| Plan Title: ALBARAHA HOSPITAL DISASTER MANAGEMENT Program
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ownership: Al Baraha Hospital Administration | Effective Date: July 2014 | Revision Due Date: July 2015 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Applies to:
þAll Hospitals of Ministry of Health ¨PHC ¨ Others (Specify) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1. Purpose & Scope:
The disaster plan identifies those individuals and departments that play key roles in the event of a disaster and provides an outline of the steps to be taken in order to insure an orderly integration of all hospital services that will allow the delivery of the highest level of medical care to those casualties injured in a medical disaster. The disaster plan uses the following principles as guidelines: 1. The normal functional organization of the Hospital should be used to advantage whenever possible. Thus, the Emergency Department, Operating Rooms, and Patient Care Units become receiving areas for casualties. Elective admissions and elective procedures, however, are curtailed during a declared disaster or facility evacuation. 2. Medical and support personnel work best in familiar surroundings. 3. Attending staff should direct and supervise all patient care.
2. Content of the plan
2.1 Policy
2.1.1 It shall be the policy of Al Baraha Hospital, to maintain a disaster plan that represents the definitive statement of actions to be taken by hospitals personnel in receiving and treating large numbers of casualties resulting from an internal or external disaster or in response to a critical incident. Al Baraha Hospital is responsible for insuring: 1. The written disaster plan is effective in providing timely care for casualties arising from both external and internal disasters and critical incidents. 2. On-going in-service training sessions are provided for staff so that they might function more effectively in the event of a disaster or critical incident. 3. Regular rehearsal and documentation of the disaster plan. 4. Timely revision of disaster plan as needed.
2.2 Introduction Disasters are not uncommon; a major disaster occurs somewhere in the world almost daily; however, to most people, disasters of the type likely to involve us are unusual events. When a disaster strikes, the general population expects public service agencies and other branches of the local, state, or federal government to rapidly mobilize to help the community. Preservation of life and health are of paramount importance to those individuals affected by these disasters. For this reason, medical professionals must be included in all phases of disaster planning as well as in the immediate response to these events.
A disaster situation requiring expansion of the Emergency Department (ED) and/or hospital resources for emergency care, shall first be evaluated by the ED to determine the number of casualties expected and the nature of their injuries 2.2.1 Classifying disasters Disasters are often classified by the resultant anticipated necessary response.
2.2.2Phases of Disaster Planning A disaster cycle has 4 phases, and all responses must pass through each. These are (1) mitigation, (2) planning, (3) response, and (4) recovery. Pitfalls during transitions occur throughout the phases. Generalized awareness, proper planning, and contingencies may reduce their overall effect. MitigationIn certain cases, some of the devastating effects of disasters can be reduced before the actual event. For example, evacuations may be orchestrated before hurricanes or floods. Early warning allows residents to seek shelter from tornadoes. Sprinkler systems in businesses and homes can reduce overall risk of total fire destruction. PlanningDisaster planning includes external and internal planning. A disaster plan encompassing both local and regional areas must focus on 3 possible scenarios:
In developing a disaster plan, leaders should remember that it is impossible to plan for all contingencies; therefore, plans must be relatively general and expandable. All phases of the disaster response must be addressed in a disaster plan. Functional job descriptions and responsibilities of all agencies and organizations involved should be delineated clearly. More importantly, these plans should be exercised and rehearsed. The ideal exercise includes participation by all parties involved The hospital disaster plan should include protocols and policies that meet the following needs: · Recognition and notification · Assessment of hospital capabilities · Personnel recall · Establishment of a facility control center · Maintenance of accurate records · Public relations · Equipment resupply ResponseA number of events occur during initial response to a disaster. If there is forewarning, certain of these events may take place even before the event. Unfortunately, significant forewarning is rare. RecoveryThe recovery phase is frequently underemphasized in disaster plans, but it is crucial for the affected community. During this phase, some semblance of order is restored, public utilities are reestablished, and infrastructure begins to operate effectively. Scene withdrawal and a return to normal operations usually occur simultaneously. Treatment of the responders is also vitally important during this phase. Valuable lessons may be learned during debriefing. It is of utmost importance to obtain as much information as possible from all parties involved in the disaster response effort. Without full disclosure, similar weak responses will impede future efforts.
