University Hospital Disaster Preparedness

1
University Hospital Disaster Preparedness

• Hospital-Wide Evacuation Guidelines

Evacuation Plan
Incident Command
Disaster Plan
2
Who needs to complete this education?

• All staff who are physically located at
  University Hospital.

3
Purpose

• NYS Department of Health requires University
  Hospital to conduct evacuation plan drill.
• Describe for staff members what their role is in
  the event of a hospital-wide evacuation.
• Identify how to categorize patients during an
  evacuation event.

4
Exercises

• Required by New York State Department of Health
• Document for JCAHO

5
Training

• Understand the plan
• Categorize patients
• Understand evacuation routes and alternate
  routes
• Decide what needs to go with the patient
• Demonstrate lifting/carrying techniques
• Expect staff to work in another facility

6
Internal Incident

• Definition event in the hospital that presents
  danger to patients and personnel warranting
  removal to another internal or external location
• Goals
• Protect patients and staff from harm
• Safe removal of patients and staff
• Isolate/contain the problem
• Maintain patient care

7
External Incident

• Definition event in the community that presents
  danger to patients and personnel warranting
  removal to another geographic location for their
  safety
• Goals
• Remove patients and staff from incident
• Protect patients and staff from harm
• Evacuation of patients and staff to alternate
  site
• Maintain patient care

8
Activation of Total Evacuation

• Incident Command will manage the evacuation

9
What Incident Command Will Do

• Confirm information before action
• Sources within the hospital will identify the
  extent of the problem
• Law enforcement personnel or Office of Emergency
  Management will describe conditions outside the
  hospital
• Determine precautionary actions
• Shelter in place vs. Evacuation
• Determine additional safety precautions

10
What Incident Command Will Do

• Call in staff as needed and per plan
• Notify receiving facilities so they can activate
  their plan
• Work closely and communicate with other agencies
• Communicate with the county Office of Emergency
  Management and NYSDOH
• DOCUMENT
• COMMUNICATE

11
Temporary Stagingand Exit Sites

• Primary, Secondary and Tertiary exit locations
  have been predetermined for each patient
  category
• Each patient category will have a designated EXIT
  TEAM.

Temporary Staging Short-term areas that
provides safety to the patient
12
Patient Categories and Exit Teams

• Red
• Yellow
• Green
• Purple
• Black

• Red Exit Team
• Yellow Exit Team
• Green Exit Team
• Purple Exit Team
• Black Exit Team

Reference University Hospital Evacuation
Categories and Holding/Exit Sites form
13
Transportation Modes

• Red ALS ambulance or Air Transport
• Yellow BLS ambulance
• Green Ambulette, bus, van
• Purple Private car

14
Patient categories

• Red Patients who require constant cardiac
  monitoring and advanced airway management,
  examples ICU, OR, ALS,
• EX Any patient that requires continuous IV
  infusion - patients on heparin Drip, Lido drip,
  PCA, epidural, etc.
• Yellow Patients who require BLS/AED transport to
  another hospital by stretcher. Ex oxygen,
  spinal precautions, traction, etc.

15
Patient categories

• Green Patients going to another hospital or
  facility by WC or ambulation only. Patients who
  require additional services before going home
  Ex psych issues, rehab, long-term care.
• Purple Patient is being discharged to home
  without services or the green patients that have
  had services arranged so they can go home.
• Black Deceased

16
Lets think about this..

• Given a list of patients, can you categorize them
  according to RED, YELLOW, GREEN, PURPLE?

17
How Would You Categorize this Patient?

• Mr. Smith is on Heparin Drip and requires a
  continuous IV infusion.
• CLICK on the correct answer

• Red ALS ambulance or Air Transport
• Yellow BLS ambulance
• Green Ambulette, bus, van
• Purple Private car

18
Categorize this Patient
The correct answer is

• Red ALS ambulance or Air Transport

• Yellow BLS ambulance
• Green Ambulette, bus, van
• Purple Private car

19
How Would You Categorize this Patient?

• 83 year old male on 6A, awaiting Nursing Home
  placement.
• CLICK on the correct answer

• Red ALS ambulance or Air Transport
• Yellow BLS ambulance
• Green Ambulette, bus, van
• Purple Private car

