Your Disaster Plan

1. Your Disaster Plan Plan Today - Survive Tomorrow Digna Cassens, MHA, RD

2. Objectives • At the end of this lesson the participants will be able to: • Organize a realistic plan that clearly defines leadership in the nursing centers dietary departments. • Provide the tools with which to develop a comprehensive plan to protect the residents, employees, and company in a disaster. 9/2010 D.Cassens, MHA, RD

3. Why should we prepare? • The decision to spend dollars and dedicate resources on disaster planning is no longer discretionary. Why? • Higher incidence of natural disasters. • More frequent manmade disasters. • Reduce risk by being prepared. • Enable fast recovery time We can’t continue gambling on our “good luck”. 9/2010 D.Cassens, MHA, RD

4. Departments affected • Administration • Business office • Nursing • Dietary • Maintenance • Housekeeping/Laundry • Social Services/Activities • Therapies 9/2010 D.Cassens, MHA, RD

5. Provide current information Agreements & credit lines with suppliers & purveyors to ensure uninterrupted deliveries Discharge & admissions agreements Assess facilities preparedness Communicate with administration & department heads Facilitate training Routine inspections and data reporting Assign staff Maintain all guidelines and procedures current Maintain mutual agreements file of vendors & other institutions Ensure training and education are conducted routinely & retain documentation Have knowledge of disaster & emergency management & recovery plans Preparedness: Administrator responsibility 9/2010 D.Cassens, MHA, RD

6. Preparedness: Nursing responsibility • Maintain current inventory lists with pharmacy & medical products supplier to ensure deliveries. • Three days emergency supplies available (or per individual state requirement): • Diapers • Treatment supplies • Enteral supplies & water for flushes • Medications • Water for hygiene, medication pass 9/2010 D.Cassens, MHA, RD

7. Preparedness: Dietary responsibility • Maintain current inventory lists with water supplier and food purveyors to ensure deliveries. • Three days emergency supplies available (or per individual state requirement). • Emergency menus & inventory list posted. • Food & supplies to serve residents & staff. • Two gallons water per resident per day (or per state or emergency management office requirement): • 2 quarts per day for drinking, the remaining per day for food preparation, hygiene, sanitation. • Ensure staff training is conducted: • Dietary staff • Other staff: nursing, housekeeping, maintenance 9/2010 D.Cassens, MHA, RD

8. Preparedness: Housekeeping & Laundry responsibility • Ensure sufficient linens & towels supplies are available to meet inventory par-levels • Ensure all housekeeping and laundry staff understand their role in a disaster • Protect available supplies • Maintain sanitation and infection control throughout structure 9/2010 D.Cassens, MHA, RD

9. Preparedness: Maintenance responsibility • Maintain testing and log for: • Generator • Utilities • Fire alarm system • Sprinkler system • Air circulating system • Elevator • Emergency repairs • Ensure adequate water supply available in collaboration with dietary department 9/2010 D.Cassens, MHA, RD

10. Preparedness: Social Services, Activities & Office staff responsibility • Notify residents, families, physicians • Maintain log of all phone calls • Recall and assign staff as directed • Keep current records of all residents including transfers • Contract transportation companies contracted • Help ready medical records, clothing, & supplies for evacuation • Maintain current lists of employees & residents with emergency contact information 9/2010 D.Cassens, MHA, RD

11. Preparedness: Staff responsibility • Attend drills and training offered • Do not use emergency stock & notify supervisor of any shortages in materials • Learn procedures for each local situation • Remain watchful and alert at all times • Report all problems to supervisor • Agree to remain or return to work as soon as safely possible 9/2010 D.Cassens, MHA, RD

12. Your risk Assess your risk by conducting a vulnerability analysis • What disasters are your locations vulnerable to? • What locations are the most vulnerable? • Are they prepared and ready to cope with the results of a disaster? • How long will recovery efforts take? 9/2010 D.Cassens, MHA, RD

13. Fire Earthquake Flood Disruption of services Extreme weather Thunderstorm Bomb threat Explosion Windstorm Civil disturbance Elopement Hurricane Your risk Types of disasters 9/2010 D.Cassens, MHA, RD

14. Your risk Fire At risk locations: • Wooded areas • High brush areas • Hillsides • Steep canyons • Metropolitan areas • Between commercial & residential buildings 9/2010 D.Cassens, MHA, RD

15. Your risk Flood • Internal: burst water pipes or main, plugged drains, burst heaters, flooded streets or neighborhood • External: tsunami, hurricane, excessive rain, high tide, lakes or rivers overflow, collapsed reservoirs 9/2010 D.Cassens, MHA, RD