3. Definition
4. Procedures & Responsibility:
4.1 Disaster announcement 4.1.1 Call will be sent by the Police 4.1.2 Call will be received by the operator who will transfer the call immediately to the nursing Supervisor On Duty 4.1.3 The nursing supervisor will take down the following information from the police: 1. When did the disaster occur? 2. Where did it happen? 3. What type of disaster is it? 4. What is the extent of the disaster? 5. What is the estimated time of arrival of victims? 6. What is the contact number for further clarification if necessary? 4.1.4 The nursing supervisor will then carry out the following actions: 1. Inform the operator to call disaster committee member 2. Inform the hospital administrator on duty 3. Inform all the residents on duty 4. Inform the engineer on call 5. Inform the blood bank 6. Inform the cleaning supervisor on call 7. Inform the charge nurse of casualty to prepare for reception 8. Inform the in house police to prepare the traffic directions 9. Inform the charge nurse of ICU for evacuation and reception 10. Inform the in charge nurse of operating theatres 11. Inform the charge nurses of all wards to evacuate cold cases and prepare for reception 4.1.5 The operator will announce Code brown level as instructed by the nursing supervisor 4.1.5.1 Code brown level 0: It is a situation in which heads of department are notified on the alert till further notification. A disaster Alert is received from Police or Civil defense by the Hospital telephone operator. 4.1.5.2 Code brown level 1: it is a situation in which the number of victims is less than 25 4.1.5.3 Code brown level 2: it is a situation in which the number of victims between 25 to 35 4.1.5.4 Code brown level 3: it is a situation in which the number of victims is more than 35
4.2 The disaster committee upon arrival will meet in the control room to receive instructions and then assume their positions in their allocated areas. The team leader for each assigned area will evaluate the area and call personal assigned to the area and direct the smooth functioning of that zone. 4.3 Upon receiving the message about the disaster, the charge nurse of casualty will activate helpers to prepare the control room and the triage areas first, followed by the resuscitation and trauma rooms and then the cubicles and support areas.
4.4 Upon arrival of the disaster committee, the surgical on call will enlighten the team leaders about the status of the disaster and all relevant information concerning the reception of patients. Each team leader will be instructed to proceed to their assigned areas where they will assess the equipment available and will bring in the personnel for that area. When they are set for the function of that area, they will report back to the control room and will await the arrival of victims.
4.5 The surgical on call and the Medical on call will keep team leaders updated and informed about needs and actions required. The team leaders will always liaise with the control room for actions required.
4.6 When the end of the disaster period is established, all team leaders will be requested to meet in the control room for audit of activity.
4.6 The Zones There are 19 zones in AlBaraha Hospital for disaster management
4.7 Role of operator 1. To receive call from police, or Rashid Hospital regarding presence of disaster situation 2. To obtain the necessary information and fill in form DPO1 3. To take the necessary actions and fill in form DPO2
4.7.1 Role of surgical Resident 1. To come to the control room immediately upon receiving the call 2. To proceed to their zone 3. To make sure all the personnel assigned to their zone are called 4. To evaluate the ongoing needs for their zone and to liaise with the control room 5. To support the management of the patients in their zone in administrative and professional capacity 4.7.2 ROLE OF Emergency Department clerk 1. To formulate a time line tracking of events 2. To record the deficiencies and discrepancies
4.8 Role of second contact 4.8.1 Hospital Administrator on Duty Upon receiving the call the hospital administrator on duty must come to the hospital and assume control of activities until the surgical on call or Medical on call reach the control room. The administrator makes sure that all areas of the hospital are aware of the disaster and that appropriate measures are being taken.
4.8.2 On-Call Residents: All on call residents present within the hospital will be notified by the supervisor and they will proceed immediately to their wards to identify patients who can be moved within the ward and hospital and those that can be discharged. They will communicate with their seniors to obtain approval for those patients identified for discharge. They will then inform the charge nurse of the decision proceed to the control room for further assignment.
4.8.3 In-House Police and security officers
The police and security officers will be requested to immediately call for back up and proceed to set up the barriers to control flow of traffic into and out of the hospital. They will be requested to make sure that ambulances are available to evacuate patients from the discharge areas. They will be requested to assign a police officer to each of the triage and discharge areas and to each of the entrances and exits of the hospital. They will be requested to liaise with the team leaders of those areas.
4.8.4 Charge Nurse Operating Theatres:
The sister in charge will immediately halt non-urgent cases from coming to the theatre, expedite the on-going theatre activities, evacuate recovery room and set up reception for disaster victims.
4.8.9 Cleaning Supervisor:
The cleaning supervisor on call will make sure that:
4.8.10 Engineer On Call:
The engineer on call will call for back up and will assess the plants and all activity areas to make sure that everything is functional. He will help with setting up of the barriers for directing the flow of traffic.
4.8.11 Charge Nurse Intensive Care Unit:
The sister in charge will immediately start the process of having enough staff available and making plans for evacuating non-urgent existing patients to the wards. 4.8.12 Charge Nurse Casualty:
The charge nurse activates the preparation of the control room, triage areas, resuscitation room, trauma room, cubicles, and the casualty support area. The charge nurse calls for back up nursing staff and assigns 2 nurses for each area within the casualty department. The charge makes sure that there are no obstructions to the flow of traffic between areas in casualty. The charge nurse makes sure there are enough supplies for each area.
