Why Be Concerned at all? Regulatory Agencies Hospital Impact
TJC EC 1.4 – Healthcare facility must be prepared to decontaminate patients and have regular drills and exercises conducted to test preparedness. – An Incident Management system is required – Hazard vulnerability analysis conducted
OSHA First Responder Requirements Published Best Practices for First Receivers General Duty Clause Sec. 5. Duties (a)Each employer (1)Shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees;
Equipment 29 CFR Must be adequate for the type and exposure levels one can reasonably anticipate. – OSHA – Level C is adequate for medical centers.
Medial evaluations 29 CFR (f) review with employee health to best implement. it is debatable of where hospital decon teams fall as they do not meet the definition of a decontamination team.
Equipment 29 CFR Equipment must be inspected and maintained Respiratory equipment is routinely integrated into medical surveillance program. – Infection control or employee health
Incident Command TJC and OSHA Using HEICS – Falls under operations – Separate Branch (HAZMAT) – On site HAZMAT Commander (OSIC) Safety Officer Medical Officer Triage Officer
So who’s it? Fire Departments Role
So who’s it? Hospitals Role
So who’s it? Working Together
Building a Team What is a Decon Team – Call it… How many people? – American Hospital Association recommends for a 48 hour response time: Recommends 50 clinicians for metropolitan medical centers 20 at non-metropolitan healthcare facilities Small facilities should aim for a two person team 24/7.
Building a Team Who do we use? – Nurses Floor - ER Home health – Engineering/Maintenance - Respiratory – Medical Records -Environmentalist – Security - Admissions – PCT’s - Education – Physical Therapy
Building a Team Team Issues Turn over So many needs, so few people.
Team Considerations Turn over rate Availability Normal Job Function Desire vs. Ability
Training No Set Standards or Requirements for First Receivers Meet TJC requirements Meet OSHA requirements – First Responder Requirements Awareness Operations
Training How often and long should we train? Research being conducted.
Training What content should be covered?
State Wide Need No one is alone – Critical access – Level 1 Trauma So what options do we have – Work alone and hope for the best – Develop Regional and State Teams
State Wide Need How would Regional Teams help? – When and When Not – How effective? Where to begin?
Conclusion Tag, You’re It!! Where do we go from here?