Tornado Utility Interruptions Fire Ergonomics Workplace Violence Reproductive Hazards Security/Emergency MSDS Chemical Spills Disaster/Emergency . Communications Tuberculosis Code Pink Accident/Emergency Bloodborne Pathogens Medical Equipment Standard Precautions.
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Tornado watch means conditions are right for a tornado. Staff should be alert to weather conditions.
Tornado warning means a tornado has been sighted.
An announcement will be made over the CDD public address system advising staff, patients, families and visitors of the tornado warning.
Areas Of Safety
Areas of safety include rooms and corridors without windows, especially rooms and corridors that do not border an outside wall. Crouch near the floor or under heavy, well supported objects and cover your head.
Areas to Avoid
Stay clear of all windows, corridors with windows, or large, free-standing expanses.
reassurance to patients.
- Patients who cannot be moved should be covered with pillows, blankets, mattresses.
- Close all doors, including corridor doors, so that they latch.
- Close all drapes, curtains, or blinds as time permits.
- Do not attempt to utilize elevators due to the possibility of power failure.
CDD room N181 (staff lounge) has been equipped as a storm shelter. This room contains a gray back-up telephone, red emergency outlets and other emergency supplies.
A notification stating, “The Tornado Warning time has expired. The Tornado Warning is no longer in effect,” will be sent out when it is safe for staff members to return to their work areas.
End of Topic
Loss of NormalPower
- Generator produced emergency power will be available to red outlets at CDD within ten seconds.
- Only critical patient support equipment should be plugged in to red emergency electrical outlets.
- Elevator A is tied into CDD’s emergency power system and will operate normally during a power outage.
Staff should report the loss of power to Safety & Security (6-2658 or 195 for emergencies).
Staff in patient care areas should ensure there are flashlights and extra batteries at the work area.
Oxygen is not affected by electrical power outage. In the event of low oxygen gas pressure (displayed by the medical gas alarm panel), oxygen cylinders will be delivered to patient areas.
Medical air compressors will be maintained by emergency power generators.
In the event of a fire alarm, check the CDD fire annunciator panel located near elevator A on first floor.
If the annunciator panel does not indicate an alarm condition in your immediate area, resume normal activities, but remain alert for signs of smoke and fire.
If the annunciator panel indicates an alarm condition in your area, proceed to the area indicated and follow the RACE procedure:
Rescue /remove the patient
Activate the fire alarm, pull the nearest pull
station and dial 195 (outside UIHC dial 911)
Confine the fire, close the door
Evacuate patients if necessary; extinguish
the fire if possible to do so safely
-Evacuate horizontally, if possible, through at least one set of smoke/fire doors.
-If not possible to evacuate horizontally, evacuate vertically using fire safe stairwells (do not use elevators).
-Evacuation routes are identified by the red exit lights.
Types of Fire Extinguishers:
Type A - Pressurized water in silver cylinders. Use on materials such as wood, paper, and cloth. Do not use on flammable liquids or electrical equipment.
Type BC - Carbon dioxide (CO2) in red cylinder. Use on flammable liquids and electrical fires.
Type ABC – Multi-use dry chemical extinguisher in red cylinder, found primarily in equipment and mechanical rooms.
Fire extinguishers are located throughout the Center for Disabilities and Development. Learn the locations of extinguishers closest to your work area(s).
Extinguish the fire with a fire extinguisher only if you are confident you can do so safely.
WHAT IS ERGONOMICS?
Ergonomics is the science of fitting the workplace conditions to the job demands of the worker.
Examples of Ergonomic Injuries
-Back Disorders (most back injuries result from lifting patients or objects without adequate assistance)
-Cumulative Trauma Disorders (CTD)
-Carpal Tunnel Syndrome (CTS)
Work Practice Controls
Ergonomic risk factors can be minimized or eliminated by
-Incorporating proper body mechanics and
neutral postures; and/or
-Managing work time at a job task by using
job rotation or breaks.
- Using engineering controls (such as patient lift equipment).
Employees shall report all injuries including ergonomic injuries to their supervisor and complete the ‘Workers’ Compensation—First Report of Injury or Illness’ form. Additionally, the employee shall complete a ‘UIHC Unusual Incident & Accident / Staff, Visitor, and Equipment Report’ form.
