HEALTH 4200- INTERNSHIP EXPERIENCE Ainsley WingardClemson-Seneca Pediatrics

INTRODUCTION In the fall semester of 2015 I completed a clinical internship at

Clemson- Seneca Pediatrics and spent over 200 hours in a pediatric practice.

This presentation includes: Description of the internship site Internship site Mission, Values, and Vision Internship Description Internship Duties and Projects

CLEMSON-SENECA PEDIATRICS Clemson-Seneca Pediatrics (CSP) is a multi-physician, multi-office

pediatric group that is a part of Greenville Health System. The practice has locations in Seneca, SC as well as Clemson, SC. Both sites share the same providers, nurses, and office staff.

CSP provides quality pediatric care to infants, children and adolescents from birth through the college years.

Services at CSP include health maintenance, acute care, emergency care, and chronic medical care.

This is a view of the Seneca location of CSP.

MISSION, VISION, VALUESClemson-Seneca Pediatrics shares the same mission, vision, and values as Greenville Health System. Mission: Heal compassionately. Teach innovatively. Improve constantly. Vision: Transform health care for the benefit of the people and communities we serve. Values: Together we serve with integrity, respect, trust and openness.

Clemson-Seneca Pediatrics also had their own mission and goals Mission: “Clemson-Seneca Pediatrics is dedicated to advancing the care of children

and promoting healthy families” The primary focus of CSP is on preventive care and keeping a child healthy. Goals:

“Serve as a family resource for raising happy and healthy children.” “Provide as much education as treatment in order to help children thrive.”

CLINICAL INTERNSHIP DUTIES I completed my clinical internship at CSP working primarily with registered nurses and

medical assistants. My role at CSP was to assist the nurses and medical assistants in any way I could and

function as a member of the healthcare team. Throughout my time at CSP I was able to observe various procedures done by

physicians including cryotherapy for warts, breathing treatments, and suture removals. My duties included:

Working up patients for providers Determining which diagnostic tests may be necessary for a patient (hemoglobin, rapid strep,

mono, flu) and performing these tests. Preparing vaccines, necessary forms and recording in electronic health record as well as SC

DHEC site. Vision and hearing screens.

I will go into more details about my duties in the following slides.

WORKING UP PATIENTS My primary role in the practice was to

work up patients for providers. Working up a patient includes calling the patient back to their room, obtaining their vital signs (height, weight, blood pressure, oxygen saturation, pulse, and temperature) as well as asking any developmental questions necessary.

While working up a patient I was responsible for determining the chief compliant of the patient as well as any potential diagnostic tests that may need to be ordered.

After working up a patient I was responsible for putting this data into the electronic health record system.

This is a picture of me obtaining a patient’s temperature

WORKING UP PATIENTS

This is a picture of me obtaining a patient’s blood pressure.

This is a picture of me obtaining a patient’s height.

PERFORMING DIAGNOSTIC TESTS One of my other duties was performing diagnostic tests on

patients. Diagnostic tests performed at CSP include rapid strep testing, flu testing, urineanalysis without a microscope, mononucleosis testing, hemoglobin testing as well as culturing any specimens necessary to be sent off to the lab.

This is a picture of a rapid strep test I performed on a patient. This test is performed by swabbing the back of a patient’s throat and then placing the specimen in a solution for 5 minutes then reading the test.

This is a picture of the results of a urineanalysis (urine dipstick) performed on a patient.

PREPARING VACCINES I also prepared vaccines for nurses to

administer at CSP. The process of preparing a vaccine includes determining the appropriate vaccine for the patient, assembling the proper forms, drawing up the vaccine, and then recording the vaccine administered into the electronic health record as well as the Vaccines for Children Program’s website. This is a picture of me

preparing a influenza vaccine.

VISUAL ACUITY TEST Patients visit the practice annually for a well check in which

the provider does a physical examination to determine that the patient is healthy and developing accordingly. One important aspect of the well check is the vision screen which I performed regularly . Each eye is tested separately for near and far vision. For patients who have not learned their alphabet yet a three dot vision test is performed to determine if the patient is colorblind.

VISUAL ACUITY TEST EQUIPMENT AND PROCEDURE

The patient looks into this vision screener and first reads the line for 20/20 vision

This panel is used to control near/ far vision as well as left/right eye tests

This chart indicates which letters the patient should be reading for the visual acuity test

HEARING SCREEN Patients presenting to the practice

for well checks also receive an annual hearing screen. The patient wears headphones while buttons which produce a “beep” sound are played at different decibel levels. When the “beep” is played the patient raises the hand which corresponds to the sound the “beep” is played on. The frequency level is changed to test the range of the patient’s hearing. This machine is used for

the hearing screen. The person operating the test raises and lowers the decibel level according to the patient’s response.

INTERNSHIP PROJECTSThroughout my time at CSP I completed various projects within the practice. Further information about these projects can be viewed in my online portfolio. Influenza Vaccine Clinic

I worked with Christie Oliver, RN to complete the practice’s annual influenza vaccine clinics which were held on Tuesdays/ Thursdays this fall. I created a form for parents to fill out upon arrival about the patient’s medical history as well as prepared vaccines for Ms. Oliver to administer. I located information pamphlets about the vaccine and ensured that patients were educated about possible side effects. After the vaccine was administered I recorded the vaccine information into the electronic health record as well as the SC CARES network which is a registry for vaccines given to children in South Carolina.

Vaccine Information Project I organized all of the information pamphlets for various vaccines by age in

which the vaccine is typically given. I ensured that these pamphlets were given to parents of patients who would be receiving the vaccine as well as being easily accessible to providers to hand out the pamphlets.

INTERNSHIP PROJECTS CONTINUED Laboratory Record Book

The State of South Carolina requires each laboratory test be recorded in a book as well as the results. I created the laboratory record book for 2016 in which providers will easily be able to record the results of laboratory tests as well as temperatures of each refrigerator in which vaccines are held in. I assembled a book for each location including tabbed dividers to find information easily.

ICD 10 With the implementation of the ICD 10 coding system in October 2015 I

assisted providers in the transition from the ICD 9 system to ICD 10. I created a spreadsheet of the most frequently used codes in each system so that providers would be able to complete their charting quicker and more accurately. I helped prevent many billing and coding errors by creating this spreadsheet.

INTERNSHIP OUTCOMESThrough my internship experience I was able to… Develop an understanding of childhood development as well as

important milestones that must be met for each age group. Learn common treatment plans for pediatric patients who have

chronic conditions such as ADHD, obesity, and anxiety/depression. Gain greater interest in pediatrics. Improve my knowledge of language used to ease pediatric patients

and their parents fears. Confirm that I want to pursue a career in a clinical medical setting.

CONCLUSIONOverall my experience at Clemson-Seneca Pediatrics was a fantastic one. I was able to see how so many different people come together as a part of a healthcare team in order to provide positive patient outcomes. This internship taught me more about being a professional and the language used in a medical practice. Many of the doctors and nurses I worked with have become my role models and I aspire to one day be as great of a healthcare provider as they are. I learned how to ease patient and family concerns through this internship and developed a greater understanding of empathy. I have enjoyed my internship that I am continuing to volunteer at CSP with the hopes of taking a part time job as a medical assistant there in the spring semester.

SOURCES

“Clemson-Seneca Pediatrics”: Greenville Health System Children’s Hospital. Web. 29 November 2015