Nursing Home #2 Disaster Planning Document
DISASTER POLICY & PROCEDURE
PURPOSE: It will be the purpose of this policy to inform facility employees of the action to take
in the event of a disaster.
It will be the responsibility of the highest ranking staff
person on duty to declare a situation a disaster and activate the facility’s disaster
and evacuation policy and procedure.
A disaster may be classified as a fire, tornado, flood, electrical power outage,
explosion, bomb threat, hazardous material spills or releases, or any other situation that
would warrant evacuation of the facility in order to protect the lives and safety of
residents and staff.
PROCEDURES:
-
In the event of an emergency, the shift charge nurse shall immediately contact the
Administrator, Director of Nursing, and the Maintenance Supervisor.
-
Once the Administrator, Director of Nursing, or Maintenance Supervisor arrives and
determines that the situation requires evacuation, the facility call tree shall be put
into effect in order to obtain available persons to evacuate the residents to safety.
-
A command center shall be set up in the Administrator’s and connecting Business
Office to handle and coordinate all internal communications. If this area is in the line
of danger a new location will be determined at that time.
-
If temporary placement for residents is needed, the Administrator, or Highest Ranking
person at the scene, shall contact the American Red Cross by calling 9-1-1 and requesting
an emergency shelter through the County Department of Emergency Government Center.
-
If permanent placement for residents is needed, the Administrator and Director of
Nursing, or highest ranking person at the scene, will assess which residents need to be
hospitalized or transferred to another nursing home.
-
The Administrator, or Highest Ranking person on the scene, shall assign a person to
coordinate transportation.
-
Once a shelter is arranged, the residents will be evacuated from the building in an
orderly fashion. All department personnel shall report at this time with the supplies they
are assigned to gather.
-
Medical Records personnel will be responsible for putting name tags on all residents
upon evacuation. They shall also be responsible for ensuring that the residents’
medical records are transported with the resident.
-
Nursing personnel will be assigned to specific wings, and are responsible for evacuating
those residents and assisting with others when complete.
-
Dietary personnel will be responsible for gathering food and dietary supplies.
-
Housekeeping and Laundry personnel will be responsible for gathering all linens and
supplies for resident care.
-
The Activities personnel shall assist wherever needed.
-
The Administrative Assistant and the Bookkeeper shall gather all departmental employee
schedules and the employee call roster, as well as other important business office
supplies and records.
-
The Social Worker will be responsible for contacting family members to notify them of
the disaster and where residents are being transported.
-
The Day Care personnel shall be responsible for accounting for all children, phone
numbers of family members of the children and organizing the children for evacuation.
-
The Apartment Residents will be evacuated the same as the residents on the east wing
being evacuated. Reminder to nurses to bring the apartment files.
-
The Administrator shall check all rooms before leaving the grounds. A "white
tag" will be placed on each door handle to verify that the room is empty to ensure
that no residents or staff members are left behind.
This plan will be in cooperation with the American Red Cross, the County Emergency
Government Office, and the local Police and County Sheriff’s Departments.
NOTE: It is important to know that each situation is going to be different, and that
a situation may not allow for the above procedure to be implemented in this specific
order.
At the time of a disaster, it is imperative that the Administrator be contacted in
order to give staff proper direction. This policy and procedure is written so that there
are clear guidelines for providing resident and staff safety in the event of a disaster.
Sound judgment and common sense are the best practices in any emergency.
FIRE POLICY & PROCEDURE
PURPOSE: To provide facility staff a course of action to follow in the event of a fire.
PROCEDURE:
R -- Rescue anyone in immediate danger.
A -- Alert other staff members by pulling the fire alarm and giving the location
of the fire. This is accomplished by putting a pillow outside of the door to indicate
where the fire is located.
C -- Contain the fire. Close all doors and windows. Turn off all sources of air
circulation: fresh air systems, fans, air conditioning exhaust fans, oxygen.
E -- Extinguish the fire if small. The extinguisher should be aimed low at the
base of the fire, and move slowly upward with a sweeping motion. If you cannot extinguish
the fire, evacuate the building immediately.
POINTS TO REMEMBER:
-
Once the fire alarm goes off, the Fire System company is automatically notified by our
alarm system and will call the facility to find out if this is a drill or a fire. In the
event of a fire, the fire department will be notified automatically.
-
ALL staff members report to the nurses’ station immediately for directions from the
charge nurse of location of fire. (Nurses refer to the fire board for location of fire.)
-
Once staff members are aware of the designated wing of the fire, begin to evacuate
residents in immediate danger to a safer section of the building first (this may be behind
fire doors); or, in the event of a disaster, remove residents from the building.
-
Ambulatory residents should be instructed on where to go. Bedfast residents should be
placed on blankets or bedspreads and pulled to safety.
-
Once a resident room has been completely checked, a "white tag" will be placed
on each door handle to verify that the room is empty to ensure that no residents or staff
members are left behind.
-
Each Department Head or designated person will be responsible for reporting to the
nurses' station with their current employee schedule. This will enable us to account for
all employees once everyone has been removed from danger.
-
The Nurses and Administrative Personnel will be the last to leave the fire area to
verify that no residents or staff members are left behind.
-
If a complete evacuation from the building is necessary, no one will be allowed to
re-enter the building until the Fire Department gives the "All Clear" signal.
-
In the case where a complete evacuation from the building is necessary, please refer to
the DISASTER POLICY & PROCEDURE.
NOTE: It is important to know that each situation is going to be different, and that
a situation may not allow for the above procedure to be implemented in this specific
order.
At the time of the disaster, it is imperative that the Administrator be contacted
in order to give staff proper direction. The policy and procedure is written so that there
are clear guidelines for providing resident and staff safety in the event of a fire.
Sound
judgement and common sense are the best practices in any emergency.
SEVERE THUNDERSTORM and TORNADO
POLICY & PROCEDURE
PURPOSE: To provide facility staff a course of action to follow in the event of severe weather.
PROCEDURE:
-
The Weather Radio is on at all times to keep staff appraised of the situation.
-
When there is a warning on the radio or local sirens go off, this means to seek cover.
-
During the day time hours, (5:00 a.m. – 10:00 p.m.) all residents will be directed
to the long hallway. Chairs will be placed in the hallway away from doors or windows where
the residents can sit down.
-
During evening hours, (10:00 p.m. – 5:00 a.m.) beds will be moved away from all
windows, and all drapes, including the privacy curtains will be pulled and room doors
shut.
-
If time allows, staff will provide each resident with a blanket to cover their heads.
-
Once residents have been evacuated to the long hallway, the Charge Nurse will review the
Resident Roster to account for all Residents.
-
Be sure to listen to the Weather Radio and Weather Reports for current updates. Do not
leave the area until the storm has passed and the warning has been lifted.
-
In the event of a disaster, if a complete evacuation needs to take place, please refer
to the DISASTER POLICY & PROCEDURE.
WATCH -- Conditions are favorable for a thunderstorm or tornado to
develop.
WARNING -- A thunderstorm or tornado have been sighted. If a siren
sounds, stay inside and take cover.
BOMB THREAT POLICY & PROCEDURE
PURPOSE: To provide facility staff a course of action to follow in the event of a bomb threat.
PROCEDURE: When a phone call is received regarding a bomb threat, please follow the following
procedure.
-
Stay Calm.
-
Keep the caller on the phone line as long as possible, get as much information as
possible.
-
Be alert for distinguishing background noises, such as music, voices, aircraft, and
church bells, etc.
-
Note distinguishing voice characteristics.
-
Ask where the bomb will explode, and at what time.
-
Try keeping the caller on the phone line, and alert another staff member so they can
notify key personnel:
-
Police 9-1-1
-
Administrator
-
If the caller indicates a specific area, that area should receive immediate attention.
-
If what appears to be a bomb is found, DO NOT TOUCH IT! Clear residents and staff
from this area and move them behind fire doors.
-
Organize staff to evacuate residents upon police or administrative order.
WATER SHORTAGE POLICY & PROCEDURE
PURPOSE: If the water supply is disrupted for any reason, this policy is to ensure that there is
adequate water supply for the residents and staff.
PROCEDURE:
-
Notify the Administrator and the Maintenance Supervisor immediately.
-
The Maintenance Supervisor will try to determine the cause of water disruption and the
approximate length of shut down time.
-
If it becomes necessary, water will be brought in through contracted services to provide
potable water in the event that the community water supply becomes contaminated or
disrupted.
-
The Dietary Department will use disposable dishes and utensils.
-
If it becomes apparent that a water shortage will last a significant period of time,
arrangements will be made to ensure proper care for those residents whose care has been
disrupted due to lack of water supply.
HEAT & HUMIDITY POLICY &
PROCEDURE
PURPOSE: To provide staff protective measures for residents during the summer months.
PROCEDURE:
-
Keep the air circulating
-
Draw all the shades and curtains in the rooms that are exposed to direct sunlight.
-
Remove the residents from areas that are exposed to direct sunlight. Relocate the
residents to cooler areas in the building during the daytime hours.
-
Discourage outside activity during the day.
-
Dress the residents appropriately with light weight clothes, loose fitting, preferably
cotton fabric. Bed confined residents shall have their sheets changed frequently. Cover
the residents lightly at nap times and bedtime.
-
Encourage and offer fluids to the residents frequently.
-
Report any changes in the resident’s condition such as edema, shortness of breath,
the skin being hot or dry.
-
Give frequent baths.
-
Place fans in hallways to get air circulating.
-
Watch for signs and symptoms of heat exhaustion and heat stroke. See attached
definitions.
DEFINITIONS:
HEAT STROKE -- Heat stroke, also known as sunstroke, is a profound
disturbance of the body’s heat regulating mechanism, caused by prolonged exposure to
excessive heat, particularly when there is little or no circulation of air.
In heat
stroke, there is a disturbance in the mechanism that controls perspiration.
Symptoms: The first symptoms may be headache, dizziness and weakness. Later
symptoms are an extremely high fever and absence of perspiration. Heat stroke also may
cause convulsions and sudden loss of consciousness. In extreme cases it may be fatal.
Treatment: Heat stroke is considered a medical emergency and immediate steps
must be taken to prevent death. The primary objective in this situation is to reduce the
body’s high temperature as rapidly as possible. This can be accomplished by immersing
the person in a cool water bath or sponging the person with cool water. The physician
should be contacted immediately and the resident transferred to the hospital.
HEAT EXHAUSTION -- Heat exhaustion, also known as heat
prostration, is a disorder resulting from overexposure to heat or to the sun.
Long
exposure to extreme heat or too much activity under a hot sun causes excessive
perspiration, which removes large quantities of salt and fluid from the body. When the
amount of salt and fluid in the body falls too far below normal, heat exhaustion may
occur.
Symptoms: The early symptoms are headache and a feeling of weakness and
dizziness, usually accompanied by nausea and vomiting. There may also be cramps in the
muscles of the arms, legs or abdomen.
The person also turns pale, breathing and pulse is
rapid, skin is cool and moist, and perspires profusely. Body temperature remains at a
normal level or slightly below or above. The person may seem confused and may find it
difficult to coordinate body movements.
Treatment: Treatment should include removing the person to a cool
environment and encouraging increased consumption of fluids. If the condition is
accompanied by cramps, the pain may be relieved by gentle massage of the painful area.
The
physician should be notified promptly to obtain specific directions for care.
ELECTRICAL POWER OUTAGE POLICY
& PROCEDURE
PURPOSE: To provide the facility with auxiliary power throughout designated areas of the facility,
should our normal power supply fail. The facility has an emergency generator that will
automatically activate in the event of disruption of power.
The generator is capable of
providing the facility with a minimal supply of electricity for approximately 2 full days.
PROCEDURE: In the event of a power outage, the facility generator operates all areas of the facility
with the exception of: the new wing outlets in the resident rooms, resident room lights,
the Director of Nursing Office and the Medical Records office.
-
Anyone in the new wing that requires oxygen must be hooked up to the piped in oxygen in
the new wing or if using a concentrator must be plugged in, in the hallway or use free
standing tanks.
-
Check all residents to ensure they are safe and remain calm.
REMINDER: During a power outage it should be business as usual once
the residents are taken care of since the majority of our facility is hooked up to the
generator, including the phone.
ELEVATOR POLICY & PROCEDURE
PURPOSE: To provide facility staff a course of action to follow in the event the elevator should
become stuck between floors.
PROCEDURE:
-
Obtain the key to open the elevator maintenance room.
-
Locate and shut off power to the elevator. This will return elevator to the ground
floor.
-
Take key with a red tag, located to the left of the power shut off.
-
Put key in hole at the top of the elevator door and turn. This opens the first door.
-
Push the latch on the second door and push open at the same time, the person on the
elevator can also help push door open.
-
Turn on power to the elevator.
-
If the power is not restored, push the reset button, which is in the panel on the left.
-
If this does not work contact the Maintenance Supervisor, if not available contact the
Elevator company at ------.
DAYCARE EVACUATION POLICY &
PROCEDURE
PURPOSE: To account for and evacuate all children and staff members to safety in the event of a
disaster.
PROCEDURE: In the event that it becomes necessary to evacuate the entire building, the following
procedure will be followed:
-
The Administrator or designated person will notify the daycare in the event of the need
for complete evacuation.
-
The Day Care personnel shall be responsible for accounting for all children, staff
members, phone numbers of family members and organizing the children for a complete
evacuation.
-
The Day Care Manager or designated person will report to the nurse’s station for
directions on the evacuation.
-
Once it has been established where to evacuate, the children will be removed in a
orderly fashion.
-
Once evacuated to a safe area, the day care manager will notify all family members of
where they are at, what is going on and where to pick their child up.
-
The day care will be under the directive of the person in charge at all times.
In the case where a complete evacuation from the building is necessary, please refer to
the DISASTER POLICY & PROCEDURE.
APARTMENT EVACUATION POLICY &
PROCEDURE
PURPOSE: To evacuate all apartment residents to safety in the event of a disaster.
PROCEDURE: In the event it becomes necessary to evacuate the entire building, or the east
wing, the following procedure will be followed:
-
The Administrator or designated person will notify the apartment residents in the event
of a disaster.
-
For the purpose of an emergency, the apartment resident will be evacuated the same as
the residents on the east wing would be evacuated.
-
Nursing personnel will direct the C.N.A.’s or staff to evacuate these tenants with
the nursing home residents.
-
Nursing staff will knock on the apartment door and notify the tenants on what to do, if
no one answers the door, go on to the next apartment and report to the Administrator
anyone who was not home.
-
The nursing staff will be responsible for bringing the apartment residents files in the
event of disaster.
-
A designated person will notify family members what has transpired and where the
apartment residents are located.
-
In the case where a complete evacuation from the building is necessary, please refer to
the DISASTER POLICY & PROCEDURE.
WANDERING RESIDENT
POLICY: It is the facility's policy to identify residents who walk or wheel about unrestricted
and are a threat to leave the facility unattended due to their confusion.
PURPOSE: To ensure the resident’s safety utilizing the least restrictive means available.
PROCEDURE:
-
Obtain information during pre-admission or admission conferences with the resident and
family regarding any history of wandering or the potential for wandering.
-
All instances of wandering or attempted elopement will be recorded in the medical
record.
-
A plan of care will be developed and implemented with specific approaches and goals for
the wanderer.
-
The resident’s name, picture, and physical description is placed in the wander book
located at the nurses station.
-
All staff, are responsible for knowing whose name is on the list and be able to
recognize the resident and be able to intervene as necessary. Every new employee will be
informed of wandering residents upon orientation.
-
A monitoring device will be placed on the resident according to manufacture’s
directions. Exit monitoring system will be kept operational 24 hours a day.
When a resident is believed to be missing, the following steps will be implemented:
-
The charge nurse shall be alerted that the resident is missing.
-
The charge nurse shall alert all staff. All employees are to report to the nurse’s
station. The charge nurse will explain the circumstances and designate where each staff
person is to search.
-
Search the building and grounds thoroughly. Be sure to search the shower room, closets,
bathrooms, and entryways.
-
If this search is unsuccessful, surrounding streets and yards will be checked. This
search should take no longer than 15 minutes.
-
If the resident is not found within the 15 minutes, notify the local Police,
Administrator and Director of Nursing.
-
Give the police a description and a current photo of the missing resident.
-
The Charge Nurse, Administrator or Director of Nursing shall call the family explaining
the situation and what is being done to find the resident. Encourage them to assist if
they desire.
-
When the resident is located, the charge nurse will notify all previously contacted
persons.
-
Upon return of the resident to the facility, the resident will be assessed for injuries
and a thorough incident report will be filled out by the charge nurse and given to the
Administrator and also documented in the resident’s medical record.
Last Updated: September 15, 2009 |
