H. W.

MILLER MEMORIAL SANITARIUM AND HOSPITAL

NURSING SERVICE DEPARTMENT CORRESPONDING DEMERITS

A. DOCUMENTATION / MEDICATION
1. FAILURE TO: 1. Fill up Medicine Kardex. 2. Start initial medication (within 30 minutes STAT MEDS, antibiotics) 3. Chart medication given to patient. 4. Observe austerity in requisition and preparation for medication such as: o Availability / preparation of drugs when giving prescription. o Medication requiring refrigeration. o Safety of leftover medications (in the proper cubicle) 5. Administer oral medications to pediatric patients 2 years below. (Delegates administration of oral drugs to SO) 6. Delegates administration of oral medications to patients. 7. Counter-check medications against doctors order. 8. Check IV potency before giving IVTT medications. 9. Refer to ordering physicians if medications are not available in the Pharmacy. 10. Refer untoward drug reactions to supervisor POD/ROD /AP. 11. Follow-up / check medications / IV of patient assigned to Nurse Trainees / Students. 12. Calibrate/time tape(color coded) / provide stickers to hooked IVF (complete data) 13. Check IV rate / calibration / IV left during endorsement. 14. Fill-in all items called for in the IV stickers (include due date) 15. Indicate medications bought by patients (indicate brand name, time) 16. Endorse reasons for omitting / referral of medications. 17. Return medication / IVF to pharmacy of discharged patient. 18. Provide medication / IVF stock for NOC shift. 19. Follow-up / check take home medication. 20. Instruct patient regarding their take home medications. 21. Log regulated drugs on the notebook. 22. Log book for RX should be completely filled-up (include name and relationship of person who received it) 2. ROUTE OF ADMINISTRATION IV IM/SC PO rectal, per vagina epidural others 3. REPORTING TIME (reactions to medication) 0 5 minutes 6 - 15 minutes 16 - 30 minutes 31 - 60 minutes 4. TYPE OF MEDICINE A. Antacids laxatives Medicated IV

ACTUAL DEMERITS

5 5 20 5 5 5 2 2 5 10 1 2 2 5 5 5 2 5 5 2 2 2 5 5

20 20 10 5 20

1 2 3 4 2 2 2

2 2 2 2 4 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5 5 10 10 10 10 5 5 5 10 10 5 10 10 5 10 10 5 5

Anti-diarrheals Oral contraceptives Expectorant / antitussive Antipyretics B. Antiemetics anti-depressants / anti-anxiety anti-histamines / histamines anti-inflammatory Estrogen Progestins Muscle relaxants non-barbiturate / hypnotics non-narcotics analgesics Complex IVs Electrolytes Anti-parkinsonian C. Antibiotics / anti-infectives Anti-convulsants Anti-psychotics Barbiturates Diuretics Narcotics antagonists Oral anti-diabetic Steroids Glucose / Glucagon 50% D. Anti-coagulants / thrombolytic Bronchodilators Cardiovascular drugs (antidysrrhythmics, antihypertensives, Narcotic agents

vasoactive/vasodilators)

E. Heparin Blood and blood components Chemotherapeutic and anti-neoplastic Total parenteral nutrition Insulin Pediatric medication 5. MEDICATION ERROR TOOL TYPE OF ERROR 1.Wrong time 2. Wrong route 3. Omission of medication (for each dose) 4. Wrong Date 5. Wrong IV solution rate (for each that is incorrect) 6. Wrong dose 7. Wrong medication solution 8. Extra dose (for each extra dose) 9. Unordered medication (for medication given to patients with stated allergy to that medication add 5) 10. Delayed drug / IV (for each hour) 11. Fast infusion (for each hour)

B. DOCUMENTATION/FOLLOW-UP PROCEDURES 10 5 10 10 10 5 FAILURE TO: 1.Fill-up Nursing Kardex 2.Update white board for reminders. 3. Chart / graph flow sheet called for. 4. Transcribe / pass charge slip / BIZBOX / job order / notice slips to: laboratory, dietary, PT, Radiology, Pharmacy, Billing, etc. 5. Document treatment / procedures given or done to patient. 6. Check / follow-up: o Laboratory, FNAB, X-ray and UTZ results o Dietary o Laboratory specimen (stool, urine) o Endoscopy results o Referrals / co-management / transfer services. 7. Give procedure / treatment promptly. 8. Do 24 hours check of doctors orders. 9. Monitor vital signs and neurological status. 10. Assist in bed bath and turning of patients. 11. Place siderails. 12. Check Emergency Cart (Medications and Supplies) 13. Update BIZBOX patients diet. 14. Return equipment used by patients. C. COMMUNICATION FAILURE TO : 1.Refer abnormal laboratory / x-ray / UTZ result to PGI/POD/ROD/AP. 2. Refer untoward procedure reactions to Supervisor/PGI/POD/ROD/AP. 3.Refer pertinent signs and symptoms to PGI/POD/ROD/AP. 4. Notify AP / BO / Dietary and other department regarding transfer to another unit. 5. Endorse canceled treatment / procedure to department concerned. 6. Endorse / instruct / follow- up patient for diagnostic procedure with special preparation such as NPO and enema. (Including procedures to be done outside) 7. Instruct patient regarding their follow-up check-up. 8. Send Surgery Notice to OR. 9. Send notice /booking / inform Endoscopy, Hemodialysis, ERD.

