Title of Standard Operation Procedure: ocedure: Person(s) responsible for the production of report First Aid at Work Procedure Health and Safety Manager Reference Number: H&S Procedure 22 Version No: 2 Issue Date: Nov 2016 Review Date:June 2019 Purpose and Background Scope (i.e. organisational responsibility) Vital functions affected by this procedure: Monitoring Compliance To outline the process for first aid at work arrangements. Health and Safety (First Aid) Regulations 1981. This procedure sets out best practice for the organisation to follow in order to demonstrate compliance with legislation. Process to be used for monitoring e.g. Audit Responsible individual / committee for carrying out monitoring Frequency of monitoring Responsible individual / committee for reviewing the results Responsible individual / committee for developing action plan Responsible individual / committee for monitoring action plan Audit H&S Sub Committee 3 yearly H&S Sub Committee H&S Sub Committee H&S Sub Committee Escalations (if you require a clarification regarding this procedure please contact): Health & Safety Manager 01625 661664 Committees / Group Date Consultation: Risk Management Sub Committee Nov 2016 Approval Committee Ratified by Committee: Received for information: N/A internal SOP N/A internal SOP N/A internal SOP H&S_Procedure_22 Page 1 of
1. Background 1.1 Legal requirements placed on the Trust as an employer require that provisions are made to provide first aid at work according to the needs of the Trust. 1.2 The requirements for first aid at their location, including any specific hazards, should be assessed by using the standard tools available in this document. 1.3 Arrangements should be put in place for the selection, training and refresher training of personnel to provide first aid. 1.4 The focus of legal requirements is for the provision of first aid for employees although there is a general duty of care towards other service users. In the hospital environment, first aid provisions for patients are usually directed through nursing staff in which case this procedure should be applied to the remaining first aid needs i.e. staff and visitors. 1.5 All staff should know how to obtain first aid. 1.6 First aid kits and other equipment should be provided and maintained. 1. Notices should be displayed indicating the contact details of first aiders. 1.8 Records should be kept of first aid administered on Datix and of first aid training on ESR. 2 Scope 2.1 The overall legal requirements are contained in the Health and Safety (First Aid) Regulations 1981, which are supported by an Approved Code of Practice. The Health and Safety (First Aid) Regulations 1981 require employers to make adequate provision for first aid for their employees and to ensure that there are a sufficient number of suitably trained and qualified persons for providing first aid. There is also a requirement to ensure that employees are adequately informed of the arrangements. The exact provision in any particular circumstance is not specified in the Regulations, but required to be assessed by the employer. 2.2 The Regulations are supported by a guidance document, which provides guidance for first aid training and requirements relating to the standard of first aid provision required. The extent of first aid provision is to be determined by each Ward/Department/Service by undertaking a risk assessment, having regard to factors such as the number of employees, the particular hazards which they face and the access to other medical assistance. 2.3 These Regulations do not require first aid to be provided for persons who are not employees. However, the Health and Safety at Work Act 194 requires employers to protect persons not in their employment who could be affected by the way in which they conduct their business. There is also a common law duty of care between the Trust and their visitors and patients which arguably would include providing a first aid response to foreseeable health concerns and injuries. For these reasons it is Trust policy to provide first aid for non-employees on our premises. 3 Responsibilities 3.1 General health and safety responsibilities are outlined in section 2.4 of the Health and Safety Policy. 3.2 All Managers are responsible for ensuring that: a) All staff for whom they have responsibility know how to obtain first aid assistance for both staff and patients, how to call a first aider and the location of any emergency equipment. H&S_Procedure_22 Page 2 of
b) Any special first aid requirements within their area of responsibility (e.g. for specific chemical or biological hazards) are identified and adequate first aid arrangements are put in place (including the provision of appropriate and adequately maintained and sited specialist equipment). This will require a risk assessment of the specific hazard as outlined below; c) Where special hazards are identified, their staff are aware of the local procedures and equipment for dealing with them. d) Ensuring that the required number of first aiders for their location and facilities for the provision of first aid are determined by assessment using (H&S Form: 06); e) Unless first aid is to be provided wholly via doctors or nurses, ensuring that there are arrangements in place for identifying staff willing to train as first aiders and to attend first aid training courses as required; f) In respect of Doctors and Nurses appointed to provide first aid support, ensuring that they have the relevant training to fulfil the role; g) Ensuring that notices are displayed with the contact details for first aiders, or clinical staff who are qualified and appointed to provide first aid, and that these notices are maintained with up to date information (e.g. H&S Form : 09 First Aid Notice); h) Ensuring that adequate local procedures are set up for the maintenance of first aid equipment and the replenishment of first aid supplies; i) Reviewing the standards of first aid cover provided at least every year, including the first aid personnel available, the provision of first aid equipment and the number, location and contents of first aid containers provided. f) The provision of a first aid box in non-clinical areas. 