University of Iowa Health Care Safety Training

Tornado Utility Interruptions Fire Ergonomics Workplace Violence Reproductive Hazards Security/Emergency MSDS Chemical Spills Disaster/Emergency Communications Tuberculosis Code Pink Accident/Emergency Bloodborne Pathogens Medical Equipment Standard Precautions University of Iowa Health Care Safety Training

Tornado Safety Tornado Watch Tornado watch means conditions are right for a tornado. Staff should be alert to weather conditions. Tornado Warning Tornado warning means a tornado has been sighted.

Tornado Safety An announcement will be made over the CDD public address system advising staff, patients, families and visitors of the tornado warning.

Tornado Safety Areas Of Safety Areas of safety include rooms and corridors without windows, especially rooms and corridors that do not border an outside wall. Crouch near the floor or under heavy, well supported objects and cover your head. Areas to Avoid Stay clear of all windows, corridors with windows, or large, free-standing expanses.

Tornado Safety General Guidelines • Remain calm, avoid panic, offer reassurance to patients. • Transfer all ambulatory patients to areas of safety. - Patients who cannot be moved should be covered with pillows, blankets, mattresses. - Close all doors, including corridor doors, so that they latch. - Close all drapes, curtains, or blinds as time permits. - Do not attempt to utilize elevators due to the possibility of power failure.

Tornado Safety CDD room N181 (staff lounge) has been equipped as a storm shelter. This room contains a gray back-up telephone, red emergency outlets and other emergency supplies.

Tornado Safety A notification stating, “The Tornado Warning time has expired. The Tornado Warning is no longer in effect,” will be sent out when it is safe for staff members to return to their work areas. End of Topic

Utility Interruptions: Electrical Loss of NormalPower - Generator produced emergency power will be available to red outlets at CDD within ten seconds. - Only critical patient support equipment should be plugged in to red emergency electrical outlets. - Elevator A is tied into CDD’s emergency power system and will operate normally during a power outage.

Utility Interruptions: Electrical Staff should report the loss of power to Safety & Security (6-2658 or 195 for emergencies). Staff in patient care areas should ensure there are flashlights and extra batteries at the work area.

Utility Interruptions: Medical Gases (including oxygen, air and vacuum) • Check status of all patients on medical gases. • Ensure life support equipment is maintained. • Dial Safety and Security (6-2658 or 195 for emergencies) to report loss of medical gases. • Only patient care staff in the affected area have the authority to shut off medical gases.

Utility Interruptions:Medical Gases Oxygen is not affected by electrical power outage. In the event of low oxygen gas pressure (displayed by the medical gas alarm panel), oxygen cylinders will be delivered to patient areas. Medical air compressors will be maintained by emergency power generators.

Code “F” (Fire) In the event of a fire alarm, check the CDD fire annunciator panel located near elevator A on first floor.

Code “F” (Fire) If the annunciator panel does not indicate an alarm condition in your immediate area, resume normal activities, but remain alert for signs of smoke and fire.

Code “F” (Fire) If the annunciator panel indicates an alarm condition in your area, proceed to the area indicated and follow the RACE procedure: Rescue /remove the patient Activate the fire alarm, pull the nearest pull station and dial 195 (outside UIHC dial 911) Confine the fire, close the door Evacuate patients if necessary; extinguish the fire if possible to do so safely

Code “F” (Fire) Patient Evacuation -Evacuate horizontally, if possible, through at least one set of smoke/fire doors. -If not possible to evacuate horizontally, evacuate vertically using fire safe stairwells (do not use elevators). -Evacuation routes are identified by the red exit lights.

Code “F” (Fire) Types of Fire Extinguishers: Type A - Pressurized water in silver cylinders. Use on materials such as wood, paper, and cloth. Do not use on flammable liquids or electrical equipment. Type BC - Carbon dioxide (CO2) in red cylinder. Use on flammable liquids and electrical fires. Type ABC – Multi-use dry chemical extinguisher in red cylinder, found primarily in equipment and mechanical rooms.

Code “F” (Fire) Fire extinguishers are located throughout the Center for Disabilities and Development. Learn the locations of extinguishers closest to your work area(s). Extinguish the fire with a fire extinguisher only if you are confident you can do so safely.

