RCRH Contractor In-service 2013

1. RCRH Contractor In-service2013 Rapid City Regional Hospital 353 Fairmont Boulevard Rapid City, SD 57701 October 2013

2. AGENDA • Handouts • General Information/Work Issues • Infection Control • Hazard Communication • Emergency Preparedness • Fire Procedure • Lockout / Tag out • Construction Management • Compliance/Privacy Training • Contact list • In-service Quiz

6. GENERAL INFORMATION/WORK ISSUES • Tobacco Free Campus • This policy supports tobacco free campuses to benefit the health, safety, and well being of all who visit and work at our facilities. The tobacco free initiative applies to all facilities in the geographic area comprising the entire campuses, off-site properties, including buildings, walkways, parking lots/ ramps, and any public sidewalk or street that falls within campus boundaries of any facility in Regional Health. • This policy will include Employees, Volunteers, Medical Staff members, Allied Health Professionals, Contractors, Vendors, Visitors, and Patients. • Those who choose not to adhere to this policy are subject to progressive disciplinary management/ corrective action. • Behavior and Attire • No profanity. • No lewd lettering or symbols on clothing. • No harassing words or body motions.

7. Influenza Vaccination • Influenza vaccination contributes to patient and employee safety • National trend – Required annual influenza vaccination • South Dakota Association of Healthcare Organizations (SDAHO) Policy • Regional Health, Sanford, and Averahave implemented required influenza vaccinations in 2013 • All Regional Health System employees, providers, volunteers and students will be required to have an annual influenza vaccination • Contractor Vaccination Plan • All contractor employees or sub-contractor employees working in a Regional Health Facility will be required to have an influenza vaccination. • Influenza vaccination records must be submitted to the General Contractor of current construction projects or the Construction Management Department by October 31, 2013. • Influenza vaccination records will be required before starting any future work at any Regional Health Facility.

8. INFECTION CONTROL • Hand washing • Before eating and off campus smoking. • After going to the bathroom. • After you wear protective latex gloves. • After any contact with blood or other body substances. • After work. • Barrier Equipment • Wear for any potential exposure to blood or body substances. • Infection Control • Plant Operations and/or the Project Coordinator/ Supervisor has access to the Infection Control Policies for your use upon request. • Masks • Wear masks when working with ceiling and carpeting materials. • Sharp Objects • If you find something that may cause an exposure to you, contact Plant Operations personnel at extension 8888 to take care of it. Security can be notified at extension 8215 if Plant Operations is not available. • Exposure to Blood or Body Substances • Wash the exposed area immediately. • Contact your supervisor for follow-up action. • Reference the Infection Control Manual for more information.

9. EMPLOYEE RIGHTS The Occupation Health and Safety Act established certain guidelines for all employers to use for the protection and safety of their staff. All employees should be oriented to the hazard communication program. Review of the Hazard Communication Program will inform the staff about this program.

10. HAZARD COMMUNICATION Over the years, research has shown that sometimes workers are exposed to chemical hazards. It is known that chemical exposure may cause serious health effects. Chemicals may also be safety hazards. Some even have the potential to cause fire or other serious problems. Goals for Hazard Communication: • Hazard Communication • Recognize the Hazard Communication. • Employee Rights • State in your own words how you can protect yourself when asked to work with hazardous chemicals. • Labels on Containers • Identify the chemical name and the manufacturer on a container label. • List the two most common hazards found on container labels. • Material Safety Data Sheets • Identify where to find material safety data sheets. • List two ways to detect the presence of hazardous chemicals. • Identify the first person you should contact if a spill or injury occurs when using a hazardous chemical. • Lockout / Tagout Procedures • Always follow OSHA Lockout / Tagout Procedures.

