qualifiers: Symptoms and/or Diagnoses,
Elimination, Medications, and Environment. If “yes” to any 2 of the secondary
qualifiers in Section II are selected I would qualify a patient for High Risk Fall
Precautions.
5. The patient is identified as being "high risk" for falls by the application of a yellow
wristband; a "star" is placed on the patient's door to notify all staff that this patient is on
High Risk Fall Precautions. A single star for bed one or private room and a double star
for bed two.
6. In addition to the Standard Fall Precautions, patients who are placed on High Risk Fall
Precautions should be assessed/ considered for the following interventions:
 Need for a staff member to remain with the patient when assisted to the bathroom or
bedside commode.
 Consult needs for Physical Therapy, Occupational Therapy, and discharge planning.
 Offer assistance for toileting every 2 hours while awake especially upon awakening, at
bedtime, and before and after meals.
 Need for “prompted” toileting schedule.
 Staff rounds on patients every hour 0600-2200 and every two hours 2200-0600.
 Use of bed alarms.
 Placement close to nurses’ station.
 Use of non-skid footwear.
 Use of assistive devices/gait belts as indicated.
 Assess need for family placement or family provided sitter.
7. The patient’s physician is to be notified after each fall. Obtain physician's order if
restraints are needed for patient safety in accordance with policy, R5.8-WBH, Restraints –
Physical for the Medical/Surgical Patient and the Behavioral Management Patient.
8. Fall prevention interventions are documented in the EMR – electronic medical record
(HED).
9. An on-line patient risk occurrence report will be completed by the staff nurse if the
patient experiences a fall, near fall, or unobserved fall while hospitalized. The medical
record documentation will include but is not limited to, the condition of the patient and
injuries sustained, vital signs, contact to physician and orders received for treatment, if
appropriate. Consideration should also be made to notify the patient’s family. The
patient will be placed on High Risk Fall Precautions at that time. The patient fall and
subsequent orders/treatment will be communicated to the next shift via report.
10.
High
Risk Fall Precautions should be marked on the Plan of Care under the Activity /Safety
Problem.
11.
The
High Risk Fall Precautions may be discontinued by the RN/LPN when the patient has 0
identified fall indicators in Sections I and II for 48 consecutive hours and has not had a
fall during the past 3 months. The yellow alert bracelet and the fall risk "star" will be
removed at that time.
INFECTION CONTROL
Susan Wurth, MSN, APRN, CNS-BC
Infection Preventionist
- Ext. 2506
Nights/Weekends- contact hospital operator to call at home
I.
Infection Prevention Measures
A.
Handwashing—Always wash hands before donning and removing gloves
1.
When hands are NOT visibly soiled but are contaminated, they should be
decontaminated with an alcohol based hand rub (rub hands until alcohol solution has dried).
Situations include:
 Before direct contact with patients
 Before donning and removing gloves for an invasive procedure (i.e., starting and IV, Foley) or
patient/catheter care
 After contact with a patient’s intact skin (i.e., taking a blood pressure, lifting patient)
 After contact with body fluids, excretions, mucous membranes, non-intact skin, or wound
dressings
 After moving from a contaminated body site before moving to a clean site
 After contact with equipment or objects in the immediate vicinity of the patient
 After removing gloves
2.
When hands are visibly dirty or soiled – wash hands with soap and water (can be regular soap or
antimicrobial soap). Soap should have contact with the skin for at least 15 seconds before
rinsing. Also, use soap and water for these situations:
 After using the restroom
 Before eating
 When caring for patients with diarrhea
Special Note: Soap and water should be used anytime a patient is suspected of having an infection from
a bacteria that forms a spore. Spores are not killed by alcohol but can be loosened from the skin and
washed off by soap, water, and mechanical scrubbing. This patient should be in CONTACT
PRECAUTIONS with the sign on the door.
 Clostridium difficile (C diff diarrhea)
 C. perfringens – (gas gangrene wound infections)
 Bacillus anthracis or (Anthrax)
B.
Standard Precautions
 Standard Precautions should be followed by all employees, volunteers, etc.
 All persons are considered infectious regardless of their diagnosis, age, race, gender, job, or
economic status.
 Use of barriers is determined by task or situation.
 All body fluids or substances are considered potentially infectious.
1.




2.

Wear the correct barrier when contact with a body fluid can be predicted.
Wear gloves for: hand contact with above fluids, mucous membranes, non-intact skin,
contaminated equipment, articles, linen, biohazard trash, specimens, to draw blood, change
wound dressings, start IVs, etc.
Wear gowns when: potential contamination of clothing is likely.
Wear masks when: potential aerosol contamination may occur.
Wear eyewear when: potential splash or spray may occur to the face. (A face shield or mask &
goggles will cover all mucous membranes.)
When a body fluid contact was not predicted, use soap and water.
Wash hands, arms, or exposed skin with an antimicrobial soap for 15 seconds and rinse well.

Examine the skin for cuts or injuries, if the skin is not intact, it is a body fluid exposure





