Disaster Preparedness Paper. Literature & Language Essay

Disaster Preparedness Paper

Contact a disaster preparedness person at either a local hospital, or local city or county emergency services agency.

Interview your contact, asking the following questions:
1) "What do you consider to be the top three disasters for which you prepare?"
2) "What would you say are your top three lessons learned about managing a disaster?"

Write a paper of 1,000–1,200 words that summarizes your findings from the interview as well as from your readings.

Refer to the assigned readings to incorporate specific examples and details into your paper.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Reading Materials
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Specific Types of Emergencies
Personal Preparedness
Businesses
Healthcare Facilities
State & Local
National
Legal
NOTE: the preparedness resources on this website are too numerous to list on one page. For more resources on specific topics, see the list of specific types of emergencies below.
Preparedness for Specific Types of Emergencies
Bioterrorism Emergencies
Anthrax, smallpox…more
Chemical Emergencies
Natural Disasters
Radiation Emergencies
See Agents, Diseases, & Other Threats for a full list of health hazards covered on this website
Personal Preparedness
Emergency Preparedness and You
Centers for Disease Control and Prevention (CDC) and the American Red Cross have teamed up to answer common questions and provide step by step guidance you can take now to protect you and your loved ones.
Chemical Emergencies: Facts About Sheltering in Place
How to find temporary shelter in a chemical emergency
Chemical Emergencies: Facts About Evacuation
Knowing when & how to evacuate an area in a chemical emergency
Chemical Emergencies: Facts About Personal Cleaning & Disposal of Contaminated Clothing
What to do if you come in physical contact with dangerous chemicals
Radiation Emergencies: Sheltering in Place
How to find temporary shelter in a radiation emergency
Preparedness for Businesses
Emergency Preparedness for Business
Instructions to building occupants, actions to be taken by facility management, & first responder notification procedures. From the National Institute for Occupational Safety & Health (NIOSH)
Guidance for Protecting Building Environments from Airborne Chemical, Biological, or Radiological Attacks
May 2002. From the National Institute for Occupational Safety & Health, CDC
Preparedness for Healthcare Facilities
Adapting Standards of Care under Extreme Conditions: Guidance for Professionals During Disasters, Pandemics, and Other Extreme Emergencies (2 MB/26 pages)
This policy paper can be used a basis for protocol development and refinement, especially in regard to ethics and standards that apply to decisions about care made during unusual or extreme circumstances such as those resulting from emergencies, disasters, or pandemics. Prepared for the American Nurses Association by the Center for Health Policy, Columbia University School of Nursing.
Bioterrorism Readiness Plan: A Template for Healthcare Facilities (1.5 MB/34 pages)
OSHA Best Practices for Hospital-Based First Receivers of Victims
Information to assist hospitals in developing & implementing emergency management plans for protecting hospital-based emergency department personnel during the receipt of contaminated victims from mass casualty incidents occurring at locations other than the hospital. Provided by the U.S. Occupational Safety & Health Administration (OSHA).
MMWR QuickStats: Percentage of Hospitals with Staff Members Trained to Respond to Selected Terrorism-Related Diseases or Exposures
National Hospital Ambulatory Medical Care Survey, United States, 2003–2004
MMWR 2007 Apr 27;56(16):401.
State & Local Preparedness
Considerations for Anthrax Vaccine Adsorbed (AVA) Post-Exposure Prioritization (237 KB/19 pages)
Preparedness Planning Tools: Spreadsheet-based software models designed to assist state, regional, and federal level preparedness planners.
Public Health Preparedness: Mobilizing State by State
Inaugural CDC report on public health emergency preparedness. Provided by the CDC Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER).
Public Health Emergency Response Guide for State, Local, & Tribal Public Health Directors
All-hazards reference tool for health professionals who are responsible for initiating the public health response during the first 24 hours (i.e., the acute phase) of an emergency or disaster. Version 2 now available!
Preparedness and Emergency Response Learning Centers
Cooperative Agreement Guidance for Public Health Emergency Preparedness
Guidance for CDC emergency preparedness funding for states. CDC has announced the availability of FY 2008 funding for continuation of the cooperative agreements to upgrade state & local public health jurisdictions’ preparedness for & response to bioterrorism, other outbreaks of infectious disease, & other public health threats & emergencies.