Ergonomic Risk Factors WHAT IS ERGONOMICS? Ergonomics is the science of fitting the workplace conditions to the job demands of the worker.

Ergonomic Awareness

Ergonomic Awareness Examples of Ergonomic Injuries -Back Disorders (most back injuries result from lifting patients or objects without adequate assistance) -Cumulative Trauma Disorders (CTD) -Carpal Tunnel Syndrome (CTS) -Tendonitis

Ergonomic Awareness Work Practice Controls Ergonomic risk factors can be minimized or eliminated by -Incorporating proper body mechanics and neutral postures; and/or -Managing work time at a job task by using job rotation or breaks. - Using engineering controls (such as patient lift equipment).

Ergonomic Awareness Ergonomic Injuries Employees shall report all injuries including ergonomic injuries to their supervisor and complete the ‘Workers’ Compensation—First Report of Injury or Illness’ form. Additionally, the employee shall complete a ‘UIHC Unusual Incident & Accident / Staff, Visitor, and Equipment Report’ form.

Ergonomic Awareness Questions? If you have a question or concern regarding The University of Iowa’s Ergonomics Program or any topic covered in this guide, contact David Hackbarth, Safety Engineer, Health Protection Office, at 335-9547 or e-mail: david-hackbarth@uiowa.edu.End of Topic

Security and Emergency Combative Patients/Code Green A Code Green violent patient management team is available to respond to potentially violent patient situations. Any staff member may declare a Code Green by dialing 192 if out-of-control patients pose a threat. When calling the Code Green number: - identify that you need the Code Green team - identify yourself - identify the unit, building and room number

Security and Emergency Disruptive, Hostile, Threatening Visitor, Family or Staff -Staff shall report incidents of violence directed at themselves, other staff, students or patients to their supervisor, Hospital Human Resources or Safety & Security (dial 6-2658 or 195 for emergencies). Safety & Security will work with Hospital Administration and local law enforcement agencies to control these situations.

Security and Emergency Violent Occurrences - Be prepared to provide as much information as possible. - location - who is involved - what is happening - type of weapon, if any

Security and Emergency Possession of Deadly Weapons by Patients, Visitors, and Staff When it is known or suspected that a person is in possession of a weapon, contact Safety & Security (195 for emergencies) for assistance.

Security and Emergency Bomb Threat - Remain calm. - Try to keep the caller on the line. - Pay attention to background noises and distinctive sounds: - caller’s voice (ethnicity, level of education) - traffic or machine sounds, other voices. - Try to obtain information on location of bomb, time of detonation and type of detonator. - Call Safety and Security (195 for emergencies) as soon as possible.

Security and Emergency Missing Patients Call Safety & Security (dial 6-2658 or 195 for emergency) for assistance in locating the patient. Also contact CDD Administration.

Security and Emergency Personal Safety - Notify Safety & Security (dial 6-2658) to report activities involving harassing or obscene telephone calls or mail, threats, confrontations. - If you are working in an area by yourself during evenings, nights or weekend hours, notify another staff member or Safety & Security.

Security and Emergency Avoid dark, isolated areas. Be aware of your surroundings and of other people who might approach you. Proceed to your destination quickly and confidently. Do not enter or remain in an elevator if individuals make you feel uncomfortable. Elevators at UIHC have a red button that when pressed will connect you with Safety and Security.

Security and Emergency Staff Escorts Staff concerned about their personal safety may request rides from UIHC to UI parking areas. - Weekdays 7:00 p.m. - 1:00 a.m., Driver is located at the main entrance. - Weekdays 1:00 a.m. – dawn, Call Safety & Security (6-2658). - Weekends 7:00 p.m. – dawn, Call Safety & Security (6-2658). End of Topic

Workplace Violence Domestic Violence Concerns It is not uncommon for domestic violence issues to be carried over into the workplace. Staff who have concerns about domestic violence should notify their supervisor and Safety and Security (6-2658). Such reports will remain confidential. Staff who are aware of domestic violence issues involving patients should report the information to their supervisor, CDD Social Services, and CDD Administration.