20
Categorize this Patient
The correct answer is

• Green Ambulette, bus, van

• Red ALS ambulance or Air Transport
• Yellow BLS ambulance
• Purple Private car

21
How Would You Categorize this Patient?

• 26 year old male on 5A, gastroplasty, 2 day
  post-operative (current weight 615 lbs)
• Click on the correct answer

• Red ALS ambulance or Air Transport
• Yellow BLS ambulance
• Green Ambulette, bus, van
• Purple Private car

22
Categorize this Patient
The correct answer is

• Yellow BLS Ambulance

• Red ALS ambulance or Air Transport
• Green Ambulette, bus, van
• Purple Private car

23
Holding and Exit Sites Primary

• Each patient category has a different site
• Red 5th and 6th floor East Wing
• Yellow ED and 2N gym
• Green 23 hour stay
• Purple Skybridge to parking garage

24
Holding and Exit Sites Secondary

• Each patient category has a different site
• Red Crouse Bridge or ED
• Yellow Main Lobby or Crouse Bridge
• Green Crouse Bridge
• Purple Adams Street

25
Holding and Exit Sites Tertiary

• Each patient category has a different site
• Red 7 South or 2 South
• Yellow 7 South or 2 South
• Green Staff Only exit
• Purple Main Lobby

26
Patient Movement Principles

• Medical Records to go with the patient
• Medications and Medication Administration Records
  (MAR) go with the patient
• ID bands match record
• Complete Patient/ Resident Emergency Critical
  Evacuation Information sheet
• In Appendix N goes with patient
• Send or secure personal possessions
• Send only life-sustaining equipment

27
Patient Movement Methods

• Move REDs, YELLOWs, and GREENs in their beds
  whenever possible.
• Inventory need for wheelchairs and stretchers
• Consider alternate devises for transfers
• Back boards
• Evacuation Chairs
• Staff training required

28
Forms to be Used
29
Unit Specific Worksheet
30
Unit Specific Worksheet

• How Incident Command will direct you to begin
  filling out this worksheet.
• What is this form used for?
• For in-hospital tracking of patients.
• Who completes this form?
• The PSL/Charge Nurse/RN on each patient care
  area.
• Where does the completed form go?
• When unit is totally evacuated worksheet should
  go to Incident Command.

31
Appendix NPatient/Resident Emergency Critical
Evacuation Information
32
Appendix N

• Who completes this form?
• This form is completed by the nursing staff on
  the unit.
• Why complete this form?
• When the patient is being evacuated from the
  hospital Appendix N goes with the patient.
• Where can I find this form?
• Disaster Preparedness Manual Incident Command
  section
• Where does this form go?
• Appendix N should either be attached to the front
  of the chart or 3 hole punched and inserted in
  the front of the chart.

33
Appendix N Page 2Patient Needs Assessment
34
Appendix N Page 2

• Who completed this form?
• RN, in conjunction with MD and respiratory
  therapy.
• Why is this form used?
• Used whenever a patient is being evacuated from
  the hospital.
• Used when accessing the equipment/supplies needed
  to safety transport the patient.

Identify those items that are absolutely
required for each phase of transport.
35
Appendix N Page 2

• Where is this form located?
• Policy web site - under Disaster Plan/Incident
  Command
• Copies of forms will be sent to each unit for
  insert into Disaster Plan notebook
• Where does the completed form go?
• Fax to the Incident Command Center at 4-8882.

36
After the Evacuation
37
AFTER the Evacuation

• Secure vacated areas
• Mark areas vacated and secured
• Arrange transportation of needed staff (to care
  for our patients in other locations), equipment,
  supplies and medications

38
Final thoughts.The Disaster Cycle
INCIDENT COMMAND WILL MANAGE THE PROCESS AND TELL
YOUWHAT TO DO AND WHEN YOU NEED TO DO IT
39
Contacts for Questions

• Anne Ryan
• Emergency Preparedness Coordinator
• 464-2982
• Email ryana_at_upstate.edu
• Janette Garlock Miller, M.S., A.P.R.N., B.C.
• Clinical Educator for Orthopedics PM R
• 464-6130
• Email millerj_at_upstate.edu
• Barbara Riggall
• Organizational Training and Development
• 464-4964
• Email riggallb_at_upstate.edu

40
Post-Test

• Click on POST-TEST to take you to the Medical
  Staff Office web site to complete the post-test.