3.3 First Aiders and doctors and nurses who have accepted an appointment to provide first aid are responsible for: a) Providing immediate first aid, as required within their level of competency; b) Attending any training arranged to maintain their competency/registration; c) Raising any concerns about their level of knowledge and training, in relation to their ability to undertake first aid duties for which they have been appointed; d) Ensuring that any first aid containers/supplies for which they have been allocated responsibility, are adequately stocked and maintained; e) Completing Datix incident report, including details of first aid treatment, after first aid has been administered. f) NOTE: Provided they can demonstrate current knowledge and skills in first aid, the training and experience of the following qualify them to administer first aid in the workplace without the need to hold a FAW or EFAW or equivalent qualification: Doctors registered and licensed with the General Medical Council; H&S_Procedure_22 Page 3 of
Nurses registered with the Nursing and Midwifery Council; Paramedics registered with the Health and Care Professions Council. 3.4 All employees responsibilities a) In an emergency, staff may access first aid materials whilst waiting for a first aider, nurse or doctor, but must not otherwise remove items from the first aid boxes. b) All staff should ensure that they know who their local first aiders are, how to call them and the location of first aid equipment. 4 Assessment and local arrangements for First Aid 4.1 First aid needs will depend on a number of factors including work activities, the numbers of employees, size and layout of the premises. 4.2 Specific first aid requirements should be assessed and documented, along with local first aid arrangements, using H&S Form: 06. 5 Training 5.1 The requirement for HSE to approve the training and qualifications of appointed first-aid personnel has been removed from October 2013. However, the Trust has chosen to continue using the optional four-layer framework for first aid provision which has been in place for many years: (1) Appointed Person; (2) First Aid At Work; (3) Emergency First Aid At Work (4) Additional Training. The training requirements for the four-layers are as follows:- 5.2.1 Appointed Person (AP) (a) (b) If the Assessment of First Aid Requirements (H&S Form 06) identifies that a first aider is not required in the workplace, a person should be appointed to take charge of the first aid arrangements. The AP role includes looking after the first-aid equipment and facilities and calling the emergency services where required. No formal training course attendance is required. 5.2.2 First Aid At Work (FAW) : First Aiders attend a 3 day course that covers the following: (a) (b) (c) Administering first aid to a casualty with injuries to bones, muscles and joints, including suspected spinal injuries; chest injuries, burns and scalds, eye injuries, sudden poisoning, or anaphylactic shock. Recognition of the presence of major illness and providing appropriate first aid. All the subject areas listed in the EFAW training below. 5.2.3 Emergency First Aid At Work (EFAW) : Emergency First Aiders attend a 1 day course that covers the following: (a) (b) (c) (d) (e) (f) Understanding the role of the first aider including reference to cross infection, the need for recording accidents and incidents and the use of available equipment. Assessing the situation and circumstances in order to act safely, promptly and effectively in an emergency. Administering first aid to a casualty who is unconscious (including seizure). Administering cardiopulmonary resuscitation. Administering first aid to a casualty who is choking, wounded and bleeding or suffering from shock. Providing appropriate first aid for minor injuries. H&S_Procedure_22 Page 4 of
5.2.4 Additional Training Additional Training may be required after completing H&S Form 06 to manage any risks specific to a Ward/Department/Service. For example, use of an automated defibrillator or where the presence of major illness (including heart, attack, stroke, epilepsy, asthma, diabetes) have been identified. 5.3 Annual Refresher Course All First Aid certificates are valid for three years. To maintain registration first aiders must attend a re-qualification course before the current certificate expires. The FAW requalification course lasts two days and should cover the same content as the initial FAW course. Staff who do not re-qualify within the time frame will be required to undertake the full course if in excess of one month has elapsed since the FAW expired. In addition, all First Aid trained staff will be required to complete an annual refresher every 12 months. The suggested course content for annual refresher training is as follows: (a) Assess the situation and circumstances in order to act safely, promptly and effectively in an emergency. (b) Administer first aid to a casualty who is unconscious (including seizure). 