Life Safety for Students

Life Safety for Students

DISASTER RESPONSE Tift Regional Health System s Disaster Response includes an emergency code system and general actions each employee should take in the specified emergency situation. For patient and personal safety, students should be familiar with each code. This CBL is designed to help the student know the code system and what they can expect to see employees doing during the codes. In addition, the CBL will describe actions the student should take. Slide 2 of 56

DISASTER RESPONSE This CBL program also reviews the basics of electrical safety. This program does not cover the unique response actions required of individual departments. Students and faculty members should seek the assistance of specific department or campus personnel and the Disaster Manual in the department area or on TRHS s MedNet intranet page to gain additional information about specific responses. The organization s master disaster plan can be viewed on our MedNet (internal webpage) for those students and faculty to whom computer access passwords are provided. Slide 3 of 56

OBJECTIVES At the conclusion of this cbl the student and faculty member should be able to: 1. List the emergency codes used at Tift Regional. 2. Identify the type of emergency by code name. 3. Verbalize the steps that students and faculty should take when an emergency code is called. Slide 4 of 56

Code PINK: Infant / Child Abduction Within the hospital, Dial 0 to initiate the code, give operator the department location of the missing child (i.e. Pediatrics, OB, etc.) Block Exits (Male Employees & Designated Department Employees) No One Leaves the Building Search all departments Look for suspicious individuals If you see anything suspicious notify Security --do not try to subdue the individual yourself. Off campus personnel should follow their clinical area response guidelines see departmental Disaster Manual Slide 5 of 56

Code PINK: Infant / Child Abduction Tift Regional has an Infant / Child Security System for the Pediatric, OB and Mother-Baby floors. The system includes banding of patients with transmitters that initiate the alarms if the patient moves out of the unit area. The bands must be removed or inactivated by nursing personnel prior to the patient leaving the area. Transport personnel should be especially aware of this unique feature. Slide 6 of 56

Code PINK: Infant / Child Abduction While the Infant Security system provides one safety link, the entrance doors to our Pediatric and Obstetrics (OB) departments remain locked. To enter these units there is a call button on the wall next to the entrance doors. When rotating in these departments, please use the call button to gain access. When our personnel answer the call button, identify yourself as a student and the school you are affiliated with. Slide 7 of 56

Code PINK: Infant / Child Abduction During a Code Pink, students should assist staff by keeping their eyes and ears open. If a student identifies a suspicious person, the student should immediately report the concern to a Tift Regional staff member so the Security department can be notified. At no time should a student try to detain or intercept a suspicious individual. Slide 8 of 56

Code PINK: Infant / Child Abduction At our campus at Cook Medical Center, a Code PINK is activated by dialing ** and after the tone entering 00 to announce the code on the overhead paging system. Instead of contacting Security, the Facility Engineering Department should be contacted. If a child goes missing while at one of Cook Medical Center s outpatient facilities, the building should be secured and 911 should be called. Slide 9 of 56

Code Silver: Hostage Situation DIAL 0 to initiate give the operator location of code. People in immediate vicinity evacuate. People in other areas, clear hallways and remain quietly in rooms with doors secured until code is called all clear. Make note of who is in your area. Slide 10 of 56

Code Silver: Hostage Situation During a Code Silver, students should immediately clear the hallways and quietly remain behind closed doors until the code is called clear. When the code is called clear, the student should immediately report to their faculty member or assigned Tift Regional employee so that their status is noted. Slide 11 of 56

On our Cook Medical Center campus, to activate a Code Silver, dial 8093. Follow all other steps as the main Tift Regional campus. 911 should be called in any of the outpatient services of TRHS and departmental policies followed. Slide 12 of 56

Code BLUE: Cardiac or Respiratory Arrest In the hospital, Dial * * to access overhead paging system, state code BLUE and room number OR exact location within the hospital. Repeat this information three (3) times. Do any Cardiac Care (CPR) you have been trained to do. USE BARRIER DEVICE (ambu bag) for ventilations. Off-site departments should follow their departmental Disaster Manual guidelines and contact EMS or other designated responders. Slide 13 of 56

Code Blue: Cardiac or Respiratory Arrest On some of our units, a Code Blue button has been installed on the head board panel in the patient s room. When activated, this alarms on that unit to notify staff of the situation. To gain additional assistance, the code still needs to be called house wide. If the code requires additional assistance, the charge nurse will initial or delegate to someone to initiate the house wide call. Students and faculty should be aware that the hospital has a Rapid Assessment Team (RAT) to assist in the assessment of patients who may be experiencing subtle changes. The RAT can be activated by a staff member, patient or patient family member. Students and faculty should consult TRHS staff members and ask for the RAT anytime they have a concern for a patient s status. Slide 14 of 56