When clothes are contaminated with a body fluid:
Remove as soon as feasible
Wash the skin with an antimicrobial soap
Examine skin for breaks or injuries (follow exposure protocol)
Obtain scrubs from Hospital Supervisor per policy
Leave clothes at hospital to be laundered
3.
II.
III.
C.
Isolation – see isolation signs
D.
Bloodborne Pathogens Standard see Exposure Control Plan for Bloodborne Pathogens
Major Nosocomial Infections
A.
Urinary Tract Infections (UTI) - 800,000 cases/year, 6,500 deaths/year in U.S.
B.
Bloodstream Infections (BSI) - 100,000 cases/year, 9,000 deaths/year in U.S.
C.
Pneumonia (PNEU) - Most expensive & highest mortality, Ventilator gives 5% risk/day, 23,000
deaths/year in U.S.
D.
Surgical Site Infections (SSI) - 10,000 deaths/year in U.S.
Major Communicable Diseases
A. HIV/AIDS: Disease of decreased immunity to infection or cancers—Immunopromised.
Transmitted-Blood, body fluids, contaminated needles/sharps, sex, perinatally, or hemophilia
treatment. Symptoms - weakness, flu-like symptoms; early, repeated infections, or no symptoms. >2
Million infected in U.S., 30 Million Worldwide
In 408,000 cases where the occupation is known, 21,000 are healthcare workers: 1,641
physicians, 108 surgeons, 4,598 nurses, 440 dental workers, 396 paramedics, 2,763 technicians, 965
therapists, 4,408 health aids. Over 5,000 of the infected healthcare workers are dead. Only 56
healthcare workers are documented to have gotten HIV on the job during an exposure.
B. Hepatitis A-E: Inflammation of liver caused by virus
Symptoms: fatigue, abdominal pain, fever, jaundice, nausea/vomiting/diarrhea, or No
symptoms Treatment: rest, fluids, B & C are treated with Interferon and/or Ribaviran
 Hepatitis A: Over 30,000 cases per year, lasts 2-4 weeks, none are chronic
Transmitted: fecal to oral (usually contaminated hands prepare food)
Hepatitis A Vaccine before exposure
 Hepatitis B: Over 300,000 cases per year, 30,000 remain chronically infectious,
At present over 1 million are infectious in U.S.
Transmitted: blood and body fluids, needles, sex, perinatal
Prevention: Hepatitis B Vaccine or Hepatitis B Immune Globulin (HBIG)
 Hepatitis C: Over 250,000 cases per year, 50-90% remain chronically infectious
(125,000 - 225,000 remain infectious each year)
Transmitted: blood and body fluids, needles (42%), perinatal, sex (small #)
 Hepatitis D: Only seen as a co-infection with Hepatitis B, high mortality
Transmitted: blood and body fluids, needles, sex, perinatal
 Hepatitis E: "Dirty Water Hepatitis" Seen usually in Asia, Africa, Mexico, Japan, etc. rarely in
Transmitted: oral ingestion of contaminated water, fecal-oral
C. Tuberculosis: 14, - 16,000 new cases per year in the U.S.
(Average 1 per year at Baptist Health Paducah)
 Infection: Positive PPD skin test, no symptoms (germ becomes dormant)
 Disease: Positive PPD, active pulmonary or extra-pulmonary infection
 Symptoms: Cough, congestion, fever, weight loss, fatigue, night sweats.
U.S.

Transmitted: airborne (should be isolated for at least 2 weeks on meds)
Guidelines for Prevention of Transmission of Infectious Disease:
Use Standard Precautions
1. All body fluids or substances are considered potentially infectious.
2. All persons (this includes patients, employees, physicians, and visitors) are potentially infectious
regardless of medical diagnosis, race, gender, economic status, lifestyle habits, job, etc.
3. All exposures to blood or body fluids shall be treated as a potential exposure to HIV/AIDS, Hepatitis B, or
other bloodborne pathogen. Proper procedures should be followed per policy I14.5-INF, Infectious
Exposure Follow-up, Employee.
Personal Protective Equipment: The following can be considered as personal protective equipment and worn
anytime a potential exposure to any body substance (blood, sputum, urine, feces, semen, spinal fluid, sweat,
tears, saliva, etc.) is expected or anticipated. They include:
Item
Purpose
*Disposable gloves
Protect hands from body substance
*Cover gowns, lab coats
Protect clothing from splash /spray of
Blood/ body fluids
*Masks
Protect nose and mouth from body fluid
splash, spray or inhalation of airborne
organisms
*Goggles or eye shield
Protect eyes from body fluid splash or
spray
*Hair and Shoe covers
Protect hair and shoes from splash or
spray.
Contaminated personal protective equipment (gowns, gloves, eyewear, etc.) should not be taken out of
facility. Disposable equipment should be disposed of in proper container and reusable equipment (gowns,
goggles) should be cleaned per procedure when contaminated.
Handwashing with the proper hand cleaner should be carried out whenever there has been skin-to-skin
contact, blood or body fluid contact, or contact with a contaminated item (such as, patient linens, equipment,
etc.) as per policy H1.1-INF, Handwashing Technique for Personnel.
Contaminated Items:





