NEWPORT HOSPITAL A Lifespan Partner Medical Staff Safety Education

1. NEWPORT HOSPITALA Lifespan PartnerMedical Staff Safety Education

2. PURPOSE OF THE PROGRAM • Inform you about your responsibilities related to the Safety Management Program

3. Your Safety Responsibilities: • If you find any unsafe conditions please notify the appropriate assistant clinical manager or director. • If corrective action is still not taken, notify Joyce Sullivan, Safety Officer (5-1177).

4. FIRE PROTECTION/ DETECTION The basis for our Life Safety Program is the Life Safety Code of the National Fire Protection Agency. We have theresponsibility to provide education related to the safety features of the hospital to ensure the safety of all.

5. NO SMOKING SMOKING POLICY … • Newport hospital is a smoke-free campus. There is no smoking anywhere on the grounds of Newport Hospital

6. Smoking • Physicians are responsible for discouraging patient smoking and providing the patient with alternatives to smoking • Our pharmacy carries: • Nicotine patch (7mg, 14mg, 21mg) per 24 hours • Nicotine gum (2mg per piece)

7. ELECTRICAL SAFETY When using hospital equipment… • Check integrity of wires, plugs and outlets. • Check equipment inspection stickers. IF THERE ARE ANY PROBLEMS OR THE ITEM IS PAST ITS NEXT TEST DATE… DO NOT USE AND REPORT TO STAFF/MANAGEMENT

9. LIFE SAFETY MANAGEMENT • Fire Alarm System • Smoke & Heat Detectors • Manual Pull Stations (Fire Pull Boxes) • Strobe Lights • Horns & Speakers • Code Red = Actual Fire or Fire Drill --Stay put - Limit Travel • Code Clear = All Clear – Free to Move About • Don’t Block Fire Pull Stations or Fire Extinguishers • Don’t Prop Open Fire Doors or Block Fire Doors

10. SAFETY FEATURES OF THE BUILDING KEY CONCEPT … COMPARTMENTALIZATION • Compartmentalization utilizes fire doors to restrict the movement of fire and smoke. • Confines the fire to the smallest area possible.

11. LIFE SAFETY MANAGEMENT • Your role in a fire emergency is to report it to a staff member immediately.

12. EMERGENCY PREPAREDNESS

13. Emergency Preparedness Ongoing…….Continuous Prepare! Training! Exercise (drills)! Evaluation! Improve!!!

14. Incident: any occurrence that requires a response to save lives/property Examples include: • Natural disaster (hurricane, earthquake) • Fire, Building collapse • Disease outbreaks • Terrorist incidents • Hazardous materials incident

15. What is NIMS?? • National Incident Management System. • Developed by Homeland Security. • Provides nationwide plan for organizations to work together during an incident. • Outline is flexible to apply to any size or cause of incident.

16. NIMS: 3 key systems • ICS: incident command system (defines management and structure) • Multiagency coordination: relationship to outside supporting agencies • Public Information: communicating accurate information to public during the emergency

17. What is HICS ?? “Hospital Incident Command System” • HICS is a “chain of command” standardized approach to directing the many activities needed to work through the disaster or incident. • Terminology same for multiple agencies. • Has been tested many times as best practice.

18. HICS: major functions

19. Newport Hospital Disaster Announcements • “Code Triage Standby”: signals information being studied about potential need for disaster response. • “Code Triage”: the Incident Commander has decided to begin full disaster response. Disaster may be internal or external • (additional information will be given)

20. Command Centers • Incident Command Center • Physician Command Center in ED

21. Physician Command Center • Physicians are given an assignment • Surgeons - Prepare Operating Room patients for transfer as needed. Assist with discharge of Ambulatory Surgery Patients, and report to the ED for assignment. • Determine which patients need discharge. • (If EMS on-scene of the disaster request MD on-scene, one off-duty ED physician/or designee will respond to the scene.)

22. Identification System for staff during disaster response • Emergency Dept. MD in charge wears a Red Cap • RN in charge of Emergency Dept. wears a Blue Cap • All other staff wear adhesive name tags with…name and title on personnel protective clothing

23. Additional Announcements • “Code Green” (bomb threat) • “Code Orange” • “Full building evacuation” More than one can be announced, so listen carefully.

24. Code Orange • Release of any contaminant (chemical, biological or radioactive agent) that may put hospital/staff at risk. • Examples: • Accidental release of chlorine from water treatment plant or ammonia from ice plant. • Letter containing white powder (? Anthrax) • “Dirty bomb” explosion • Response: protect First: Self Second: Hospital Third: Patient

25. Code Orange: Responses • Immediate lock down of hospital (Shelter inPlace). • Goal is to protect the greatest number. • Code Orange is announced. • Hospital Staff institute “Code Amber” approach manning stations to assure people don’t enter or leave the department/hospital. • Listen for further instructions.

26. Code Orange • Shelter in Place Philosophy • In the hospital or at home • Whenever there is a biochemical threat or release - close windows, doors, drafts. • Shut off heat, air conditioning, fans. • Listen for further instructions, i.e. intercom, radio, TV. • STAY INSIDE !!