Code BLUE: Cardiac or Respiratory Arrest If a student finds a victim of Sudden Cardiac or Respiratory arrest, the student should initiate CODE Blue just the same as a staff member would do. The student should provide CPR within the scope of their training until TRHS staff can take over. All students who participate in clinical rotations that have direct patient contact are expected to maintain certification in Basic Life Support--Healthcare Provider. Slide 15 of 56

To activate a Code Blue on our Cook Medical Center campus dial **, then after the tone enter 00, to access the overhead paging system. State Code Blue and the room number OR exact location within the hospital three (3) times. Slide 16 of 56

Code RED: Fire Code Rescue anyone in immediate danger. Activate the fire alarm nearest the location of the fire/dial 0 and tell the operator the exact location. Contain the fire: close doors, turn off oxygen in immediate area of the fire, TRHS know where the main oxygen shut off valves are if authorized to shut off, move medical gas tanks away form fire area. Evacuate the immediate area. Extinguish the fire if your safety can be assured and you have been certified in extinguisher use. Certified Employees should report to fire area with a fire extinguisher. Slide 17 of 56

Code RED: Fire Code At Cook Medical Center: Rescue anyone in immediate danger. Activate the fire alarm nearest the location of the fire/dial ** and after the tone enter 00. Announce the location of the fire. Contain the fire: close doors, turn off oxygen in immediate area of the fire. Evacuate the immediate area. Extinguish the fire if your safety can be assured and you have been certified in extinguisher use. Certified Employees should report to fire area with a fire extinguisher. Slide 18 of 56

Pull the pin Code RED: Fire Code Aim at the base of the fire Squeeze the trigger Sweep from side to side ONLY EMPLOYEES WHO HAVE EXTINGUISHER CERTIFICATION Slide 19 of 56

Code RED: Fire Code Students should respond to a Code Red in the same manner as a staff member -- R.A.C.E. Students are reminded that they should not open or pass through closed fire doors unless evacuating the area to a safer zone. Only TRHS certified staff members should retrieve fire extinguishers. Students should assist patients and visitors to safe zones. Slide 20 of 56

Signal 808: Tornado Alert This code signals a Tornado has been spotted and TRMC is in its path - Work quickly TIME IS CRITICAL (3-10 minutes to accomplish response). Keep away from windows. Instruct patients, visitors and employees to move to the designated safe zones for the departmental area. Close window blinds in exterior rooms and doorways to hallways. Sit on the floor and cover your head. Slide 10 of 56

Signal 808: Tornado Alert Personnel (other than nursing) should report to nearest patient care units to assist (see departmental Disaster Manual for particular assignments). Off-campus departments should maintain a weather radio tuned to the National Weather Service and follow their Disaster Manual guidelines for handling Tornado Alerts. Slide 22 of 56

Signal 808: Tornado Alert During a Signal 808, students are asked to assist TRMC staff in moving all patients and visitors to safe zones. Students should continue to assist staff with patient care needs throughout the emergency and remain in the hospital until the code is called clear and all patients have been returned to their rooms. Slide 23 of 56

Code Gray: Severe Thunderstorm When a severe thunderstorm warning has been issued OR a reduction of intensity of a Signal 808 occurs, this code may be called by the Incident Commander, Administration or House Supervisor (Nights and Weekends). If the code is called in reduction of a Signal 808, patients and guests can be moved back into their rooms. Staff should implement the Code Gray steps. Slide 24 of 56

Code Gray: Severe Thunderstorm Move patients, visitors and employees away from windows and advise them to remain away from the windows during the code. Lower blinds to protect from possible glass damage. Remain vigilant in monitoring weather changes and prepared to respond to a Signal 808 if conditions warrant. Slide 25 of 56

Code Gray: Severe Thunderstorm During a code Gray, students should assist staff in securing the environment and informing patients and visitors of safety steps. If the code has been called as a reduction of a Signal 808, assist patients back to their rooms with the appropriate precautions and instructions. Slide 26 of 56

Code Triage Standby Both the main campus of Tift Regional and our Cook Medical Center campus uses the Incident Command structure and process outlined by the National Incident Management program when dealing with Emergency responses. A Code Triage Standby is used when a disaster event occurs in another community and TRHS s assistance is requested for patient diversion. Slide 27 of 56

Code Triage Plan A: External Disaster A major event has occurred in our area outside the hospital. The hospital is expecting multiple victims. Incident Command Center (Control Center) Activate the GHA 911 system. If the computer system is not operational, Dial 6125 at TRMC campus or 8044 at CMC campus. (The Command Center for the both the TRMC & CMC campuses is located in their respective Administrative Conference Rooms). Prepare For Patients (per departmental directions). Request additional personnel from Personnel Pool (ext. 6162 at TRMC and 8162 at CMC) if needed, or send extra personnel to Personnel Pool located in the Education Classroom at TRMC and the Dining Room at CMC. Assemble equipment & supplies as directed. Slide 28 of 56