CDC Support for the Emergency Management Assistance Compact (EMAC)
Information about EMAC, the interstate mutual aid agreement that provides a mechanism for sharing personnel, resources, equipment & assets among states during emergencies & disasters.
MMWR: Brief Report: Terrorism & Emergency Preparedness in State & Territorial Public Health Departments — United States, 2004
MMWR 2005 May 13;54(18):459-460.
MMWR: Assessment of Epidemiologic Capacity in State & Territorial Health Departments — United States, 2004
MMWR 2005 May 13;54(18):457-459.
MMWR: Improvement in Local Public Health Preparedness & Response Capacity — Kansas, 2002–2003
MMWR 2005 May 13;54(18):461-462.
Guidance on Initial Responses to a Suspicious Letter/Container With a Potential Biological Threat[PDF – 241K]
Guidelines for local responders, based on existing procedures, on the initial response to letters, packages, or containers containing suspicious powders, liquids, or other materials. Developed by HHS/CDC, FBI, & DHS.
Cities Readiness Initiative (CRI)
Pilot program to aid cities in increasing their capacity to deliver medicines and medical supplies during a large-scale public health emergency
National Preparedness
CDC Resources for Pandemic Flu
Strategic National Stockpile
National repository of pharmaceuticals & medical supplies.
Epi-X: The Epidemic Information Exchange
Secure, Web-based communications network connecting CDC with state & local health departments, poison control centers, & other public health professionals.
MMWR: Biological & Chemical Terrorism: Strategic Plan for Preparedness & Response
Recommendations of the CDC Strategic Planning Workgroup.
MMWR Recommendations & Reports 2000 Apr 21;49(RR-4);1-14.
Emergency & Environmental Health Services
From the National Center for Environmental Health. Description of NCEH involvement in providing national & international leadership for the coordination, delivery, & evaluation of emergency & environmental health services.
MedCon‎
A tool to estimate the pre-event population at risk of medical consequences in a disaster.
Legal Preparedness
Regulations to control communicable diseases[PDF – 29K]
42 U.S.C. 264 (From United States Code Annotated; Title 42; The Public Health & Welfare; Chapter 6a–Public Health Service; Subchapter Ii–General Powers & Duties.; Part G–Quarantine & Inspection).
EID Journal: Collaboration Between Public Health & Law Enforcement: The Constitutional Challenge
Emerging Infectious Diseases 2002 Oct;8(10):1157-1159.
Public Health Emergency Preparedness Clearinghouse
The Public Health Emergency Preparedness Clearinghouse is a central repository for emergency preparedness-related statutes, regulations, orders, reports, and legal tools. The Clearinghouse is intended to aid jurisdictions considering updates and clarifications to their public health emergency legal preparedness activities.
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Page last updated: July 9, 2018
Content source: Center for Preparedness and Response (CPR)
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Death of a Surgeon:
A beloved surgeon was gunned down by an obsessed family member of a deceased cardiac patient. . . . . . . . . . . . . . 5
Positive vibe: Seeing nursing through a different lens can bolster staff against negative stressors ............5
Overcoming addiction:
Washington state program provides a way back to the bedside for nurses..............7
Banish burnout:
Cross-training, holistic nursing, and getting off the clock . . . . . . . . . . . . 9
JANUARY 2017 Vol. 36, No. 1; p. 1-12 Boston Strong: Raising a Voice
Against Hospital Violence
Leaders emerge in wake of surgeon shooting, marathon bombing By Gary Evans, Medical Writer
I
Health, we look at some underlying causes and much-
n the conclusion of our report on healthcare violence from the December
2016 issue of Hospital Employee
bombing, has certainly instilled a sense of readiness and vigilance in the city’s healthcare facilities.
That said, the open campus of a medical facility cannot
needed solutions in
a conversation with officials in Boston, which has suffered healthcare violence and a terrorist attack in recent years.