16. Your risk Structural • Multi-story, number of floors • Elevators, stairs • Type of construction • Age of building • Access, entry, egress, exit 9/2010 D.Cassens, MHA, RD

17. Evacuation Difficulty – Physical Ambulation difficulties Impaired cognition Hearing impaired Visually impaired Injured Evacuation Difficulty – Environmental Elevators City streets Crowds Alleys Traffic Your risk 9/2010 D.Cassens, MHA, RD

18. Your risk • Loss of water • Loss of gas • Loss of electricity • Loss of transportation • Loss of services & deliveries due to strike • Loss of staff due to walk-out or strike Disruption of services 9/2010 D.Cassens, MHA, RD

19. Fire procedure • Call out the code word • Move residents & visitors to safety • Close all doors & windows • Activate the nearest fire alarm box • Call the fire department • Notify all staff • Return to area with fire extinguisher 9/2010 D.Cassens, MHA, RD

20. Loss of water procedure • Notify water company • Know the water shut-off location • Restrict the use of water • Deploy potable water • Release use of other water for cleaning, hygiene • Turn off toilets main; line bowl with plastic bags for waste • Implement emergency menu for “no utilities” to avoid excessive water supply use 9/2010 D.Cassens, MHA, RD

21. Water purification table Liquid chlorine bleach (laundry bleach) 5 ¼ % Sodium Hypochlorite solution AmountClear WaterCloudy Water 1 Qt 1 drop 3 drops 1 Gal 4 drops 10 drops 5 Gal ¼ tsp ½ tsp Let stand for 30 minutes 9/2010 D.Cassens, MHA, RD

22. Loss of gas procedure • Notify gas company • Know gas shut-off location • If gas leak suspected notify fire department • Do not use matches, candles or open flames • Turn off automatic starters & pilot lights • Use emergency menu for “no utilities” 9/2010 D.Cassens, MHA, RD

23. Loss of electricity procedure • Notify the power company • Know main power panel location • If emergency generator does not start automatically notify Maintenance & person in charge • Use flashlights (no matches or open flames) 9/2010 D.Cassens, MHA, RD

24. Earthquake procedure • Protect yourself so that you can then help the residents • Make initial check for injuries and damage • Shut doors to damaged areas • Calm the residents • Move beds away from windows,close drapes & curtains • Prepare for aftershocks • Follow specific “loss of” procedures as needed 9/2010 D.Cassens, MHA, RD

25. Flooding procedures • Causes: • Broken water main • Excessive rain • Broken dam • Shut off all utilities • Notify fire department • Activate any subterranean pump • Move residents to safety away from the water 9/2010 D.Cassens, MHA, RD

26. Extreme heat procedures • Close shades & blinds • Protect residents • Plan for air circulation & cooling • Serve cold meals • Increase hydration & include frozen items • Turn off all unnecessary electric • Ensure generator works • Santa Ana conditions • Excessive heat • Wind • Brown-outs • Black-outs 9/2010 D.Cassens, MHA, RD

27. Windstorm procedures • Secure all outdoor furniture & equipment. • Move residents inside, away from windows. • Shut & secure windows & doors. Close curtains, shades. • Expect and prepare for disruption of services & possible fires. 9/2010 D.Cassens, MHA, RD

28. Bomb threat procedures • If a threat is called in: • Remain calm, respectful and attentive • Ask for bomb location, description, timing • Try to attract attention of other staff to call police 9/2010 D.Cassens, MHA, RD

29. Explosions procedures • Shut off utilities • Move residents to safest location • Notify fire department • Notify utility companies • Administer first aid • Arrange for casualties transport • Inspect for damage 9/2010 D.Cassens, MHA, RD

30. Extreme weather procedures • Thunderstorms • Prepare for loss of power & possible fires • Turn off all electrical appliances, TV, radio • Excessive rain • Prepare for possible flooding & loss of power • Tornadoes • Move residents to safe location • Secure doors, windows, draw shades & curtains 9/2010 D.Cassens, MHA, RD

31. Civil disturbance procedures • Secure building locking all doors & windows. Close shades & curtains • Move residents to safest, most secure locations • Plan for staff not being able to arrive for next shifts if problems nearby 9/2010 D.Cassens, MHA, RD

32. Emergency phone list Disaster tags Emergency treatment record Admission record Zip-lock bags for valuables Ball-point pens Note paper Battery radio/TV Spare batteries Flashlights Safety pins First aid kit Floor plan Casualty flow chart Mutual assistance agreements Heavy duty plastic bags & sturdy ties Disaster kit contents sample list Each department must have their own disaster kit & include their own needed supplies 9/2010 D.Cassens, MHA, RD