Education and Training Yale New Haven Center for Emergency Preparedness and Disaster Response 2008 Spring Course Guide About Our Courses The Yale New Haven Center for Emergency Preparedness and Disaster Response (YNH-CEPDR) develops, delivers and evaluates educational programs designed to prepare the health care delivery workforce for effective response to all types of disasters and emergencies. YNH-CEPDR creates and adapts s for health care organizations based on the latest research and developments in emergency response, incorporating national standards and regulations relevant to health care emergency preparedness, adhering to industry standards for instructional design and considering the special needs of busy adult learners. 1 Church Street, 5th Floor New Haven, CT 06510 Tel (203) 688-3224 E-Mail center@ynhh.org www.yalenewhavenhealth.org/emergency Disasters are inevitable.your response is not.
Incident Command/National Incident Management System (NIMS) training: During an emergency, an Incident Command System (ICS) assists in the command, control and coordination of all efforts aimed at protecting life, preserving property, supporting the emergency response and stabilizing the operations of a health care site. NIMS was designed by the federal government to function as a system to support consistent responses for everyday emergencies to major multiple casualty incidents. Introduction to Emergency Management (EM 103 w/nims) Health care workers in acute care hospitals, community health centers, home health agencies, urgent care centers and skilled nursing facilities Narrated CD-ROM train-thetrainer Train-thetrainer CD-ROM Assists staff in understanding their role in providing continuous care for existing patients and additional patients in the event of an emergency EM 103 with NIMS information topics include: Understanding the impact of emergencies and disasters on their facility Preparing for their roles and responsibilities in an emergency or a terrorist event Identifying mental health needs in an emergency Preparing their families for a possible disaster This meets The Joint Commission (EC 4.10-4.18) and Centers for Medicare and Medicaid Services (CMS, 482.42A1) requirements for emergency management training completion provided for online and instructorled 1.0 CME credit online Incident Command Systems for Health Care (EM 140 w/nims) Leadership roles within a health care organization EM 140 with NIMS information topics include: The ways an ICS can provide a consistent approach to command and control during an emergency or disaster The composition of an effective ICS before an actual incident occurs An overview of roles and responsibilities of ICS members Review of Unified Command, needed when incidents involve not only health care facilities, but also other response organizations both private and governmental This meets The Joint Commission (EC 4.10-4.18) and Centers for Medicare and Medicaid Services (CMS, 482.42A1) requirements for incident management structure training completion provided for online and instructorled 1.0 CME credit online Page 2
Incident Command for Medical/Technical Specialists (EM 141) Identified Medical/ Technical Specialists within a health care organization Advanced EM 141 information topics include: Review of the roles and responsibilities for Medical/Technical Specialists within the Incident Command System Review of the types of documents, tools and resources a Medical/Technical Specialist may use during an incident Identifying various information status reports for the Incident Commander and other delivery network hospitals Emergency Operations Centers Considering strategies for advising the Incident Commander on medical staff, clinical or operational requirements related to specific types of emergency events National Response Framework (NRF), the National Incident Management System (NIMS) Federal Emergency Management Agency (FEMA) The Joint Commission Hospital Incident Command System (HICS), 4th Edition Prerequisite: EM 140 w/ NIMS Hospital Incident Command System (HICS IV) Workshop Incident command staff class with exercises HICS IV information topics include: New items for the Hospital Incident Command System (HICS IV) Changes to the organizational chart, job action sheets, and forms Implementation strategies for HICS IV Facilitated tabletop discussion Designed to allow ICS staff to be current on the latest evolution of the Hospital ICS system and to apply their knowledge Prerequisite: This workshop is intended for health care professionals already using the Hospital Emergency Incident Command System, 3 rd Edition (HEICS III) Page 3