Code Triage Plan A: External Disaster Department Managers contact the Control Center through GHA 911 and Report on: Additional personnel as needed. Status of supplies / equipment. Number of personnel sent to Personnel Pool. Nursing Units Report: Available beds. Number of personnel off duty that could come in. Slide 29 of 56

Code Triage Plan A: External Disaster Emergency Department serves as Triage Center. Endoscopy serves as First Aid area. 20 th Street Lobby serves as Communication Center for family and visitors seeking information regarding victims and for Media seeking information on the TRMC campus. The Front Lobby serves this function on the CMC campus. Critical unstable Emergency Department. Critical awaiting immediate surgery PACU II (Day Surgery) Stabilized awaiting admission Direct Admit to floor or Day Surgery Holding. Slide 30 of 56

Code Triage Plan A: External Disaster Off-site campuses may experience an influx of patients or patient families arriving without appointments. Off-site campuses should follow their Disaster Manual guidelines when responding to a Code Triage Plan A affecting the main hospital. Slide 31 of 56

Code Triage Plan A: External Disaster During a Code Triage Plan A, students should report to their instructor or assigned TRMC/CMC employee to receive information about the disaster and appropriate assignments. Students are not asked to participate in the personnel pool. Continued participation in patient care and the clinical day during the disaster will be at the discretion of the hospital and faculty member based upon the type and extent of the emergency and the safety of students leaving the facility. Slide 32 of 56

Code Triage Plan B: Internal Disaster Tift Regional is the victim. We have structural damage and disruption of service. Outside resources will be required. Male employees report to damaged area to help evacuate. Evacuate persons in danger to nearest safe area as determined by nursing supervisor or off-campus department manager. Close all doors. Turn off electrical equipment. Slide 33 of 56

Code Triage Plan B: Internal Disaster Incident Command Center will be set up (location depending upon the impact of the event on the structural aspect of the hospital if possible, Administrative Conference Room). Department supplies and equipment should be assembled and sent to treatment center(s). Personnel sent to Personnel Pool or specific treatment center(s) as assigned. Department Manager or designee, communicate via GHA911 or call report to Control Center (ext. 6125 at TRMC or 8044 at CMC). Slide 34 of 56

Code Triage Plan B: Internal Disaster Personnel should take steps similar to Fire Plan to prevent secondary events. Use Red Phones and Red Outlets only. Take other appropriate measures specific to your department functions to preserve function and prevent secondary fires or explosions (i.e. turn off electrical equipment, check oxygen delivery areas, etc.) Slide 35 of 56

Code Triage Plan B: Internal Disaster During a CODE Triage Plan B, students are asked to help secure their area in accordance with Fire code response. Then the student should immediately report to their instructor or assigned TRHS employee so their safety and whereabouts are known. Based upon the type of disaster, the student may be released from clinical or may be requested to remain in the facility to help assure their safety as well as patient safety. Slide 36 of 56

Code Orange Code Orange = Biological Code Orange C = Chemical Code Orange R = Radiation If Code Orange is attached to Code Triage, it is the signal to set up decontamination stations before caring for the victims of the disaster. Decontamination is necessary so that employees and students will not become victims of the contaminate when providing treatment. Slide 37 of 56

Code Triage N95 Designates a potential airborne contaminate within the facility such as SARS or Avian Flu. All staff should immediately apply their fit tested N95 Respirator. Hospital is placed in lock down. Employees should begin marking their use time for the respirator. Off-campus sites will initiate community-based care in accordance with Disaster Response guidelines in the Disaster Manual. Slide 38 of 56

Code Triage N95 The Emergency Department will continue to serve in its trauma and emergent care role. Non-emergent walk-ins will be diverted to off campus clinic sites for primary care. Slide 39 of 56

Code Triage N95 During a Code Triage N95, students should immediately report to the Education Classroom if on the TRMC campus. Continuation of clinical experiences will be at the discretion of the faculty and individual student. If the desire of the student and faculty are to continue to remain in the building and to assist TRMC staff with patient care, students will be fit tested and provided the N95 respirator to assure their safety. Otherwise, students will be immediately dismissed from the hospital. Slide 40 of 56

Slide 41 of 56 Refer to the Department Disaster Response Manual for your specific departmental responsibilities and details related to each emergency situation.