Combative Patients/Code Green
A Code Green violent patient management team is available to respond to potentially violent patient situations. Any staff member may declare a Code Green by dialing 192 if out-of-control patients pose a threat. When calling the Code Green number:
- identify that you need the Code Green team
- identify yourself
- identify the unit, building and room number
Disruptive, Hostile, Threatening Visitor, Family or Staff
-Staff shall report incidents of violence directed at themselves, other staff, students or patients to their supervisor, Hospital Human Resources or Safety & Security (dial 6-2658 or 195 for emergencies). Safety & Security will work with Hospital Administration and local law enforcement agencies to control these situations.
- Be prepared to provide as much information as possible.
- who is involved
- what is happening
- type of weapon, if any
Possession of Deadly Weapons by Patients, Visitors, and Staff
When it is known or suspected that a person is in possession of a weapon, contact Safety & Security (195 for emergencies) for assistance.
- Remain calm.
- Try to keep the caller on the line.
- Pay attention to background noises and distinctive sounds:
- caller’s voice (ethnicity, level of education)
- traffic or machine sounds, other voices.
- Try to obtain information on location of bomb, time of detonation and type of detonator.
- Call Safety and Security (195 for emergencies) as soon as possible.
Call Safety & Security (dial 6-2658 or 195 for emergency) for assistance in locating the patient. Also contact CDD Administration.
- Notify Safety & Security (dial 6-2658) to report activities involving harassing or obscene telephone calls or mail, threats, confrontations.
- If you are working in an area by yourself during evenings, nights or weekend hours, notify another staff member or Safety & Security.
Avoid dark, isolated areas. Be aware of your surroundings and of other people who might approach you. Proceed to your destination quickly and confidently.
Do not enter or remain in an elevator if individuals make you feel uncomfortable. Elevators at UIHC have a red button that when pressed will connect you with Safety and Security.
Staff concerned about their personal safety may request rides from UIHC to UI parking areas.
- Weekdays 7:00 p.m. - 1:00 a.m., Driver is located at the main entrance.
- Weekdays 1:00 a.m. – dawn, Call Safety & Security (6-2658).
- Weekends 7:00 p.m. – dawn, Call Safety & Security (6-2658).
End of Topic
Domestic Violence Concerns
It is not uncommon for domestic violence issues
to be carried over into the workplace.
Staff who have concerns about domestic violence should notify their supervisor and Safety and Security (6-2658). Such reports will remain confidential.
Staff who are aware of domestic violence issues involving patients should report the information to their supervisor, CDD Social Services, and CDD Administration.
Single characteristics do not serve as an indicator, but combinations of characteristics could indicate an increased likelihood of violence.
Use of alcohol or drugs
Expressing anger regularly in the workplace
Loud and aggressive nature
Change in mood
Mental health issues
History of violence
In most cases it is best to avoid challenging the aggressive person. Try to show empathy and understanding.
It is almost always better to let a person “vent.” Respond in a soft voice. This may cause the person to stop yelling in order to hear what you are saying.
In some cases, setting acceptable limits with the individual may be effective, e.g., “I’m sorry, I can’t talk to you when you are yelling at me; please stop yelling so we can talk.”
Staff should be certain they are at least one body length away from an aggressive person. Position yourself so you can step back or exit the area quickly.
Staff who are facing a potentially violent situation should attempt to leave and report the incident to their supervisor or Safety & Security (195 for emergencies).
A reproductive hazard is any biological, chemical, or physical stressor that has the potential to adversely affect the human reproductive process. These effects may occur through either parent’s reproductive cells, prior to conception or during the development of the fetus.
Each year some 14 million workers are exposed to conditions that may impair their reproductive systems or unborn children. The University of Iowa Hospitals and Clinics is committed to a safe and healthy workplace, and reproductive health is one aspect of that program.
The following table lists examples of some common reproductive hazards that you may encounter here at the hospital and in everyday life.
This list is by no means exhaustive. You should consult your Department’s Hazard Communication plan and review all chemical MSDSs that you work with for a complete listing.
