Environment of Care: Security and Safety Management

Transcription

1 The Westchester Medical Center s Environment of Care Quality Improvement Committee (ECQIC) is responsible for the overall safety of all patients, visitors and employees. Environment of Care: Security and Safety Management Although they are two separate plans, both the Security Plan and the Safety Plan have the overall responsibility of ensuring that all patients, visitors and employees are safe and secure. A Safety Surveillance Team inspects every clinical care area of the Medical Center no less than twice a year. The Security Plan addresses the photo-identification system, proper lighting, security surveillance, theft, bomb threats, child abductions (Code Amber), threats, violence and agitated patients (Code Gray). More on Security issues: Security is everyone's business! Effective security management depends upon the cooperation of those persons it is designed to protect. Compliance with hospital safety and security policies is the responsibility of every employee. Reporting potential risks and/or security incidents: Supervisory staff of the security department is available on a 24-hour basis, seven days per week. A security supervisor may be contacted by contacting the Security Operations Office at x 8535, or on emergency pager x0911. Upon notification, security personnel will immediately respond to the caller's location document all incidents and concerns that are reported. Hospital photo identification: Hospital policy and state law require all staff members to wear employee photo identification. Security personnel monitor compliance with the hospital identification policy. Employees in violation of this policy are subject to disciplinary action. Smoke Free Facility: Smoking is prohibited anywhere on the hospital campus. Bomb Threats: When the Medical Center receives a "bomb threat", our objectives are Provide for the safety of our patients and employees. Prevent panic Minimize disruption of the institution Coordinate with appropriate public safety departments, i.e. Westchester County Police and the Bomb Squad. Sometimes suspicious items are discovered without a previous warning. If you should discover such a suspicious item: DO NOT TOUCH, MOVE OR DISTURB SUCH ITEM! Call the Security Supervisor at x7209, x8535 or emergency pager x0911. Keep all persons away until Security arrives. If found in a room with a door, close the door so that a potential blast may be confined that room only. Suspicious objects should be isolated and avoided until checked. Page 1 of 12

2 Environment of Care: Hazardous Materials and Waste Management This plan is concerned with making sure that every employee at Westchester Medical Center is working in a hazard-free environment. EMPLOYEE RIGHT TO KNOW RULE If you have any questions while reading this material or any questions when using chemicals in your job, never hesitate to ask you supervisor. What is Hazardous Material? A material is considered hazardous if it is: Specifically listed as hazardous in the law (called the Z table) Assigned a threshold limit value (TLV) Determined to be cancer causing, corrosive, toxic, an irritant, a sensitizer, or has damaging effects on specific body organs. The Material Safety Data Sheet (MSDS) A Material Safety Data Sheet (MSDS) is the safety information for each chemical purchased for use by the hospital. It contains detailed information on a chemical and its hazards to you and what the treatment is should you be exposed to it. The MSDS can be obtained from your department library or on i-care. MSDSs from different vendors will look slightly different but MSDSs, when completed, should include all of the following: 1. Identity of the material, including its chemical and common names. 2. All ingredients 3. Cancer causing ingredients 4. List of physical and chemical hazards and characteristics (flammable, explosive, corrosive, etc ) 5. List of health hazards including a. Acute affects (occur immediately, such as burns or unconsciousness). b. Chronic affects (build up over a period of time, such as allergic reaction or respiratory disease). 6. Limits to which a worker can be exposed and primary entry route into the body. 7. Precautions and safety measures. 8. Emergency and first aid procedures 9. Identity of the organization responsible for creating the sheet. It is the responsibility of each employee to read and follow the instructions on the MSDS. If you have any questions, contact the Safety Officer who is responsible for enforcement of this standard. He can be reached at x Page 2 of 12