Discard uncapped (or capped) needles/syringes and sharps in a puncture-resistant container designated
for this purpose. It should have a biohazard emblem on the container.
Discard all contaminated trash, diapers, dressings, etc. into a red hazardous waste bag in the hospital,
Prime Care, etc. (not all diapers in Child Care) and dispose of in manner consistent with Waste
Management Plan and Bloodborne Pathogens Exposure Control Plan. Diapers from well children in Child
Care are disposed of in regular trash.
All soiled linen is considered contaminated and is treated as infectious per policy L1.2-INF, Laundry and
Linen Services Infection Control.
Employee garments when soiled are to be removed and laundered at this facility as per policy L1.3-INF,
Laundering of Soiled Employee Linen.
Central Service reusable instrument trays shall be cleaned and transported to Central Sterile per policy
C5.1-INF, Central Sterile Processing Infection Control.
 Terminal cleaning of an isolation room is carried out the same as all other rooms, except for those in
Contact/Spore Precautions. These rooms will be closed for 2 hours and terminally cleaned twice. The
first time with Dispatch and the second time with TBQ.
Isolation Signs:
Isolation signs should be placed on the door except in Transitional Care where they can be placed on
bathroom door or on the foot of the patient’s bed.
Communication:
Isolation information shall be communicated to all departments in the following manner:
 Radiology, Rehabilitation Services, and Cardiology: Type of isolation on order requisition screen.
 All departments: Sign on the door (except TCU) & Sticker on front of chart.
Droplet Precautions:
PRIVATE ROOM PREFERRED
Droplet Precautions should be used for any patient who is known or suspected to have an illness which can be
transmitted by air a short distance from a patient’s mouth. The infectious organisms are usually transmitted
1½ to 6 feet from the patient. Therefore, a regular surgical mask needs to be worn when the healthcare
worker is within 6 feet of the patient. Influenza is the most common illness this method of precautions will
prevent. The patient should be in a private room unless the facility is very full of patients (e.g., community
influenza outbreak), in which case, two patients with Influenza can be placed in a semi-private room. The
patient room door may remain open. The isolation sign is bright yellow and can be obtained from Infection
Control. If transport or movement is necessary, instruct the patient to wear a surgical mask and to follow
proper Respiratory Hygiene/Cough Etiquette. No mask is required for the persons transporting the patient.
Contact Precautions: PRIVATE ROOM
Contact (or Wound and Skin, or Enteric) precautions should be used for any patient which is known or
suspected to have a serious illness easily transmitted by direct patient contact or by contact with items in the
patient's environment. A patient on contact precautions should be placed in a private room unless the patient
census is high. In that case the Supervisor or Nursing Director may determine a suitable roommate (one with
low risk for infection or with same infection). Examples of conditions requiring contact precautions include:
Shingles (except disseminated requires respiratory isolation), RSV, Lice, Scabies, surgical wound infections,
draining skin lesions, etc. See Disease specific list attached. Contact isolation sign is white. Note: Persons
who have not had chickenpox should not enter room of person with shingles. Gloves and gown should be
donned upon entering the patient’s room or area. Gloves and gowns should be removed before leaving the
patient’s area and hand hygiene should be performed. Whenever transport of the patient is necessary, ensure
that the infected or colonized areas of the patient’s body are contained. Transporter should don gloves and
gown as they enter the patient’s area and remove the PPE before they leave the room and perform hand
hygiene. Don clean PPE to handle the patient at the transport destination. Multiple patient medical equipment
such as stethoscopes and blood pressure cuffs should be cleaned and disinfected before use on another
patient.
Contact/Spore Precautions:
PRIVATE ROOM
Contact /Spore Precautions should be used on any patient who is known or suspected to have Clostridium
difficile associated diarrhea, anthrax or any other type of Clostridium infection. Gloves and gown should be
worn whenever in close contact with the patient or patient environment. Hands should be washed immediately
with soap and water. Do not use the alcohol based hand sanitizer! Alcohol based hand sanitizers are
ineffective against organisms that produce spores. Contact/Spore Precautions sign is orange.
Enhanced Contact Precautions:
PRIVATE ROOM
Resistant Organisms such as VRE (Vancomycin Resistant Enterococcus) or any organism deemed highly
resistant by the Infectious Disease physician should be treated with extra caution. These organisms have
developed resistance to many or all antibiotics when used alone. Infections caused by these organisms are
more difficult to treat. For this reason, extra care should be used with these patients. All patients with VRE (or
colonization) should be treated by personnel and physicians wearing gowns and gloves. Handwashing must be
meticulous and thorough. Hands should be washed with an antimicrobial hand soap or alcohol hand rinse
product. The sign for Enhanced Contact Precautions should be placed on the door and cleaning followed per
policy M18.1-INF, MRSA, VRE, and Other Resistant Organisms. Enhanced Contact Precautions sign is green.
Airborne Isolation:
PRIVATE ROOM WITH DOOR CLOSED
Special isolation precautions are instituted for patients whose organisms may be airborne, such as Measles,
Disseminated Zoster, Meningitis, and other infections determined by the attending physician, Infection Control
Practitioner, or Chairman. See Disease specific list attached. Airborne Isolation Sign (blue) must be placed on
door. If transport or movement is necessary, instruct the patient to wear a surgical mask and to follow proper
Respiratory Hygiene/Cough Etiquette. No mask is required for the persons transporting the patient.
*Mask may be worn by any employee when that employee is concerned about the patient or his/her own
infectiousness. An example would be the patient with a chest cold - congested and coughing - which requires
close physical contact for patient care.
Special Respiratory (Airborne) Isolation:
PRIVATE ROOM WITH DOOR CLOSED
Patients diagnosed or suspected of having Mycobacterium Tuberculosis (TB), Chickenpox, or Smallpox (see
Bioterrorism Plan) are placed in special respiratory isolation. They should be placed in a negative pressure
room with appropriate ventilation unless special care requires them to be in a particular unit (Coronary Care,
Intensive Care, Pediatrics, etc.). If placed in a non-negative pressure room, a portable filtering unit should be
placed in the room. Particulate respirators should be worn by any employee or physician entering the room.
See Exposure Control Plan-Tuberculosis and Tuberculosis Isolation.
Special Respiratory Isolation sign must be placed on door (pink).
Neutropenic (Protective) Isolation:
PRIVATE ROOM
Neutropenic/Protective Isolation is used for patients whose immunity is not high enough to protect them from
infection. Most physicians (usually Oncologists) usually want a mask and gloves used in addition to,
meticulous hand washing. Each physician makes that determination based on the patient’s condition. The
isolation sign is purple and is marked with the specific restrictions needed. See policy, R5.5-INF,
Reverse/Protective Isolation.
See Policy I19.1-INF for additional information
Isolation signs are as follows:
Droplet Precautions
Visitors Inquire at Nurses Station for Assistance
Wear a MASK* when within
6 feet of the patient.
Private room preferred, Door
may remain open.
WASH HANDS after contact
with the patient or contaminated
articles before leaving the room.
GLOVES should be worn for
touching infective material or
contaminated equipment.
Standard Precautions should be followed with all patients.
*Standard Surgical mask
Contact Precautions
Visitors Inquire at Nurses Station for Assistance
WASH HANDS after touching
patient or contaminated articles
before leaving the room.
GLOVES must be worn for
every patient visit,
wash hands after removal.
GOWNS should be worn if
clothing is likely to come into
contact with the patient or
contaminated articles.
Standard Precautions should be followed with all patients.
Contact/Spore Precautions
Visitors Inquire at Nurses Station for Assistance
WASH HANDS after touching
patient or contaminated
articles before leaving the room WITH
SOAP AND WATER.
GLOVES must be worn for
every patient visit,
wash hands after removal.
GOWNS should be worn if clothing
is likely to come into contact with the
patient or contaminated articles.
Room should be closed for 2 hours and
terminally cleaned twice, first time with
Dispatch, second time with TBQ.
Standard Precautions should be followed with all patients.
Enhanced Contact Precautions
Visitors Inquire at Nurses Station for Assistance
GLOVES must be worn for
every patient visit, wash
hands after removal.
GOWNS must be worn for
every patient visit, discard in
room.
WASH HANDS after contact
with the patient or
contaminated articles before
leaving the room.
All equipment must be left in
room or completely disinfected
before removing. (This room
must remain empty for 24 hours
after discharge or transfer of this
patient.)
Private Room. Door may be open.
Patient may leave room but may not visit other patients.
Standard Precautions should be followed with all patients.
Airborne Isolation
Visitors Inquire at Nurses Station for Assistance
Wear a MASK* when
entering the patient’s room.
Private Room.
Keep door closed.
WASH HANDS after contact
with the patient or
contaminated articles before
leaving the room.
Standard Precautions should be followed with all patients.
*Standard Surgical mask
Special Respiratory
(Airborne) Isolation
Visitors Inquire at Nurses Station for Assistance
Wear an N95 MASK
whenever entering the patient
room. Private room with
negative pressure ventilation.
