Archive for: Emergency Action Plans
I had the pleasure yesterday of spending a day at the 2015 annual conference of the American College of Emergency Physicians (ACEP), which is being held here in my beautiful hometown of Boston.
Being in the safety business, I sat in on a session about active shooter response preparation in healthcare facilities, led by an emergency physician and security director with Carolinas Medical Center in Charlotte. I didn’t leave with that feeling like we have our collective act together.
Are we really ready for someone to come into our hospitals with a gun, bent on causing mass carnage?
First, let’s start with the numbers. From 2000-2007, there were “only” about 6 shootings a year. From 2007 to today, the numbers jumped to 17 per year.
Many facilities are following the government’s recommendations to “run, hide, and fight” when confronted with a gunman. That’s fine training, if you’re in an office building. Run first, hide when you can, and fight back as a last resort.
But that won’t fly in hospitals and clinics where people are counting on you to help them survive. Poll numbers I heard quoted estimate that at least 40% of healthcare staff wouldn’t leave their patients’ sides, even when confronted with a shooter.
Hospitals need to train their staff to stay alive. Most active shooter incidents end within 7 minutes, and doctors and nurses are then required to turn around and treat the wounded and prevent as much death as possible.
So my question is this: What are you doing to prepare for an active shooter in your facility? Do you have specific plans? Are you training your staff, and what resources are you using?
Please drop me a line at email@example.com and share your thoughts on this very real threat.
Dan Scungio, MT(ASCP), SLS, is a laboratory safety officer for Sentara Healthcare, a multihospital system in the Tidewater region of Virginia and otherwise known as “Dan, the Lab Safety Man.”
Every year I love to use autumn as the time to discuss fire safety. After all, many other organizations promote fire safety ever since October was designated as National Fire Prevention Month in 1922. This year, as always, I do want lab safety professionals to be “fired up” about safety, but there have been some questions about regulations in this area that need special discussion.
The College of American Pathologists (CAP) is the accrediting agency for many labs in the United States, and they have specific regulations about fire safety on their General Checklist.
One regulation states: “If the fire safety plan includes laboratory staff use of fire extinguishers, personnel are instructed in the use of portable fire extinguishers.”
If fire extinguishers are present in your laboratory, their purpose is to be used by the staff in the department, whether or not the safety plan includes staff using them or not. OSHA has something to say about this as well:
“If fire extinguishers are available for employee use, it is the employer’s responsibility to educate employees on the principles and practices of using a fire extinguisher and the hazards associated with fighting small or developing fires.”
The CAP checklist strongly recommends that staff have hands-on fire extinguisher operation that includes the actual use of the device (or a simulator). They do not indicate how often this training should occur. Many labs I have inspected only provide the training once, but OSHA states that it must be provided upon hire and annually thereafter. That makes sense, and lab staff should be ever-ready and able to extinguish a small fire should that become necessary.
Some facilities offer fire extinguisher training as they need to empty out their refillable extinguishers (typically CO2 extinguishers). However, if that does not happen where you are, you have other options. One is to contact your local fire authority. They may happily provide fire extinguisher training for your staff. Another option is to provide the training yourself. You may be able to obtain a test extinguisher or you may simply have to use a full extinguisher without actually discharging it. The important thing is to go through all of the steps of PASS (Pull, Aim, Squeeze, and Sweep) and to let the staff actually handle the fire extinguisher.
If you are providing the training, make sure you give some information about fires that people may not know. Describe the different classes of fires (A, B, and C) and the types of fire extinguishers used to fight them. Remind them not to use more than one extinguisher at a time so they do not blow a small fire onto another person. Tell them to always keep themselves between the fire and the exit. If the fire gets too big or out of control, make sure they leave the firefighting to the professionals.
Inspect your lab for fire risks. Are electrical cords frayed? This is a major cause of fires in the laboratory. Are items stored too close to the ceiling? This may block the action of your sprinkler system. Are ceiling tiles missing or out of place? This disrupts an important fire and smoke barrier. Who performs these inspections? You can, or your local fire authority can as well.
Autumn is a great time to raise fire safety awareness in your laboratory, but this is something that must be done all year. Drill your staff, make sure they know how to react to a real fire. Train them in the use of fire-fighting equipment. Walk your evacuation routes annually. Your staff truly cannot be too prepared.
Have you performed fire drills this year? Have your staff had hands-on fire extinguisher training? If not, it’s a great time to perform these tasks. Many people in history have lost their lives to fires, and laboratory fires are more common than you may think. Be aware, be ready, and ensure your staff remains safe if a fire situation does occur in your workplace.
The compelling reports about the evacuation of St. John’s Regional Medical Center in Joplin, MO, after a tornado tore through the city May 22 is a sober reminder about severe weather hazards and the need for emergency action and evacuation plans.
Drills not included, has your healthcare facility ever had to actually initiate an emergency action plan or evacuate due to weather-related hazards? Our OSHA Healthcare Advisor weekly poll asked this very question. Below are the results:
A new OSHA web page, emphasizes both preparedness and response in protecting workers from tornado danger.
Since tornadoes can occur without much warning, it is important for employers to make advanced precautions to ensure the safety of workers, according to OSHA.
Preparation guidance for businesses in tornado-prone areas includes:
Sometimes medical offices are so focused on workplace hazards like bloodborne pathogens that they forget about other areas of OSHA compliance.
Recently as I was doing one of my mock OSHA inspections, I asked the manager if I could see the office’s emergency action plan (EAP). She had no clue what I was talking about.
A CDC report found that nearly one-third of hospitals are not prepared for mass casualty disasters and epidemics such as influenza.
A new question regarding security is arising in the October 23 alleged murder of a Napa State Hospital nurse.
Donna Gross was checking into the guard station after taking her break when she was murdered by Jess Massey, an inmate patient. Hospital security was questioned after it was found to let patients walk around at their own leisure.
On Monday, the Food and Drug Administration (FDA) announced that the design for external defibrillators will improve through a program to promote safe defibrillators.
External defibrillators are life saving devices used when people suffer from cardiac arrest, though according to The Los Angeles Times, they don’t always work properly.
Q: We had a discussion at one of our clinic safety meetings about the practice of placing an “X” with chalk on the patient exam rooms in the event of a fire to identify which rooms were checked for patients before exiting the building. Is this still a recommended practice for evacuation? Do fire fighting personnel look for these “X” marks? Some of our clinics still do this while others do not. We would like to standardize our clinics on this issue.
A: This one of those concerns for which there is really no correct or incorrect response and ultimately should hinge on a cooperative review of the practice with your local fire departments.
Spartanburg (SC) Regional Medical Center has begun using technology to instruct healthcare workers on RACE and PASS.
The acronyms represent basic concepts in fire safety and response:
The U.S. Agency for Healthcare Research and Quality (AHRQ) recently released a report on selecting and operating alternate care facilities during a disaster.
Alternate care facilities need to be carefully chosen and outfitted with appropriate equipment and materials for use when your hospital is inoperable due to a disaster.
Unfortunately pandemics aren’t just reserved for larger hospitals. This year, more than ever, many physicians realized their important role in managing the threat of pandemic influenza.
To reinforce that point, the CDC has released an “Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices: Guidance from Stakeholders.” But this isn’t your typical convoluted, lengthy guidance. It’s a 12-page template created by physicians, office managers, hospitals, local and state public health departments, and local and state emergency management agencies to help physician offices quickly and effectively prepare for pandemic influenza now, or in the future. The CDC plans to release a more robust Pandemic Influenza Organizer in the spring.