1. Safety, Fire, and Disaster Chapter 28 Code Blue Health Science Edition 4

2. Safety in the Hospital • As the administrator of an aging hospital, Wes Douglas is responsible for taking the steps needed to assure that patients, visitors, and employees are safe while in his hospital. • He will be helped in these efforts by anumber of governmental agencies.

3. Government Agencies • Occupational Safety and Health Administration (OSHA) – The purpose of this agency is to prevent work-related injuries, illnesses, and deaths. • The agency was created in 1971. • It is been credited with reducing occupational deaths since that time by 62%, and injuries by 42%.

4. Government Agencies • Center for Disease Control and Prevention (CDC) – This federal agency is charged with protecting the health and safety of the American people. • It serves as the source of credible information on disease prevention and control, environmental health, and health promotion, and education. The CDC in Atlanta

5. Center For Disease Control and Prevention (CDC) • The CDC plays an important role in identifying and controlling infectious diseases, including HIV/AIDS and tuberculosis. • In addition to identifying outbreaks, the agency uses “fingerprinting” technology to classify strains of thousands of infectious diseases that impact populations around the world.

6. Clinical Laboratory Improvement Amendments (CLIA) • Congress passed the Clinical Laboratory Improvement Amendments in 1988 to set up quality standards for laboratory testing in the United States. • The focus of the legislation was on accuracy, reliability, and timeliness of patient test results.

7. Clinical Laboratory Improvement Amendments (CLIA) • CLIA legislation defines a laboratory as a unit that performs laboratory testing on specimens taken from humans for diagnosis, prevention, or treatment of disease.

8. The Hospital Fire Plan • Another important component of hospital safety is the fire plan. • Usually, this is a written document that all employees must understand. • Many hospital fire plans use the acronym RACE in training employees.

9. RACE Stands for . . . • Rescue • Alarm • Contain • Extinguish

10. The Hospital Disaster Plan • Hospitals are designed to handle patients who are admitted one at a time. • What happens when a plane crashes, or an earthquake occurs, and the hospital is suddenly deluged with 150 patients?

11. The Hospital Disaster Plan Questions that must be answered . . . • Who is treated first? • How are the patients admitted? • Who handles the flood of family members that may storm the hospital demanding information about their loved ones?

12. Communication • Communication is an important component of the disaster plan. • Switchboards often use code language to communicate with employees.

13. Code Language • Code Red – announces a hospital fire • Code Blue – solicits help for cardiac arrest at a specific location • Code Orange – announces that the disaster plan is being activated

14. Components of the Disaster Plan • Line of authority – a list of persons who will be in charge • Often the following persons, in the order listed, will be in charge • Administrator • Director of nursing • Nursing supervisor • Emergency room supervisor

15. Components of the Disaster Plan • Communication – The plan will specify where each of the following communication centers will be established, and who will be in charge. • Public Communication Center – This is a communication center for receiving outside calls, and giving information to the press, radio, and relatives of the injured. • Internal Communication Center – This is a center to coordinate and handle internal communications. • Emergency Room Radio Communication Center – This is the center that receives and sends messages to ambulances, police, fire vehicles and government agencies.

16. Triage • Triage is the process of sorting people to determine who receives treatment first. • The goal is to “do the most for the most.” • Triage is usually performed by a triage officer, who sorts patients, but does not give care. • Patients are sorted into casualty categories which indicates the priority in which patients will receive care. • Categories are assigned using numbered or colored tags.

17. An Example of Triage Categories

18. Temporary Morgue Facilities • The disaster plan will specify where dead on arrival (DOA) patients will be taken. • It will also specify whether personal belongings will be removed from the dead, and how the Command Center will be notified for casualty list purposes.

19. The End Hospital Disaster Drill