“THE QUESTION ALWAYS COMES UP: DO YOU HAVE METAL DETECTORS? DO YOU ARM YOUR STAFF? YOU HAVE TO WEIGH WHAT IS MOST APPROPRIATE FOR PATIENT CARE AND KEEPING EMPLOYEES SAFE.”
be locked down like airport security, so officials strive for
a balance between delivering care and protecting patients and healthcare workers.
“The question always comes up: Do you have metal detectors? Do you arm your staff?” says Constance L. Packard, CHPA, executive director of support services at Boston University Medical Center.
She answers “no”
An incident
that shook the
Boston medical
community occurred
in January 2015,
when a surgeon
at Brigham and
Women’s Hospital
was shot and killed
at work by a relative
of a deceased patient.
That shocking event, on
the heels of the 2013 Boston Marathon
to both questions, though her team
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has handheld wands for weapon detection if needed.
“You have to weigh what is most appropriate for patient care and keeping employees safe,” Packard says. “I learned a lot from my colleagues in the Boston Marathon bombing — have those tools and be able to put them in place when you need to use them. That’s versus having, for example, a stand-alone metal detector. We see 12,000 to 15,000 people here a day. It’s a
very busy place with 42 buildings and hundreds of entrances. It’s just impossible to do that and do it well.”
Having developed active shooter training videos and scenarios, Pack- ard praised The Joint Commission’s recent development of a violence pre- vention resources portal for health- care. (To see the portal, visit: http://bit(dot)ly/2d8U2IW.)
“I know from going through Joint Commission accreditation
for numerous years that emergency management and workplace violence are probably two areas that they
do focus on when they look at environment of care standards,” she says. “They are interested in how you are doing your program, and more importantly, how you are educating your staff should an event occur.”
At Boston Medical, that education includes an ongoing reminder to
staff that no incident is “too little” to report.
“We want them to give us a heads-up that [for example, a patient] has an outburst,” Packard says.
“It gives us, from a public health perspective, the ability to look at
risk. As police officers, it gives us the opportunity to reduce vulnerabilities. In the last year, we have worked
with our IT department to put something in the [patient] chart called administrative precautions
— an FYI or flag when we have a
problem patient or a problem family member.”
The staff are supportive of having that information in the patient chart, which may encourage reporting of incidents that may otherwise go untracked.
“I can tell you the staff has been very vocal about how important it is to see that information,” Packard says. “They have to call us and tell us about the event, whether it was the patient or the patient’s family, and then we will determine if it is at the level that needs to be [recorded in the medical record]. It may just generate a public safety report
or it may develop what we call a comprehensive care plan, but we have nothing to lose by sharing the information.”
While such policies may encourage more reporting of violent or threatening incidents, many healthcare workers are reluctant to take it a step further and formally press charges against patients they may regard as suffering from drug- related behavior or mental health problems.
“Others, depending on the injuries, say, ‘Yes, I want to go forward,’ and we work with them and pursue prosecution in the courts,” Packard says.
Though some violent incidents are completely unpredictable, the training advised by Packard and others can still mitigate a situation and save additional injuries or
loss of life. In July 2016, a man entered Parrish Medical Center in Titusville, FL, and fatally shot a patient and caregiver for no apparent reason. Security guards managed to disarm the man and hold him for law enforcement, prompting this comment from Titusville Police Chief John Lau: “I cannot stress enough [that] the response of the
2 |
HOSPITAL EMPLOYEE HEALTH® / January 2017
EDITORIAL QUESTIONS:
For questions or comments, call Gary Evans at (706) 424-3915.
Parrish Medical Center staff, without a doubt, saved more lives.”1
The Broken Window
The failure to report and act when an incident may be verbal or seem minor can contribute to the “broken window” effect, which essentially suggests that an ongoing tolerance for a low level of crime may contribute to its subsequent escalation, says James P. Phillips, MD, of the Department of Emergency Medicine at Beth Israel Deaconess Medical Center in Boston.
“Both verbal and nonverbal violence from patients against providers are classified as ‘Type II’ workplace violence,” Phillips explains to Hospital Employee Health. “The broken windows theory is adapted from street crime, and [suggests] that intolerance of low-level crimes such as broken windows — or in the case of workplace violence, verbal escalation and disrespect — helps to prevent higher-level crimes such as physical battery in the workplace.”
