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ENVIRONMENT OF CARE 2013 Mary Ellen Lesperance RN, MSN, CIC, CHSP Director, Environment of Care, Epidemiology, Safety Officer

What is the Environment of Care? • It is the roadmap in our organization of how the environment is managed safely for everyone. • It is a set of programs that assess the environment for hazards and develops action plans that will minimize or eliminate risk

#1 Safety Management The first of seven plans: Safety Management • The Safety Officer and a team assess risks based on information collected from the web based incident reporting system. 2. The team examines work related injuries such as slips, trips and falls, muscle sprains, blood and body fluid exposure, exposures to chemicals

Safety Management • The most frequent types of employee injury at Karmanos Cancer Center include: • sprains • slips and falls

Injury Prevention Employees can prevent injury by: • Reporting hazardous conditions such as uneven flooring • Report wet floors to Environmental Services department • Always wearing the appropriate personal protective equipment

Soiled Linen Management Follow 3 simple Steps to avoid incorrect disposal of medical supplies and equipment • Segregate linen properly • Look for non-linen items from the bed that may have been rolled up in the linen by mistake • Roll only soiled linen before placing in the blue soiled linen bags

Soiled Linen Management Examples of items that should never go into the soiled linen bag include: • IV tubing • IV bags • Medication • Needles syringes • Monitoring equipment • Ambu bags • Diapers

#2 Hazardous Materials & Waste Management The 2nd plan is Hazardous Materials and Waste Management. Staff can prevent harm by: • Disposing of medical waste in designated containers • Placing the trace chemo waste in the yellowcontainers • Pharmacy disposes of chemo waste, also called bulk waste chemo waste in the black containers

#2 Hazardous Materials & Waste Management The Material Safety Data Sheet poster has the phone number for locating chemical information It is your guide to chemical safety. The MSDS contain basic information on the chemicals like: • Chemical Identification • Hazardous Ingredients • Fire and Explosive Data • Health Hazards • Spill Response MSDS MDS

Patient Sharps Disposal • Karmanos Cancer Center is not able to accept used sharps, except those containing chemotherapy. • Do not accept patients used needles and syringes from home even if they are in a used detergent container or coffee can. Michigan Department of Environmental Quality does not allow sharps from a persons home to be disposed at hospitals.

Patient Sharps Disposal • Each patient is given an instruction pamphlet on how to dispose of used medications including sharps. • Please refer your patient to their local health department to get information on how to dispose of sharps. • Contact Patient Education for brochures to give to your patient.

#4 Medical Equipment Management • Be sure to review procedures for the proper use of equipment. • Notify your supervisor if a patient brings in patient owned clinical equipment. There are special procedures that must be followed if this occurs. - Immediately take any faulty equipment out of service and call FIXIT or 34948 for repairs. - Notify your supervisor if the faulty equipment has caused harm to patients or employees.

#5 Utilities Management • Utility failures refers to loss of water, electricity or heating and cooling. • Report any utility failures to your supervisor. • Call FIXIT or 34948 for all utility failures or emergencies.

#5 Utilities Management • Clinical staff must know where the medical gas shut off is in there department. • You could be instructed to turn the medical gases off if there is a fire in the department. • Plug essential equipment into the red outlets if there is a power failure.

#6 Fire Safety Management If a fire does start, you need to know what to do and do it quickly. Remember—stay calm and do the following: (RACE): - Rescue anyone from immediate danger to a safe area past the fire doors. - Pull the Alarmbox nearest you. Contact your operator or security department and give exact location of fire. Sites not located on main campus will call 911. - Confinethe fire. Close all doors. - Extinguish (put out the fire) with the appropriate fire extinguisher, if you are trained to do so.

Fire Safety Management Other Expectations: • DO NOT USE ELEVATORS • LIMIT TELEPHONE USE You must be able to locate the following: • Nearest extinguishers • Pull alarm boxes • Evacuation plan • Two exit routes in your assigned area

Fire Safety Tips • Keep your area clean and clutter free • Keep overhead storage at least 18 inches below the ceiling • Minimize storage • Do not block hallways. Computers on wheels should not be stored in the hallway. When recharging, place them off to the side of the corridor.

Fire Safety Tips • Do not prop doors open • Keep hallways clear • Do not use personal cooking devices such as toasters & small ovens • Do not overload electrical circuits

Fire Safety Management When using an extinguisher: Remember P A S S - Pull the pin Aim low, at the base of the fire Squeeze the handle Sweep from side to side at the base of the fire

Smoke Compartments During a Code Red, DO NOT pass through doors with this sticker above them unless you are evacuating from the fire area.

Smoke Compartment • If there was a fire in a patient care area and you were asked to evacuate patients, you would move patients through the door with this sticker above it.

#7 Emergency Management • When there is an Emergency Code call on main campus, refer to the flip chart posted in your department for quick reference • Karmanos Cancer Center has an Emergency Operations Plan, Policy EM 039 that gives instruction on how to manage events that may affect our daily operations.

Emergency Management • The plan describes the Incident Command System and the function of the Emergency Operations Center sometimes called the EOC. • Staff are notified of an event through a Fan out process that alerts all managers.

Emergency Management • There are plans in place for 96 hour sustainability or hospital stand alone capabilities. • These include back up plans for utilities, communications, staff management, patient care, resources and security.

Emergency Management • Karmanos Cancer Center partners with vendors and community agencies to share resources if needed. • We participate in community exercises to prepare for real events such as severe weather, power outages and possible patient evacuation.

Emergency Management • The Emergency Management Committee discussing all events and exercise regularly. • The committee evaluates our readiness, response and recovery for any type of hazard or emergency event. • A Hazard Vulnerability Assessment prioritizes which types of emergency events staff will prepare for. • At Karmanos our focus is communication and utility system preparedness.

ENVIRONMENT OF CARE SUMMARY As a healthcare worker, you must be alert to the dangers of infection and injury. Making your safety and health a priority is one of the best ways to create a safe and healthy environment for patientsand for you! And above all, apply a healthy dose of common sense to everything you do on the job.

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