Keep door closed at all times.
WASH HANDS after contact
with the patient or
contaminated articles before
leaving the room.
Standard Precautions should be followed with all patients.
Neutropenic Isolation
(Protective Isolation)
Visitors Inquire at Nurses Station for Assistance
Every effort should be made to protect this patient from germs. Standard Precautions
should be followed with all patients. His or her doctor has ordered the following precaution
measures:
ALWAYS WASH HANDS
before entering this patient’s
room or before contact with
this patient.
Additional measures include those marked:
_______Wear a MASK
whenever entering the
patient’s room.
________Wear GLOVES with
any patient contact.
No raw fruits or vegetables.
No live plants.
Pain: Assessment and Management
Patients have the right to appropriate control and management of pain. A list of patient rights and
responsibilities is posted and is provided to all inpatients and are available upon request for outpatients.
All patients will be asked about pain through questions on admission and every 4 hours. The patient’s
report of pain is the single most reliable indicator of the existence and intensity of pain. Patients will be
assessed for pain utilizing the appropriate pain rating scale according to the Baptist Health Paducah Pain
Assessment Tool. Patient encounters excluded from this policy are outpatient lab, education sessions
and diagnostic imaging.
Pain management will be a collaborative effort when appropriate. Pain management will be included as
part of the plan of care. A patient's personal, cultural, spiritual and/or ethnic beliefs will be considered
during the pain assessment and development of the interdisciplinary care plan.
PROCEDURE:
I.
Patient and Family Education
A. At the time of admission, patients and families will be taught that pain management is an
important part of their care and about the use of the pain rating scale. Staff will inform patients
and families about the medications ordered for pain.
Materials to help with patient and family education may include:
1. Logicare documents.
2. Pamphlets.
3. Videos.
4. Verbal explanation.
B. At the time of discharge, patients will be educated on the importance of pain management at
home. Patients will receive education about medications, equipment and other pain techniques as
applicable for pain management at home.
II. If the patient is having pain, choose the appropriate pain rating scale, from the Baptist Health
Paducah Pain Assessment Tool to evaluate the pain. See attached Baptist Health Paducah Pain
Assessment Tool.
III. The Wong Baker Faces Pain Scale is appropriate when the patient is awake, alert, and able to
communicate. The patient may be a child or an adult. This scale is recommended for pediatric
patients between the ages of 3 and 12.
1. Point to the faces. State "These faces show how much hurt/pain you can have."
2. Ask: "How much hurt/pain do you have now?" If the child/patient seems confused or doesn't
respond, point to face 0 and say, "This face has no hurt/pain." Slide your finger to face 10 and
say, "this face hurts as much as you can imagine, although you don't have to be crying to feel
this bad."
3. "Pick the face that tells me about your pain right now."
4. Record the number that is under the chosen face in the designated place.
IV. Visual Analog Scale (VAS) is appropriate when the patient is awake, alert, and able to communicate.
The patient must be able to count to 10. This scale is recommended for patients over the age of 12.
1. Show the patient/child the VAS 1 to 10 scale. Say, "These numbers show how much pain/hurt
you have. Number zero means that you are comfortable and number 10 means you are having
as much pain as you can imagine. You don't have to be crying to feel this bad."
2. "Pick the number that tells me about your pain right now."
3. Record the number that is chosen in the designated place.
V. Face, Legs, Activity, Cry, and Consolability (FLACC) Scale is appropriate for children under the age of
3 and adults who are unable to speak or understand due to injury, drugs, treatments, or mental
ability.
1. Assign a numerical score to each observation. Add the scores together. Total score correlates
with 0 to 10 pain scale (maximum total score is 10).
2. Record the score in the designated place in the documentation system.
VI. Ask patient to describe pain. Description must include:
1. Location: Where is the pain? Ask patient to be as specific as possible.
2. Onset: When did the pain begin?
3. Duration: How long does the pain last?
4. Radiation: Does the pain spread to other areas of the body?
5. Frequency: How often do you experience this pain?
6. Type of pain. What word does the patient use to describe their pain. Check all that apply.
7. Aggravating Factors: What makes your pain worse?
8. Alleviating Factors: What makes your pain better?
9. Interference with ADLs: Ask patient to be specific.
VII. Chronic Pain Questions
1. Identify if patient has chronic pain. Define type of pain. Example: arthritis, back pain,
headaches.
2. Identify if this pain might be a care issue. Example: positioning, ambulation, ADLs.
3. Identify if patient is being treated for the chronic pain. Example: under physician care, selfmanagement, heating pad, magnets, copper, prescription drugs, OTC, herbal remedies.
4. Recommend the patient see a physician if current pain management is unsatisfactory.
VIII. On Going Pain Assessment
A. Each time pain is assessed, an appropriate pain scale will be used from the Baptist Health Paducah
Pain Assessment Tool. Patient pain is always documented numerically (0 to 10). The numerical
pain rating and type of scale used will always be documented together. Pain rating scales will be
identified as:
1. W = Wong Baker Pain Faces;
2. V = Visual Analog Scale;
3. F = FLACC scale;
4. R=Resting;
5. S=Sedated (Note: Sedated score should only be used for patients in procedure areas who are
too sedated to reply with a pain score.
Example: Patient pain rating is 3 using the Visual Analog Scale. This will be documented as 3/V.
Pain is assessed and documented every 4 hours. A pain rating will be obtained and documented
with the patient’s self-report of pain. If the patient denies presence of pain, a assessment and
score (0) should be documented every 4 hours. If the patient is experiencing any degree of pain,
an assessment and score should be documented specific to the needs of the patient.
1. A patient's self-report of pain can be obtained by any staff member.
2. Non-licensed staff obtaining patient’s self report of pain is responsible to inform a licensed
staff member if the pain score is 5 or greater, or the patient states the pain is not acceptable,
or the patient requests pain medication.
3. Only licensed staff can use the FLACC Scale to assess pain.
4. Pain will be assessed and documented prior to pain medication given and within one hour after
patient receives pain medication. Assessment before and after medication is to be
documented in the nurses’ notes or in Admin RX.
Barriers to Effective Pain Management
1.
2.
3.
4.
5.
6.
7.
8.
Inadequate knowledge of pain management.
Poor assessment of pain.
Concern about regulation of controlled substances.
Fear of patient addiction.
Concern about patients developing respiratory depression.
Concern about patients becoming tolerant to analgesics.
Patient’s reluctance to report pain.
Patient’s reluctance to take pain medications.
Fear of Addiction
There are many fears of addiction related to managing pain. These fears occur in the patient and
family as well as the healthcare provider. Most of these fears can be grouped into one of two
categories:
1. The fear of using an opioid to manage pain causing addiction, or
2. The fear (or prejudice) of treating patients who previously have an addiction
To understand this better, it helps to know the correct terminology.
Opioid
Physical
dependence
Tolerance
Addiction
Pseudoaddiction
Pseudotolerance
Ceiling
effect
This term is now used instead of narcotic and describes natural, semi-synthetic,
and synthetic drugs that relieve pain by binding to opioid receptors in the
nervous system.
Physiologic state. Physical dependency on opioids is an expected occurrence in
all individuals in the presence of continuous use of opioids for therapeutic or for
non-therapeutic purposes. The abrupt cessation of the opioid, or administration
of an opioid antagonist, results in withdrawal symptoms. It does not, in and of
itself, imply addiction.
The need for an increased dosage of a drug to produce the same level of
analgesia that previously existed. Tolerance is not the same thing as an
addiction, and it is an expected physiologic occurrence in the presence of
continued use of opioids.
Psychological dependence. A pattern of compulsive drug use characterized by
continued craving for an opioid and the need to use the opioid for effects other
than pain relief. Physical dependence and tolerance are not the same as
addiction. The quality of life decreases in the addicted patient.
Often interpreted by healthcare workers as addiction, but it actually occurs when
the patient’s pain is never relieved. This patient is usually talked about by the
nurses as the one who "always knows what time his pain med is due", "starts
asking for his pain med an hour before it is time"," knows his pain meds well",
etc. The problem is that the patient never gets complete relief because the dose
is not high enough; therefore it helps only for a short period of time and then the
pain returns before the next dose is due. This type behavior stops once the
patient’s pain is relieved.
The need to increase the dose that is not due to tolerance but due to other
factors such as: disease progression, new disease, increased physical activity,
lack of compliance, change in medication, drug interaction, etc.
A dose above which further dose increments produce no change in effect.
Baptist Health Paducah
Age-Specific and Cultural Awareness
Age-specific and cultural awareness are tools for learning more about how to best meet
each patient’s unique needs as they are cared for.
There are many ways to learn about each patient’s specific needs. Depending upon the
patient and your job, it may be appropriate to:

Ask the patient questions (and talk with his or her family).

Look for clues, such as what the patient wears or keeps in his or her room, or how he
or she acts around others.

Check with a supervisor for information.
Each patient is unique. Always keep in mind that:

Growth and development follow general patterns. But every person grows and develops
in his or her own unique way.

Not every member of a cultural group may share all or its values, beliefs or practices.

A patient may appear similar to you, but still be different from you in certain ways.

Avoid stereotyping a patient—consider all the factors that may affect his or her care
needs.
Age-specific groups generally are broken up accordingly:








Infants and toddlers (birth to age 3)
o Keep the child with the parent if possible.
Young children (ages 4 to 6)
o Speak in a soothing voice and in simple terms, avoid scary terms.
Older children (7 to 12)
o Praise cooperative behavior, ask the child about interests.
Adolescents (ages 13 to 20)
o Might be self-conscious about appearance, privacy is important.
Young adults (ages 21 to 39)
o More comfortable with body image, they can look at problems from different
points of view.
Middle adults (ages 40 to 64)
o Family oriented, develop new roles with aging parents, interested in learning.
Adults (ages 65 to 79)
o May experience depression, loneliness and anxiety over changes or about
future, give information in short segments and repeat as needed.
Adults (ages 80 and older)
o Mobility becomes harder, may have reduced attention spans.
Developing cultural awareness starts with self-awareness. It’s important to know your
own culture. This can help you remember that a patient may hold different views. For
example:

You may value certain communication styles such as making eye contact and touching.

You may have certain views about illness and the causes.

You may believe a particular remedy is needed for a certain illness.
Being open-minded and respectful toward other beliefs, values and practices is important
to making others feel comfortable.
Health Insurance Portability and
Accountability Act
HIPAA
Privacy and Confidentiality
The Baptist Health Paducah’s HIPAA and Compliance
Committee has and continues to develop necessary
policies and procedures to assure compliance with
the new Privacy Regulations.
At the time of registration, staff ask new patients if they would like to be listed in our
hospital directory. If a patient indicates that they would like to be listed on our
hospital directory, employees should follow all existing patient privacy and
confidentiality policies and procedures.
All visitors or callers must know the patient’s registered first and last name in order to
receive any information on the patient. Staff cannot research or allow the visitor or
caller to research our database to locate the correct name of the patient.
Condition information about a patient that has agreed to be listed in the hospital
directory can be provided and can be given without special patient consent. The
condition information is limited to one word and must be one of the following:
Undetermined
GoodFairSeriousCritical-
Patient awaiting physician assessment
Vital signs are stable and within normal limits. Patient is
conscious and comfortable. Indicators are excellent.
Vital signs may be unstable and within normal limits. Patient is
conscious, but may be uncomfortable. Indicators are
questionable.
Vital signs may be unstable and not within normal limits. Patient
is acutely ill. Indicators are questionable.
Vital signs are unstable and not within normal limits. Patient may
be unconscious. Indicators are unfavorable.
Staff can also disclose this following information to visitors or to the public:
Treated and Released
Treated and transferred – THE LOCATION CANNOT BE DISCLOSED
Privacy Patient
A patient that decides not to be listed in the hospital directory is considered a
privacy patient. The meaning of a privacy patient is verbally provided to the
patient at the time of registration.
No information on a privacy patient can be disclosed to the public without
authorization from the patient. Internal staff that have a “need to know” have access to
all of the patient information needed to perform their job responsibilities. Extra efforts
must be made to accommodate “privacy” for this patient. Each clinical unit may want
to develop their own internal way to monitor these patients.
Should a visitor inquire about a privacy patient, it is best to state that “there is no
information available on this patient”. If there is further inquiry, please direct the
person or caller to a family member. In the best interest of a privacy patient, staff
should not call around to other units, look in other computer systems, etc. If the
visitor or caller remains insistent, please direct them to registration, the nursing office,
or a hospital supervisor.
Disclosures of Protected Health Care Information
Disclosures of protected health care information can be made without patient
authorization when the request relates to medical payment, patient treatment, or
hospital operations. Disclosures of PHI should be limited to the “minimum necessary
standard”. Do not provide more PHI than what is requested.
Disclosures for purposes other than treatment, payment, and hospital operations
require patient authorization (except when required by law) and must be tracked and
reported in the medical record according to HIPAA. Health Information Management
(HIM) will be responsible for this process. Any person that discloses PHI outside of
payment, treatment, and hospital operations must report this to the HIM release
department.
Safeguards
HIPAA requires each health care provider to ensure that patient health care information
is protected and that all reasonable safeguards have been implemented. Reminders of
these safeguards include:



Limiting conversation about PHI to confidential and secure areas. All staff must be
careful to not intentionally disclose confidential health care information through
casual conversation.
Assuring that passwords are secure. Never provide your password to co-workers or
supervisors. Passwords should be periodically changed.
Do not leave charts and files within public view. Take time to turn records face
down when they are exposed to the public.








Make every effort to maintain the confidentiality of a “privacy patient”. No
unauthorized visitors or phone calls. Basically, to the public, the patient does not
exist in the hospital.
Shred any documentation that has a patient’s name and medical information. This
type of documentation cannot be discarded in the regular trash.
Do not identify patients by first and last name on public documentation or
correspondence. Always use account numbers, room numbers, or other means to
identify the patient.
Use the HIPAA compliant fax cover sheet when faxing PHI and verify the fax number
in advance.
Please page patients/visitors to an internal phone extension and not a location
within the hospital. For example, “Jane Jones please call extension #2115”.
Peel off the label on any IV bag that contains the name of the patient and the
medication name.
Do not access your own (or your dependents) medical records. Contact the medical
records department for assistance.
Staff and students should only review medical files where there is a “need to know”
in order to perform required duties and responsibilities. Requests to review open or
closed medical files for research purposes should be submitted to the Compliance
Officer at 270-415-7105.
Penalties
Please remember that civil and criminal penalties can be implemented for violations of
HIPAA. The civil and criminal penalties can range from $100 per violation up to
$250,000 and 10 years in prison for malicious and intentional misuse of the
information.
Corporate HIPAA Policies
Baptist Healthcare System’s attorneys and HIPAA committee members have developed
several privacy-related policies to comply with the regulation. All HIPAA/Privacy related
policies are located in the intranet and can be found under the legal manual heading.
Questions and Resources
If you have any HIPAA related questions or concerns, feel free to contact the Baptist
Health Paducah Privacy and Compliance Officer.
Missy Freeman
270.415.715
Other resources include:
www.aspe.hhs.gov
(complete text of HIPAA regulations)
www.hhs.gov/ocr/hipaa
(Office of Civil Rights)
www.ama-assn.org
(American Medical Association news)
HIPAA Security “What you need to know”
HIPAA Security Officer
HIPAA Security mandates there be one person responsible for information security. The following
are the designated Information Security Officers for Baptist Healthcare System and Baptist Health
Paducah:
BHS: Michael Erickson
Baptist Health Paducah: Brad Nelson
Compliance Hotline
If you have a question or need to report a security incident contact the Information Security Officer
or call the Compliance Hotline at 1-800-783-2318.
BHS workstations
Workstations should be used for business activities. Activities that interfere with your job or
compromise the availability, confidentiality or integrity of EPHI (Electronic Protected Health
Information) are not permitted.
Computer/Workstation Access
It is the responsibility of the department managers and/or supervisors to determine and authorize
all access, including access by people who are not employees (contractors, business associates) to
BHS’ information systems.
Internet/Intranet Access
If you have access to a workstation but do not have access to the Internet, you can use the hospital
Medical Library or one of the Kiosk units to request required information. Employees who do not
have workstations and need access to the Intranet can use one of the Employee e-Stations located in
your hospital.
Workstation Internet/Intranet Access
To access the Internet or Intranet from your workstation, you must have a valid “account”. To obtain
an Internet or Intranet Account, director must complete the Internet & Intranet Access Request Form
and return to the Hospital IS Director/Manager with employee/manager signatures.
You should always log off your computer terminal before leaving it unattended.
Laptops and other portable devices should be stored in secure areas to minimize the potential for
theft or unauthorized access.
Workstations/Work areas should remain clear of any patient information that could be visible to the
public.
Keep your password safe. Never share your password with anyone. Don’t write it down and don’t
post it on the wall.
When you are logging onto the system, be aware of people who might be looking over your
shoulder. “Shoulder Surfing” is a common way to obtain someone’s password.
What are my responsibilities?
1. Recognize and report security incidents.
2. Don’t turn a blind eye to security breaches. Report any suspected or actual breaches of
information security to the BHS or Hospital Information Security Officer or call the BHS
Compliance Hotline (1-800-783-2318). Challenge special requests or direction that contradicts
published policies and procedures.
Federal False Claims Act
What is it?
The Federal False Claims Act (FCA) was adopted in 1863 to deter military contractors from
fraudulently billing the government.
The FCA covers fraud involving any federally funded contract or program.
This includes Medicare and Medicaid.
The FCA prohibits anyone from knowingly submitting or causing the submission of a false or
fraudulent claim to the U.S. government for payment.
The FCA does not require proof of a specific intent to defraud the U.S. government.
Baptist Healthcare System requires all employees to report any activities that may be categorized
as fraud or abuse. Here are a few examples that must be reported:

Falsification of Records

Double or duplicate billing

Submitting bills for services never performed or items never furnished

Billing for services not medically necessary
Ways to report a concern:

Contact your department manager

Contact Baptist Health Paducah Compliance Officer: Missy Freeman, 270-415-7105

Compliance Hotline
800-783-2318

BHS General Counsel
502-896-5000
Patient Rights and Ethical Concerns
Effective health care requires collaboration between patients and physicians and other health care
professionals. Open and honest communication, respect for personal and professional values, and sensitivity
to differences are integral to optimal patient care. As the setting for the provision of health services, primary
care centers must provide a foundation of health understanding and respecting the rights and responsibilities
of patients, their families, physicians, and other care givers. Primary care centers must ensure a health care
ethic that respects the role of the patients in decision making about treatment choices and other aspects of
their care. We must be sensitive to cultural, racial, linguistic, religious, age, gender, and other differences as
well as the needs of persons with disabilities.
The patient or patient's surrogate is given a list of these rights and responsibilities upon registration. A copy
of these patient’s rights may be obtained by contacting any staff member at any time during the patient’s stay.
In the event that the patient does not have decisional capacity, these rights apply to the patient's surrogate.
The patient’s rights and responsibilities are displayed in lobbies and waiting rooms throughout the facility,
and all inpatient rooms.
PATIENT RIGHTS:
When you are a patient you have the right to:
1. Receive fair and compassionate care at all times and under all circumstances.
2. Be treated equally and receive the same level of care regardless of your race, religion, sex, age or
disability.
3. Retain your personal dignity and privacy, receive care sensitive to your personal feelings and need for
bodily privacy, receive care in a safe setting, and to be free from abuse and harassment.
4. Have family members, representatives, and physicians of your choice notified promptly of your admission
to the hospital.
5. Receive personalized treatment, through an individual treatment plan and to participate in the
development and implementation of your treatment plan. This institution values each patient’s cultural,
racial and religious heritage as part of that plan.
6. Maintain confidentiality of your clinical records and to access information contained in your medical record
within a reasonable time frame.
7. Receive visitors unless such visits harm your medical condition and negatively affect your recovery.
8. Send and receive mail without interference from hospital personnel or other parties.
9. Examine and receive an explanation of your bill.
10. Be informed of hospital rules and regulations that affect your activities and behavior as a patient.
11. Formulate advance directives (living will, durable power of attorney, health care surrogate, etc.) and to
have hospital staff and practitioners comply with these directives in accordance with federal and state law.
12. Be free from restraints and seclusion, of any form, that are not medically necessary or are used as a means
of coercion, discipline, convenience or retaliation.
13. Appropriate control and management of pain.
14. Request assistance if you have difficulty reading, hearing or speaking English.
Patients and/or their designated surrogate have the right to:
15. Be informed of your rights before the furnishing or discontinuance of care, whenever possible.
16. Make informed decisions regarding your care, including being informed of your health status, be involved
in care planning and treatment, be able to request or refuse treatment to the extent permitted by law, and
be told of the medical consequences of your actions.
17. Refuse to participate in clinical training programs or to be used in the gathering of data for research
purposes, regardless of your payment source – government, personal or third party.
18. Know the identity of the doctor responsible for your primary care.
19. Be told of any medical procedures and tests to be performed, the reason for the procedure and tests, and
the identity of those who will be performing them.
20. Expect reasonable continuity of care to assure that you are advised of your outpatient care options,
requirements and of your follow-up care needs.
21. Communicate your problems or concerns with the hospital to the Executive Assistant, Telephone (270)
575-2101, or to the Kentucky Cabinet for Health Services by contacting the Office of Inspector General,
Division of Licensing and Regulation, 275 E. Main Street, 4E-A, Frankfort, Kentucky 40621, (502) 564-2800,
or to the Joint Commission, Oakbrook Terrance, Illinois 60181 (800) 994-6610.
Ethical Concerns
If you feel that a patient’s rights have been violated or a patient voices a concern that may be a violation
of their rights, follow the process listed below.
It is the policy of Baptist Health Paducah that the hospital staff, patient, or the patient's designated
representative have the right to participate in the consideration of any ethical concern related to the care of
the patient.
1. Staff member or patient/family member identifies ethical concern that should be addressed. Concern may
include but is not limited to that of health care provider, activity or policy of the facility.
2. Staff member or patient/family member notifies director/supervisor and attending physician of concern or
situation.
3. Director/supervisor and attending physician will attempt to resolve the situation if possible. If resolved, no
further action is taken.
4. Should the director/supervisor be unable to resolve the situation or the staff, patient/family member are
not in agreement with the actions taken at this level, a request for a consult with the Ethics Committee can
be made.
5. The Ethics Committee Chair or designee should be notified immediately.
6. The Ethics Committee Chair or designee will consult with all parties involved and will arrange for a meeting
consisting of members of the Ethics Committee, and others as needed, who are not involved with the
issue/situation. The consultation should be arranged as soon as practical. When meeting for a
consultation, any available members will be utilized. Persons other than Ethics Committee members will
be consulted as appropriate, (i.e. physicians, attorneys, clergy, ethicists).
7. The Ethics Committee will function only in a consultative role and will advise only on the “ethical”
appropriateness of any action. All decisions related to patient care will be made between the patient
and/or the patient’s surrogate and the physician.
8. The committee will complete the “Ethics Committee Consultation” form located on Optio and will
document appropriately in the patient’s chart.
9. If the issue cannot be resolved, Administration and/or the patient or patient’s surrogate may seek
resolution through appropriate legal channels. Seeking court action should only be a “last resort” when all
other attempts to resolve an issue have failed.
10. Confidentiality will be maintained at all times.
Baptist Health Paducah
Dress Code
The following dress code is derived from the belief that a well-groomed and professional appearance
leads to pride in the workplace and fosters confidence and respect from the public we serve.
Appropriate attire enhances the professional appearance of students and employees and inspires
confidence in their ability.
Male and Female:
1. It is not possible to list all styles or items that could be worn. If something you would like to
wear is not specifically listed ask your Supervisor/Director if it will be permissible before you do
it.
2. For security reasons and as a courtesy to our patients, all students are required to wear their
nametag at all times, including preparation for rotation and time in the library. Also in order for
Food and Nutrition Services to make correct charges, all employees are asked to wear their
nametag in order to receive the discount in the cafeteria.
3. All wearing apparel, uniform or non-uniform, must be neat, clean, pressed and tailored to allow
freedom of movement (no tight, form fitting clothing is permitted). No showing of midriff
allowed at any time.
4. No denim jeans of any color will be permitted
5. Hosiery must be worn with dresses (skirts/ dresses no shorter than 2 inches above the knee).
6. Socks or hosiery must be worn with slacks.
7. The following are not permitted:
a. Sleeveless tops, dresses/Low cut sheer blouses, dresses/Tank tops/Halters
b. Shorts (cuffed, walking or otherwise)
c. T-shirts (except on designated days or under scrubs)
d. Sweatshirts or Sweatpants (all colors) or hooded jackets
e. Socks with skirts or dresses
f. Bikini and colored undergarments with white uniforms
g. Canvas tennis shoes or barefoot sandals/ flip flops
h. Leggings/Capri pants
i. Midriff tops or anything bearing midriff
10. Shoes must be neat, clean, polished and the type designated within the department. Open-toe
shoes are permitted in office areas only.
11. Fingernails must be manicured and well kept. Nail polish may be worn but free from chips,
cracks and peeling. Loud / inappropriate colors should be avoided. No designs, jewels, or
sculptured nails are permitted. See policy, A18.1-INF, Artificial Fingernails.
12. Hair must be neat, clean, and controlled at all times not to obstruct vision. Anyone in patient
care areas with hair longer than shoulder length must have it secured back or pulled up at all
times. Caps or hairnets must be worn in areas where required. Beards, sideburns, and
moustaches are permitted but must be kept well groomed and neatly trimmed so as not to
promote infectious concerns. No unnatural hair color i.e. green, purple, pink, orange. No Hair
feathers. Cosmetics and perfume/aftershave should be used in moderation and in good taste.
13. Males working in clinical areas requiring the use of special mask for TB protection may not have
a full beard due to OSHA fitting requirements of the mask.
14. No visible tattoos or excessive body piercing.
15. Jewelry should not be excessive especially with those employees having direct patient contact.
16. All employees are expected to practice good personal hygiene. Any employee with persistent
body odor will be told by the Department Director and/or Supervisor and expected to correct the
situation immediately.
17. Any student who does not, in the opinion of their Director/Supervisor, meet the above
requirements will be asked to return home and make the appropriate adjustments in dress or
appearance and return to work in compliance.
Artificial Fingernails
The use of artificial fingernails has been associated with infection transmission due to poor
handwashing and residual bacterial/fungal contamination under nails. It is forbidden by AORN
Guidelines in the operative setting (OR, delivery suites, cath lab, etc.) Therefore, the Infection
Control Committee has decided to further limit the use of artificial nails. All personnel should abide
by the standards and guidelines of Infection Control and the Administration of Baptist Health
Paducah.
Artificial fingernails may be made of many substances (Teflon, fiberglass, acrylic, etc.). People wear
artificial nails for several reasons. They may wear them to create a “long fingernail” look, as jewelry
(may actually have jewelry glued to the nail), or to cover split nails. They may also be referred to as
“overlays.” While nail polish has not been associated with patient infections, artificial nails can cause
several infection control related issues:
1. Length of the nail which extends past the tip of the finger may cause increased residual dirt to
remain after handwashing;
2. Attention, cost, and look of the nail may discourage handwashing which would damage the nails;
3. Jewelry on the nail may harbor dirt and germs despite handwashing;
4. Lack of vigorous scrubbing with nailbrushes;
5. Length of the nail may puncture exam or sterile gloves; or
6. Length of the nail may scratch patient’s skin.
Therefore, artificial nails are:
1. Forbidden in all clinical areas such as surgery settings, nursery, radiology, Emergency
Department, and critical care units (except for Secretarial personnel if they do not have physical
contact with patients, specimens, or provide patient care);
2. Forbidden in non-clinical areas where good hand hygiene or glove use is required such as
Food/Nutrition, Pharmacy, Central Sterile, Central Distribution, etc.
3. Allowed in all non-clinical areas on personnel who have no patient contact;
4. Length of the nails are restricted to 1/4” past the end of the fingertip to allow for adequate
scrubbing;
5. Jewelry on nails is forbidden in all clinical settings.
Student Parking