Phillips wrote a definitive review article2 on the problem of violence in healthcare last year in the New England Journal of Medicine,
noting that while the murder of a healthcare worker certainly draws national attention, there is still an underappreciation of the scale of the daily problem.
“[E]pisodes of workplace violence against medical providers happen daily across the country,” Phillips wrote in the review article. “Although the majority of these incidents of workplace violence are verbal, many others constitute assault, battery, domestic violence, stalking, or sexual harassment.”
In the paper, Phillips places violence into four categories, including the aforementioned Type
II. Each of the categories reflect the relationship of the perpetrator to the workplace or employees:
• Type I: No association (e.g., person with criminal intent commits armed robbery).
• Type II: Perpetrator is a patient or customer of the workplace or employees (e.g., intoxicated patient punches nurse’s aide).
• Type III: A current or former employee of the workplace (e.g. recently fired employee assaults former supervisor).
“BOTH VERBAL AND NONVERBAL VIOLENCE FROM PATIENTS AGAINST PROVIDERS ARE CLASSIFIED
AS ‘TYPE II’ WORKPLACE VIOLENCE.”
• Type IV: Perpetrator has a personal relationship with employ- ees, none with the workplace (Ex- husband assaults ex-wife at her place of work).
As Phillips emphasizes, Type II violence — which can be physical or verbal assaults — is the most common form faced by healthcare workers. Indeed, a 2014 study3 found that healthcare workers had the highest number of Type II incidents in U.S. workplaces. Type II workplace violence accounted for 75% of aggravated assaults and 93% of all assaults against employees, Phillips reports.
In addition, there appears to be a direct relationship between patient contact time and possible violence,
placing nursing aides and nurses at the greatest risk. Not surprisingly, ED nurses report high rates of violent incidents, and in one study4 approximately 25% of emergency medicine physicians reported being targets of physical assault in the previous year.
Given the level of violence against healthcare workers documented, it
is disconcerting to consider Phillips’ conclusion that episodes of workplace violence of all categories are “grossly underreported.” In particular, he notes that nurses have cited fear of retribution from supervisors and disapproval of administrators as barriers to reporting, possibly in part due to the prevailing “the customer
is always right” mentality. This
raises the disturbing connotation
that somehow a level of violence is ingrained in the healthcare work culture.
“The recent trend over the last two decades toward viewing a patient as a customer has had deleterious effects on the patient-physician and patient-nurse relationships in many ways, in my opinion,” Phillips says. “There has been a depersonalization, and a subsequent decrease in respect between patients and physicians in both directions. This obviously is
not the case in every field or every situation, but I think most physicians and nurses would agree with my opinion in general. That decrease in respect for the provider has certainly contributed to increased verbal disrespect and probably violence.”
By the same token, the patient as a customer expecting quality service may be less tolerable to long waits in the ED, beds temporarily placed in hallways, or lack of nursing and physician attention due to census overload.
“Patients who do not feel they are getting their ‘money’s worth’
HOSPITAL EMPLOYEE HEALTH® / January 2017 | 3
are much more likely to act out,
in my opinion,” Phillips says. “In regards to underreporting, there are many barriers that prevent victims from documenting and reporting such incidents. There is a general feeling that there is no worthwhile consequence or punishment for
the offender that is worth the time and energy of the provider-victim to pause their work, fill out a form, make a phone call, or file a police report.”
Healthcare administration must address this problem, encouraging reporting and taking action to overcome this depressing status quo.
“Providers have not been made
to feel that violence prevention and redress is a priority in their workplace despite the statistically proven risk
in healthcare, and without that, I do not think we will see much increase in reporting.” Phillips says. “It is
an administrative responsibility to acknowledge that this violence exists in every healthcare setting, and that if individual institutions do not
start making real improvements, the government and accrediting bodies will eventually regulate them into doing so.”
Budgeting for Violence Prevention?
Phillips and colleagues are undertaking a multiple hospital study to look at whether facilities have sufficiently dedicated budgets and policies to protect healthcare workers from violence.