4.8.13 Charge Nurses of All Wards:
Charge nurses of all wards will start making preparations for redistribution of patients on the wards and evacuation of all non-urgent cases / cold cases awaiting procedures. They will call back up nursing staff and make preparations for the reception of disaster victims
4.8.14 Blood Bank:
The blood bank will immediately start the process of making O Negative blood available in house. The team leader will then evaluate the continuous need for blood and related products during the disaster period.
4.9 Administration Role 4.9.1 DIRECTOR OF HOSPITAL 1. Ensures that all department know and follow protocol for disaster management 2. Upon notification of a disaster occurrence the following tasks are to be performed: a. During regular working hours, upon notification by the switchboard operator will initiate the disaster plan and will assign an assistant to inform the Second Contacts b. Take charge in the control room c. Supervise all personnel assigned as Team Leaders in the zones of activity d. Make sure that personnel arrive expeditiously and are given appropriate instructions and communication devices e. Liaise with the Police and the Press for continuing updates and release of information f. Make sure his or her deputy is aware of the procedure in his or her zone during his or her absence
4.9.2 ON-CALL HOSPITAL DIRECTOR 1. Upon notification of a disaster occurrence from the Nursing Supervisor on duty the following tasks are to be performed: a. Immediately proceed to the control room b. Take charge of activities until the Surgical on call arrives c. Evaluate on going need of personnel and supplies d. Communicate with the Director of the Hospital e. Inform off duty personnel and instruct them according to need
4.9.3 MEDICAL DIRECTOR
1. Assignments will be given to Team Leaders and other personnel according to the need 2. Off duty personnel will be notified and instructed according to the requirements 3. Liaison will be made with the police and the press 4. Will supervise activity within each zone 5. Will keep close communication with Team Leaders 6. Make sure his or her deputy is aware of the procedure in his or her zone during his absence
4.9.4 DEPUTY DIRECTORS / FINANCIAL DIRECTOR 1. Will be assigned Team Leader in one of the zones 2. Assignments will be given to staff in the zone 3. Off duty personnel will be notified and instructed according to the requirements 4. Will supervise activity within each zone 5. Make sure his or her deputy is aware of the procedure in his or her zone during his absence
4.9.5 ASSISTANTS 1. Will aid team leaders where required 2. Assignments will be given according to requirements 3. Off duty personnel will be notified and instructed according to the requirements
4.10 PHYSICIANS ROLE 4.10.1 HEAD OF DEPARTMENT
4.10.2 CONSULTANTS
4.10.3 SPECIALISTS
4.10.4 GENERAL PRACTITIONERS1. Will be required, as far as possible, for experience related activity, however they may be assigned for other medical duties
4.10.5 RESIDENTS
4.10.6 TECHNICIANS & NON-MEDICAL STAFF OF THE DEPARTMENT
4.10.7 FIRST ON CALL PHYSICIAN OR SURGEON
4.10.8 SECOND ON CALL PHYSICIAN OR SURGEON
4.10.9 ROLE OF MAIN STORE IN CHARGE
4.11 .HAZARD VULNERABILITY The hospital leadership will conduct Hazard Vulnerability Analysis to determine the type likelihood and consequences of hazards threats and events. Hazard Vulnerability Analysis is a tool to identify possible event in order to develop effective response program. Please check appendix of Hazard Vulnerability Analysis.
4.12. CONFLICT OF INTEREST During disaster when the staff personnel responsibility conflict with the organization’s responsibility for patient care, the organization shall assign the Public Relation officer to communicate and coordinate with the employees family members to ensure their safety and security. The same will be communicated to the employees on duty.
4.13 AFTER THE DISASTER When the disaster is over, the hospital telephone operator will announce “Code Brown all clear” following the instruction. At the completion of the disaster the evaluation form will be filled by the disaster committee, please find disaster drill evaluation tool
5. Annual evaluation of disaster preparedness plan’s objectives, scope, performing and effectives: The annual evaluation of the disaster preparedness plan will include a review of the scope according to the current JCI standard to evaluate the degree in which the program meets accreditation standards and the current risk assessment of the hospital. A comparison of the expectations and actual results of the program will be evaluated to determine if the goals and objectives of the program were met. The overall performance of the program will be reviewed by evaluating the results of performance improvement outcomes. The overall effectiveness of the program will be evaluated by determining the degree that expectations were met. The performance and effectiveness of the disaster preparedness plan shall be reviewed by the facility Management and Safety committee. .Performance Standard · One disaster drill to be conducted per year
6. Tools/Attachments Forms:Evaluation Drill for Emergency Disaster form
7. References:
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Prepared by:
Dr Shuaib Kazim (Head of General Surgery)
Signature:
Ms Shua Al Mutawa (Radiation protection officer)
Signature: Date:
Reviewed by
Dr Ahmad Ibrahim (Head of Accident & emergency –Deputy technical director)
Signature: Date:
Approved by:Mr. Ahmad Obaid Al Khadeim (Hospital Director)
Signature: Date:
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Department of Surgery 