3 Hazardous Spill Procedures Small spill, no hazard to trained employee or the environment, REFER TO MSDS SHEET! Trained user should clean up spill with appropriate personal protective equipment, decontamination materials. An incident report should be completed and filed. Any spill which may present a hazard to people or the environment or the effects are unknown: REFER TO MSDS SHEET! Isolate the spill area. Deny entry to others. Notify your supervisor. Assist contaminated victims in decontamination process if you can do so safely. Notify Environmental Services at x7777, and Security at x8535. Call Telephone Operators x 5700 to notify the WMC- Safety Officer. Seek/coordinate medical treatment of decontaminated victim. Complete an incident report. Environment of Care: Fire Safety Management Plan EVERY EMPLOYEE MUST KNOW: 1. Each employee must learn their department s fire plan as soon as they begin working. 2. Each employee must know the location of the nearest fire fighting equipment and alarm box nearest his/her workstation. WHAT YOU SHOULD DO IF A FIRE OCCURS: 1. Shout Code Red and location of the fire. 2. Remove patients and personnel from the area. 3. Pull the nearest fire alarm box. 4. Call x7911-tell the hospital switchboard operator where the fire is. 5. Stay in the general area to direct fire fighting personnel to the fire. 6. Close all doors and windows including all doors in the hallway. 7. Prevent the spread of smoke by placing blankets at the bottom of doors (if you cannot enter the room). 8. If oxygen is in use, tell the proper personnel that it must be shut off. Respiratory Therapy, with the assistance of nursing staff, will shut the oxygen zone valve. Page 3 of 12

4 9. Before entering the room, feel the door with the back of your hand. If not hot, feel the doorplate or handle with the back of your hand. If that is not hot, stand to the side of the door (not behind it) and open it slowly by cracking it first and taking several steps away in the opposite direction. 10. If you are not in danger proceed into the room with the proper fire extinguisher. NEVER FIGHT A FIRE ALONE! 11. Begin fighting the fire with the proper fire extinguisher if it DOES NOT endanger your life. 12. Personnel should be staged and ready to evacuate to the nearest fire compartment, if necessary. 13. Do not leave the area unless ordered to evacuate by the person in charge. USE THE STAIRS ONLY! REMEMBER THIS WORD: RACE Remove Alarm Contain Extinguish Patients and personnel from area of immediate danger. Close the door to the room containing the fire. Sound the alarm from the nearest fire alarm box or call 7911 to verify location of the fire. The fire by closing all doors and windows including all doors on the corridor. Shut off all oxygen outlets The fire with the proper equipment, if possible, without putting yourself in danger. Never attempt to extinguish any fire regardless of how small, without first sounding the alarm. FIRE BELLS Upon the sounding of the fire bells in your work area, STOP and be ALERT in the event that you may need to evacuate the work area. In the main hospital, Macy Pavilion, Taylor Pavilion and MFCH, the location of the fire will be shown on a remote enunciator panel located at each nurses station. For all other buildings, consult the code chart at each pull station. When Code Clear is paged overhead, this means the all-clear signal has been given. FIRE EXTINGUISHERS If you feel comfortable fighting the fire and are sure you are not in any danger, here is something you should know: To use an extinguisher, remember this simple word: PASS Page 4 of 12

5 a. Pull (the ring). b. Aim (the extinguisher at the base of the fire). c. Squeeze (the handle together). d. Sweep (the extinguisher from side to side). Environment of Care: Medical Equipment Management Plan and Utilities Management These plans ensure the maintenance of medical equipment and other equipment and promotes its safe and effective use. The plans provide for tracking all medical equipment, preventative maintenance, initial assessment of new equipment and incident reporting when equipment is believed to have caused harm to a patient. Medical Device Reporting A medical device is defined as an instrument, apparatus, contrivance, implant, In vitro reagent or any component part which is intended for use in the diagnosis of disease or other conditions, or in the cure, treatment or prevention of disease. Examples of medical devices/ equipment include but are not limited to: catheters, infusion pumps, hospital beds, patient restraints, suture material, syringes, defibrillators, pacemakers, tampons, in vitro (test tube), wheelchair, diagnostic equipment. Staff responsibility includes: 1. Any patient injury related to a medical device/equipment should be reported immediately to department supervisor and patient's attending MD/designee to ensure that patient receives appropriate medical evaluation or treatment. Any event resulting in serious injury or death should also be verbally communicated to the appropriate clinical administrative leadership and the Department of Risk Management at ext The event should then be documented on the hospital incident reporting system called Midas using the Equipment Event Report Form. 3. To ensure the equipment is not used on another patient, remove from operation and sequester the medical device/equipment, all components and packaging in a secure location. Do not throw out any components such as tubing or packing if applicable. In addition, the Device/equipment should not be given to vendors unless directed to do so by the department of Risk Management. Page 5 of 12