Courses focused on the protection of the health care workforce: Provide information on hazardous substances and the risks associated with them as well as procedures needed to ensure the safety of health care workers and patients during an emergency or disaster. Best Practices for the Protection of Hospital-Based First Receivers (EM 120) Employees who might be in a position to identify a contaminated victim who arrived unannounced. This group includes ED clinicians, ED clerks and ED triage staff who would set-up the decontamination system before victims arrive or tracking patients from a location outside of the decontamination zone Narrated CD-ROM EM 120 information topics include: Threats from specific agents Levels of biological, chemical and radiological protection and isolation Various levels of respiratory protection Principles of decontamination Decontamination procedures Mental health concerns regarding decontamination Personal safety issues regarding decontamination OSHA, 29CFR 1910.120(q)(6)(i)) Hazardous Waste Operations and Emergency Response (HAZWOPER) awareness-level standard related to hospital-based first responders 1.0 CME credit online N95 Respirator and Personal Protective Equipment (PPE) Training for Health care Workers (EM 121) Civilian and military health care workers who need to don and doff the N95 respirators and basic personal protective equipment (PPE) while caring for certain infectious patients, including those with pandemic influenza CD-ROM EM 121 information topics include: Reasons for respirator and personal protective equipment (PPE) use PPE, proper methods for inspecting PPE and donning and doffing a respirator The effective use of a respirator and PPE Common errors made in PPE and N95 respirator use OSHA Respirator Standard 1910.134(k), 1910.120 Armed Forces training requirements (USACHPPM, NHRC, AFRL) Page 4
Civilian and military health care workers who need to perform a fit test for health care workers who must wear the N95 respirator Intermediate just-intime training CD-ROM EM 122 information topics include: Identifying the need to conduct the N95 respirator fit test Conducting a fit test for N95 respirator use Performing proper inspection and disposal of respirators OSHA Respirator Standard 1910.134(k) Armed Forces training requirements (USACHPPM, NHRC, AFRL) N95 Respirator Fit Tester Training (EM 122) Best Practices for the Protection of Hospital- Based First Receivers, Operations Level (EM 220) MD/DO, PA, NP, RN, LPN, allied health, maintenance, environmental services, facility, engineering staff, security and contractors who are part of decontamination teams and/or setting up and taking down decontamination facilities Intermediate Two part : Operationslevel instructor-led practical EM 220R yearly review EM 220 information topics include: Preparation for health care workers, such as emergency department clerks and clinicians, who are assigned to work in contaminant-free areas but who may need to identify possible risks associated with unannounced patients Preparation for health care workers with designated roles for contaminant removal or who will work in areas that are considered contaminated; training includes proper use of protective equipment Preparation for hazardous materials technicians and hazardous materials specialists, including radiation safety officers Regulations outlined in Congressional Federal Register, CFR 1910.120, and the Best Practices for Hospital-Based First Receivers of Patients, which was a result of the Occupational Health Safety Act revisions of February 2005 to address the concerns of hospital responders and practical programs Prerequisite: EM 120 Page 5
Courses focused on CBRN: Recognizing and responding to chemical, biological, radiation and nuclear disasters. Introduction to Radiological Emergency Preparedness (EM 110) Nurses, doctors, radiology technicians, radiation oncologists, radiation safety officers, patient care associates, technical assistants, nuclear medicine workers, EMS workers Narrated CD-ROM EM 110 information topics include: Basic principles of radiation Definitions of terms commonly encountered in radiological and nuclear incidents A description of the health risks associated with radioactive material Recommendations for safeguarding personal safety during a radiological or nuclear incident An outline of strategies for addressing the psychological impact of radiological and nuclear incidents Nuclear Regulatory Commission (NRC) OSHA The Joint Commission Radiation Principles for Treating Patients with Radiological Injuries (EM 210) Physicians and other clinicians, including APRNs and PACs Intermediate EM 210 information topics include: Principles of ionizing radiation Precautions and personal protective equipment for handling potentially irradiated and contaminated patients Processes of victim decontamination Common radiological and nuclear accidents The etiology of radiation induced-injuries Recognizing the presence of local and whole-body radiation injury Treatment priorities for patients with combined injury Internal decontamination agents and uses Treatment modalities for irradiated individuals The psychological effects of victims involved in radiation accidents Nuclear Regulatory Commission (NRC) OSHA Page 6