5.4 First Aid training is provided through the Learning and Development Team. 6 First Aid Equipment Every location must have sufficient first aid equipment to meet the local needs. The relevant first aider should normally be given responsibility for checking on the contents of first aid boxes under their control. First aid containers must be checked regularly (at least quarterly) for general condition. Contents must be checked regularly to ensure that materials used are replenished, materials remaining are sufficient and are in date. Dated records of these checks and actions must be kept. H&S Form 0 can be kept in the first aid kit and used to record the checks. First Aid Kits.1 Workplace First Aid Kits There is no mandatory list of items to be included in a first aid container. Whether using a first aid kit complying with BS 8599 or an alternative kit, the decision on what to provide will be influenced by the findings of the assessment of first aid requirements (H&S Form 06). As a guide the following list is a suggested list of minimum contents where work activities involve low hazards: (a) (b) (c) (d) (e) (f) (g) (h) 1 leaflet giving general guidance on first aid 20 individually wrapped plasters of assorted sizes appropriate to the type of work (hypoallergenic plasters can be provided if necessary). 2 sterile eye pads 2 individually wrapped triangular bandages, preferably sterile 6 safety pins 6 medium sized individually wrapped unmedicated dressings (12cm x12cm) 2 large sterile individually wrapped unmedicated dressings (18cm x18cm) At least 3 pairs of disposable gloves It is recommended that tablets and medicines should not be kept in a first aid box. Some H&S_Procedure_22 Page 5 of
workers carry their own medication prescribed by their doctor (e.g. an inhaler for asthma). If an individual needs to take their own prescribed medication, the first aider s role is limited to helping them do so and contacting the emergency services, as appropriate..2 Optional Extra Items depending on Needs Assessment Foil blankets, disposable aprons, individually wrapped moist wipes. Adhesive hypoallergenic microporous tape, shears capable of cutting through clothing and sterile disposable tweezers..3 Travelling First Aid Kits There is no mandatory list of items to be included in first aid kits for travelling workers. They might typically contain: (a) (b) (c) (d) (e) (f) (g) 1 leaflet giving general guidance on first aid 6 individually wrapped plasters of assorted sizes (hypoallergenic, if necessary). 2 individually wrapped triangular bandages, preferably sterile 2 safety pins.4 Eyewash Stations 1 medium sized individually wrapped unmedicated dressings (12cm x12cm) individually wrapped moist cleansing wipes 2 pairs of disposable gloves If mains tap water is not readily available for eye irrigation, at least one litre of sterile water or normal saline (0.9% w/v) in a sealed disposable container should be provided. Once the seal is broken containers should not be kept for reuse. Containers should not be used beyond their expiry date..5 Spare Supplies Sufficient spare supplies should be kept to enable first aid kits to be promptly re- stocked. Each ward and department is responsible for the up keep and ordering of first aid stock. 8 Other Special Provisions The first aid provision for one-off individual work activities involving special or unusual hazards should be determined on a case by case basis and included in a specific risk assessment covering all the safeguards for the work involved. In some cases such work is undertaken by contractors in which case the primary responsibility for the provision of first aid will rest with the contractor unless a specific agreement is made with the Trust to the contrary. 9 Cardiac Arrest or Other Medical Emergencies 9.1 In the event of a cardiac arrest or other medical emergency outside the boundaries of Macclesfield District General Hospital, please contact the Emergency Services on 999. Within the boundaries of Macclesfield District General Hospital, when an adult or child collapses - with suspected cardiac arrest (or other medical emergency requiring immediate medical attention) - staff should immediately call for the Resuscitation Team by dialling the telephone number 2222. 9.2 The precise location of the patient / person must be communicated promptly and clearly to the Switchboard Operator: For adults state "adult cardiac arrest" and specify precise location For children state "paediatric cardiac arrest" and specify precise location H&S_Procedure_22 Page 6 of
For neonates state "neonatal cardiac arrest" and specify precise location 9.3 The Resuscitation Team will respond to all 2222 calls, including those made from the Millbrook Unit and also for areas external to the main hospital building, e.g. hospital drive / grounds / car parks, New Alderley Building, Silk House, Dialysis Unit, etc. However, for those occasions whereby a 2222 call is made for a location external to the main hospital building, on receiving the 2222 call, Switchboard will immediately make a 999 call - to ensure the patient/person is transferred to the appropriate department via Ambulance. Within all the clinical areas, all staff are responsible for knowing the location of the nearest available Resuscitation Trolley. Please Note: If you are a Resuscitation Team member you must ensure you familiarise yourself with all the areas contained within the boundaries of Macclesfield District General Hospital. Furthermore, on receiving a message to attend a 2222 emergency you must attend without undue delay taking steps to ensure your own personal safety during your response. If you have any queries regarding medical emergencies please contact the Resuscitation Officer on ext: 3081 or bleep: 9999. 10 Notices Signs should be displayed indicating the contact details for first aiders should be displayed for the attention of staff. Standard signs complying with the Health and Safety (Safety Signs and Signals) Regulations 1996 can be obtained from good sign suppliers. Alternatively, H&S Form: 09 may be completed then printed on a colour printer and laminated. 11 Insurance First aiders, Appointed Persons, Doctors and Nurses are covered by the Trust s insurance whilst undertaking first aid at work. 12 Records of First Aid Treatment 12.1 A Datix incident form will need to be completed for staff suffering an injury at work in line with the Policy for the Management and Investigation of Incidents, Complaints and Claims Including the Analysis of Data. 12.2 Any accidents which result in specified injuries, result in more than seven days sickness absence to a member of staff or involve certain specified injuries to members of the public are reportable to the Health and Safety Executive under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 2013 (RIDDOR). Details of the reporting arrangements are given in the Policy for the Management and Investigation of Incidents, Complaints and Claims Including the Analysis of Data. H&S_Procedure_22 Page of