6 4. Tag the device/equipment with an Orange Tag (sample shown) with all completed elements. Orange Tags are available at all nursing stations. 5. Call the department that "owns" the device/equipment to come and collect the affected device. For example, if the equipment is managed by Hill-Rom then Hill-Rom should be notified and Biomedical Engineering should be called to pick up equipment managed by that department. Environment of Care: Body Mechanics The Occupational Safety and Health Administration (OSHA) has called back injuries the nation s number one workplace safety problem. Many back injuries are very painful and can lead to a long lasting disability or extensive loss of work. The funny part is many back injuries can be prevented if a person knows and uses proper body mechanics. Good body mechanics can: 1. Save your back 2. Save time and energy 3. Prevent fatigue (tiredness) 4. Allow you to give better care or do a better job Your job may require you to lift heavy objects several times a day, a few times a day, once a week, or maybe once a month. Perhaps your job does not require you to lift heavy objects at all but you may sit at a desk, or stand on your feet for several hours at a time. Whatever the case may be, proper body mechanics can prevent your back from being overworked, which can lead to injuries. Some injuries can cause you pain that keeps you home in bed for a day or two, requiring you to take some medication. But some back injuries can cause serious injury to your spinal column resulting in excruciating pain, extensive therapy and possibly even surgery. LIFTING Before starting to lift or carry anything, check your entire walkway to make sure your footing will be solid. Your shoes should give you good balance, support and traction. Do not rush. Take enough time so that you can take all the necessary precautions. Plan ahead and get someone to help you if the object is very heavy. Clear any movable objects out of your way, and make sure you know where any unmovable objects may be. Cautiously lift the object slightly to get a feel for its weight and where its center of gravity (the heaviest point) may be. 1. Face the object squarely and get as close as you can. 2. Balance yourself solidly, with your feet slightly apart or one foot in front of the other. 3. Kneel down with one leg in front of the other or squat down, bending your knees. Keep your back as straight and upright as possible. Page 6 of 12

7 4. Grip the object firmly and bring it close to you. 5. Tighten your abdominal muscles. 6. Use your legs to bring you to a standing position, keeping your back straight. 7. Make the lift smoothly and under control. CARRYING AND LOWERING OBJECTS When carrying an object, be sure to hold it firmly with both hands and hold the object as close to your body as possible. 1. Keep your back straight 2. Tighten your abdominal muscles 3. Bend at the knees 4. Take rest periods if the object is particularly heavy SHOVELING, SWEEPING, MOPPING, ETC Even if you are not bending to sweep or mop, you need to still practice good body mechanics because these tasks can strain or sprain back muscles due to the movement of the task. 1. Make sure your balance is solid 2. Grip the shovel, mop, broom etc., firmly with two hands 3. Tighten your abdominal muscles 4. Keep your knees bent, not your back 5. Keep the tool you are using close to your body 6. When lifting, use the strength of your leg muscles to raise the object(s) PUSHING AND PULLING For difficult lifting tasks, keep these options in mind: 1. Ask a co-worker for help 2. Use a pushcart, dolly or other assistive device. If using an assistive device, only use one you are familiar with. 3. If the object is on a cart, remember that pushing is easier on your back than pulling. When pushing the object on a push cart: 1. Position your body close to the pushcart 2. Do not lean forward; keep your back straight 3. Use both arms 4. Keep your stomach muscles tight If you must pull something, remember these few points: 1. Face the object squarely, with one foot at least 12 inches in front of the other 2. Keep your back straight 3. Bend your knees slightly 4. Pull the cart with one smooth motion, avoid jerking motions that start and stop suddenly Page 7 of 12