Contact instructor or Andrea Williams for a parking tag


Hang top portion of tag from review mirror



Students do not park in the garage or patient/visitor parking
All students must have a parking tag that is filled out completely
Return bottom half of tag to your instructor or Andrea Williams in
Education
All students must park in the designated student parking lot. See green lot
on left of diagram below
Security Officers will ticket students parked in the wrong lots
Instructors will be notified of all student parking tickets
Broadway
Broadway
Student
Student
Parking
Parking
Radiology/Onc
Radiology/Onc
DOB’s
DOB’s
27thth Street
Street
27
28thth Street
Street
28
Imaging
Imaging
Center
Center
Garage
Garage
EE
SS
25thth Street
Street
25
Residential
Residential Housing
Housing
W
W
ER
ER
Dept.
Main
Main Dept.
Ent.
Ent.
Visitor
Visitor Parking
Parking
Washington
Washington Ave.
Ave.
N
N
Doctor’s
Doctor’s
Lot
Lot
Hospital
Hospital
Heart
HeartCtr.
Ctr.
vvee..
A
A
kkyy
c
c
u
t
u
nt
KKeen
Employee
Employee
Parking
Parking
Tilghman
Tilghman
High
High
School
School
Thank you!
We hope you enjoy your experience at Baptist Health
Paducah.
Please remember to print and sign the first 4 pages and
return them to Andrea Williams in the Education
Department. We appreciate your comments and feedback
so that we can better serve you in the future!
Andrea Williams, RN, BSN
Education Instructor / Student Placement
Baptist Health Paducah
2501 Kentucky Ave
Paducah, Ky. 42003
270.575.8370 office
270.575.2251 fax
andrea.williams@bhsi.com
BaptistHealthPaducah.com