Appendix 1 Assessment of First Aid Requirements Ward/Department Service Complete the checklist (section 3, pages 3-4) and then view the table below (section 1) to estimate the number of firstaid personnel for your Ward/Department/Service to be available at all times people are at work. Record your first-aid provision in the table on page 2 (section 2). Where the term first aider is used in the following table, you may take this to include Doctors and Nurses who confirm that they are suitably trained and agree to be appointed to deliver first aid to the group (see 3.4 of the procedure). Section 1 - Suggested numbers of first-aid personnel to be available at all times people are at work H&S_Procedure_22 Page 8 of
Section 2 Record of first-aid provision First-aid personnel Required Yes/No Number Needed Appointed Person First-aider with an emergency first aid at work certificate First-aider with a first aid at work certificate First-aider with additional training (specify) First-aid equipment and facilities Required Yes/No Number Needed Dust and damp proof first aid container Kit contents Additional equipment (specify), e.g. foil blankets, eye wash bottles, shears, microporous tape Defibrillator Travelling first-aid kit First-aid room *The minimum first-aid provision for each work site is: A person appointed to take charge of first-aid arrangements; A suitably stocked first-aid kit; Information for all employees about what they need to do in case on an emergency. H&S_Procedure_22 Page 9 of
Section 3 Checklist for Assessment of first-aid needs Factor to Consider Yes No Impact on first-aid provision Does your workplace have low-level hazards such as those that might be found in an office environment? Does your workplace have higher level hazards such as chemicals or dangerous machinery? The minimum provision is: an appointed person to take charge of first-aid arrangements; A suitably stocked first-aid box. You should consider: providing first-aiders; providing additional training for first-aiders to deal with injuries resulting from special hazards; providing a suitably stocked first-aid box; providing additional first-aid equipment; precise location of first-aid equipment; providing a first-aid room; Informing the emergency services of specific hazards etc in advance. Do your work activities involve special hazards such as hydrofluoric acid or confined spaces? Does your Ward/Department/Service employ more than 25 staff? You should consider: providing first-aiders; additional training for first-aiders to deal with injuries resulting from special hazards; additional first-aid equipment; precise location of first-aid equipment; providing a first-aid room; informing the emergency services of specific hazards etc in advance. Where there are small numbers of employees, the minimum provision is: an appointed person to take charge of first-aid arrangements; a suitably stocked first-aid box. Where there are large numbers of employees, ie more than 25, even in low-hazard environments, you should consider providing: first-aiders; additional first-aid equipment; a first-aid room. Page 10 of 11
Factor to Consider Yes No Impact on first-aid provision Are there inexperienced workers on site, or employees with disabilities or particular health problems? You should consider: additional training for first-aiders; additional first-aid equipment; local siting of first-aid equipment. Your first-aid provision should cover any work experience trainees. What is your record of accidents and ill health? What injuries and illness have occurred and where did they happen? Do you have employees who travel a lot, work remotely or work alone? Do any of your employees work shifts or out-ofhours? Are the premises spread out, e.g. are there several buildings on the site or multi-floor buildings? Is your workplace remote from emergency medical services? Do any of your employees work at sites occupied by other employers? Do you have sufficient provision to cover absences of first-aiders or appointed persons? Do members of the public or non-employees visit your premises? Ensure your first-aid provision will cater for the types of injuries and illnesses that have occurred in your workplace. Monitor accidents and ill health and review your first-aid provision as appropriate. You should consider: issuing personal first-aid kits; issuing personal communicators/mobile phones to employees. You should ensure there is adequate first-aid provision at all times people are at work. You should consider the need for provision in each building or on each floor. You should: inform the emergency services of your location; consider special arrangements with the emergency services; consider emergency transport requirements. You should make arrangements with other site occupiers to ensure adequate provision of first aid. A written agreement between employers is recommended. You should consider: what cover is needed for annual leave and other planned absences; what cover is needed for unplanned and exceptional absences. Under the Health and Safety (First-Aid) Regulations 1981, you have no legal duty to provide first aid for non-employees but HSE strongly recommends that you include them in your first-aid provision. Page 11 of 11