8 STANDING AND SITTING Posture is the way your body is aligned. Good posture (proper alignment) will create less strain on your back and help at preventing injuries. If you stand a lot at your job, follow these rules of good posture: 1. Avoid slouching and an unnatural stiff posture. 2. Keep abdomen, buttocks and chin tucked in. 3. Hold your shoulders slightly back and your chin in. 4. When standing for long periods of time, keep your weight unevenly distributed by resting your foot on a stool. Rest each leg in turn. If you sit a lot at your job, follow these rules of good posture: 1. Find a chair with good back support. 2. Keep your feet flat on the floor and your hips lined up with your legs without slumping your lower back. 3. Use a pillow or rolled-up towel to support your lower back. 4. When driving, keep seat far enough forward to reach instruments and pedals easily. 5. Keep your chin in. 6. Position computers and other work at eye level. 7. Try to rest your elbows on the armrests of the chair to prevent strain on the back. 8. Keep commonly used objects close to you. REPETITIVE MOTIONS Repetitive motions are ones that you do over and over again like stacking boxes, moving trays, stacking laundry, etc. If you do a lot of repetitive motions in your job area remember this: 1. Keep loads as small as possible 2. Tighten your stomach muscles before lifting 3. Change positions frequently 4. Turn your whole body by taking little steps BACK INJURY PREVENTION TIPS 1. Do not lift any object over your head. 2. Do not twist your body when lifting or putting an object down. Always keep your back straight, turn your feet. 3. Do not reach over one object to lift something just past it. Instead move the object blocking your way or go around it to the other side. 4. Pace yourself to avoid fatigue when doing heavy work for a long period of time. 5. Follow specific safety guidelines in your workplace. BHC staff only: Activation of the fire alarm system in the Behavioral Health Center 1) Fire alarms are located near each stairwell. 2) Fire alarms may be activated using your BHC issued fire key Page 8 of 12

9 3) Insert key, turn to left, box will open. This will activate the alarm. Close box cover, turn key to right (upright position), remove key. Note* There is also a fire alarm key located on each unit medication ring. All BHC staff with unit door keys will have a fire key issued. A series of coded bells will be repeated three (3) times throughout the Behavioral Health Center. You may determine the location of a fire by counting the bells and looking at the code signal card at each fire alarm box. The operators will broadcast a code word and location of the fire over the page system. NOTE: Stairwell 5 in the B Wing - Emergency/Admitting area - shall not be used for evacuation unless this is the only usable exit. This stairwell is for use by firefighting personnel. E. ALL Personnel in BHC : o Be sure that you know the location of the fire alarm box in your area and its coded signal. Instructions for sounding an alarm are on the front of each fire alarm box, printed on the local fire station code sheets which are located at each fire alarm box. o When a fire alarm is sounded from an alarm box in the Behavioral Health Center, the fire doors will automatically close throughout the building These doors will stay closed until the code clear has been sounded and the fire alarm system is reset. o Automatic smoke detector alarms (sensors) are located on each side of the smoke-retarding doors, on all floors. When the fire alarm bells sound: 1. Determine the location of the fire according to coded bells and by listening to directions given over the page system. A list of code locations is located at each fire alarm box. 2. DO NOT use the elevators. 3. TELEPHONES are for EMERGENCIES only. 4. All personnel shall stage for evacuation of patients and staff. If you are with patients in an area of the building other than a nursing unit, stay in that area and stage the patients for evacuation. DO NOT return to the Nursing Unit with patients 5. If assistance is needed in the fire area, the operator will be notified by the person in charge, of the type of staff needed and a Page will be broadcast alerting those employees to report to the designated area. Staging involves the orderly movement of patients to the nearest exit, away from the area of the fire and waiting there for further instructions. Take a head count in the staging area. F. Psychiatrists, Residents and Medical Students, Social Workers and Psychologists: Page 9 of 12