“Preventing workplace violence is not free — it may not be cheap,” he says. “It certainly requires a budget, and employees who are working in the field should not be expected to volunteer their time to fix this problem. I would bet that
the large-scale hospital study we are beginning now will demonstrate
that most do not have a dedicated budget for prevention of patient-to- provider violence, and I hypothesize that many probably do not have
any hospital policy on the subject, either. Equipment and personnel
are expenses, and for administrators who are responsible for keeping the lights on — and for some, generating profits — I do not think we will see widespread change until OSHA, The Joint Commission, or government regulations mandate it.”
“EACH HOSPITAL MUST FIRST ADMIT THAT THEY ARE NOT SPECIAL, AND THAT SUCH VIOLENCE OCCURS IN EVERY FACILITY.”
In the interim, employee health professionals and their healthcare colleagues can take the first step by acknowledging the problem and raising awareness.
“Each hospital must first admit that they are not special, and that such violence occurs in every facility,” Phillips says. “I understand the apprehension that hospitals may
have toward publicly acknowledging that there is violence in their
facility. Even more so, it will take
a brave, dedicated administration
to be willing to allow research and release of violence statistics in their hospital because of the perceived risk that such public admission will be deleterious to patient and employee recruitment. I ask for such courage
from hospital administrations.” Phillips suggests establishing
a multidisciplinary workplace violence committee that includes administrators, supervisors, technicians, nurses, and physicians and other employees. With the input of clinicians and providers, develop a basic reporting system that includes — as cited by Packard — a “red flag” warning to future providers of
a patient or family member with a history of violence.
“Most importantly, frontline providers must be made certain
that their administrators and supervisors will support them
fully and will ‘have their backs’
in such cases,” Phillips says. “This requires real communication and acknowledgment of the issue. Hospitals should eliminate customer service measurements like the Press Ganey scale, which are often tied
to physician payment. [These scales hinder] the provider setting limits with patients when disagreements and conflict arise, which ultimately contributes to the continued decline in the quality of the patient-physician relationship.” n
REFERENCES
1. Ferenc, J. Florida hospital proves an active shooter plan can save lives. American Hospital Association: Healthcare Facilities Management. August 18, 2016: http://bit(dot)ly/2gA1MG8.
2. Phillips, JP. Workplace Violence against Health Care Workers in the United States. N Engl J Med 2016; 374:1661-1669.
3. Vellani KH. The 2014 IHSSF crime survey. J Healthc Prot Manage 2014;30:28-35.
4. Kowalenko T, Gates D, Gillespie GL, et al. Prospective study of violence against ED workers. Am J Emerg Med 2013; 31: 197-205.
4 | HOSPITAL EMPLOYEE HEALTH® / January 2017
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3-December 2015
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think about. But the important thing is it’s very multidisci- plinary. You don’t want it too large so that it’s manageable and that you can get good information.
And you really want someone who does have a good understanding of your building, what your building’s
capabilities are, where the exits are, your locking mecha- nisms. All that stuff is something I think is always good to have when you’re doing a risk assessment. [With] those, you’re always assessing your risks into different areas and where you fall within those risks. H
Managing security and safety during disasters
In this excerpt from the new HCPro book, Emergency Management Compliance Manual, Second Edition, author Thomas Huser, MS, CHSP, CHEP, safety coordi- nator of emergency management and hazardous mate- rials with Indiana University Health in Indianapolis, discusses the things facilities need to know to comply with The Joint Commission’s emergency management (EM) standards. For more information, or to order
the book, please visit the HCPro Marketplace at www. hcmarketplace.com.
The security and safety of your facility are critical components of providing an appropriate environ- ment for the care and treatment of patients in the best of times, and during a disaster, maintaining a secure and safe environment is even more important. Unfortunately, during an emergency or disaster, there are people who are more than willing to take advan- tage of your bad situation for their profit. This chap- ter covers the requirements you will need to meet
to provide for a secure environment during disaster activation. These do not replace the requirements found in the Environment of Care (EC) chapter of The Joint Commission’s Comprehensive Accreditation Manual for Hospitals (CAMH) but rather supple- ment them with special requirements related to disaster activities. These include controlling vehicu- lar and personnel access to your facility, along with the movement of personnel within the facility and coordination of your security activities with outside agencies and responders.