11. Material Safety Data Sheets Should a spill or injury occur when using a hazardous chemical, contact your manager or supervisor immediately. Review of the Material Safety Data Sheet (MSDS) will provide facts on how to handle the chemical if spilled. It will also inform you of what to do in case of an injury. Below is a list of the information provided on the MSDS. Section I Identification • Manufacturer’s name, address and telephone number. • Chemical name, family and formula. Section II Hazardous Ingredients • Product ingredients and percentages. • Conditions for safe exposure. (Threshold Limit Value - TLV) Section III Physical Data (Basic Scientific Data) • Boiling Point. • Appearance and odor. Section IV Fire and Explosion Hazard Data (Basic Safety Data) • Flash point and flammable limits. • Fire fighting procedures and materials. Section V Health Hazard Data • Safety information. • Effects of overexposure. • First-aid procedure. Section VI Reactivity Data • Stability of the product and what will react with it. • Conditions to avoid. Section VII Spill or Leak Procedures • Steps to control spills. • Proper disposal of wastes. Section VIII Special Protection Information • Personal protective equipment. • Ventilation needed to control exposure. Section IX Special Precautions • How to handle and store the product. • Other necessary precautions. A list of all chemicals used in the building, along with their MSDS forms, are on file. All containers that hold chemicals must display a label that lists the contents and dilution rate.

12. Labels on Containers Any container which holds hazardous substances must have a label on it. The label should include the following items: • Name of chemical. • Name, address and telephone number of manufacturer. • Type of hazard(s). • Care to be taken when using the chemical. Each employee must be able to read and understand these labels. The information included on them will be of great value in case of a spill or an injury when using the chemicals. Certain information may be of value to the user regarding chemicals. Listed below are the two most common hazards found on container labels. • Physical Hazards - Reactive – chemicals that may undergo a violent change. - Flammable – chemicals that may ignite. • Health Hazards - Irritant – a substance that affects the skin, eyes, nose or respiratory tract upon contact. - Sensitizer – a substance that may cause an allergic response. - Corrosive – a substance that causes damage to the skin upon contact. - Toxic – a substance that can cause harmful effects depending on the dosage. - Carcinogenic – an agent that may cause cancer.

13. SUMMARY OF HAZARD COMMUNICATION Review of the Hazard Communication Program is crucial to any staff member who works with hazardous chemicals. Being able to read the labels on containers is vital to all staff members. The label provides facts on the type of chemicals found in each container. The Material Safety Data Sheets provide more information on what to do in case of an accident or spill involving the chemical. Be sure you know how to respond if an OSHA surveyor asks you specific questions about hazardous materials. Sample questions you may be asked by an OSHA surveyor include: • What training have you received in dealing with hazardous materials? • What hazardous material is commonly used in your work area? • What is an MSDS? • Where do you find an MSDS in your department? • What type of information is found in an MSDS? Reference of Resource List 1. Hazard Communication 2. Hazardous Materials and Waste Management 3. Department Manager/Supervisor 4. Safety Officer -- 719-5544 or Pager 536

14. Security • Hazard Communication • Hazard Communication • Employee Rights • Labels on Containers • Material Safety Data Sheets • Fire Procedures • R.A.C.E. • P.A.S.S. • Emergency Preparedness

15. EMERGENCY PREPAREDNESS MANUAL Rapid City Regional Hospital maintains an Emergency Preparedness Program. Within the program are the policies and procedures to follow in the event of an emergency. A quick response to a real emergency is vital to the safety of everyone. Policies and Procedures Policies have been established to help direct staff in case of an emergency. Everyone should learn what to do when a disaster notice is given. It is also vital to know what each code means. Listed below are a number of different disaster codes and a brief description of each. External Disasters: 1. Emergency Room Disaster (Paged “ERD”) Staff is informed that more patients are arriving than can be handled by on- duty staff. Departments most likely affected include Emergency, Lab, Radiology and Surgery. 2. Standby Disaster (Paged “Standby D”) People on duty are warned that a disaster may occur. This will allow time for planning, resource gathering, etc. Should the disaster occur, a major disaster would be declared. 3. Major Disaster (Paged “Major D”) Staff is informed that a disaster has occurred. Also, more resources will be needed to handle the influx of patients expected. The entire system will then function on an emergency basis.

