SUBJECT: CENTRAL IOWA HEALTHCARE Marshalltown, Iowa HEALTH & SAFETY POLICY EMERGENCY MANAGEMENT POLICY UTILITY FAILURE CONTINGENCY PLAN Policy No. HS.9.1.6 PURPOSE: To provide guidelines for the action to take in the event of a specific utility failure. In the event of any utility failure, the Facilities Management/Security Department will: 1. Determine the nature and extent of the problem. 2. Notify affected areas (outlined below) of the problem & the estimated down time if possible. 3. Restore functioning as soon as possible. 4. Notify affected areas (outlined below) when repairs have been completed. The Associate Director of Patient Care should notify the Nursing Departments affected by the utility failure. In addition to the above mentioned action Facilities Management, Administration, Associate Director of Patient Care or the department identified should consider taking the following action: Alarms (Security, medical gases & central vacuum) Operating Room Emergency Department 2. If repairs are out of the scope of the Facilities Management Department, request outside assistance from: Security Alarms: A-Tech @ 515-276-5040. Medical Gas: Airgas @ 319-233-3549. Beepers (See Beeper system Back Up Plan HS.9.1.6, Att. 1) Electrical Power (Generator power is available) All departments through a broadcast fax from ER Dispatch or the Business Office fax OR broadcast voice mail message to Department Directors. 2. All Departments: Ensure life-support systems and essential equipment is connected to emergency power. Discontinue the use of non-essential equipment that is connected to emergency power. Have flashlights available. 3. Ensure all generators continue functioning. 4. Consider acquiring additional portable generators from the community. 5. Extension cords can be used to receive power from another area, if there is a critical need as determined by the Department Director. 6. : Have necessary equipment available to ventilate patients. 7. Operating Room: Complete and/or do not begin new surgical cases. 8. Alliant Energy supplies electrical power to the hospital. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Alliant Energy Action Desk @ 800-246-3750.
Electricity (Generator power is not available) All departments 2. Call for immediate service on the generators. 3. Consider acquiring portable generators from the community. 4. Consider implementing the Disaster Plan, depending on the extent and nature of the problem. 5. Ensure the battery-operated lights are functioning. 6. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Ziegler @ 800-342-7002 or Wolin 7. All Departments: Have flashlights available. 8. ICU and ER: Hand ventilate patients. 9. Nursing: Closely monitor IV pump battery functioning. When necessary, remove the cassette from the pump and regulate manually. 10. Operating Room: Complete and/or do not begin new surgical cases. Elevators 2. If personnel, patients or visitors are in the elevators, stay in verbal contact until elevator becomes operable or they are rescued. 3. If all elevators are out of service, potential surgical patients should be admitted to ICU, Surgical Holding or PACU. 4. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Schumacher Elevator @ 800-779-5438. Fire alarm and extinguishing systems Notify the Marshalltown Fire Department The fire alarm company, Central Station Command Center @ 800-432-6533. 2. Facilities Management Department will post fire watch in the affected areas. A log will be kept of all fire watch activities. These logs will be filed in the Facilities Management Department when the fire watch has been cancelled. 3. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Xenotronics @ 563-355-3700. 4. Notify fire department and the alarm company when repairs have been completed. HVAC (Heating, Ventilation & Air Conditioning) Environmental Services The departments affected by the HVAC failure 2. Operating Room: Complete and/or do not begin new surgical cases. 3. Environmental Services: Distribute fans upon request, delivering to patients and areas with temperature sensitive equipment as a priority. 4. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Wolin Mechanical @ 800-561-5191 or Kapaun & Brown @ 515-753-3563. 2