Examplesof Reproductive Hazards Found at Work
Employees shall report reproductive hazard concerns to their supervisor as soon as possible.
If you have a question or concern regarding reproductive hazards, contact the University Employee Health Clinic at 356-3631 or the UIHC Safety Manager at 384-5208.
End of Topic
All staff have the right to know what hazards are present when working with chemicals.
Each department shall maintain an inventory of all chemicals used in an area along with MSDSs for those chemicals. MSDSs will be available to all staff during work hours.
In addition to the MSDS, other sources of information regarding chemicals in your work area include container labels and the INFORMM system
The sections of an MSDS include:
Physical and Chemical Characteristics
Fire and Explosion Data
Health Hazards (including exposure hazards and symptoms)
Precautions for Safe Handling and Use
Control Measures (including spill clean up)
READ LABELS! Labels will identify health and physical hazards. All hazardous product labels must include the name of the chemical, the nature of their hazards, and what precautions should be taken. If a secondary container is used, the name of the chemical and the hazards must be transferred to the new container. End of Topic
Before cleaning up a spill, staff need to know what chemicals are involved.
Use the MSDS to find out what kind of precautions and procedures to take in cleaning up the spill.
Spills should be contained so that they do not get into drains and sewers.
Report all hazardous chemical spills using a Staff/Equipment Unusual Incident & Accident Report, Form 261.
Unmanageable Chemical Spill
If any of the following conditions apply, immediately call Safety & Security (195 for emergencies):
- the chemical is unknown
- there is an immediate danger to life or health
- there is a combustible or explosive hazard
- there is a threat to the environment
- staff have no knowledge of the material
or cleaning process
Every CDD staff member must be familiar with the role of their department within the CDD Disaster Plan.
Unless patient care duties or facility conditions dictate otherwise, report to your supervisor or CDD Administration for further instructions upon learning that a disaster response situation is in effect.
Staff responsible for patient care should continue their normal activities, but remain alert for further instructions and information. Be prepared to assist CDD patients, families and visitors to exit the facility.
Do not leave your area of assignment until released by your supervisor or CDD Administration.
When off duty, remain at home and await telephone, radio, or television notification before reporting to CDD or other areas of University of Iowa Hospitals and Clinics.
Refrain from using telephones, overhead public address system, paging system, or other communication systems except for reasons required for patient care obligations or priority activities related to the disaster.
Disaster and Emergency Preparedness Plans are available at CDD in Administration, the Environmental Services Office, the Healy Clinic and on The Point under the Safety and Security Department site.
In case of telephone outage, grayback-up telephones will be activated. Locations and telephone numbers for gray back-up telephones are available in the UIHC Disaster and Emergency Preparedness Plan.
Emergency outgoing calls shouldbe placed through the hospital operator by dialing “0.”
Public pay phones may or may not be operational during loss of UIHC Telephone System.
Cell phones should not be used (or turned on) in close proximity (within 3 feet or less) to patient care equipment.
If staff are unable to access the“131” UIHC Paging System through gray backup phones, emergency paging requests should be directed to the UIHC operators by dialing "0." Emergency requests for overhead pages should also be directed to the operators.
End of Topic
Transmission of TB
TB is transmitted by the airborne route. The organism, Mycobacterium tuberculosis, becomes airborne on droplet nuclei that are produced when a person with active disease talks, sings, coughs or sneezes.
TB infection versus active disease
A susceptible person becomes infected when they inhale droplet nuclei that contain M. tuberculosis. In most people who are infected, the immune system effectively contains the organism. The tuberculin skin test becomes positive, but the person has a normal chest x-ray and does not have symptoms. Therefore, this person is not contagious.
About 10% of persons infected with M. tuberculosis will develop active disease. The interval between TB infection and active disease may be weeks or years. The person with active disease has an abnormal chest x-ray and develops symptoms. The person with active disease IS contagious, should be placed on airborne precautions and begin treatment.
Symptoms of Active TB
Symptoms include fever, weight loss, cough (lasting longer than 3 weeks) fatigue, night sweats, loss of appetite, and blood in the sputum.
Work Practice Controls/ Personal Protective Equipment (PPE):
- Identify patients or health care workers with active disease early.
- Place patients with known or suspected active TB on airborne precautions and post sign.
- Wear a TB mask when providing care to patients with known or suspected active TB.
Tuberculin Skin Testing Program
- Staff at UIHC have annual tuberculin skin test (TST) unless known to be TST positive.
- Staff exposed to a patient with active TB should notify their supervisor and report to the University Employee Health Clinic (UEHC).
End of Topic
When Safety and Security is notified of an infant or pediatric abduction, telecommunications will initiate an overhead page announcement of a “Code Pink” and the age of the abducted infant or child.
Once a Code Pink has been announced, all staff have the authority to question a person who is acting in a suspicious manner and request to inspect any bags. (It is not uncommon for abductors to place infants
in duffel bags, gym bags or a backpacks.)
Approach the suspicious person in a non-threatening manner, facing the person at a safe distance.
Instruct the nearest coworker or bystander to immediately contact Safety and Security (dial 195) for assistance.
Speak using a calm, steady voice, explaining that the hospital is on alert for
a possible infant abduction.
Attempt to delay the person by keeping him or her in front of you—even walk backwards slowly if necessary.
In the absence of a Code Pink announcement, staff who observe a suspicious/potential abduction situation should:
Advise Safety & Security (dial 195) or request another staff member to do so.
Try to keep the people under observation as long as possible.
Note physical descriptions of those involved as well as vehicles and license plates.
End of Topic
Code Blue (dial 199) is activated
when a person is in respiratory or cardiopulmonary arrest.
Dispatch runners to the third-floor courtyard entrance to meet the Code Team and to the first-floor main entrance to meet the ambulance.
Bloodborne Pathogen Exposures
Exposures to blood and body fluids consist of:
If exposure occurs, wash and flush the affected area and report immediately to the University Employee Health Clinic (UEHC) from 7:30 a.m. - 4:30 p.m. Monday thru Friday. After hours and weekends, report to the Emergency Treatment Center (ETC).
Standard precautions are designed to reduce the risk of transmission of bloodborne pathogens and applies to ALL patients regardless of their diagnosis or presumed infection status.
Contaminated surfaces need to be properly disinfected with a hospital-approved disinfectant. Disinfectant solutions need to remain on contaminated surfaces for a minimum of 10 minutes to ensure disinfection. Hepatitis B virus has been demonstrated to survive in dried blood at room temperature on environmental surfaces for at least 1 week.
Use of Safety Engineering Controls, Work Practice Controls and Personal Protective Equipment is Required. OSHA regulations as well as UIHC policies and procedures require that identified Engineered Safety Devices (such as sharps containers) Safe Work Practice Controls (such as hand hygiene) and Personal Protective Equipment (gloves, masks, gowns) be used by all staff. The use of these controls and devices is not optional.
Blood and blood-tainted body fluids
pose a risk for the transmission of HIV
and Hepatitis. Signs and Symptoms:
HIV – Incubation period is variable. Most HIV infected persons sero convert 6-12 weeks after exposure. Initially, flu-like symptoms may develop; may also develop fatigue, fever and weight loss.
Hepatitis B – Incubation period is 30-180 days. 30% of persons have no signs or symptoms. Slow onset (without symptoms in the majority of patients for the first 20+ years after infected). Symptoms include loss of appetite, abdominal discomfort, nausea, vomiting, malaise.
Hepatitis C – Incubation varies; range is 2 weeks to 6 months. 80% of persons infected have no sings or symptoms. Onset is slow. 10-25% of persons develop nonspecific or gastrointestinal symptoms or jaundice. Chronic infection develops in 75-85% of infected persons.
Hepatitis B Vaccine
The vaccine is available to any staff member free of charge through UEHC. Staff are encouraged to accept the vaccine, as it has been shown to be a safe and effective preventive measure. Staff will be asked to document whether they accept or decline the vaccine.
All needles and other sharps must be disposed of by placing into identified sharps containers. Do not recap used needles. If recapping is necessary, use a one-handed scooping method. Replace sharps containers when they are 2/3 to 3/4 full.
Place all regulated waste (potentially infectious waste) in a red plastic bag or in a containerwith a biohazard label on the outside. Regulated waste containers that may leak must be placed in a secondary, leak-proof plastic bag or container that is either red in color or displays the biohazard symbol.
Direct questions to the Program of Hospital
Epidemiology at 6-1606.
End of Topic
In the event of a medical equipment
Incident involving a patient:
and all associated disposable parts.
All electrical patient-care equipment
used in CDD will be evaluated by
the UIHC Bioengineering Department
Standard precautions (formerly knownas universal precautions) reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in hospitals and applies to all patients regardless of their diagnosis or presumed infections status.
Standard precautions apply to
Any body fluids (except sweat)
Secretions, and excretions regardless of whether or not they contain visible blood
Non-intact skin, (includes rashes and lesions)
Equipment or surfaces that may have come in contact with these substances
Hand Washing should be performed:
- If hands are visibly dirty or contaminated with blood and/or body fluids or visibly soiled.
- If exposure to spores is suspected or proven
- Before eating and after using the restroom
Hand Hygiene should be performed with an alcohol based hand rub (Avagard D): - Before having direct contact with patients
- Before donning sterile gloves
- After contact with a patient’s intact skin
- After contact with body fluids or excretions, mucous membranes, non-intact skin and wound dressing.
- If moving from a contaminated body site to a clean body site during patient care
- After contact with inanimate objects (including equipment) in the immediate vicinity of the patient
- After removing gloves
- Wear gloves when touching blood, body fluids, secretions, excretions, non-intact skin and contaminated items.
- Gloves should be removed after use, before touching another patient, before touching non-contaminated items and environmental surfaces.
- Gloves should be changed between patients, between tasks and procedures on the same patient and after touching material that may contain high concentrations of microorganisms.
- Perform hand hygiene immediately after removing gloves as hands can be contaminated.
Mask, Eye Protection Face Shield
- Wear mask and eye protection or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures and activities that generate splashes, sprays, splatters, droplets or aerosols of blood or other potentially infectious material.
- Wear a non-sterile gown to protect skin and to prevent soiling of clothing during procedures and activities that generate splashes or sprays of blood or body fluids.
- Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other patients or environments.
Patient Care Equipment
- Handle used patient care equipment that
has been soiled with blood, or body fluids, in a manner that prevents skin and mucous membrane exposures, or contamination of clothing.
- Send reusable equipment to Central Sterilizing Services for processing or clean and disinfect with a hospital-approved disinfectant.
-Discard single use items in designated receptacles.
- Bag and close linen at the point of generation.
- Place soiled linen directly into white plastic bags.
- Place linen that is dripping into a white plastic bag and then place the first bag into a second white plastic bag to contain the moisture.
- Do not pre-rinse soiled items.
Personal Protective Equipment (PPE) is specialized clothing or equipment worn by an employee for protection against infectious materials.
Use of identified PPE is not optional and must be used by staff.
*Combination of PPE will affect sequence – be practical
Remove and discard PPE carefully, in the following sequence, either at the doorway or immediately outside patient room:
Direct questions to the Program of Hospital Epidemiology at 6-1606.
End of Topic
Infection Control Manual
(large green notebooks)
are available for review on The Point under the Safety and Security Department Site and at CDD in the following locations:
are located in each CDD office and are also available on The Point under the Safety and Security Department site and in and IPR under
“UIHC Policies and Procedures”.
End of Training ProgramTo view the Power Point program and take the quiz through ICON please follow these instructions:Open ICON courseware by clicking on the ICON on your desktop (black circle outlined in green with a green arrow pointing up) or go to: http://icon.uiowa.edu.After opening ICON, log on using your HawkID and password.In the middle of the screen locate the blue bar labeled My ICON courses. If no courses are listed, click on “ongoing” to expand the selection.Click on the Center for Disabilities and Development course selection. Under CDD Safety and Security, click on View the CDD Safety and Security Training and review the information on the Power Point program.After viewing the program, return to the Center for Disabilities and Development course listing and click on Take the UIHC Safety and Security quiz. Take the quiz, remembering to click on save following each question and again at the conclusion of the test to record your answers and then press submit to electronically record your test.After this final step you are done for another year! Please contact Mary Irey, Jessica Perry or myself if you have any questions about these instructions.