10 If you are with a patient, family or visitors: remain with them, and proceed to staging area for your location. If you are alone: return to your assigned unit, if safe to do so, or report to Administrator or Nursing Care Coordinator of your location for assignment. G. Secretaries and all other professional and non-professional support persons report to the administrator/ nursing care coordinator of their areas for assignments to assist others. All activities( i.e. secretarial, Xeroxing, therapy, interviews) stop during period of fire drill or emergency. H. PROCEDURE IF A FIRE OCCURS ON AN INPATIENT UNIT OR THE PSYCH ER RESPONSIBILITY OF PERSON DISCOVERING FIRE: 1. Remove any patients from the area of immediate danger to a safer area on the nursing unit. 2. Isolate the fire by closing the doors to the area. If possible, close any open windows. 3. Sound the alarm from the nearest fire alarm box. 4. Using the proper equipment, begin extinguishing the fire. I. RESPONSIBILITY OF ALL STAFF ON THE INPATIENT UNIT/ ER On the unit: Upon hearing alarm, nursing staff report to Charge Nurse for assignments. If with patients in any area of the building other than the nursing unit, stay in that area and stage the patients for evacuation and page the NCC for direction. Staff members shall be assigned to stage patients at stairwell exit 1, 3 or 4 and take a head count. If fire is in that area, staff shall follow the RACE procedures. Patients on Protective Observation or Frequent Awareness shall be assigned to one specific staff member for staging. The BHC NCC shall assume responsibility for all activities on the unit until relieved by Administration Decision to evacuate unit shall be made by administrator in charge (VP-BHC), except in instances deemed an emergency. The NCC may order evacuation. If necessary, the charge person on a unit may initiate the evacuation of a unit. The security guard assigned to BHC shall station himself at the Emergency/Admitting entrance and determine the location of the alarm by observing which light is on in the annunciator panel between the entrance doors. He will direct fire personnel to the scene and notify the Security Supervisor by telephone or page. The Security Guard Supervisor shall report to the BHC and ascertain if more guards are necessary. Page 10 of 12

11 J. EVACUATION PLAN 1. Partial Evacuation: Evacuation of patients to a safe area is a duty of the Nurse-in-Charge who should not wait for special instructions to safeguard patients. Evacuation to a safe area would mean moving a patient or number of patients horizontally to a room or number of rooms on the same floor or wing. The need to evacuate patients to another floor should await specific instructions before movement is attempted. Orders for this procedure could come from Fire Officials, the Vice President of BHC, or an authorized person so recognized to do so. When evacuation to another floor becomes necessary, the evacuation should always be to a lower floor and should not be attempted without orders from an authorized person as outlined above. 2. If a TOTAL Evacuation on is ordered for BHC: Evacuation is to be achieved via the stairways only. Do not attempt to use the elevators. Stairwell 5 in the B Wing - Emergency/Admitting area - shall not be used for evacuation unless this is the only usable exit. This stairwell is for use by fire-fighting personnel. If evacuation is ordered by the person in charge, patients are to be moved to the Recreation blacktop or grass areas outside BHC as indicated, using stairwells and under supervision as follows: The NCC in the Main Hospital shall furnish any additional personnel required to assist in the evacuation and to render any other assistance required. Unless directed otherwise, only the patients on the affected unit shall be evacuated. Patients are to be kept staged for evacuation, however, until directed otherwise. A head count must be done as soon as the patients are staged. Upon reaching the predetermined area of safety, the charge person from each unit shall conduct a head count to ascertain that all patients are present. Discrepancies shall be reported immediately to the Administrator-in-Charge or an authorized person. When the all clear has been sounded, the Administrator-in-Charge (VP-BHC) or authorized person will direct that the patients be returned to the unit or will make arrangements for temporary housing for the patients. Nursing staff are to remain with patients at all times. Patients designated as being on CO or CS are to be assigned to one specific staff member for staging. NOTE: The patient s medical record shall accompany any evacuation if possible. Page 11 of 12

12 3. House Staff Responsibilities In response to a fire or evacuation, members of the House Staff will report to their area of duty. They will report to the Nurse-in-Charge for assignment of duties in the care and evacuation of the patients in the affected area. 4. General Notes on Evacuation The Charge Nurse is responsible for keeping census records and knowing the location of patients at all times. He/She will be certain the patient's chart be moved to the area to which the patient has been evacuated. A head count of patients must be conducted at the safe area. The general conduct of all personnel is primarily her/his responsibility and review of the evacuation plan should be discussed frequently. A SUMMARY OF THE FIRE SAFETY PROCEDURE FOLLOWS: A. Get patients away from danger areas immediately. B. Move patients exposed to danger laterally to a safer area. C. Upon instructions, organize downward evacuation of patients to a safe area. D. Have someone check stairwells as possible means for ambulatory patients to be moved downward. The charge nurse is to be certain that she/he knows to what area her/his patients have been evacuated, and will conduct a head count. E. Rehearse with all new personnel their part in evacuation plan. Page 12 of 12