Health Occupation Student

Orientation Module 2: Environment of Care

FIRE AND LIFE SAFETYSection 1

Safety/Emergency Resources – Fast Facts

Fast Facts is a quick reference response guide to

Codes, e.g Code Grey, Pink, Orange

Other events e.g. System Failures, evacuation, disasters, emergency communication systems

Form Samples e.g. bomb threat, abduction record.

Emergency Codes

TO CALL ANY CODE:

SJH Campus: Dial 7111; GH Campus: Dial 811 – activates the overhead paging system

Off Site Locations: 9-911

Identify type of code and location

Repeat the message.

CODE RED Fire

CODE BLUE Adult medical emergency

Pediatric Code Blue Pediatric medical emergency

CODE PINK Infant abduction

CODE PURPLE Child abduction

CODE YELLOWNotification of a bomb on campus

CODE GRAY Combative person

CODE SILVER Hostage or weapon

CODE ORANGE Hazmat spill or release

CODE TRIAGE Internal or external disaster

CODE STEMI ST Segment Elevation MI

Life Safety – Fire Safety

Action to Take for Code Red

Department

Response Plan

You should know the following: Evacuation routes and location of

exits and stairs

Location of smoke/fire doors

Location of fire alarms/extinguishers

Look for posted evacuation signage as shown on the next slide.

Life Safety - Fire Safety

Sterile Processing

Diagnostic Imaging

Emergency

NORTH

EAST

WING

Life Safety – Fire Safety

Action to Take for Code Red

R REMOVE

all persons in danger

A ACTIVATE ALARM

use pull station or emergency # 7111

C CONFINE fire

close doors and windows

EEXTINGUISH

the fire if manageable

Immediate Response Plan

Life Safety – Fire Safety

Action to Take for Code Red

Student Response

When You Hear Code Red Paged:

Follow the instructions or your Clinical Instructor or Charge Nurse guidance.

Never prop doors open with trash cans, chairs etc – prevents automatic door closure in event of fire.

Life Safety - Fire Safety

Order of Evacuation• Ambulatory / Non-ambulatory

patients closest to danger;

• Ambulatory patients, visitors and staff;

• Non-ambulatory patients in wheelchairs, Isolettes and cribs;

• Non-ambulatory patients in their beds

• Critical Care and ventilator patients using gurneys/beds;

Action to Take for Emergency Evacuation: Move patients beyond nearest

fire doors – “area of refuge”

Place an “X “on door with tape

Take meds and medical record with patient

Follow instructions of the Charge Nurse

SECURITY MANAGEMENTSection 2

Security

We have Security / Engineering staff that provides security 7 days a week, 24 hours a day for our facility. We use interior /exterior close circuit monitoring of strategic areas and 2 way communication.

Even with these measures, Security cannot be everywhere at all times. You are actually the extra “eyes and ears” of our Security / Engineering staff.

The key to providing effective security for our facility is prevention, and prevention begins with you.

Your Role in Security

Always wear your ID badge Keep personal belongings out of

sight Ask for a security escort when

leaving after hours - dial 7101, enter 065 at the beep.

Main doors are locked between 8p – 5:30a. Use ED entrance during those times.

Be alert and observant of people that normally should not be in an area.

Report all suspicious activity to the Charge Nurse on your unit.

Security Features

Warning: Card reader locks as shown at right are installed in the North East Wing. These locks:

Restrict Access to: OR, SSU, PACU, ICU, Cath Lab, Diagnostic Imaging and ED treatment area

Restrict access to med rooms, supply rooms etc

Students will receive coded badges enabling limited access. THESE MUST BE RETURNED TO YOUR INSTRUCTOR.

Security: EMERGENCY CODES

CODE SILVER

Hostage or weapon

CODE GRAY Combative person

CODE YELLOW

Notification of a bomb on campus

CODE PINKInfant abduction (<1 year)

CODE PURPLE

Child abduction

(<18 years)

The hospital has 4 emergency security codes (shown at right) that you need to be aware of.

In the event of an emergency, report to your Charge Nurse for direction.

Security Management – Hostage / Weapon Situation

Action to Take: Staff / students:

DO NOT go to announced location This is an extremely dangerous and sensitive

situation that should only be handled by local police agencies.