Information Management System 1. Data Processing will notify the following departments/individuals: Director of Data Processing All departments through a broadcast fax from ER Dispatch or the Business Office fax OR broadcast voice mail message to Department Directors. 2. If it is necessary to order a procedure from Lab, Respiratory Therapy, Rehab, Radiology or Dietary, use paper requisition form. 3. Nursing will look at each chart for daily orders and complete a paper requisition for these orders. 4. Ancillary departments will fax results back to the ordering department. 5. The ancillary departments will be responsible for entering those orders into the system as soon as it becomes operational. 6. Patient care provided will be charted on paper. 7. If repairs are out of the scope of the Data Processing Department, request outside assistance from CPSI. Medical air system 2. : Determine the need for portable compressors throughout the hospital. Place all respiratory therapy care requirements on a priority basis. Order additional medical air supplies until the failure has been corrected and purity tests made (if required). 3. Nursing: Closely monitor & support patients during the interim period. Be prepared to relocate patients. 4. In the event the main supply line has ruptured, request emergency outside assistance from Wolin Mechanical @ 800-561-5191. Medical gas Nitrous Oxide Anesthesia/Operating Room 2. Request emergency delivery of nitrous oxide from Airgas @ 319-233-3549. 3. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Wolin Medical gas - Oxygen 2. If the reserve supply is in use, call Airgas @ 1-877-285-5778. 3. If the oxygen supply has been disabled, should: Deliver portable cylinders to the most oxygen sensitive patients and determine the need for portable oxygen throughout the hospital. Place all respiratory therapy requirements on a priority basis. Request emergency delivery of oxygen as needed from Airgas @ 752-3216. Coordinate tests of the oxygen system. 4. Nursing will closely monitor and support patients during the interim period. Be prepared to relocate patients. 5. Operating Room: Complete and/or do not begin new surgical cases. 3
6. If repairs are out of the scope of the Facilities Management Department, request outside assistance from: Airgas for bulk tank or outside line problems @752-3216 or 1-877-285-5778 or 1-319-231-9836. Wolin Mechanical for inside line problems @ 1-800-561-5191. 4 Medical vacuum CSS 2. CSS: Deliver portable vacuum pumps to Nursing Departments as needed. Refer to the list of locations for CIH portable vacuum pumps. Additional portable pumps may be borrowed from the Iowa Veteran s Home. 3. Operating Room: Complete and/or do not begin new surgical cases. 4. In the event the main supply line has ruptured, request emergency outside assistance from Wolin Mechanical @ 800-561-5191. Natural Gas Lab FANS 2. Switch boiler to fuel oil operation to maintain steam, hot water and building heating services as required. 3. Alliant Energy supplies natural gas to the hospital. If repairs are out of the scope of the Facilities Management Department, request outside assistance from the Alliant Energy Action Desk @ 800-246-3750. Nurse Call system 2. Nursing: Provide temporary hand operated bells to each patient in the affected area. Emergency hand bells are located on SCC. Move patients who are unable to use hand bells for visual observation. Make rounds to the patient rooms every 15 minutes. 3. If repairs are out of the scope of the Facilities Management Department, request outside assistance from: Hillrom @ 800-445-3720 Dukane (CEC) @ 515-278-6642 Ideacom @ 800-433-6208. Paging system 1. The Switchboard Operator will notify the following departments/ individuals: Facilities Management/Security co-worker 2. Authorize the use of hospital & personal cell phones as necessary. 3. Obtain additional cell phones from the telephone maintenance office. Calling our cell phone provider service can activate them very quickly. 4. Ideacom maintains the paging system. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Ideacom @ 800-433-6208.
