Hospital Orientation Completion Check
- Review attached information about each topic.
- Discuss with Preceptor/Manager.
- Date each item as completed
- Complete signatures and dates.
- Original completed checklist form to be placed in department (for students or agency) or HR file (for SHC employees) – Send a copy to the Nurse Education.
- “Workforce Confidentiality Agreement” filed in department for agency; in HR for employee; or send to Staff Development for students.
| Date Completed |
Topic |
| 1. | Overview of Shriners' Hospital Purpose – SHC Mission History, Organization, Application Process, Customer Relations, Code of Ethics |
| 2. | Plan of Patient Care Overview – Family Centered Care Policy, Scope of Services, Patient Care Standards |
| 3. | SHC HIPAA Overview – Complete HIPAA Prof training – Manger/staff to witness "Workforce Member Confidentiality Agreement" |
| 4. | Infection Control (Body Substances, PPE, Barriers, Hand washing) explains responsibility. |
| 5. | Emergency Response (Internal and External Emergencies/Drills/Policy /Procedure) |
| 6. | Fire Response Plan (Discuss: RACE, Location of Alarm Pull Stations, Exits, Extinguishers, and Evacuation Procedures). Life Safety Management. Location of Quick Reference Guidelines. |
| 7. | Electrical Safety (identify work hazards, red/white outlets). |
| 8. | Hazard Substance Release Response – Discuss and review chemical used. |
| 9. | Discuss General Department, and Patient Safety Concerns and Goals, as applicable. |
| 10. | Code Adam – Explain role in the vent of child abduction. |
| 11. | Code Rambler – Explain role in the event of a disruptive person. |
| 12. | Code 99 – Explain role and emergency number to call.First Aid Response – Minor and Code First Aid |
| 13. | Back Safety/Safe Moving and Lifting - Review proper body mechanics techniques and review workspace if applies. Identify assisting methods. |
| 14. | Smoking Policy |
| 15. | Sexual Harassment Policy |
Name (please print) Start Date Department/School
Signature of Orientee Date Orientation Coordinator/Preceptor/Supervisor Signature Date


