Chapter 39 Emergency Preparedness

1. Chapter 39Emergency Preparedness

2. Safety and Preparedness • Safety in the healthcare facility extends to clients, employees, students, and visitors. • The goal is to prevent accidents and to be prepared for emergencies. • *Safety committee is responsible for disaster plans, safety policies and procedures, procedures for handling hazardous substances, and information sheets regarding these substances.

3. Client Safety • A client has the right to expect that a healthcare facility will protect against injury and disease. • Facility safety measures • General emergency preparedness • Plans for specific emergencies • Plans for evacuation • Policies for resuscitation • Accurate administration of medications and treatments.

4. Client Safety (cont’d) • Most healthcare facilities require all staff to attend regular training sessions regarding safety. • Topics include • Fire safety • Handling of hazardous materials • Code or disaster procedures

5. Measures That Help Prevent Accidents • Double-lock medicine carts and medicine rooms. • Ensure all medications are kept out of the reach of children. • Get adequate assistance to move and walk clients. • *Use a transfer belt when necessary. • *Assessing clients and documenting on them q 24 hours

6. Measures That Help Prevent Accidents (cont’d) • Always use two means to identify each client before performing any procedure or giving a medication. • Conduct and document fall risk assessment. • Place the client’s necessary items within reach. • Especially consider the left-handed client.

7. Fall Risk Evaluation • Clients are evaluated on a regular basis for the risk of falling. • Hendrich Fall Risk Tool may be used. • The client is scored on each risk factor in the Fall Risk questionnaire. • If a factor is absent, the score for that factor is 0. • If the total score is 5 or greater, the client has a high risk of falling.

8. Fall Risk Evaluation (cont’d) • *The client at risk for falling is often identified by • A special yellow wrist band • Yellow slipper-socks • A “falling star” sign outside the room

9. Employee Safety • OSHA requires a job safety analysis (JSA) for each position. • Employee right-to-know laws • Employees have the right to be aware of all dangers associated with hazardous substances or harmful physical or infectious agents they might encounter in the workplace.

10. *Occupational Hazards • Flammables • Poisons • radiation • Oxygen • Chlorosorb • X-rays

11. Material Safety Data Sheet (MSDS) • Each facility must have an MSDS describing any substance considered hazardous. • *It gives information on protective equipment required, safe handling information, and first-aid interventions for accidental exposure. • The information helps staff provide appropriate treatment and to take necessary precautions when exposed to contaminated individuals in an emergency department or ambulance.

12. *Safety Tips for Hazardous Substances • Have the phone number of the local Poison Control Center readily available. • Read labels carefully and note emergency information. Follow instructions for use, storage, and disposal. Never use any unlabeled substance. • Never store hazardous materials in alternative containers. Do not use or store gasoline or turpentine indoors, or use hairspray or other aerosol products around an open flame, eyeglasses, or contact lenses.

13. Safety Tips for Hazardous Substances (cont’d) • Avoid breathing mists or vapors; follow radiation prevention guidelines closely. Use protective equipment as recommended. • If any hazardous substance is spilled, consult facility or home care agency procedures for the safe and approved method of cleanup. • Always wear gloves and carefully wash hands when cleaning up spills. Any major spills must be cleaned up by specially trained personnel.

14. Considerations Affecting Client andEmployee Safety • Weapons, narcotics, and other contraband: If the nurse suspects that a client or visitor has a weapon, the nurse should report it to the supervisor and security department immediately. • Flowers and gifts: Flowers and other gifts can pose a threat to certain clients. • Immunocompromised patients may be affected* • Workplace violence: If a client or visitor becomes threatening, the nurse must protect other clients and self by speaking calmly, moving those threatened to a safer area, and notifying the supervisor or the security staff immediately.

15. Emergency Preparedness • Nurse’s call light and intercom: Check clients frequently if they are sedated or physically unable to use the call light. A tap bell may be used in certain situations. • *Emergency signal: In most facilities, the call signal in the client’s bathroom causes an additional buzzer to sound at a central station, staff can request assistance if needed • Emergency resuscitation: In the hospital and in a skilled nursing facility (SNF), each area generally has a crash cart stocked with emergency medications and equipment. Know the procedure for CPR.