5 10 5 2 10 10 + payment 2 5

10 2 2 2 5 10 2 2 2
CORRESPONDING DEMERITS

OFFENSES CONCERNING EMPLOYEE REGULATIONS

1. Refusal or failure to attend departmental devotional without justifiable reason. 2. Refusal or failure to attend staff meeting without justifiable reason. 3. Refusal or failure to attend hospital meeting without justifiable reason. 4. Refusal or failure to attend meetings/ conferences without justifiable reason. 5. Coming in late for duty for more than five minutes without justifiable reason. 6. Coming in late for duty for more than ten minutes without justifiable reason. 7. Coming in late for duty for more than fifteen minutes without justifiable reason. 8. Coming in late for duty for more than thirty minutes. 9. Coming in late for duty for more than one hour. 10. Coming in late for duty after break for more than five minutes.

ACTUAL DEMERITS

5 10 5 10 5 10 15 20 25 5

25 5 10 5 5 5 5 5 5 5 5 5 5 5 2 2 2 2 10 50 20 5 10 10 10 + Payment 10 10 10 10 50 50 50 50 25 25 25 25 25 25 25 50

11. Coming in late for duty after break for more than thirty minutes. 12. Failure to log in/out daily time record more the once in a fifteen day period. 13. Changing work schedule without prior approval of the immediate supervisor. 14. Rough playing or fooling around within the hospital premises whether or not on duty causing damage or wastage. 15. Rough playing or fooling around within the hospital premises whether or not on duty causing injury to self or any person. 16. Rough playing or fooling around within the hospital premises whether or not on duty causing disruption of work flow or considerable annoyance to co-workers or customers. 17. Not complying with prescribed dress code and appearance standard: Hair: Female - long hair should be tied in a bun or enclosed with a hair net, should not touch uniform. All hair paraphernalia should be colored black only. Male - hair should be clipped close to the nape; should not touch the level of eyebrows, ears, nor the uniform; it should not be gelled upwards. Face: Female may use moderate make up only. Male should be clean shaven. No make-up should be used. Jewelries should not be worn while on duty. Hospital ID or nameplate should worn at all times. Female: Nurses Cap should be worn at all times especially in the station. Nursing shoes or tennis shoes should be all white and clean. Socks worn should be all white. Uniform should be all white and ironed neatly. Nurses assigned in Special Departments should wear prescribed uniform and hair should be worn neatly. Purely white colored jacket, sweatshirts and windbreakers should be used during duty hours. Wear plain colored face mask (white, green, blue). 18. Excessive absences. 19. Habitual tardiness. 20. Failure to meet work requirements or standards. Incomplete or unfinished charting on the chart (BACKWORKS) Unfinished procedure. Failure to return borrowed equipment, apparatus to the CSR. Failure to give Medical Certificate /Sick Leave Form within 24 hours. Failure to give Vacation leave form. 21. If absent and no calls have been received. 22. If absent and no approval has been given. 23. Taking off or not reporting for work despite specific instruction to report, or when no suitable reliever has been scheduled. 24. Leaving or quitting work assignments during official work hours without proper authorization. 25. Refusal or failure to report if there is an immediate need. 26. Gross inefficiency and/or habitual neglect of duty. 27. Sleeping while on duty. 28. Loitering while on duty. 29. Sidelining while on duty. (Conflict of interest) 30. Loafing (idleness) while on duty. 31. Misuse of work time . Texting and charging of cellphones (except supervisors) Playing of computer Taking of pictures, using camera/video cams not allowed unless with patients

50 25 25 100 100 100 100 100 100

written consent. Posting of pictures, etc are not allowed on social networks (patient right to privacy) 32. Misuse of sick leave. 33. Malingering. 34. Insubordination and uncooperative. 35. Refusal or willful disobedience to lawful orders of the hospital. 36. Inducing others to violate hospital rules and regulations. 37. Deliberate slowing down, limiting production or limitation causing other s to do so. 38. Inciting or participating in work stoppage, slow down, mass leave, sit down, or other similar disruptive activities. 39. Willful breach by the workers of the trust reposed in him/her by the hospital or its duly authorized representative.

ACTS AGAINST CUSTOMERS AND PERSONS WITHIN THE HOSPITAL PREMISES

25 25 50 50 50 100 100 100 100 1. Arguing or debating with any individual especially with a customer for ANY REASON. 2. Discourteous behavior with any individual especially with a customer for ANY REASON. 3. Fighting or intimidating others to flight of inflicting physical injury to anyone. 4. Attempting/threatening to use physical force on any person within hospital premises. 5. Carelessness or negligence in handling customers resulting to customer complaints and/or grievances. 6. Carelessness or negligence in performing procedures resulting to erroneous outcome with injury. 7. Carelessness or negligence in performing procedures resulting to erroneous outcome without injuring. 8. Carelessness or negligence in performing duties with resulting loss or damage. 9. Carelessness or negligence in performing duties without resulting loss or damage.