This chapter also covers provisions for maintain- ing a safe environment for patients, visitors, and staff during the hectic activities normally associated with a disaster. Some of the provisions include handling and disposing of general and hazardous wastes, radioactive wastes, and waste from decontamination. Additionally,
environmental emergencies, either internal or exter- nal, can add their own special problems to an emer- gency. Think of the safety and health issues related to a major sewer line break or backup within the build- ing. “Black water” (sewage) carries multiple risks and can play havoc with the care of your patients. So do not just think about the big external disasters when
it comes to health and safety; consider the internal events that would trigger emergency operations plan (EOP) activation and present a health risk to the occupants of the building.
(Also, please see p. 12 for a handy Disaster Plan Evaluation Form that you can use during a drill or actual event to critique the effectiveness of your EOP.)
EM.02.02.05: Managing Security and Safety
What the standard says: The hospital establishes strat- egies for the management of safety and security during an emergency.
Safety and security are important aspects during normal operations; however, during an emergency, the ability to maintain a safe and secure facility can become an even greater challenge. With an influx of patients comes an influx of problems. More people will arrive at your facility than you are used to seeing on a normal day. Additionally, you will have people trying to gain access to your facility who have other ideas—such as stealing, hiding, kidnapping, drug diversion, gaining accessibility to patients (including lawyers and mem- bers of the press), and others who are just there to take advantage of the chaotic conditions.
You will need to control access to the building, as well as movement of those within the building. This will be a daunting task with limited resources and little, if any, help from outside agencies, at least during the initial response to a disaster.
© 2015 HCPro, a division of BLR. For permission to reproduce part or all of this newsletter for external distribution or use in educational packets, contact the Copyright Clearance Center at copyright.com or 978-750-8400. HCPRO.COM 9
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December 2015
Elements of performance (EP)
there are no consequences should the contractor fail to comply. As a friend once asked, “Would you buy a new car with an MOU?” In the aftermath of Super- storm Sandy, there were no portable generators avail- able east of the Mississippi River. When a hospital had to pull their generator for emergency repairs, the com- pany with whom they had an MOU told them they had gone where the money was and to look elsewhere for a generator. One was finally located in Kansas and had to be transported to Indiana. Had the facility lost power while waiting for the generator from Kansas, it would have had to evacuate its patients. Have strong contracts with consequences to the vendor if they fail to comply and ensure they are not stretched so thin that they are unable to keep all their promises.
3. The hospital’s EOP describes how the organization will coordinate security activities with external secu- rity agencies (e.g., law enforcement, National Guard, etc.). Coordination of activities is key during a disaster. Think about how and to whom you will communicate your needs for additional security. Once outside assis- tance arrives, how will you integrate manpower from those agencies into your security plan? How will staff from outside agencies identify personnel who do or do not belong, not only in the building but also in restrict- ed areas of the facility? How will your hospital share these resources with other affected facilities? These are all considerations you need to discuss both inter- nally and externally as part of your response plan- ning activities. Remember that the National Guard is
a unique organization and is under the control of the state governor and not local government. However, any requests for the National Guard must be initiat- ed at the local level. Meet with your local emergen- cy manager to ensure that the protocol for requesting such assistance is in place.
4. The hospital’s EOP describes processes for the management of hazardous materials and wastes. The maintenance of a safe facility during an emergency includes the management of hazardous materials and wastes. These will accumulate very quickly if you are unable to treat or dispose of them. This also includes infectious and human waste. Ensure that your plan includes what you will do with decontamination
1.
The hospital’s EOP describes internal security and safety arrangements. The organization needs to have a plan in place to ensure the safety and security of the facility and its occupants. This may require plans for a full facility lockdown, limited access, and/or the post- ing of personnel at every external door and outside areas where you will allow the public, such as the caf- eteria and family waiting areas. The response needs to match the threat; you would not place unarmed per- sonnel at entries in response to a civil disturbance or reports of an active shooter, so how would you secure your facility to protect the occupants? Use of inter- nal card access systems will ensure that the movement of nonhospital personnel within the facility is limited. The safety officer will need to work to ensure that the hospital maintains safe operations. An emergency dec- laration is not a declaration of “freedom from regula- tory requirements.” Depending upon the condition of the structure, safety will be very critical to ensure that accidents are minimized during very hectic conditions.