Staff / students who see person with weapon: Seek cover/protection; warn others Report “Code Silver” to Operator including

location, number of suspects/hostages, number and type of weapons

CODE

SILVER

Security Management – Combative Person

Action To Take:

Student Response:

Stay clear of announced location

Reassure other patients

Follow directions of your Clinical Instructor or Charge Nurse

CODE

GRE Y

Security Management - Bomb Threat or Suspicious Package

Action to Take:Students - IMPORTANT:

Do not use radios, pagers or cell phones.

If you see a suspicious package, don’t touch it – notify the Charge Nurse

Follow the directions of the Charge Nurse.

CODE

YELLOW

Security Management - Infant or Child Abduction

Action to Take:

Staff Response: Go to nearest unmanned exits, stairwell, or

parking lot Politely ask for ID of people exiting hospital Do NOT go to area of abduction.

Student Response: DO NOT give out any information about a

possible abduction. DO note any suspicious activities, persons or

vehicles and report to Clinical Supervisor. DO NOT participate in facility wide response.

INFANT

CODE

PINK

CHILD

CODE

PURPLE

Security Management - Protected Health Information

What Must be Protected? an individual’s health information that…

Includes at least 1 of the 18 personal identifiers

Is created, received, or maintained by a health care provider or health plan

Is written, spoken, or electronic

Personal Identifiers

Name

Date of Birth

Address

Phone Number

Email Address

Medical Record Number

Social Security Number

License Number

Facial photos

Account Numbers

And more . .

Security Management - Protected Health Information

Steps to ensure Privacy and Security of PHI Position WOWs and bedside computer

screens out of sight of visitors or casual viewers

Lock computer screen or log out when done working

Manage/secure all printed patient census sheets e.g. use cover sheet to hide PHI

Manage/secure all patient identification stickers

Minimize work conversations in elevators, hallways and public areas

Security Management -Protected Health Information -

HIPPA Requirement - Minimum Necessary Standard

This standard provides guidance for use of PHI while maintaining security and privacy

Use / disclose the minimum amount of identifiable patient information needed by your job regardless of access

Applies to all users of PHI in the workplace

OTHER EMERGENCY RESPONSE

Section 3

Emergency Management – CODE BLUE (ADULT) / Pediatric Code Blue

Action to Take:

Staff Response: Code Team goes to announced location (ED MD &

RN, ICU RN, RT, Admin Sup, Compressor, recorder)

Unit / department staff bring crash cart

If YOU discover the patient: Identify signs/symptoms of cardiac / respiratory

distress. Call the code Begin first responder CPR until staff arrive to relieve

you. Note: after the first response, students may only

observe a Code Blue if first approved by their instructor.

CODE

BLUE

PEDIATRIC

C ODE

BLUE

Emergency Operations Plan - Code Triage

MajorUtility

Failure

ChemicalRadiationAccident

Infant AbductionCode Pink

Bomb ThreatCode Yellow

Natural Disaster

Child AbductionCode Purple

HostageSituation

Code Silver

FireEvacuationCode Red

Activate CODE

TRIAGE

Each of the Emergency Situations shown at right could result in activation of the Emergency Operations Plan (EOP), Code Triage.

The EOP enables us to effectively respond to these emergencies regardless of scope. The hospital adopted the Hospital Incident Command System (HICS) model for its plan.

Emergency Operations Plan - Code Triage

About the Hospital Incident Command System (HICS) ModelThe HICS model provides a standardized response to all kinds of emergencies regardless of magnitude.

Hospital Command Center (HCC) In the event of a Code Triage, the HCC serves as the clearinghouse for all information and all instructions during the disaster.

Incident Commander (IC)

The IC is responsible for ALL decisions regarding resources, personnel, patient flow, safety and security issues during the disaster.

Action to Take for Code Triage:

Students:Follow the directions of your immediate supervisor.

UTILITIES / MEDICAL EQUIPMENT MANAGEMENT

Section 4

Utilities - Utility Failure

Action To Take:

• In the event of a utility failure, follow the directions of the charge nurse on your unit.