Workplace Violence Warning Signs Single characteristics do not serve as an indicator, but combinations of characteristics could indicate an increased likelihood of violence. Use of alcohol or drugs Expressing anger regularly in the workplace Loud and aggressive nature Change in mood Personal hardships Mental health issues Negative behavior Verbal threats History of violence

Workplace Violence Response In most cases it is best to avoid challenging the aggressive person. Try to show empathy and understanding. It is almost always better to let a person “vent.” Respond in a soft voice. This may cause the person to stop yelling in order to hear what you are saying. In some cases, setting acceptable limits with the individual may be effective, e.g., “I’m sorry, I can’t talk to you when you are yelling at me; please stop yelling so we can talk.”

Workplace Violence Response Staff should be certain they are at least one body length away from an aggressive person. Position yourself so you can step back or exit the area quickly. Staff who are facing a potentially violent situation should attempt to leave and report the incident to their supervisor or Safety & Security (195 for emergencies).

Reproductive Hazards A reproductive hazard is any biological, chemical, or physical stressor that has the potential to adversely affect the human reproductive process. These effects may occur through either parent’s reproductive cells, prior to conception or during the development of the fetus.

Reproductive Hazards Each year some 14 million workers are exposed to conditions that may impair their reproductive systems or unborn children. The University of Iowa Hospitals and Clinics is committed to a safe and healthy workplace, and reproductive health is one aspect of that program.

Reproductive Hazards The following table lists examples of some common reproductive hazards that you may encounter here at the hospital and in everyday life. This list is by no means exhaustive. You should consult your Department’s Hazard Communication plan and review all chemical MSDSs that you work with for a complete listing.

Reproductive Hazards Examplesof Reproductive Hazards Found at Work

Reproductive Hazards Employees shall report reproductive hazard concerns to their supervisor as soon as possible. If you have a question or concern regarding reproductive hazards, contact the University Employee Health Clinic at 356-3631 or the UIHC Safety Manager at 384-5208. End of Topic

Material Safety Data Sheet (MSDS) Information All staff have the right to know what hazards are present when working with chemicals. Each department shall maintain an inventory of all chemicals used in an area along with MSDSs for those chemicals. MSDSs will be available to all staff during work hours. In addition to the MSDS, other sources of information regarding chemicals in your work area include container labels and the INFORMM system

Material Safety Data Sheet The sections of an MSDS include: Chemical Identity Hazardous Ingredients Physical and Chemical Characteristics Reactivity Data Fire and Explosion Data Health Hazards (including exposure hazards and symptoms) Precautions for Safe Handling and Use Control Measures (including spill clean up)

Material Safety Data Sheet READ LABELS! Labels will identify health and physical hazards. All hazardous product labels must include the name of the chemical, the nature of their hazards, and what precautions should be taken. If a secondary container is used, the name of the chemical and the hazards must be transferred to the new container. End of Topic

Hazardous Chemical Spill Response Before cleaning up a spill, staff need to know what chemicals are involved. Use the MSDS to find out what kind of precautions and procedures to take in cleaning up the spill.

Hazardous Chemical Spill Response Spills should be contained so that they do not get into drains and sewers. Report all hazardous chemical spills using a Staff/Equipment Unusual Incident & Accident Report, Form 261.

Hazardous Chemical Spill Response Unmanageable Chemical Spill If any of the following conditions apply, immediately call Safety & Security (195 for emergencies): - the chemical is unknown - there is an immediate danger to life or health - there is a combustible or explosive hazard - there is a threat to the environment - staff have no knowledge of the material or cleaning process

Disaster/Emergency Preparedness and Response Disaster Preparedness Every CDD staff member must be familiar with the role of their department within the CDD Disaster Plan.

Disaster/Emergency Preparedness & Response Unless patient care duties or facility conditions dictate otherwise, report to your supervisor or CDD Administration for further instructions upon learning that a disaster response situation is in effect.

Disaster/Emergency Preparedness & Response Staff responsible for patient care should continue their normal activities, but remain alert for further instructions and information. Be prepared to assist CDD patients, families and visitors to exit the facility.

University of Iowa Health Care Safety Training