OFFENCES AGAINST PUBLIC MORALS

25 25 50 100 100 100 100 100 100 1. Use of profane, abusive or insulting language in addressing another person. 2. Discourtesy and insult towards co-workers, officers, superiors. 4. Public passionate kissing. 5. Coming to work under the influence of intoxicating drinks or any prohibited drugs or bringing them within hospital premises. 6. Sexual harassment. 7. Showing of pornographic materials/films. 8. Abandonment of family. 9. Homosexual relationship. 10. Immorality such as premarital sex or extramarital relationship.

ACTS OF DISHONESTY
25 50 50 100 100 100 100 100 100 1. 2. 3. 4. 5. 6. 7. 8. 9. Accepting or performing outside job without official permission. Filing out another employees record. Giving false testimony during investigation. Failure to turn in collections, cash receipts and other documents. Falsify information and employment application. Falsify/tamper with hospital records and documents. Falsify/tamper with hospital work schedule. Falsify/tamper with hospital records and documents Falsify/tamper medical certificates, etc.

OFFENCES AGAINST INSTITUTIONS INTEREST AND INTEGRITY

50 50 50 50 100 1. Unauthorized use of hospitals name to obtain personal benefits. 2. Spreading of malicious rumor/s or public misconduct/s which brings reproach upon the institution or the Seventh-day Adventist Church. 3. Patronizing or promoting outside ancillary services that are presently available in the hospital. 4. Accepting money or anything of value by entering into unauthorized arrangement with suppliers and clients. 5. Revealing or passing on to any person or agency any information about hospitals business transactions and financial matters without official authorization. 6. Circulation/Posting of any report/publication/letter damaging the reputation of the hospital, its administration, or co-employees.

100

OFFENSES AGAINST SECURITY

25 100 100 100 20 20 25 25 25 50 50 50 100 100 100 1. Refusal to submit or failure to meet security requirements of the hospital. 2. Violation of rules on confidentiality of information. 3. Unauthorized releasing of patients records, etc. 4. Unauthorized possession of firearms or any deadly weapons within hospital premises. 5. Unauthorized posting or removing of any notice or document posted on bulletin boards or hospital property at any time. 6. Unauthorized or negligent handling of hospital property leading to loss, wastage, damage or spoilage. 7. Careless, improper or incorrect use of supplies, machinery and equipment. 8. Vandalism, defacing or marking hospital walls, materials or equipment. 9. Obtaining, giving or passing out or keeping any time, supplies, any hospital stock without payment or proper authorization. 10. Unauthorized use of hospital facilities, equipment or materials for private or personal interest. 11. Deliberate violation of safety rules or common safety practices which causes injury or damage to life and property. 12. Fraudulent withdrawal, requisition/release of hospital property to other persons. 13. Malversation of hospital funds, fraudulent cash advances or receiving salaries for other workers without proper written authorization. 14. Theft, unauthorized possession or use of property belonging to the hospital, patient, visitor or co-worker.

OFFENSES AGAINST HEALTH AND SANITATION

10 50 1. Creating or contributing to unsanitary conditions in the hospital premises, e.g. littering, spitting, etc. 2. Smoking cigarette/cigar/tobacco and drinking alcoholic beverages and use of prohibited drugs inside or outside hospital premises. 3. Improper Waste Segregation
30 + payment 40 + payment 50 + payment 1st offense 2nd offense 3rd offens

POINT RANGES WITH DISCIPLINARY ACTION

1-20 Counseling session with supervisor involved 21- 40 Counseling session plus personal study and written reports related to error committed in medication/procedure. Supervisor /NSD 41-60 Counseling session and a written corrective action (a form that goes into nurses employment file) from the unit supervisor. And she writes an analysis of the error, including ideas for preventing similar errors, plus personal study and written reports related to error committed on medication/procedure. 61-80 Along with the counseling session and written corrective action, the unit supervisor checks the nurses performance (medication/procedure) for 3 days. Nursing Council 81- 100 the nurse is suspended for 1 week without pay. Nursing Council More than 100 the nurses work record is examined and if warranted shes dismissed.

The Nursing Service Council / Nursing service Director may implement any discipline. If a nurses error is extremely serious (endangers life of patient) or if she acts negligently after the error (if she tries to cover it up or falsify records).

For unwritten rules: When an employee breaks any of the Hospitals policy in a manner not included/stated in the preceding list, the Administrative Council may administer the appropriate and just disciplinary action addressing such act. In taking disciplinary actions for infarctions, the intention of the institution is not so much to punish as to prevent the recurrence of undesirable acts by either the offending employee or other employees who might follow the example. Management reserves the right to appreciate any aggravating or migrating circumstances on the violation(s) made by the Hospital employee to determine the proper sanction. I HAVE READ AND UNDERSTOOD THE MERITS/DEMERITS SYSTEM BEING IMPOSED BY H.W. Miller MEMORIAL SANITARIUM AND HOSPITAL NURSING SERVICE DEPARTMENT.

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