Presentation on theme: "Impact of Water Outages and Restrictions on Healthcare Facilities"— Presentation transcript:
1Impact of Water Outages and Restrictions on Healthcare Facilities Presented by:Jeremy JerniganEmergency Management CoordinatorColumbus Regional Healthcare System& Columbus County Health Department
2Overview Impacts to healthcare facilities Causes of restrictions/outagesActions to takeLessons learnedPlanning documents and guides
3Examples of water usage: Hand hygieneMedical gas systemsDrinking waterHVAC systemsIce machinesDecontamination/Hazmat responseFood preparationBathing patientsEyewashFlushing toiletsLaundryCleaning and sterilization of instrumentsDialysisFire suppression
4What types of facilites? HospitalsNursing homesAssisted living facilitiesDialysis clinicsDental officesDoctors officesGroup homesHome health???
5Causes of water supply interruptions Natural disastersFiresExplosionsConstruction (on-site & off-site)Vehicle accidentsFailure related to the utility providers infrastructureFailure related to the facilities infrastructure
6Effects of water supply interruptions DiversionEvacuationCancellation of services
7Drinking water advisories and notices System Pressure Events – low or no pressure can cause back siphonage and introduce bacteria into drinking water.Coliform Boil Water Advisory – total coliform bacteria has been detected in the drinking water system. This can indicate the presence of other harmful bacteria and until test results show no coliforms all water for consumption should be boiled.
8Drinking water advisories and notices Fecal Coliform Notice – testing has indicated that fecal coliforms are present and the water may be contaminated with human or animal waste. All water for consumption should be boiled.Do Not Drink the Water – Water has been contaminated and should not be used for consumption.Do Not Use the Water – Water is contaminated and should not be used for consumption, bathing, cleaning, etc.
10ActionsConsumptionDiscontinue use of tap water for consumptionTurn of ice machinesSoda fountainsLabel water fountains and sinks “Do not drink”Any other uses that would result in consumptionIf only a “Boil Water Advisory” water can be boiled for consumption
11ActionsDishwashingIf a dishwasher does not reach 180 degrees then disposable eating and drinking utensils should only be used
12Actions Food preparation During a boil water advisory All food cooked to 165 degreesAll food service workers use hand sanitizers after washing handsBoil water notice or do not useUse only prepackaged foods
13Actions Hand washing Food service workers use hand sanitizers Healthcare workers use alcohol-based antiseptic hand rubs***Do not use contaminated water to scrub for surgeries, waterless surgical scrubs should be used***Workers caring for patients with C. Diff need to use soap and water for hand washing.
14ActionsBathingAvoid bathing anyone with weakened immune systems, elderly, and children. Use waterless bath products.Care should be taken to not get contaminated water into open wounds
15Lessons learnedColumbus Regional Healthcare System – Boil Water Event – May 2012Plans were in multiple places and were at differing stagesCity quickly notified the hospital but notifications to the municipality in general were slow and inadequateHospital made good use of signage to communicate to patients, staff, and visitors not to use the water for consumption.Hospital has only one water source and only one way for water to enter the building.Communicated with local EM
16Lessons LearnedNew Hanover Regional Medical Center – Water Main Break - July 2010Breakdown of communications internally – human errorReference documents were out of dateBetter communications with other facilitiesCommunicated with local EM
17Lessons LearnedMission Hospital, Memorial and St. Joesph Campus– Water Main Break – May 2008Quickly moved bottled water to both sitesCoordinated with FD to deliver non-potable water to facilities for laundry, HVAC, toilet flushingOrder Port-A-Johns for staff and visitorsDelivered “Bath in a Bag” supplies to the facilitiesCommunicated with local EMActivated their PIO within the ICS structure to communicate internally and externally
18Planning documentsNC Drinking Water Section Quick Reference Guide for Public NotificationEnvironmental Health Emergency Preparedness and Recovery Guidance Manual For North CarolinaCDC Healthcare Water System Repair Following Disruption of Water Supply
19Planning documents HICS Planning Scenario 10 – Loss of Water CDC Emergency Water Planning Guide for Hospitals and Healthcare FacilitiesCalifornia Hospital Association - Hospital Water Disruption Best Practices
20Planning documentsEPA – Planning for an Emergency Drinking Water Supply
21Regulations related to planning Center for Medicare & Medicaid Services (CMS) 42 CFRThe Joint Commission 2009 Emergency Management Standards, specifically EM
22Review Impacts to healthcare facilities Causes of restrictions/outages Actions to takeLessons learnedPlanning documents and guides
23Thanks to:Mark Bennett – NHRMCNed Fowler – Mission Health System