Bioterrorism Preparedness for Clinicians (EM 201) Recommended for physicians and other clinicians, medical professionals and first responders Intermediate Designed to prepare physicians and other clinicians for a bioterrorist event or other potential public health emergency EM 201 information topics include: Bioterrorism events Bioterrorism agents Clinical recognition of syndromes Preventing person-to-person transmission Communication Disposition Mental health issues Additional resources Columbia University School of Nursing and Association of Teachers of Preventive Medicine Clinician Competencies (HRSA endorsed) specific to biological events completion for online 1.0 CME credit Page 7
Courses focused on special populations: Designed to prepare physicians and other clinicians to better treat at-risk populations during a health-related emergency. Course Name Targeted Audience Modality Course Overview Mental Health Aspects of Emergencies and Disasters for Non-Mental Health Professionals (EM 230) Health care professionals who may come in contact with victims of an event EM 230 information topics include: Identifying and managing expected stress anxiety associated with emergency events Recognition, treatment and referral of patients exhibiting behavioral health consequences related to public health emergencies Brief video vignettes to enhance the learner experience Columbia University School of Nursing and Association of Teachers of Preventive Medicine Clinician Competencies; Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR)- defined at-risk population 1.0 CME credit Page 8
Small Victims, Big Challenges: Pediatric Triage, Treatment and Recovery in Disasters (EM 250) Recommended for physicians and other clinicians, medical professionals and first responders Advanced EM 250 information topics include: Identifying required and desirable personnel, equipment and infrastructure for pediatric disaster preparedness Demonstrating the ability to triage children who are victims of multiple casualty incidents (MCIs) using internationally accepted criteria (JumpSTART ) Describing and identifying clinical manifestations and appropriate treatment for child victims of natural and human-caused disasters Summarizing the mental health needs of infants, children and adolescents in disasters Identifying key elements for designing an exercise for children with special needs Applying lessons learned to new and updated plans, treatments, preparedness, procedures, response and recovery This addresses an ASPR-defined at-risk population and is an ASPR partnership project. This was developed in collaboration with the AHEC of Southern Nevada. Page 9
Geriatric Preparedness, Triage, Treatment and Recovery in Disasters (EM 260) Recommended for physicians and other clinicians, medical professionals and first responders Advanced EM 260 information topics include: Identifying the need for geriatric-specific disaster health care practice Describing the geriatric disease model as it pertains to disaster medicine Identifying the necessary systems, personnel and materials for geriatric disaster preparedness and evacuation Demonstrating the ability to triage geriatric victims of mass casualty incidents Describing and identifying the clinical manifestations and appropriate treatments for geriatric victims of natural and human-caused disasters Naming elements for designing drills and exercises that address issues related to geriatric patients Incorporating lessons learned into new and updated plans and procedures for response and recovery This addresses an ASPR-defined at-risk population and is an ASPR partnership project. This was developed in collaboration with the AHEC of Southern Nevada. Page 10
National Disaster Life Support (NDLS) s: YNH-CEPDR has been designated as the Northeast regional provider for NDLS by the American Medical Association. These s are recommended for physicians, nurses, physician assistants, nurse practitioners, emergency medical technicians, paramedics, dentists, pharmacists, medical examiners, allied health professionals, health profession students, emergency management and disaster relief workers. Course Name Targeted Audience Length and Modality Course Overview Basic Disaster Life Support (BDLS) Physicians, nurses, physician assistants, nurse practitioners, dentists, pharmacists, medical examiners, allied health professionals, health profession students, emergency medical technicians, paramedics, emergency management and disaster relief workers BDLS information topics include: All-hazards overview Natural and human-made disasters Traumatic and explosive events Nuclear and radiological events Biological events Chemical events Psychosocial aspects of terrorism and disasters The role of the public health system No prerequisites training, valid for 4 years 1.0 CME credit Advanced Disaster Life Support (ADLS) Physicians, physician assistants, nurse practitioners, nurses and paramedics Advanced Practicum ADLS information topics include: Hospital and field triage techniques Medical decontamination Legal issues of disaster response Media and communications during a mass casualty incident Health care facilities and planning Community, state and federal responses Mass fatality incidents practical stations Must have successfully completed BDLS training, valid for 4 years 1.0 CME credit Page 11
Physicians, physician assistants, nurse practitioners, nurses and paramedics Advanced NDLS Instructor Training information topics include: Small-group discussions and practice sessions to assist physicians, PAs, NPs, nurses and paramedics with becoming familiar with establishing and conducting an NDLS Specific detail regarding the labor-intensive needs of the program are discussed along with potential sources of assistance Must have successfully completed the ADLS training, valid for 4 years No CMEs offered at this time National Disaster Life Support (NDLS) Instructor Training Page 12
This focuses on volunteers: This is designed to prepare hospital disaster volunteers (ESAR-VHP, MRC) for their roles during a disaster. Introduction to Emergency Management for Health Care Disaster Volunteers (EM 102 w/nims HDV) Hospital volunteers This is designed to help hospital disaster volunteers understand their role in providing continuous care for existing patients and additional patients in the event of an emergency. EM 102 w/nims HDV information topics include: Understanding the impact of emergencies and disasters on hospitals Preparing for their roles and responsibilities in an emergency or a terrorist event Identifying mental health needs in an emergency Preparing their families for a possible disaster The Joint Commission (EC 4.10-4.18) Centers for Medicare and Medicaid Services (CMS, 482.42A1) Page 13
This focuses on drills and exercises: This is designed to prepare emergency management personnel in designing and conducting drills and exercises. Course Name Targeted Audience Modality Course Overview Introduction to Designing Exercises for Health Care Facilities (EM 170) Emergency management personnel, emergency planners and other personnel responsible for developing drills and exercises Intermediate EM 170 information topics include: Benefits of exercises to the facility and its personnel Regulatory requirements for exercises Differences between discussion-based and operations-based exercises Five phases of developing an exercise Prerequisites: Completion of FEMA IS 120 Recommended completion of FEMA IS 139 Understanding of the National Incident Management System (NIMS) Review of the Homeland Security Exercise and Evaluation Program (HSEEP) guidelines Familiarity with The Joint Commission requirements for environment of care Page 14
Courses focused on evacuation: This is designed to prepare all health care personnel for evacuations. Course Name Targeted Audience Modality Course Overview Competency/Capabili ty Introduction to Evacuations (EM 150) All health care employees All health care facilities are at risk for incidents that lead to partial or full evacuations, from water pipe breaks to fire to natural disasters to human-made incidents. EM 150 information topics include: Events that cause evacuation Approaches to evacuations Scenarios that lead to certain types of evacuations Tasks key to any evacuation Security concerns that affect evacuations and related procedures Patient flow Concerns and suggested solutions involved in resource tracking OSHA Health Insurance Portability and Accountability Act (HIPAA) The Emergency Medical Treatment and Active Labor Act (EMTALA) All health care employees that might be called upon to assist in the evacuation of patients Intermediate Health care evacuations, partial or full, involve the movement of patients and equipment. Evacuations are often time-sensitive and must be carried out quickly, sometimes with minimal resources. Use of proper techniques helps ensure that people are moved safely and effectively during an evacuation. OSHA Patient Movement during Evacuations (EM 151) EM 151 information topics include: Proper lifting techniques Ratio of workers to patients Types of special considerations and solutions that add complexity to a potential evacuation Step-by-step instructions for using modes of transport during an evacuation Response agencies that may be involved or impact a health care evacuation Page 15