The hospital’s EOP describes the roles of external se- curity agencies (law enforcement, National Guard, etc.). The reality is that you will most likely be on your own during the initial phase of a disaster, at least un- til the National Guard or other reinforcements arrive to assist local law enforcement. How long it will take to receive outside help will depend upon the type and extent of the emergency. Your facility needs to have a plan in the event that outside assistance is not avail- able, whether for a few hours or several days, hence the so-called “96-hour rule” discussed under standard EM.02.01.01. Most likely, local law enforcement will be very busy responding to public issues, so the secu- rity of your facility will be left up to you. Work with your local law enforcement and emergency manage- ment (EM) agency to ensure that you are on their pri- ority list so that when help is available, you will be one of the first locations to receive assistance. You must also have a plan for when outside help does not ar- rive. In the event of an influenza pandemic, for exam- ple, the resources of the outside agencies—both public and private—will also be affected by illness and ab- senteeism. Also do not depend on Memorandums of Understanding (MOU). These are not enforceable, so
2.
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residue, lab chemicals, cleaners, sewage, and infectious and chemotherapy waste. Depending upon the emergency, you may need to establish a holding area where you can store these items until workers can remove them. However, if you use this approach, identify how you will secure the area and notify personnel of the hazards and, most important, how you will clean the area upon the return to normal operations. Do not forget to include how you will manage your general waste as well. Just because the waste is not hazardous does not mean it is safe. General waste can attract flies and other insects, along with mice and other vermin, which can carry diseases and place your patients and staff at risk. You will also need to plan for the acquisition and placement of portable toilets. If you lose water or sewage utilities, these will become critical to minimize the amount of waste you will need to manage. As many hospitals learned during Ebola preparedness, not all bio- waste can be handled the same. The Ebola waste is actually a hazardous material and requires special shipping containers, precautions, and disposal that
are completely different from those of standard bio- wastes. Take into consideration special wastes as you are making your plans. Even if you have the ability
to treat bio-waste, you will still need to deal with waste after it has been treated. Also, with the new requirements for capturing pharmaceutical wastes, ensure these are taken into consideration. If you are like most facilities, suitable storage for these types
of wastes is in a very limited supply. You may need
to vacate units and seal them off from the rest of the hospital to prevent release into patient care areas. See what contingencies your waste hauler has along with contingencies from your local health department and solid and sanitary waste districts.
5. The hospital’s EOP describes how the hospital will provide decontamination and isolation facilities
for radioactive, biological, and chemically exposed personnel. Decontamination is and will remain an issue of top importance in any emergency event because of the threat of radiological, biological, or chemical attacks. The Joint Commission does not require hospitals to provide decontamination facilities; however, you must have a plan for how to react should a contaminated
person or persons arrive at your facility. I highly endorse some type of decontamination capability
for every hospital. Decontamination equipment is relatively affordable, and facilities do not always have to buy the equipment. If you work with your local fire department, EM agency, or even National Guard unit, they might help you acquire and store equipment. Or they may be able to purchase the equipment and then store it at your facility. In the event of an emergency, the agency is a partner and could provide additional manpower to help you decontaminate victims. Decontamination is manpower intensive, and in warm weather, personnel need to be rotated every 15 to 20 minutes and will not be ready for reentry for hours depending on their physical condition, along with the environment in which they are having to work. Those conducting the decontamination need to be trained
as Occupational Safety and Health Administration (OSHA) First Receivers and maintain the training through documented annual competency. Staff also needs to know what they are working with and how to remove the hazard. This is something that needs to be planned well in advance of the need.
Talk to other hospitals about what they do for decontamination. In the case of one hospital that could not afford the decontamination equipment and did not have adequate staff to provide decontamina- tion, it formed a partnership with its local volunteer fire department. The facility obtained funding for equipment through its local EM agency to pay for the equipment and training.