16. Emergency Preparedness (cont’d) • Personal preparedness: • Plan for prolonged power outages. • Keep a first-aid kit stocked and on hand. Carry an emergency kit, an emergency hammer, and a charged cell phone in your car. • Store 1 gallon of water per person in the household per day, and adequate food supplies to last 4 days. • Store prescriptions, glasses, dentures, hearing aids, and other essential items in a secure and accessible area. • Identify safe areas in the home.

17. Disaster Plan • A facility’s disaster plan describes actions to take in a disaster. • Healthcare facilities are required to have regular, periodic fire and disaster drills to allow their staff to practice emergency skills. • These disasters may include tornadoes, blizzards, hurricanes, earthquakes, avalanches, floods, or mudslides.

18. Bomb Threat • In case of a bomb threat, notify the supervisor and security personnel, and protect clients. • In case of threat over the phone, check the “caller ID” to determine the origin of the call, ask questions and write down the caller’s answers, and listen to other cues and note the things heard. • A search will be conducted by the police bomb squad. • The nurse must report anything unusual and follow the professionals’ instructions.

19. Bomb Threat (cont’d) • Stay away from windows or other large glass objects during the search. • Do not use elevators until the situation is cleared. • Carefully document the incident after the danger has passed.

20. *Internal Versus External Disasters • Internal disaster • The facility itself is in danger or damaged and/or function is impaired. An internal disaster may be caused by a fire, an explosion, terrorist activity, radiation, a biological spill, or a storm. • External disaster • Occurs outside the facility and has an impact on normal operations

21. Staff Notification • When telephone service is disrupted, use: • Amateur radio ham operators, television or radio broadcasts • Runners (people who transport messages on foot) • Computers (email), pagers • Contacts outside the affected area • Portable or handheld radios • Police

22. Staff Notification (cont’d) • Implementation • A disaster plan describes duties and responsibilities of staff in a disaster. • It identifies the location of the command center, which provides overall direction of the facility’s activities.

23. Staff Notification (cont’d) • Triage • Process of sorting and classifying injured persons to determine priority of needs • *Simple triage and rapid treatment (START) system: • Identifies people who are going to die quickly if they do not receive immediate medical care

24. Staff Notification (cont’d) • *A disaster medical assistance team (DMAT) provides assistance and support in many environments, both inside and outside healthcare facilities. • The extent of the emergency will affect the decision to evacuate a portion or the entire facility.

25. Evacuation

26. Infant/Child Abduction • Usually a “code pink” is called • Give a full description of the child and the suspect, including what they were wearing. • Tell parents to stay with their children in their rooms. • Move the parents of the abducted child to a private area. • Be prepared with the following information for law enforcement personnel: • Infant footprints, full written description, photos, blood samples, condition of the child, any special health problems of the child such as diabetes or seizures

27. Fire Prevention • Fire prevention requires constant alertness. • Enforce “no smoking” regulations; be sure no smoking occurs near oxygen use or storage. • Inspect the home care client’s home for potential fire hazards. • Make sure all equipment is operating properly; practice electrical safety; make sure fire alarms, fire doors, and emergency stairs are clearly marked and unobstructed; and never prop open a fire door. • Make sure all hallways are clear. Regularly practice procedures to follow in case of a fire.

28. RACE • RACE is an acronym on the general order of procedures for a fire: • R = Rescue: Remove clients from the general area. • A = Alarm/Alert: Sound alarm. • C = Confine: Contain fire. • E = Extinguish fire.

29. PASS • If you must put out a fire, remember the letters PASS: • P = Pull the pin. • A = Aim at the base of the fire, near the edge. • S = Squeeze the handles together. • S = Sweep across the base of the fire, with a back-and-forth motion.

30. Fire Extinguishers and Their Uses • Type A contains water under pressure used for burning paper, wood, cloth. • Type B contains carbon dioxide used for fires caused by gasoline, oil, paint, grease, and other flammable liquids, chemicals, gases, anesthetics. • Type C contains dry chemicals used to put out electrical fires. • Type ABC contains graphite used to put out any type of fire.