Steam Distribution (No hot water or steam) and all boilers fail at the same time: Administrator on-call Environmental Services CSS FANS 2. Operating Room Consider possible cancellations. Inform doctors if and when appropriate. 3. Nursing: Restrict hot water use. Use Bag Baths as appropriate. Sterile water is available in some areas in the blanket warmers. Use waterless hand cleaner. Heated water is available in some of the coffee makers. Call FANS for delivery of containers of hot water, using caution not to burn self or patients. 4. Laundry & ENS Supply extra blankets for patient comfort. 5. FANS: Restrict hot water use & use paper plates for food service. Cooking may have to be by steam table or outside charcoal grill. 6. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Trabue @ 800-886-9034 or Wolin Telephone 1. The Switchboard Operator will notify the following departments/ individuals: Telephone Maintenance co-worker (Dennis Bachman) All departments through a broadcast fax from ER Dispatch or the Business Office fax OR broadcast voice mail message to Department Directors. 2. Page one co-worker from each department to report to the Switchboard to act as runners between nursing departments, ER and the OR. 3. Co-workers can be assigned to man the pay telephones which are located in the front lobby, ER lobby and by Medical Records. 4. Facilities Management Department co-workers will stand by in the ER and the front lobby with walkie-talkie radios to act as directed. 5. Authorize the use of hospital & personal cell phones as necessary. 6. Obtain additional cell phones from the phone maintenance office. Calling our cell phone provider service can activate them very quickly. 7. Telephone service is supplied to the hospital by US West. CIH s contact person is Dennis Bachman. If repairs are out of the scope of the Facilities Management or Telephone Maintenance Department, request outside assistance from McLeod Integrated Business (Repair) @ 1-800-383-8353. Waste Stream Disposal (sanitary, solid, liquid & biohazard) In the event of failure of the external sewer main: All departments through a broadcast fax from ER Dispatch or the Business Office fax machines OR broadcast voice mail message to Department Directors. 2. All Departments: Do not use toilets/sinks in the affected areas. 3. Instruct all co-workers & visitors not to use toilets/sinks in the affected areas through signage at the front door, ER and all public restrooms. 4. Limit available bathrooms for public and staff to one per floor. Post restriction signs or lock the other bathrooms if necessary. 5
5. ENS: Install red bag liners in the available bathrooms. If the failure results in flooding, ENS will remove water with wet vacuums. 6. Transporting of wastes by container to a sanitation truck may be necessary. 6 In the event of failure to the internal plumbing lines: Departments in the part of the hospital affected. Environmental Services (ENS) Infection Control 2. Departments in the affected area: Do not use toilets/sinks in the affected areas. 3. Instruct all co-workers & visitors not to use toilets/sinks in the affected areas through signage at the front door, ER and all public restrooms. 4. Limit available bathrooms for public and staff to one per floor. Post restriction signs or lock the other bathrooms if necessary. 5. ENS: Install red bag liners in the available bathrooms. If the failure results in flooding, ENS will remove water with wet vacuums. 6. Transporting of wastes by container to a sanitation truck may be necessary. 7. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Wolin Water Distribution System Disruption or breakage of main water supply into the hospital: All departments through a broadcast fax from ER Dispatch or the Business Office fax machines OR broadcast voice mail message to Department Directors notifying them that reserve water supply is being used & that water rationing must be put into effect. 2. Potable water can be obtained from the Iowa National Guard @ 753-9421, Pepsi @ 753-3422 or Swiss Valley @ 877-497-9478. 3. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Marshalltown Water Department @ 515-753-3997. Breakage or disruption of inside water pipes: Departments affected by the breakage. 2. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Wolin Contamination of water supply: All departments through a broadcast fax from ER Dispatch or the Business Office fax machines OR broadcast voice mail message to Department Directors notifying them not to drink the water or flush the toilets. 2. The is to notify the Department of Health immediately of water supply contamination.
7 3. Potable water will be obtained Pepsi @ 753-3422 and Swiss Valley Farms @ 800-497-9478. Swiss Valley Farms will provide two gallons of potable water per patient per day. 4. Non-potable water will be provided from facility reserves such as condensate return tanks and hot water storage tanks. This is estimated to be 7,500 gallons at any given time. This water will be transported to the patient care areas in containers clearly labeled NON-POTABLE WATER. 5. If repairs are out of the scope of the Facilities Management Department, request outside assistance from Wolin Originated By: Environment of Care Facilitators Effective Date: October 1999 Chief Operating Officer Environment of Care Facilitator (Utilities) Revised: July 2001 Revised: April 2002 Revised: February 2004 Revised: February 2006 Revised: February 2007 Reviewed: February 2010 Reviewed: March 2015 T:\Data\Policies\H & S Intranet policies\09 Utilities Mgmt\2015 Contingency plan 9 1 6 r1.doc