Keep in mind that radiological, biological, and chemical terrorist attacks are not the only source of contamination you may encounter; industry, agricul- ture, and illegal drug labs are all possible sources. If you do choose to form an internal decontamination team, ensure that your hospital trains all personnel who participate in the decontamination process on the OSHA hospital-based First Receiver requirements. Several years ago, OSHA created new requirements for personnel involved in decontamination.
You can learn more about these standards and how to properly train your staff to perform decontamina- tion at the OSHA website at www(dot)osha(dot)gov/dts/osta/ bestpractices/html/hospital_firstreceivers.html. H
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Disaster plan evaluation form
Circle One: Drill or Actual Event
Program/Location: __________________________________________________________________________________________
Type of Event:
q Evacuation
q Chemical Response
q Severe Weather/Tornado q Severe Weather/Snow-Ice q Utilities Interruption
q Bio-terrorism
q Bomb Threat
q Child Abduction
q Civil Disorder
q Essential Services Interruption
If drill, name and title of person conducting drill:____________________________________________________________________
If actual event, name and title of person assuming lead role: ________________________________________________________
Describe scenario of event: ____________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
1. Did employees respond appropriately when alerted?
2. Were patients and staff correctly informed of the emergency?
3. Did staff move patients and other staff members to the appropriate location for the emergency? 4. Were all visitors and patients accounted for?
5. If it is utility interruption, was the utility company called?
6. If there was a gas leak, did staff evacuate without creating any sparks?
7. Was the overall drill/disaster conducted efficiently?
8. Is corrective action necessary?
CORRECTIVE ACTION: List problems noted and/or questions asked by staff.
Action:_______________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
(Use additional paper if required)
Responsible Person: _______________________________________________________ Date Completed: ___________________
Source: Emergency Management Compliance Manual, Second Edition
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Copyright of Briefings on Hospital Safety is the property of HCPro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Rubric:Disaster Preparedness Paper - Rubric
No of Criteria: 7 Achievement Levels: 5
Criteria
Achievement Levels
Description Percentage
Unsatisfactory
0.00 %
Less Than Satisfactory
65.00 %
Satisfactory
75.00 %
Good
85.00 %
Excellent
100.00 %
Content
70.0

Demonstrate thorough knowledge of the principles of disaster readiness and lessons about managing a disaster. Clearly develop a strong analysis of the lessons learned. Introduces appropriate examples.
40.0
Does not demonstrate understanding of the principles of disaster readiness and lessons about managing a disaster. Does not demonstrate critical thinking and analysis of the material.
Demonstrates only minimal understanding of the principles of disaster readiness and lessons about managing a disaster. Demonstrates only minimal abilities for critical thinking and analysis.
Demonstrates knowledge of principles of disaster readiness and lessons about managing a disaster, but has some slight misunderstanding of the health care implications. Provides basic critical thinking and analysis. Does not include examples or descriptions.
Demonstrates acceptable knowledge of the principles of disaster readiness and lessons about managing a disaster. (in your own words). Develops an acceptable analysis of the lessons learned. Utilizes some examples.
Demonstrates thorough knowledge of the principles of disaster readiness and lessons about managing a disaster. Clearly develops a strong analysis of the lessons learned. Introduces appropriate examples.
Integrates information from outside resources into the body of paper.
30.0
Does not use references, examples, or explanations.
Provides some supporting examples, but minimal explanations and no references.
Supports main points with examples and explanations and includes few references to support claims and ideas.
Supports main points with references, explanations, and examples. Analysis and description are direct, competent, and appropriate of the criteria.
Supports main points with references, examples, and full explanations of how they apply. Thoughtfully analyzes, evaluates and describes major points of the criteria.
Organization and Effectiveness
20.0

Assignment Development and Purpose
7.0
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction
8.0
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5.0
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.
Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
Format
10.0

Paper Format (Use of appropriate style for the major and assignment)
5.0
Template is not used appropriately, or documentation format is rarely followed correctly.
Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.
Appropriate template is used. Formatting is correct, although some minor errors may be present.
Appropriate template is fully used. There are virtually no errors in formatting style.
All format elements are correct.
Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment and style)
5.0
No reference page is included. No citations are used.
Reference page is present. Citations are inconsistently used.
Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present
Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.
In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.
Total Percentage 100