27. Code Orange (Cont.) • 2 Tiered • Decontamination occurs outside the Emergency Department inside an inflatable tent or in the decontamination room located at the ambulance door. • Medical treatment in Emergency Department after patient decontaminated

28. Staging Areas ( for holding patients) • Yellow (less critical) go to the Hill courtyard and Gudoian Conference Room areas. Exit will be out front lobby door. • Red (critical patients) go to the Emergency Department. Exit will be out ambulance entrance to ED. • Green (ambulatory patients) go to Health Information corridor extending into Borden-Carey building. Exit out to Borden-Carey lot.

29. Emergency Preparedness Plan • Drill 2 x per year with community/state involvement. • Dynamic Process – we are always trying to improve. • Good communications provide greatest chance for success, so please don’t assume someone knows something- ask/tell somebody.

30. Communication • Command Center at x 5-2222, if you need anything • Overall details of the disaster will be available via a voice mail at 845-4242. • Blast e-mail may also be considered. This will be prepared by the Incident Commander in conjunction with the Public Information Officer and updated as needed. • The Public Information Officer is the only person releasing information about the incident.

31. HAZARDOUS MATERIALS AND WASTE PROGRAM (HMW)

32. HMW Hazardous materialis defined as any chemical or product that is classified as toxic, flammable, corrosive, reactive or an irritant CAPABLE OF CAUSING HARM OR SERIOUS INJURY.

33. MATERIAL SAFETY DATA SHEET (MSDS) • Purpose of MSDS: • Concisely informs the user of known hazards of a chemical or product and any special handling, training and/or disposal methods. • Refer to MSDS binder (orange) to aid in interpretation or online at MSDSdirect. The hospital has MSDS available for all known chemical and products used.

34. Hazardous Material Spill • Your role is to report a spill and the staff will take care of it.

35. Infection Control Program Purpose: To reduce the risk of infection for any person entering the hospital: • Patients • Healthcare Workers • Physicians • Contract Workers • Students • Volunteers • Visitors

36. Responsibilities of the Infection Control Program • SURVEILLANCE • PREVENTION & • CONTROL OF INFECTION

37. Hand Hygiene • Hand Hygiene is the most important measure to prevent the spread of infection! • Wash Hands with soap and water if they are visibly soiled. • Sanitize Hands with Purell if hands are not visibly soiled or contaminated with blood or body fluids.

38. Technique for Hand Hygiene Alcohol Hand Gels (Purell) • Apply to palm of one hand, rub hands together covering all surfaces until dry Handwashing • Wet hands with water, apply soap, rub hands together for at least 15 seconds • Rinse and dry with disposable towel • Use towel to turn off faucet

39. When Should You Perform Hand Hygiene • Before and after contact with a patient or their environment. • After removing gloves. • Whenever hands become soiled.

40. Environmental Asepsis • Clean patient care equipment before use with another patient. Use environmental wipes (Stethoscopes and Ophthalmoscopes/Otoscopes)! • Clean Equipment should have a pink “Clean” Label on it. CLEAN CLEAN CLEAN CLEAN CLEAN CLEAN CLEAN CLEAN

41. Standard Precautions • Stop and Think!!!!!! • Anticipate a possible exposure to blood or body fluids • Use personal protective equipment (gloves, gown, mask and goggles) • Dispose of waste and sharps carefully! • Use sharps safety devices to protect you and others!!

42. Transmission Based Precautions • Contact Precautions • Droplet Precautions • Airborne Precautions • These precautions are used in addition to Standard Precautions for some infectious diseases. • Always wear the personal protective equipment (PPE) as written on the sign outside the patient’s room.

43. SECURITY MANAGEMENT OBJECTIVES • Maintain a safe and secure environment of care for patients, employees, physicians, and visitors. • Protect the physical assets of the hospital.

44. SECURITY MANAGEMENT PERSONAL SECURITY • I.D. badges are required when in the hospital rounding on patients (Obtain from Security) • Must be visible (photo facing forward -above waist) This is a Newport Hospital/R.I. Dept. of Health requirement. • Close and latch doors upon entering and leaving the building. • Personal belongings such as purses should be locked away.

45. SECURITY MANAGEMENT REPORTING SECURITY INCIDENTS • Report any unusual situation or occurrence to the security officer. • Call operator to page security. • If you need help quickly in an EMERGENCY, dial 5-3333.

46. SECURITY MANAGEMENT CODE GRAY • The call to summon a team of responders (Engineering, Environmental Services, and Security) to help diffuse a potentially violent situation. • Goal: a “show of force” or, if necessary, “take down” a patient safely. • Accessed by dialing x5-3333.

47. CODE SILVER • Any situation that escalates beyond a Code Grey, or a weapon/hostage situation is present. • CODE SILVER: is announced three times, with the location of the problem, alerting staff and other people to stay away from the potentially violent area. • Reporting: Call x5-3333.

48. CODE AMBER • Infant/child Abduction • Assigned staff to report to specific observation areas. • Medical staff be on the alert to unusual/ suspicious behavior, attempt to verbally detain or continue to observe suspected abductor (if found), and notify a staff member.

49. NEWPORT HOSPITAL FALLS PREVENTION PROGRAM • Certain patients are assessed to be at high risk for falls. • They are identified with a yellow patient ID band and a yellow safety sign on their chart and door. • Please notify nursing immediately if you find a patient is trying to get out of bed by him/herself, reaching, or wandering about.

50. Any Emergency Call 53333