• Emergency power outlets have a RED cover or outlet connections. These receive power from the emergency generator and are used for critical equipment only

Medical Equipment – Safety Inspections

Patient Care Equipment Look for inspection sticker with

last date noted

OK to use if within 12 mos. of date

Non Patient Care Equipment Look for the “OK to use

Sticker)

Patient Owned Equipment Physician order required Must be inspected by

Engineering before use RCP can inspect respiratory

therapy equipment from home

Medical Equipment – Safe Use Basics

DO NOT plug in any patient care equipment without the third grounding prong in place.

DO NOT use extension cords. DO NOT unplug devices by pulling on the cord. DO NOT use wet, damaged or obviously defective

equipment. DO NOT use equipment without first being trained Always inspect equipment before using it on

patients. Notify the staff of any malfunctioning equipment –

describe exactly what the problem is.

HAZARDOUS MATERIALS AND WASTE STREAM MANAGEMENT

Section 5

Hazardous Materials– Your Right to Know

Warning Labels on Containers: Material Safety Data Sheets

(MSDS) - written information supplied by the manufacturer or distributor of the product.

The MSDS lists chemical composition, protective equipment, types of exposure and effects, spill clean up and more.

Your Role in HazMat Carefully read and follow

warning labels and MSDS.

Ask staff for help if you are unclear about what safety measures to take.

When in the hospital, you may be exposed to hazardous chemicals. You have the right to know and be informed of these potential hazards. This information is available from 2 sources:

Material Safety Data Sheets (MSDS)

To Access MSDS Information:

Call the toll free number shown at right and have the following information available: Product name and number Manufacturer Name UPC code if applicable Your fax number

Emergency requests are responded to within 15 minutes

Urgent requests are responded to within 30 minutes.

MSDS on Demand

1-800-451-8346

Hazardous Materials – Spill Procedure

Action To Take:

If You Witness a Spill: REMOVE all persons in danger NOTIFY hospital staff immediately Keep others away from spill area DO NOT clean up the spill

If You are Exposed: Notify your clinical instructor and

hospital staff. Follow emergency first aide

measures as directed.

CODE

ORANGE

Waste Stream Management

Biohazardous waste Red bags

Soiled linen Yellow bags

Pathology waste Labeled Red containers

Chemotherapy Waste

Labeled containers

Sharps and broken glass

Red sharps containers

Pharmaceutical waste

Blue and white containers

PHARMACEUTICAL WASTE – Any unused medication must be discarded in the pharmaceutical waste containers including narcotics and fentanyl patches

o Electrolytes/TPN may be discarded in sink

Special attention must be given to disposal of hospital generated wastes. Follow the disposal guidelines listed below.

RADIATION SAFETYModule 6

Radioactive Materials Continuously emit radiation. They are made from radioactive

elements.

Radiation Producing Devices Emit zero radiation when they

are turned off. Devices are not a safety

concern when they are not being used.

Look for the signs shown at right.

Radiation – About Radiation

Radiation - Radiation Sources

Ways To Reduce Your

Exposure

TIMESpend as little time around radiation as

possible.

DistanceMaximize your distance

from radiation.

ShieldingShielding yourself behind

a wall or high density material can substantially

reduce the dose received.

Location Radiation Source

Radiology Devices - X-Ray Machines

Cardiology Devices - Portable X-ray

Surgery Devices - Portable X-ray

ED Devices -Portable X-ray

Cath Labs Devices - X-Ray Machines

Nuclear Med Radioactive Materials

RadiationOncology

Devices - Linear Accelerator andRadioactive Materials

Nursing Units Devices - Portable X-ray

Radiation sources are present in many areas of the hospital as shown below:

Radiation – Radiation Sources

When you hear the x-ray tech announce – “X-Ray” – get clear of the room.

Only the patient and essential personnel remain in the room.

Personnel remaining in the room must: Wear a lead apron Not be pregnant Stay out of the path of the x-ray

beam.

Portable x-rays are routinely taken on the nursing units. Please observe these precautions:

Magnet Safety – MRI

No metal items are allowed in the magnet area.

Patients must be screened for implanted metal devices prior to this procedure.

Do NOT enter with equipment unless you have been screened by MRI staff.

Our diagnostic imaging services include Magnet Resonance Imagery (MRI). The magnet in the MRI room is always on so the following measures must be observed at all times for patient and staff safety: