Embedded Files
Safety Equipment and MSDS
Education on Emergency Preparedness and staff responsibility during a disaster.
NOTE:
Fire Extinguisher Locations and Usage (if applicable) in a facility ask in charge person.
MSDS Manual Location (if applicable) in a facility ask in charge person.
Eye Wash Station Location (if applicable) in a facility ask in charge person.
Safety is an Agency Wide Priority
A. All home care personnel will be alert to safety factors in the home environment. Quality Improvement is an ongoing agency goal. Please report any findings to your supervisor that may improve safety or quality of care. The patient/patient and family/caregiver will be encouraged to:
1. Have grab bars installed in the bathroom.
2. Use non-skid mats or emery strips in the tub.
3. Use a shower stool or transfer bath bench.
4. Remove throw rugs or other environmental hazards such as loose extension cords, small mats and slippery waxed floors.
5. Use assistive equipment such as toilet handrails, or walking belt, as indicated by the patient/patient’s condition.
6. Always lock any wheeled equipment.
7. Utilize a medication sheet to ensure proper administration of prescribed medications.
8. May apply distinct and complete labeling of medications, including large letters indicating if it is for internal or external use and good illumination of the medication cabinet in order to avoid errors in self-administered medications.
9. Refrain from smoking or being near open flames while using oxygen.
10. Post no smoking sign in highly visible place if oxygen is in use.
B. Home care personnel will provide assistance in obtaining safety equipment whenever possible.
Falls are the second leading cause of accidental death in the United States. Seventy-five percent of these falls occur in the older adult population. One third of the older adults who fall, sustain a hip fracture and are hospitalized, die within a year. Falls not only affect the quality of life of the individual but also influence the caregiver and family. Health care costs for falls and rehabilitation average 70 billion dollars a year!
Even if the fall does not result in hospitalization, fear of falling becomes a major factor. Fear leads to inactivity and loss of confidence. This, in turn produces a cycle of fear, loss of self-confidence, and inactivity, thereby decreasing the quality of life and increasing the risk of falls. The agency shall protect all individuals from preventable injuries and illnesses. The agency will undertake a program of education and enforcement in safety directed at employees and patients.
Procedure:
Perform a home safety check.
Make referrals to Physical Therapy as needed. Tinetti Assessment may be utilized to help identify mobility issues.
Educate patients on the following Fall Prevention Tips:
Have your vision checked at least once a year by an eye doctor. Poor vision can increase your risk of falling.
Get up slowly after you sit or lie down.
Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.
Improve the lighting in your home. Put in brighter light bulbs. Florescent bulbs are bright and cost less to use.
It is safest to have uniform lighting in a room. Add lighting to dark areas. Hang lightweight curtains or shades to reduce glare.
Paint a contrasting color on the top edge of all steps so you can see the stairs better. For example, use a light color paint on dark wood.
Think about wearing an alarm device that will bring help in case you fall and cannot get up.
Equipment Malfunction
A. Personnel should report any medical equipment malfunction to the Clinical Manager and/or Case Manager.
B. An Unusual Occurrence (Incident/Accident) Report will be completed if injury or the potential for injury has occurred.
C. If the medical equipment malfunction or misuse results in serious injury, illness or death, the Administrator shall be notified immediately.
D. If you suspect that a piece of equipment is malfunctioning contact the Clinical Manager/Case Manager immediately. If a piece of equipment is malfunctioning you should call the Clinical Manager/Case Manager immediately. Do not attempt to unplug/unhook or correct the issue without consulting with the Clinical Manager/Case Manager first. Prior to placing equipment into use assess the equipment for obvious damage or frayed electrical lines, if this is apparent do not use the equipment. Report it to the Clinical Manager/Case Manager. Patient Safety is an agency wide priority, proper instruction on equipment to the patient/caregiver is an important in reducing equipment issues. Staff are encouraged to educate patients/caregivers and required to document their teaching.
Reporting Emergencies
An EXTREME EMERGENCY may be, but is not limited to:
1) Unresponsiveness (except in a known comatose patient).
2) Severe chest pain with diaphoresis, nausea, radiation of pain to neck or arm or cardiac arrest.
3) Signs and symptoms of hemorrhage or acute bleeding (G.I.), vomiting or diarrhea.
4) Extreme respiratory distress, duskiness with impending arrest.
5) Fall with obvious fracture.
6) Initiate CPR if no MD orders or DNR in place to prevent it and patient status indicates CODE.
In the event of an EXTREME EMERGENCY:
1. Call for emergency transfer to hospital immediately.
2. Call physician.
3. Stay with the patient until emergency medical personnel arrive.
4. Document exactly what happened on the visit slip, appearance of the patient when first seen by Agency personnel on the day the emergency was discovered and all steps and actions taken.
5. Complete verbal orders for transfer.
A MODERATE EMERGENCY may be, but is not limited to:
1) Change in pulse, such as threadiness, irregularity, tachycardia or bradycardia
2) Blood pressure with systolic less than 90 or diastolic greater than 110
3) Shortness of breath with dusky appearance, change in breath sounds
4) Decreased urinary output over twenty-four (24) hours
5) Blood sugar via glucometer greater than 250 or less than 60 (or anything abnormal for given patient)
6) Vomiting or diarrhea with potential for dehydration
7) Temperature > 101 degree p.o.
8) Signs/symptoms of infection of wound or decubitus not previously identified
9) Fall with suspicion of injury
10) Medication irregularities, i.e., questionable dosages or potential interactions between medications prescribed
In the event of a MODERATE EMERGENCY:
1. Stay with the patient until you are satisfied that appropriate follow-up has been initiated.
2. Call the office and report to the person taking your call that this is a moderate emergency, and the name of the patient.
3. Call the physician if directed to do so.
4. Document exactly what happened on the visit slip, appearance of the patient when first seen by Agency personnel on the day the emergency was discovered, and all steps and actions taken. Complete any verbal orders, which may have been received.
A MINOR EMERGENCY may be, but is not limited to:
1) Fluctuation in vital signs, which are not life-threatening
2) Medication irregularities, i.e., questionable dosages or potential interactions between medications prescribed (but patient is in no immediate danger)
3) Complaints of pain, weakness, diaphoresis, upset stomach, unexpected weight loss greater than 5 lbs., UTI, GI symptoms indicating impending illness.
4) Falls without apparent injury
5) Change in wound or decubitus size
In the event of a MINOR EMERGENCY:
1. Call the office
2. Document exactly what happened on the visit slip, appearance of patient when first seen by Agency personnel on the day the emergency was discovered, and all steps and actions taken. Complete any verbal orders, which were received.
3. It is not necessary to stay with the patient until resolved (except see below).
NOTE: As with all written guidelines, certain situations do not fit the criteria listed. When unusual situations occur, DO NOT HESITATE to call the office and/or nurse on call for advice. Field staff can tell the physician directly when it would cause a delay to call the office first. If you call the physician, report the conversation and any change to the plan of care to the supervising therapist as soon as possible. Also, remember to document the situation thoroughly as soon as possible on the visit slip and clinical record.
Be aware that patients living alone or those without responsible family/caregivers present may need to be attended to until resolution is met.
Fire Safety
Chapter 1- Fire Emergencies: General Instructions
Despite everyone’s most conscientious efforts, fire and other emergency situations may occur. It is important to have appropriate planning, training and skill to be ready and able to react effectively. The training and information you receive is designed to help prepare you so that if an incident does occur, your response should be immediate, intelligent and most importantly, effective.
The following instructions need to be followed throughout the agency for all Fire Emergencies (e.g., fire, smoke, odor of smoke or burning, crackling noises, unusual heat conditions, and any automatic detector activation). Although specifically geared to “fire” type emergencies, much of this would apply in any generalized emergency situation.
GENERAL INFORMATION:
1. ALL AUTOMATIC ALARMS shall be treated as TRUE EMERGENCIES. Everyone should immediately implement the Fire Plan and begin an evacuation as outlined in your evacuation plan, regardless of the cause of the automatic alarm.
2. ANY Staff members and any other occupants in the building(s) at the time of an alarm or other emergency shall render such assistance as directed.
3. Beds, mattresses and other bulky equipment should NEVER be used to evacuate occupants unless absolutely necessary. (Use blanket drags, carries, etc.)
4. STAY LOW. Keep yourself and all occupants low if in a smoke involved area. The fire generated smoke and gases are potentially more dangerous than the actual flames.
5. Elevators shall not be used during a fire or emergency situation, other than by firefighters.
6. NO ONE other than firefighters shall enter or re-enter a fire or smoke involved structure.
7. Based on your training and/or your obligation, you may need to re-enter areas that are not involved with fire or smoke to assist others. Use your training and caution if necessary to do this. If re-entry is attempted, make someone aware of your actions, to provide accountability for arriving emergency responders.
8. REPORT ALL FIRES TO THE FIRE DEPARTMENT IMMEDIATELY, EVEN IF IT APPEARS TO BE OUT, OR IS CONSIDERED INSIGNIFICANT!
9. If your local fire department is responding to assist, DO NOT reset your alarm until they arrive and evaluate the situation.
"R.A.C.E Plan"
Remove Alert Confine Extinguish
The following general instructions explain these fundamental steps and provide guidance in the event of an emergency. It must be understood and stressed that each emergency will present itself in a unique way and with a different set of circumstances each time. Therefore, staff must be creative and confident to implement these steps in various situations.
In addition, it is important to note, that although these “steps” are presented in an organized manner in order to provide guidance on the importance and general sequence of these events, in the case of a true emergency, it could happen that many of the functions of this Guideline will be conducted at the same time or in an order appropriate to that specific situation. In all cases sound practical judgment, experience and training will prevail.
Pending the arrival of the fire department or other back up and responding personnel, YOU are the first line of defense. The lives of those entrusted to your care, and possibly your very own, may well depend upon your reactions.
TO SUMMON HELP IN ANY EMERGENCY SITUATION...
IMMEDIATELY CALL .... 911
REMOVE
DO NOT PANIC - REMAIN CALM - DO NOT SHOUT OR YELL.
YOUR FIRST CONCERN IS FOR LIFE SAFETY - SAFETY OF THE OCCUPANTS, OTHER STAFF AND YOURSELF IS OF PARAMOUNT IMPORTANCE.
EVACUATE EVERYONE TO A POINT OF SAFETY. All occupants in the building must be evacuated as quickly and as orderly as possible to a pre-designated POINT OF SAFETY, using the following guidelines:
1. ORDER OF REMOVAL OF OCCUPANTS:
Remove anyone in immediate danger (i.e., in the room of origin).
Evacuate occupants who can walk on their own. (This is done first to facilitate evacuating the most, the fastest)
Evacuate occupants who cannot walk, require additional assistance, use walkers, etc.
Evacuate occupants who are connected to life sustaining devices or medical management devices.
2. HOW TO EVACUATE THE OCCUPANTS:
Movement of any occupant shall be done as planned in advanced. As a general rule, the method that is used during non-emergency situations is going to be the best method for movement under emergency situations.
3. WHERE TO EVACUATE:
ANYONE IN IMMEDIATE DANGER should utilize the nearest and most immediate EXIT. If you have to escape through smoke, crawl on your hands and knees where air will be cleaner. Test all doors in your escape path for heat prior to opening them. Always test doors with the back of your hand. Remember to practice your escape plan several times annually.
ACCOUNTABILITY: As soon as all occupants are gathered in a safe place (either within the building, in an area of refuge, or outside), someone (i.e. staff in charge) shall take a roll call, using a checklist roster. If anyone is missing, immediately report this to the first arriving fire personnel. If staff and/or occupants are trapped by smoke, close doors, stay low, block openings to room and open a window to attract attention of rescuers.
ALERT
ALERT ALL NEARBY STAFF – By voice or use of code phrase. (This may be accomplished simultaneously with the Remove step)
PULL THE NEAREST ALARM BOX IF PROVIDED. This will automatically notify the occupants, and possibly the Fire Department and additional help. In addition this may initiate automatic fire protection features of the building.
CALL 911- If no fire alarm is available, immediately call 911. If there is an alarm system available, make a back-up call to 911 as soon as everyone is in a point of safety. Although redundant, this assures response and provides additional information to the responders.
Give the dispatcher the following information:
NAME, LOCATION, BRIEF DESCRIPTION OF THE INCIDENT, ANSWER ALL QUESTIONS. PREPARE TO FOLLOW INSTRUCTIONS, AND DO NOT HANG UP UNTIL DIRECTED BY THE DISPATCHER.
EXTINGUISH
EXTINGUISH THE FIRE. Attempt to extinguish the fire only after all occupants are in a point of safety (unless extinguishment of the fire is needed to evacuate, i.e., fire is between you and the door). Any attempts to extinguish the fire should be considered a “Last-Resort”. Evacuation should always be your first priority.
Fire Prevention is potentially the most powerful strategy for reducing both life and property fire hazards.
A FIRE THAT NEVER HAPPENS CAUSES NO LOSS OR DAMAGE !!!!
The most important thing that can be done to protect people from a fire is to prevent it from occurring. By preventing the outbreak of fire, you not only save lives, but also avoid property damage. Everyone has a responsibility to protect those that they support from fire. Assuring adherence to common fire safety practices; regarding the use of appliances and other dangerous items, and assuring that all fire protection systems are operating properly all promote good fire safety. Practicing the Fire Plan is also an integrated component of a well-rounded fire prevention program.
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