Bomb Threat via Telephone Respond in calm manner. Obtain as much information as possible from the caller, keep the caller on the line as long as possible. Ask the caller to repeat every word and have someone else listen if possible. Use bomb checklist to collect information (located in disaster manual bomb procedure). Slide 42 of 56

Bomb Threat via Telephone Inform the caller that the building is an occupied hospital or health care facility and detonation of a bomb could result in death or serious injury to innocent people. Call or have someone else call security and the hospital supervisor. Off-site departments should call their appropriate TRHS administrator and, where appropriate, local law enforcement agency (see individual department Disaster Manual). Slide 43 of 56

Bomb Threat via Telephone Students are encouraged not to answer telephone calls within the hospital. This eliminates the possibility of a student receiving a bomb threat. Students will be verbally notified by their instructor or a TRHS staff member if a bomb threat response is required. This response would include looking for suspicious packages or unattended luggage, etc. and notifying Security /Plant Operations if such an article was discovered. Slide 44 of 56

Security Stat A situation in which an Employee, Patient or Visitor is in Physical Danger. Dial 0 on the TRMC Campus or push the Panic Alarm on Patient Care Units. Dial 8093 on the CMC campus. The Security Supervisor at TRMC is in charge of situation (Nursing supervisor or charge nurse will guide medical management). On the CMC campus the House Supervisor is in charge of the situation. If the STAND CLEAR command is called, move behind security personnel for your safety. Off-site department personnel should respond in accordance with their department specific Disaster Manual guidelines. Slide 45 of 56

Security Stat To intervene in a physical situation, Tift Regional Security Officers carry: Handcuffs Ashton Batons Pepper Foam/Spray Officers receive training in the use of these devices to help assure our campus is safe for all employees, visitors and patients. Slide 46 of 56

Security Stat Any student who feels they are being physically threatened may activate a Security Stat in the same manner that TRHS staff would. Students are encouraged to report early to a staff member or their instructor any time they believe the possibility of such a situation could develop. It is better to place pro-active steps in action to avert such a physical threat than to wait until a situation escalates to a threat. Slide 47 of 56

Code E (Elopement/Wandering Patient) Cook Medical Center Campus Only Any patient who is unable to go out of the building safely and/or becomes disoriented if out of a protective environment is regarded as a wanderer. Special precautions are taken to provide a safe environment for these types of patients. Patients designated to be a wanderer or at risk will wear an arm band identifying the patient and the facility. Wander Guard bracelets may be worn as well. Staff are introduced to patients designated as wanderers in order for all staff to be aware of the patient s proneness to wander. Slide 48 of 56

Code E (Elopement/Wandering Patient) This code is used at our CMC campus where skilled nursing care is provided. If a patient with wandering tendencies leaves the unit, the Charge nurse will notify the Director of Nursing and Administrator. An announcement to locate the patient by calling the Code E may be made. If a Code E is called, staff, students and faculty should search their department areas to help locate the patient. If the patient is located in your area, he/she should be escorted back to their skilled unit. Slide 49 of 56

ELECTRICAL SAFETY Types of electrical shock Micro shock Only felt by Patient Most Deadly form Follows a direct pathway to heart Macro shock Felt by everyone Slide 50 of 56

ELECTRICAL SAFETY Defective equipment or frayed electrical cords should NEVER be used. Remove from service immediately. Report to a TRHS staff member and the Biomedical Department. Equipment failure that causes injury to a patient, employee or visitor: must be reported to the Nursing Supervisor and the Safety Officer. must have a completed occurrence report. Slide 51 of 56

ELECTRICAL SAFETY All new equipment must be safety tested by the Biomedical Department before it can be used in the hospital. Biomedical labels on the equipment indicate the last safety test date. Electrical malfunction is the leading cause of hospital fires. Slide 52 of 56

EMERGENCY POWER When normal power is interrupted, the emergency power system takes over. Emergency power receptacles are RED in color. Slide 53 of 56

CELL PHONES By hospital policy, staff, students and faculty are not permitted to keep a personal cell phone on their person nor turned on. During the working shift, attention must be paid to the patient and the patient s family. Personal business may not be conducted while in the clinical area. Students are encouraged to provide their family members the contact number for the area they are assigned to for emergency purposes. Using a personal cell phone in a clinical area can lead to a breach of HIPAA guidelines and can also result in the loss of clinical privileges. Prior to coming on shift and after going off shift, DO NOT use a cell phone within 10 feet of patient care areas. The hospital permits cell phone usage only in the following areas: main hospital lobby outside Slide 54 of 56

ELECTRICAL SAFETY Magnets and magnetic materials will damage computer equipment. Employees and students should be cautious and never bring a magnet close to computer equipment. Extension Cords are to be limited to temporary use in emergency conditions. When used, an extension cord must have a 3 wire grounding plug. Slide 55 of 56

DISASTER RESPONSE For additional information about TRHS s Disaster Response and Electrical Safety, the student should: Refer to the Disaster Response Manual located in the specific department they are assigned to. Talk with their faculty supervisor. Talk with a TRHS employee. Talk with TRHS s Safety Officer. Consult the BioMedical Department for electrical equipment concerns. Slide 56 of 56