16. Internal Disasters: 1. Tornado Warning (Paged “Condition Tornado”) Staff is warned that a tornado has been sighted or announced by weather radar. 2. Winter Storm Warning (Paged “Condition Snow”) Staff is warned that the weather may cause a problem in staffing and supplies. 3. Utilities/Communication Failure (Paged “Condition U”) Staff is warned that one of the systems has failed: - Water Medical Vacuum Heating fuel (natural gas, oil, etc.) - Electricity Medical Air Oxygen 4. Hazardous Materials Incident (Paged “Condition Hazmat”) Staff is warned of an accident involving hazardous materials. 5. Cardiac/Respiratory Failure (Paged “Code Blue”) Alerts the Code Blue Team to respond to a cardiac/respiratory failure. 6. Evacuation (Paged “Condition Evac”) Staff is alerted that evacuation measures will take place in certain parts of the building. 7. Threat of Violence Plan (Paged “Condition TOV”) Alerts security personnel that a hostage or workplace violence situation may be occurring. 8. Bomb Threat (Paged “Condition X”) Staff is informed that a bomb threat has been received or that a bomb has been detected. 9. Fire Emergency (Paged “Condition Red”) Staff is informed that smoke or fire has been observed; the fire alarm system has been set off or an explosion has occurred. 10.Infant Abduction (Paged Condition “PINK”) Alerts staff that a possible abduction has occurred; watch all exits from the hospital.

17. FIRE PROCEDUREFollow the R.A.C.E. acronym when you smell smoke, hear an explosion or see fire!R.A.C.E. • R…Rescue • Fire demands attention. • Rescue anyone in immediate danger. • A…Alarm • Activate the alarm system. • Notify people in the area. • Call the switchboard at 3111. • Give the precise location of the fire. • C…Confine • Close all doors and windows. • Turn on all lights. • E…Evacuate • Move all people to a safe location. • Extinguish the fire only if your safety can be assured. • (Note: All drills are treated the same as an actual fire.)

18. FIRE PROCEDUREFollow the P.A.S.S. acronym when you smell smoke, hear an explosion or see fire!P.A.S.S. • P…Pull Pin • A…Aim • S…Squeeze • S…Sweep (Note: All drills are treated the same as an actual fire.)

19. LOCKOUT / TAGOUT PROGRAM RAPID CITY REGIONAL HOSPITAL What is Lockout / Tagout? Lockout / Tagout is for the control of hazardous energy sources and covers servicing and maintenance of machines and equipment in which the unexpected energization or startup of the machines or equipment or a release of stored energy could cause injury to employees. The OSHA ruling generally requires that the energy sources for equipment be turned off or disconnected and that the switch either be locked or labeled with a warning tag. Hazardous energy sources associated with machinery are: 1. Electrical 2. Pneumatic 3. Hydraulic 4. Fluids and Gases 5. Mechanical Basic Rules Applying to Lockout / Tagout Procedure • Anytime more than one person is performing “Servicing or Maintenance” on a piece of equipment at the same time, each shall place his/her own padlock on the energy isolating device. • No one other than the person(s) placing padlock(s) on energy isolating devices shall remove padlocks and restore power. • It shall be the responsibility of the contractor to enforce this policy in their trade. • The contractor must provide training to all authorized and affected employees to ensure the policy is understood. Basic Rules for Using Lockout or Tagout System Procedure • All equipment needs to be locked out or tagged out to protect against accidental or inadvertent operation when such operation could cause injury to personnel. • Do not attempt to operate any switch, valve, or other energy-isolating device where it is locked or tagged out.

20. Contractors Parking Company vehicles only Contractors Personal Vehicle Parking Construction Storage Trailer Parking

21. Construction Management • Facility Usage • Parking • Designated areas • Towing vehicles • Elevators • Cafeteria • Entrances • Mechanical/Electrical areas • Materials storage • Work Permits • Cutting/Welding open flame • Cutting concrete floors • Airborne Contaminants • Risk assessment • Containment • Body protection • Clean-up • Daily inspection • Stop Work

22. Construction Management • Rated Separations • Corridor and ceiling work • Fire caulking • After hours work • 2 to 3 day notice • How work affects adjacent hospital program • Something Wrong? Please Report! • Set off alarms • Disrupt building operation • Before any floor drilling, contact a RCRH representative

23. Regional Health (RH) Compliance Program • RH Commitment • Code of Conduct • Open Lines of Communication • Anonymous Hotline – 1-877-800-6907 • Corporate Responsibility Department – 716-4738 • Non-retaliation

24. HIPAA Privacy and Information Security • Health Insurance Portability and Accountability Act (HIPAA) • Privacy Rule: What information is protected? • Security Rule: How we protect such information? • What information is protected by HIPAA? • What responsibilities do I have in protecting and securing information? • What are the consequences of non-compliance?

25. Additional Information • For further information on any aforementioned manual or program in this presentation contact the Director of Safety or the Project Coordinator (Contact information is on the contact list) or your supervisor.