Employee Safety Training 2012

Employee Safety Training 2012
General Safety Information High Risk Injuries Electrical and Equipment Safety Employee Incident Reporting

Introduction This training is an annual refresher on general safety information so that you can continue to create and maintain a safe environment for yourself, your colleagues, patients, and visitors. What you review in this module, you need to apply all the time at work.

Training Objectives At the end of this training module, you will be able to: List your rights and responsibilities related to safety in the workplace. Describe at least two strategies to prevent: Blood and body fluid exposures Back injuries Slips/Trips/Falls Struck By/Struck Against incidents List two do’s and don’ts for electrical safety. Explain how to report an accident that happened to you or your coworkers.

General Safety Information

General Safety Information Employee Safety Risks You have a right to know about the health and safety risks where you work. These risks include the possibility of: Back injuries Needle sticks Blood and body fluid exposures Slips, trips, and falls Utility failures Fires Equipment failures Hazardous material exposures Workplace violence

General Safety Information Employee Safety Risks (cont.) We protect our employees from these risks by: Removing risks once they are known. Putting into place engineering controls , such as Sharps containers in patient care areas Fire alarms Vaccination programs Putting into place administrative controls,such as: Conducting safety inspections Providing department-specific safety training Developing policies and procedures Providing personal protective equipment (PPE)

General Safety Information Your Rights and Responsibilities As an employee, you have certain rights and responsibilities related to your safety. You have a right to: Work in a safe environment. Know what dangers are in your workplace. See the results of any safety reports (example: air quality monitoring) Call Occupational Safety Health Administration (OSHA) without fear of the hospital getting back at you. Accompany an OSHA inspector during an inspection of your work area. Your responsibilities are: To follow all safety policies and procedures. To report all unsafe conditions to your boss or the employee safety team.

General Safety Information Employee Safety Policies If you need to review safety policies or procedures so you can better understand your roles and responsibilities, do the following: Log in to NMI.

General Safety Information Employee Safety Policies Go to “Policies.” Click on Safety & Security SFTY to open a page listing all the safety and security policies.

High Risk Injuries

High Risk Injuries Hospital Employee Injury Rate Over the past five years, the top five employee injury categories at NMHC are: Blood and body fluid exposures (caused by sharps and splashes) Patient Handling Material Handling Slips, Trips, and Falls Struck By/Struck Against You are now going to learn how you can prevent these types of injuries.

High Risk Injuries Blood and Body Fluid Exposures To prevent blood and body fluid exposures, you must: Follow standard precautions by wearing the correct Personal Protective Equipment (PPE): Gloves Goggles Gown Use appropriate precautions to prevent injuries from needles, scalpels, and other sharp instruments. Let’s now learn about back injuries that are the result of patient and material handling. This is the second most common injury at NMHC.

High Risk Injuries Back Injuries Back injuries happen by……. Moving the same way too many times or for too long a time. Sitting or moving the wrong way. Lifting heavy or odd shaped objects. Standing in an awkward position.

High Risk Injuries Back Injuries (cont.) Back injuries……. Can cost the organization a lot of money. Are painful. May never fully heal. Can be prevented. Back injuries are usually NOT caused by a single incident. Most often, they are the result of damage that has built up over time.

High Risk Injuries Proper Body Mechanics: Standing To reduce the risk of back injury while standing, do the following: Stand up straight with your ears in line with your shoulders and your shoulders over your hips. This is done by raising your chest up, which causes everything else to fall into place. Keep your back straight by tightening your stomach (abdominal) muscles. This prevents swayback, which is a deep curve in the back between the waist and behind that puts pressure on your spine. Wear low heels or flat shoes. High heels increase swayback and puts pressure on your toes. Stand with your feet slightly apart and your knees slightly bent. Shift weight from one foot to the other often. If standing for a long time, put one foot on a low stool to reduce back strain.

High Risk Injuries Proper Body Mechanics: Sitting Sitting incorrectly is one of the worst positions for your back. Shift positions often and get up to stretch or walk to relieve muscle tension. Avoid cradling the telephone between your ear and shoulder when on the phone for a long time. To avoid neck/back strain, computer users should align the top of the monitor at eye level, 18-24 inches away from your eyes. Sit all the way back in your chair. Use a back support if available. When seated, your knees should be level with or lower than your hips. Keep your forearms supported during handwriting or computer tasks. Sit with your feet flat on the floor. If you’re short, you may need a stool to support your feet. Dangling your legs put strain on your lower back.

High Risk Injuries Proper Body Mechanics: Sitting (cont.) Here is the correct way to sit at your desk to avoid back problems.

High Risk Injuries Safe Patient Handling To reduce your risk of a back injury when lifting or transferring a patient, complete the mobility assessment in PowerChart so you select which equipment meets your patient’s mobility goals. Refer to the Safe Patient Handling page on NMI for more information on this topic. Total lifts* (ceiling lift, Golvo, Viking) Sabina sit-to-stand lift Roller board (Surgery) Hover mat (lateral transfer aide) Criteria: Patient handling equipment is indicated when patient requires more than minimal assistance of one caregiver. *Note: NLFH only has the Golovo full lift.

High Risk Injuries Safe Material/Patient Handling Before lifting/moving heavy objects or patients, you should think about the: Weight and size of the object/patient. Distance and direction you must lift/move it.

High Risk Injuries Safe Material/Patient Handling (cont.) To safely lift an object: Stand as close to the object as possible. Bend your knees, tighten your stomach (abdominal) muscles, and keep your back straight. Use your legs, not your back, to lift up the object. Use the same rules when setting the object down again.

High Risk Injuries Safe Material/Patient Handling (cont.) Remember these other tips when lifting: If the box is heavy or odd shaped, get someone to help you lift it. Stand on a stool or ladder with feet staggered when lifting a heavy item off a shelf higher than your chest (see picture on right). Move item as close to you as possible before lifting. Use carts or chairs with rollers to help you move heavy items. Push carts with both hands instead of pulling them.

High Risk Injuries Slips, Trips, and Falls Some of the things that cause people to slip, trip, and fall are: Wearing inappropriate shoes to work. Not paying attention to surface changes or changes in floor levels. Spills left on floors.

High Risk Injuries Reducing Slips, Trips, and Falls To reduce the risk of slips, trips, and falls….. Report immediately any spills to Environmental Services. Use the umbrella bags, if available, on rainy and snowy days. Wear shoes with traction.

High Risk Injuries Reducing Struck By/Struck Against Incidents Struck By/Struck Against incidents are a risk. These occur when an person comes into contact or collides with an object. Some causes of these incidents are: Employee rushing or working too fast. Not letting staff know what you are about to do or where you are about to go, especially when moving equipment. Employee not paying attention to what is happening around him/her. IV pumps that are not secured on poles. Equipment breaking down.

High Risk Injuries Reducing Struck By/Struck Against Incidents (cont.) To prevent struck by/struck against incidents…. Push carts, IV poles, and other portable equipment in front of you, never at your side or behind you. Use the mirrors at intersections to look for others. Open doors with caution. Securely fasten items prior to moving them.

General Safety Information Workplace Violence NMHC does not tolerate any type of workplace violence. Staff cannot make threats or take part in violent, illegal, or unauthorized activities. Some examples of workplace violence are: Injuring or threatening a person. Being aggressive with someone so that is causes fear or worry in the person. Getting back at someone who reported workplace violence. Damaging NMHC or other people’s property. Having any of the following: Weapon, including a gun, knife, spray, shock device (Taser), etc. Explosives of any kind that are not allowed or restricted under local, state, or federal law. Contraband or illegal substances.

General Safety Information Workplace Violence (cont.) NMHC expects employees to use good judgment and common sense in noticing behavior that could be dangerous. Staff need to report any potential issues of workplace violence to Employee Relations (a department of Human Resources) or Security. Staff can make these reports anonymously. All reports will be investigated by employee relations.

Electrical and Equipment Safety

Electrical and Equipment Safety Electrical equipment is all around you. You should know how to keep safe when working around and with any electrical equipment.

Electrical and Equipment Safety Electrical Safety DO’S DONT’S Use caution around sweaty or incontinent patients and patients with drainage, IV, or feeding tubes. The presence of additional fluids on the patient and in tubes provides a pathway for the flow of electricity. Turn off equipment and unplug it if: Its cord or plug is warm/hot to touch You smell something burning Report immediately electrical problems to your boss, facilities (electrical outlets, lights) or clinical engineering (medical equipment). Always unplug equipment by pulling out the plug from the outlet. Do not yank on its cord. Never touch an electrical cord or use equipment when your hands are wet or while standing in water or on a damp floor. Don’t use water and chemicals around electrical outlets. Don’t put metal objects into electrical equipment or an outlet. Don’t overload electrical outlets or adaptors with too many plugs. Don’t place electric cords under rugs or roll equipment over electrical cords.

Electrical and Equipment Safety Personal Electric Equipment Safety Personal electrical equipment can be brought in from home and used at work, however it has to meet the following criteria: It is in good working condition. It has a visible “UL” or “CSA” approved tag. It has a 3-wire or double insulated AC cord. Items not meeting the above criteria will be removed from the department by Employee Safety Department.

Electrical and Equipment Safety Medical Equipment Safety Clinical Engineering (NMH and NMPG) or Clinical Technology Services (NLFH) needs to check all purchased, rented, borrowed, or leased medical equipment before it can be used in the organization. Now let’s review how to report safety issues and employee injuries.

Electrical and Equipment Safety Non-Medical Equipment Safety When non-medical equipment is broken, you must: Remove it from service. Tag/label the equipment with “Do Not Use.” Contact Facilities and/or place a Sentact request (NMH and NMPG) or place a work order (NLFH). The appropriate person will come and look at the equipment and determine what needs to be done to it.

Employee Incident Reporting

Employee Incident Reporting Reporting Employee Safety Concerns The ways to report safety concerns at NMHC are: Tell your manager. And/Or Contact the Employee Safety Department at 6.7238 (6.SAFT).

Employee Incident Reporting Reporting an Employee Injury If you have been injured on the job, you need: Get treatment. You should immediately report to: Corporate Health during regular business hours (downtown campus) or Occupational Health (Lake Forest campus) OR Emergency Department (nights/weekends) * Complete a Employee Incident Report within 24 hours of the incident. Provide as many details as possible. The next few pages will explain how to complete an EIR. * If you receive medical treatment in the Emergency Department, a follow-up visit is required with Corporate Health (downtown campus) or Occupational Health (Lake Forest campus) during the next regular business day (before returning to work).

Employee Incident Reporting Completing an EIR If you are injured at work, you need to complete an Employee Incident Report (EIR) within 24 hours of the injury. You must do the following: Log in to NMI.

Employee Incident Reporting Completing an EIR (cont.) Go to “My NMI.” Note: If you like, you can add the “SafetyNet” application to your Toolbox so you can easily access the tools to report incidents.

Employee Incident Reporting Completing an EIR (cont.) 3. Do one of the following: Click on Report a Work Injury to report any other type of injury (sprain, strain, slip, fall, etc.). Click on Report an Exposureto report an exposure (needle stick, and blood or body fluid exposure). OR

Employee Incident Reporting Reporting an Exposure If you are exposed to blood/body fluids, you must complete the Blood and Body Fluid Exposure (BBFE) Requisition Form. It will provide procedures to follow for a blood or body fluid exposure. Note: For an exposure during normal business hours, you report to Corporate Health (downtown campus) or Occupational Health (Lake Forest campus). After business hours, a provider on call on the downtown campus will evaluate you while at the Lake Forest campus, you would report to the Emergency Department.

Employee Incident Reporting Employee Incident Reporting (EIR) EIR DON’Ts Don’t report non-work-related incidents (i.e. , illness from eating your own food, etc.). Don’t submit an EIR for an incident that happened to a coworker; only a manager can submit an incident report for his/her employee. Don’t use NETS (NMH and NMPG) or MIDAS (NLFH) to submit an workplace incident. NETS and MIDAS is used only to report patient and visitor incidents.

Summary You should now be able to: List your rights and responsibilities related to safety in the workplace. Describe at least two strategies to prevent: Blood and body fluid exposures Back injuries Slips/Trips/Falls Struck By/Struck Against incidents List two do’s and don’ts for electrical safety. Explain how to report an accident that happened to you or your coworkers. Now you have an opportunity to review what you just learned with some quiz questions.

Hazardous Materials and Waste Safety Training2012
Labeling Procedures Hazardous Materials Types Material Safety Data Sheets Personal Protective Equipment (PPE) Disposal Procedures

Introduction As an employee of Northwestern Memorial Healthcare, you have both a need and a right to know the hazards and identities of the chemicals you are exposed to when working. Additionally, you need to know what protective measures are available to prevent adverse events from occurring. After completing this module you should be able to take steps to reduce exposures, establish proper work practices, and have a general understanding of how to work safely in the healthcare environment.

Objectives At the end of this training module, you will be able to: List the four types of hazardous materials. Explain proper labeling procedures. Describe how to protect yourself during a hazardous materials exposure. Explain how to access and read a Material Safety Data Sheet (MSDS). Identify proper disposal procedures for hazardous materials.

Hazardous Material Types

Hazardous Material Types What is a Hazardous Material? A hazardous material is any substance that can cause physical health problems when not handled safely. The types of hazardous materials include: Flammables Corrosives Poisons/toxins Reactives Let’s learn some more about each type now.

Flammables Flammables are liquids with a flash point less than 100 degrees Fahrenheit Flammables can also be gases, liquids and solids These chemicals may catch fire or explode when they come into contact with an ignition source and oxygen Flammables should be stored separately from other materials

Corrosives Corrosives are caustic substances that can destroy living tissue and have a destructive effect on other substances Acids and bases are corrosives Corrosives should be stored separately from other types of chemicals Corrosives should be stored in a well-ventilated area

Poisons Poisons and toxins can produce injury, illness or lethal effects upon entering your body Use appropriate PPE while using poisons/toxins Never store poisons/toxins where food or drink is stored Be sure that poison or toxic containers are sealed tightly

Reactives A reactive is defined as anything that reacts violently with other substances (even water or air) Dropping a reactive may result in an explosion, burning or corrosion Make sure you read the label to ensure you do not expose the chemical to anything dangerous Familiarize yourself with chemical spill procedures

Hazardous Material Types Routes of Exposure The four ways workers can be exposed to hazardous materials in a healthcare setting are: Injection- Injuries can result from needle sticks, cuts, or abrasions from contaminated items. These exposures are very serious because of the potential for immediate entry of the agent (contaminate) into a person’s bloodstream. Skin Absorption- Irritants are most often absorbed through the skin. Exposure may cause a painful rash, burn, or tissue destruction. Inhalation- Fumes that irritate your lungs and cause a cough or scratchy throat. Ingestion- Ingested through eating or drinking.

Hazardous Material Types Health Hazard Symptoms When you are exposed to hazardous materials, the two kinds of health hazard symptoms you may experience are: Acute Symptoms – Appear immediately. Symptoms include coughing due to fumes, or contact with a chemical, etc. Chronic Symptoms - Takes years or decades to occur, causing more serious harm to your organs or birth defects in your children. Enforcing safe work practices within your department will help prevent the occurrence of work-related illnesses and injuries caused by chemicals.

Hazardous Material Types Introduction to Compressed Gas Cylinders Compressed gas cylinders are also a type of hazardous material found in the healthcare environment. Compressed gas cylinders are stored in large, heavy, and highly pressurized metal cylinders. Picture 1 Picture 2 If a nozzle on the cylinder is damaged (shown in Picture 1), the amount of energy contained within the cylinder that is released can cause the cylinder to become a missile or bomb that breaks apart (shown in Picture 2).

Hazardous Material Types How to Store Compressed Gas Cylinders To prevent the nozzle from being damaged, compressed gas cylinders should always be stored and transported appropriately. They need to be: Standing upright (Picture 1). Secured in a cart or on a patient bed (Picture 2 and 3). Chained to the wall (Picture 4). Stored in an approved storage cabinet. Picture 1 Picture 2 Picture 3 Picture 4

Hazardous Material Types Key Points When Working with Compressed Gas Cylinders Remember the following when working around compressed gas cylinders: Do not carry an unsecured cylinder. Do nottransport an unsecured cylinder on top of a patient’s bed. Do not store cylinders near heat sources or elevators.

Hazardous Material Types Introduction to Radiation Safety In a healthcare setting, exposure to radiation on the job is possible. It is important to read warning labels or signs before entering unfamiliar departments or areas. This is the universal symbol for radiation.

Hazardous Material Types How to Protect Yourself from Radiation Exposure Ways to protect yourself from radiation exposure include: Limit Your Time- Spend as little time as necessary around the radiation source, such as an x-ray machine. In the picture above, the patient is getting a procedure and the employee works quickly to limit his time around the radiation source. Maximize Your Distance- Stand as far away as possible from the radiation source. Stay behind shielding during a procedure with the door closed (or stand as far away as possible from the radiation). If you must hold a patient during a procedure or test, avoid direct exposure with the x-ray beam. In the picture above, the employee is in another room during the test. Use Shielding- Use shielding, such as lead aprons, to avoid direct exposure with the x-ray beam. In the picture above, the employee is putting on a lead apron to protect/shield herself.

Hazardous Material Types How to Protect Yourself from a Hazardous Materials Spill/Release Leave the area, closing the door behind you. Dial the emergency number to report the incident: Downtown Northwestern Campus: ext 5.5555 Lake Forest Campus: ext 1313 Explain incident details to the operator (spill/release location, name of material, etc.) Stop people from entering the area until the response team arrives. Only trainedpersonnel should clean up hazardous materials spills. For any hazardous materials spill/release, do the following:

Hazardous Material Types Emergency Eye Wash Stations If your face/eyes are exposed to a hazardous material, do the following: Immediately use the eyewash station to flush your face/eyes with water. Continue to flush for 15 minutes. Complete an Employee Incident Report (EIR), which is located on My NMI, and report to Corporate Health or Occupational Health (during daytime) or the Emergency Department (during evenings, nights, and weekends).

Labeling Procedures

Labeling Procedures What Must Be on a Label? All hazardous materials must be labeled. Labels must have: Chemical name of product Name(s) of hazardous ingredients Warning statement, message, or symbol Chemical manufacturer’s name and address Safe handling procedure(s)

Labeling Procedures Your Responsibilities With Labels Labels tell employees about any substances that can cause physical and health problems. You must always do the following when working around hazardous materials: Read their labels. Follow the label’s instructions. Report any missing or unreadable labels to your manager or the Employee Safety Department. Do not use any chemical that is missing a label. Never pour a chemical into a bottle that has a different label than the chemical that is being poured.

Labeling Procedures Secondary Containers A secondary container is a container into which a substance is transferred from another labeled container. Secondary containers should be clearly labeled with: Chemical’s name Date of the transfer into the secondary container A spray bottle is an example of a secondary container.

Other Warning Labels Medical Symbol-general health hazard, exposure can cause acute or chronic health problems Poisonous Symbol-skull and crossbones; can cause serious injury or death if swallowed, inhaled or contact is made with the skin Corrosive Symbol-chemicals that can burn/damage the skin, eyes or mucous membranes Radioactive Symbol- radiation producing devices or materials Biological Symbol- materials and substances that have a potential for transferring human infection during normal handling or disposal Carcinogen Symbol- substances that can increase your risk of cancer 65

Other Warning Labels Fire Symbol- Do not expose to sparks, flames, heat sources, NO SMOKING Flaming “O” Oxidizers (OX) Symbol- Do not expose to sparks, flames, heat sources, NO SMOKING Explosive Symbol- very dangerous; may release a tremendous amount of energy in the form of heat, light and expanding pressure in a short period of time Cylinder Symbol- gases bottled under great pressure, handle carefully

Labeling Procedures Chemical Hazard Symbols There are also labels that classify the level of hazards that a certain chemical may contain. The National Fire Protection Association (NFPA) chemical hazard label rates four types of hazards on one label: Red- How Flammable It Is Yellow- How Reactive It Is White- Any Special Hazards Blue-Any Health Impact Rating Scale: The rating scale applies to the blue, red, and yellow diamonds. It goes from 0-4 with 0 being the lowest level and 4 being the highest level.

Labeling Procedures What does 4 mean in the yellow diamond of the chemical symbol below? Chemical Hazard Symbols It means this chemical is very reactive. It is rated at the highest level.

Personal Protective Equipment (PPE)

PPE Overview of PPE Personal protective equipment (PPE) is specialized clothing or equipment worn by an employee. This clothing and equipment protects the employee from harm, such as being exposed to infectious or hazardous materials. Common types of PPE in healthcare are: Gowns/Aprons (protect skin or clothing) Gloves (protect hands) Masks/Respirators (protect lungs and airways from airborne infectious contaminants) Goggles (protect eyes) Face Shields (protect face, mouth, nose, and eyes) Remember to use PPE carefully so contamination doesn’t occur.

PPE Where to Find PPE Employees should know where to find PPE in their departments. Signs telling employees where PPE can be found should be posted throughout departments. PPE is available to any employee free of charge!

PPE Tips for Using Gloves When you are wearing gloves, do the following Keep gloved hands away from your face. Avoid touching or adjusting any other PPE that you are wearing. Remove gloves if they become torn; perform hand hygiene before putting on new gloves. Limit the number of surfaces and items you touch.

PPE Introduction to Respirators Respirators are an important piece of equipment that protects employees and allows them to perform necessary work. Some respirators are used to limit an employee's exposure to hazardous chemicals or contaminants they may be working around. Most respirators are designed to fit the face. They protect the person by creating a tight seal between the respirator's edge and the face so nothing can enter. A “fit test” is the only way to know if a proper seal has been created between the respirator and the user's face. Any employee who is required to wear a respirator must be “fit tested “and receive respirator training.

PPE Reminder about PPE Remember to wear the appropriate PPE to reduce your exposure risk to hazardous materials!!!! Goggles Mask Gloves Gown

Material Safety Data Sheets (MSDSs)

MSDSs MSDS Overview In addition to labels, all chemicals and other substances must have a Material Safety Data Sheet (MSDS). These are provided by the company that produced the hazardous material. Each MSDS contains helpful information about the substance, including how to handle it in an emergency situation.

MSDSs What is on a MSDS? Information on a MSDS includes the following: Product name and ingredients MSDS publication date Manufacturer’s address and phone number Exposure limits Physical and chemical data Fire and explosion hazard data Toxicity data (cancer causing ability) Reactivity data Health hazard data Clean procedures Protective equipment

MSDSs How to Find a MSDS To find a MSDS on a specific product, do the following: Log in to NMI.

MSDSs How to Find a MSDS (cont.) 2. Go to “Departments” and then “Safety Management.”

MSDSs How to Find a MSDS (cont.) 3. Click on “MSDS Link.”

MSDSs How to Find a MSDS (cont.) On the MSDS online home screen, search for MSDS by any of the following: Product name Manufacturer Cost center Next you will learn about how to properly dispose of various materials.

Disposal Procedures

Disposal Procedures Overview You will learn how to properly dispose of the following items in this section: Infectious medical waste Specimen bags Syringe Chemotherapeutic waste Hazardous pharmaceuticals (medications, IVs) Clean and soiled linen Regular waste

Disposal Procedures Infectious Medical Waste Disposal Infectious medical waste is also a hazard and must be placed in a red bag or bag with a biohazard label. The infectious medical waste that goes in the bags includes: Blood and drainage soaked dressing Disposable items that could release blood or other potentially infectious materials if compressed (packed tightly) Laboratory waste IV tubing with visible blood Sharps (needles, scalpel blades, lab slides) MUST BE placed in a sharps container.

Disposal Procedures Specimen Bag Disposal Specimen transport bags (bags having a biohazard symbol) are to be used only for transporting blood, urine, or other hazardous materials. Remember: Even “clean” or unused specimen transport bags must be thrown away by placing them in a red biohazard bag. Do NOT place any specimen transport bags in regular trash. Because the bag in the picture has a biohazard symbol, it must be disposed of in a red bag, even if it is “clean” or unused.

Disposal Procedures Syringe Disposal All syringes with or without needles should be disposed of in the sharps container.

Disposal Procedures Chemotherapy Items Disposal There are two different ways to dispose of chemotherapy waste: Black Containers- Usedfor the disposal of “bulk” chemotherapeutic agents. Examples include: Non-empty chemotherapy items Chemo spill clean-up materials Yellow Chemo Containers- Used for the disposal of trace chemotherapeutic waste. Examples include: Empty chemo vials, IV’s, and tubing Chemo syringes. This is the only exception! Uncontaminated PPE (gloves, gowns, goggles) Pads and wipes

Disposal Procedures Hazardous Pharmaceuticals Disposal For assistance on the disposal of pharmaceutical waste, you should refer to the poster, Pharmaceutical Collection Program, which is located near pharmaceutical collection containers.

Disposal Procedures Clean and Soiled Linen Disposal Clean and soiled linen should be disposed of in a soiled linen bag. No special handling is needed for heavily saturated (very wet) linen since the laundry service staff practice standard precautions. REMEMBER to use good judgment while handling contaminated linen. Replace linen bags in hampers when ¾ full!

Disposal Procedures Regular (Clear Bag) Waste Regular waste, such as paper and food, should be thrown away in a regular garbage container or bag. Items that should NEVERbe thrown out in the regular waste stream include: Chemotherapeutic medications Chemicals Pharmaceuticals (medications and IVs) Clean or “Unused” biohazards bags

Summary You should now be able to: List the four types of hazardous materials. Explain proper labeling procedures. Describe how to protect yourself during a hazardous materials exposure. Explain how to access and read a Material Safety Data Sheet (MSDS). Identify proper disposal procedures for hazardous materials.

Call Employee Safety at 312.926.7238 (6.SAFT) with any safety-related concerns or questions about this training. Thank you for helping to make Northwestern a safe place to work!

Northwestern Memorial Hospital
Fire Response R.A.C.E.Annual Training

Learning Objectives At the end of this module, you will be able to: Describe how to prevent fires Use the “Defend in Place” when responding to fire or smoke situations Perform the steps of “RACE” Describe how to operate a fire extinguisher using “PASS”. Describe the things you must do during a fire drill.

Fire Prevention We are a smoke-free facility. Anytime you see someone smoking in the building, it should be addressed immediately Regularly inspect electrical cords and remove any equipment from service that has a damage cord or plug Do not store supplies and equipment in or near electrical closets Do not use unapproved extension cords or power strips

Prepare to Respond to Fire or Smoke Smoke can make it difficult to see during a fire. Keep corridors, fire exits and stairwells clear of anything that could prevent you from safely evacuating during a fire Do not use door stops to hold open doors. They can make it difficult to close doors during a fire Report any fire door or fire extinguisher problems via Sentact Know your department’s fire plan. It describes the location of fire alarm boxes, extinguishers and fire exits in your department Participate in fire drills to test how well you know “RACE” Treat every fire alarm you hear as if it is an actual fire

Defending In Place Many of our patients aren’t able to walk by themselves and depend on us to take care of them in a fire or smoke situation To keep them safe during a fire, our plan is to…. …Defend in Place The patient care buildings are divided into safe zones or compartments to prevent the spread of fire and smoke By closing the doors and windows in safe zones, we can greatly reduce the spread of smoke into other safe zones. Smoke is the greatest risk during a fire If you need to evacuate during a fire, you would first move to another safe zone on your floor and only after this would you go down the stairwell. NEVER use the elevators during a fire in your building

Responding to Fire or SmokeR.A.C.E. Rescue Alarm Confine & Clear Extinguish or Evacuate We’ll now go through the steps you should follow when you discover a fire or smoke

Rescue Stay calm. Rescue anyone in immediate danger of the fire. You should move them down the hallway to the other side of the fire doors. This is a “safe zone”. R.A.C.E.

Alarm Pull the handle on the nearest fire alarm station. These are usually located by stairwells AND, Call 5-5555 to report the fire or smoke. Tell the Operator the building, floor and room of the fire or smoke Fire Alarm Station R.A.C.E.

Alarm ALL of the following will then happen when you activate the alarm station and call 5-5555: Fire alarm system is set off Fire doors and smoke dampers close to prevent the spread of smoke & fire The stairwell doors will unlock The Operators call 911 to report the fire or smoke Chicago Fire Department comes to the hospital Fire Alarm Strobe The strobe will flash & the fire alarm speaker will make a whooping sound when activated by the Fire Department. R.A.C.E.

Confine & Clear To prevent the spread of fire and smoke Close doors to patient rooms and offices to keep smoke and fire out Make sure the fire doors close completely Clear equipment and supplies from the hallways so you can safely evacuate patients and others if it becomes necessary . Fire doors R.A.C.E.

ExtinguishandEvacuate To put out a fire, you must first know what type of fire it is. There are three types of fires and each has its own extinguisher. These extinguishers are Class A – Paper, wood, etc. Class B – Liquids: oil, gasoline, etc. Class C - Electrical Class A Class B Class C R.A.C.E.

Extinguish Before trying to put out a fire, ask yourself: Can I put the fire out safely with one extinguisher? Do I have the right type of extinguisher? Do I have a “buddy” to help me? If you answered NO to any of the questions, do not try to put out the fire. If you answered YES to both questions, use the P.A.S.S. method to put out the fire.

. P.A.S.S. P.A.S.S. is an way to help you to remember the steps to use a fire extinguisher. These steps are: P: Pull the pin. A: Aim the hose at the base of the fire. S: Squeeze the handle. S:Sweep the extinguisher back and forth

If it becomes necessary, evacuate the area In most situations, the Chicago Fire Department will tell you when to evacuate and the safest route to follow. The Fire Department will make an announcement over the fire alarm system telling you to prepare to evacuate In most cases you will move horizontally first and then vertically down the stairs If time allows, prepare the patients by following the Evacuation Job Action Sheet for patient care areas. These can be found on NM Interactive Evacuate

Moving horizontally means you move away from the fire, through a set of fire doors into another safe zone (or fire compartment). You will not leave the floor you are on Moving vertically means you will use the stairs to go DOWN to a different level of the building You may also be told by the Fire Department to move outside of the building once you arrive on the first floor Evacuate

What to Do When You Hear the Fire Alarm Every time the fire alarm beeps/chimes you must take the correct actions. Do not ignore it because you think it is a test. Close all doors and windows and fire doors to prevent the spread of fire & smoke. Clear the hallways of equipment to assure you can safely pass through if evacuation becomes necessary Determine the location of the alarm in case it is close to you

Locating the Area of Alarm The fire alarm chimes/tones in a sequence that identifies where the fire alarm was set off. The fire alarm sounds in three groups of chimes/tones with a pause between each group. The first two groups tell you the floor. The third group tells you the section of the floor. Here is how to locate the area of alarm Count the number of chimes/tones in each group. The numbers from each group makes up a three digit code. Example 4-1-7 Look at the fire alarm code signs on the wall (see pictures at right) to know where the fire alarm was set off

Locating the Area of Alarm Let’s practice locating an area of alarm. Using this chart, identify the location of this chime sequence: 1-3-7 FIRE ALARM CODES Floor: Code: Level 9 2-4-* Level 19 4-4-* Level 1 1-1-* Level 10 2-5-* Level 20 4-5-* Level 2 1-2-* Level 11 3-1-* Level 21 5-1-* Level 3 1-3-* Level 12 3-2-* Level 22 5-2-* Level 4 1-4-* Level 13 3-3-* Level 23 5-3-* Level 5 1-5-* Level 14 3-4-* Mezzanine 5-4-* Level 6 2-1-* Level 15 3-5-* Basement 5-5-* Level 7 2-2-* Level 16 4-1-* Level 8 2-3-* Level 17 4-2-* Level 9 2-4-* Level 18 4-3-* FIRE ZONE DESIGNATIONS *Code for Fire Zone Examples: 1 = Galter Pavilion Zone A1 & AA Floor/Fire Zone Signal Code 2 = Galter Pavilion Zone A2 Level 1 – Zone D 1-1-8 3 = Link Zone B1 & BA Level 2 – Zone B2 1-2-4 4 = Link Zone B2 Level 16 – Zone C3 4-1-7 5 = Feinberg Pavilion Zone C1 6 = Feinberg Pavilion Zone C2 7 = Feinberg Pavilion Zone C3 8 = Parking Garage Zone D What is the location of this alarm? Feinberg 2, Zone C2 Feinberg 3, Zone C3 Feinberg 3, Zone C2 Correct Answer: b

Department Fire Plan Every department has to have a fire plan. Check with your Manager if you don’t know where your department’s plan is located In your department’s fire plan you will find the following: Fire Alarm Pull Locations Chime/Tone Chart Locations Evacuation Routes: Primary and Secondary Fire Extinguishers: Type/Location Oxygen Shut-Off Valves (patient care only)

Fire Drills Fire drills are conducted to allow you to practice responding to fire and smoke situations. Drills also help us test our fire plan and improve it if needed. During drills we ask you to respond to a situation as if it was a real life fire. We are required to have fire drills in patient care buildings every quarter on all shifts. In administrative buildings, we have drills once a year. Please participate in drills to make sure you are prepared for a real life fire.

Northwestern Memorial Hospital
Emergency ManagementAnnual Training 2012

Learning Objectives At the end of this module, you will be able to: Describe emergency events that impact hospital services. Describe the NMH Emergency Operations Plans. State what to do during specific emergency operations events. Describe available resources for responding to emergency operations events.

What is an Emergency? Northwestern Memorial Hospital must be prepared to respond to a wide range of emergency events including internal disasters, natural disasters, terrorist attacks, and any situation that disrupts our ability to provide our normal services.

Emergency Operations Events An emergency operations event is a situation that impacts our ability to provide patient care and service. The event types include: Utility outage: power, water, phone/paging, medical gas Floods Hazardous material spills Severe weather Community disasters: fire, explosions, airplane accidents

Emergency Operations Plan NMH Emergency Operations Plan provides guidance for responding to all hazard events. Our response to an emergency operations event is managed using the Hospital Incident Command System (HICS). Each event has an individual who assumes the Incident Commander role. This could be a vice president, director, hospital operations administrator (HOA), or a member of the Emergency Operations Team. The NMH Emergency Operations Plan is integrated with city, state and federal response plans. The federal plan is the National Incident Management System (NIMS).

How to Respond to an Internal Emergency? For all internal emergencies, follow these steps: Rescue Protect patients and others from injury. Rescue anyone in immediate danger. Notify Call 5-5555. Report your location and the type of emergency. Notify your manager of the situation. Respond Your manager will lead the response in your department. Follow steps of the appropriate job action sheet in your departmental Emergency Preparedness Binder. For large events, you will receive information from the Command Center.

Emergency Response The NMH Emergency Operations Team is activated any time there is an emergency event. The members will assist your department in responding to the event. Job Action Sheets and the Emergency Response Guidelines poster can guide you on how to respond to a variety of emergency events.

You Are Essential During an Emergency Event

How Will You Know What Is Happening During an Emergency Operations Event? Emergency-related information will come from: Your manager or supervisor NM Interactive (NMI) Email Emergency Hotline - 926-INFO (4636). Itcan be called to obtain general info about the event. You should refer all media calls or questions to Public Relations at 926-2038.

NMH Emergency Response Plans What should you do during specific emergencies? The next section provides you with information on a number of the NMH emergency response plans.

Mass Casualty Response Plan This plan allows us to manage an increase in emergency department (ED) visits and hospital admissions by victims of disasters or disease outbreaks in the community. You will be told when this plan is activated by your manager or the hospital’s emergency notification systems. Every employee should follow the specific job action sheet in the departmental Emergency Preparedness Binder and instructions from his/her manager.

Biological Outbreak Response Plan This plan is designed to control and minimize the spread of disease while caring for an increase in the number of patients, who are contagious and/or critically ill. Infection control precautions will be used based on the specific disease. These precautions will reinforce hand washing, use of personal protective equipment, and appropriate signage. If there are any special precautions, your manager will tell you about them.

Hazardous Material Casualty Plan This plan is activated when one or more people at the hospital are known to be contaminated with chemical, radioactive, or biologic substances. Only those people who are directly involved in this event are told about it using the emergency notification process. What should you do if you come upon a person/patient you think is contaminated with a hazardous material?

Hazardous Material Casualty Plan If you come upon a person you think is contaminated with a hazardous material: Rescue Keep a distance of 5-6 feet between you and the person as you escort him/her outside to the E.D. ambulatory entrance. Notify Tell the person to stay at this entrance while you get help. Notify the E.D. triage nurse of the situation. Respond The ED nurse will assess the patient(s) and activate the plan if necessary.

Bomb Threat Plan Before a threat is received: Review the Bomb Threat Checklist and place a copy near the phones in your department. The checklist can be found on NMI. When you receive a bomb threat by phone: Stay calm. Try to keep the caller on the line. Notify security at 6-2311. Complete the Bomb Threat Checklist. If you receive a bomb threat letter: Notify security at 6-2311. Try not to handle it any more than necessary. Store it in a secure location until it can be picked up by a security officer.

Bomb Threat Plan - Security Response Security services will notify the Chicago Police Department and NMH administrative personnel. Security will work with Chicago Police to determine whether a search is necessary. You may be asked to help security look for suspicious objects in your department. You will be told when a decision is made to evacuate your area.

Armed Intruder Response Plan – General Response If you or anyone else is being threatened with physical harm by someone with a weapon, call 5-5555. You will be connected to security who will take information about your location, a description of the intruder, and the type of weapon he/she has. Security will immediately notify the Chicago Police Department Move patients, visitors, co-workers, and yourself to a room and lock the door or place heavy items in front of it. You can also hide under a desk or behind other large furniture. Do not take any actions that may result in harm to you or others . Keep informed by checking NMI, 926-INFO (4636), and email. The Command Center will be posting updates using these sites.

Tornado Response Plan There may be a very short amount of time to respond to a tornado siren in our area. Below are the actions you should take when you hear a tornado alert. When there is a siren or warning for our area, your department will be notified by phone. In Feinberg, Galter, and Prentice, an announcement will also be made over the public address system. Immediately move yourself and others away from windows so you reduce the chance you will be struck by flying glass or debris. Close doors behind you when leaving a room. If it is safe to do so, move to the basement or lower floors of the building. Move patients into the corridor or bathroom and close the door. If the patient is bedbound, move the bed so the head is pointing away from the window. Cover yourself and the patient with blankets and remove objects from the room that could become hazards. There will be an all clear announcement when it is safe to return to normal activities.

Evacuation/Relocation Plan There may be emergency events that result in the need to relocate or evacuate patients, visitors, and/or staff. The decision to relocate or evacuate is made by: Staff in the area of immediate danger (fire, smoke) The NMH Incident Commander, and/or Chicago Fire Department or Chicago Police Department You will be told of the need to evacuate by your manager, director, or the fire or police department.

Evacuation/Relocation Plan When you hear that your building is being evacuated, prepare for evacuation by following the steps of the evacuation job action sheet for your area. To evacuate patients, we first determine their status using the Reverse Start Triage method. The START level helps us plan the evacuation sequence for patients. REVERSE START TRIAGE

Evacuation/Relocation Plan Complete the Facility Relocation/ Evacuation and Employee Forms and prepare for relocation/evacuation. When directed to do so, begin evacuating following the route given to you by the NMH Incident Commander or Chicago Fire Department. All patients will be moved to a staging area before being moved to another facility.

Evacuation/Relocation Plan There may be situations in which you must evacuate using the stairs. This is when special evacuation equipment located in the patient care pavilions and other campus buildings will be used to move those who cannot walk. Become familiar with the location and the used of this equipment in your building. Infant Evacuation Stretcher System Location: Prentice NICU Evacuation Chair

Your Role in Medical Emergencies When you are the FIRST RESPONDER in a medical emergency, you must do the following: Call 5-5555. Remember, all emergency numbers are listed on the back of your ID badge. Answer the operator’s questions. Operator will ask you a few questions to decide which medical team needs to be sent to the emergency. Tell the operator if the victim is conscious or not conscious, or is a child. Give the operator your exact location—building, floor, and room. Indicate the nearest sign when possible. Stay with the victim until help arrives. IMPORTANT: If you are a clinician , begin BLS and AED. Watch for the emergency team members. Ask someone to assist you if possible to help direct the team to your location. If the victim’s condition changes or the victim chooses to leave, call 5-5555 again to report the situation.

How to Find Emergency Response Resources?

Emergency Response Resources In addition to your manager and department safety rep, there are a number of emergency response resources available to you. Take the time to review these resources before an emergency event occurs.

Emergency Response Resources

Emergency Response Resources The plans, job action sheets, and other emergency preparedness materials can be found on the Emergency Management Department Page of NMI. On the NMI Departments drop down menu, click on Emergency Management to access all on-line emergency response resources.

Job Action Sheets For Job Action Sheets, click on “Job Action Sheets” under the Disaster Preparedness Site Map.

Emergency Response Plans For Emergency Response Plans, click on the link for the plan you want to access.

Contact Emergency Management at 926-9651 or emmgmnt@nmh.org with any emergency preparedness or response questions or concerns.

Employee Safety Training 2012