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Mizell Memorial Hospital External Disaster Plan

INTRODUCTION AND SCOPE
It is a well known fact that in every disaster there is a need of immediate medical, nursing, and hospital care, along with other basic necessities.  Keeping these thoughts in mind, the Mizell Memorial Hospital has developed a Disaster Plan which will go into effect in the event of a community disaster.

This plan is a Disaster Plan and does not in any way supplement the existing Fire Plan which has proven to be effective and comprehensive and would, of course, be placed into effect in the event of a fire.

This Disaster Plan takes into consideration incidents of disaster, which occur within our community, excluding the hospital and leaving the hospital intact.  Such disasters would be a large community fire, explosion, tornado, hurricane, civil riot, flash floods, transportation accidents, mass power failures, and enemy attack.

From a hospital standpoint, an External Disaster has been designated as an unusual occurrence involving injured persons which requires extraordinary coordination of the hospital=s personnel and equipment and interrupts the hospital=s routine activity.

TYPES OF DISASTERS
Basically, there are three types of disaster.  The first would be the sudden, with little or no warning; secondly, which is forewarning; and thirdly, a disaster which occurred within the hospital, causing extensive damage to the hospital.  

For the purpose of our disaster planning, we are assuming that the hospital will remain intact without any internal damage.

DEFINITIONS OF EXTERNAL DISASTER AND CONDITION CATEGORIES

CODE BLUE - CONDITION I:
On duty staff sufficient to respond to the influx of patients.

Department managers will be notified to activate their departmental plans at the discretion of Administration.

Supplemental disaster supplies and equipment identified in case they are needed.

Areas for patient care expansion notified.


CODE BLUE - CONDITION II:
Supplemental staff required for expected patient influx.

Selected staff called in by Department Manager or House Supervisor as required by their departmental plans.

Supplemental disaster supplies and equipment distribution as required.

Treatment area and bed capacity expansion required.

Discharge or transfer of inpatients as needed.


CODE BLUE - CONDITION III:
All available staff is required at the hospital.

All supplemental supplies and equipment in place.

Maximal facility expansion required.

Discharge or transfer of inpatients where possible.

Additional hospital beds or cots in place to accommodate increased population.

ACTIVATION

Notification of an External Disaster will normally be received by the Switchboard/Emergency Department desk.

Notice may come from the Covington County Emergency Management Office, Red Cross, or a Law Enforcement Agency.
Caller should identify expected number and nature of casualties.

Upon notification that a disaster situation exists or is imminent, the Switchboard will  immediately notify:

Administration - Extension 111
House Nursing Supervisor - (At Supervisor=s discretion, notification of an Administrative Official at home).

Activation of the plan may be authorized by:

Administrator/Emergency Department/House Supervisor

Assistant Administrator/Director of Nursing

Assistant Administrator/Chief Financial Officer

NOTE: When the Administrator is not on the premises, the House Supervisor may ascertain the disaster condition and authorize activation of the disaster plan.

When authorization to activate the plan is received, the paging system will be used to notify hospital staff of the disaster condition.  Those departments which do not hear the hospital paging system will be notified by the Switchboard operator by phone.  After hours, notification will be made using phone triage, by 3rd floor personnel.

The internal designation for paging purposes is ACode Blue Alert@ with the category (Condition I, Condition II, or Condition III) at the end.  This code should be announced in three consecutive and distinct patterns (example - ACode Blue Alert Condition I@,@Code Blue Alert Condition I@,@Code Blue Alert Condition I@).  Access to the hospital=s internal paging system is 63 and wait for tone.

The disaster will require coordination of one or more of the following agencies:

Covington County Emergency Management Association - Susan Carpenter - 428-2560.
Police Department - 493-4511 - 911
Fire Department - 493- 7015 - 911
Rescue Squad -  911
Hospital - 493-3541
Covington County Sheriff=s Department 428-2640.

In the event of a disaster, an administrative control center will be established in the Business office.  This center will be responsible for communications internal and external to the facility.  Attached is the current list of administrative personnel who must be contacted to implement their departmental responsibilities during a disaster.

MEDICAL STAFF ASSIGNMENTS

1. NOTIFICATION:
The House Supervisor will designate the 3rd floor personnel to notify the following physicians:

a) ER physician on call
b) Back up physician on call
c) Chief of Staff
d) Other physicians as needed:
Additional Family Practice physicians 
Orthopedic
Surgeon

EMPLOYEE POOL:
Unassigned personnel and volunteers should report to the Business Office where a representative of Administration will supervise and dispatch runners, transporters, etc., as requested by hospital departments or disaster treatment centers.

MEDIA/VISITOR CONTROL
Immediate family of disaster victims will be directed to the Wing Conference Room where Volunteer chaplains and employee/volunteer pool staff will be available to assist as needed.

Visitors present in the hospital at the time the disaster plan is activated will be allowed to stay if they do not add to the workload of disaster management personnel.  Otherwise, they will be asked to leave.  Entrances to the hospital may be locked if excessive visitors become a problem.

MEDIA: The Home Health Conference Room on the Wing will be the designated briefing area for all media.  An Administrative official will be responsible for both family and media areas.

In the event of a significant occurrence media information should be handled as follows:

Develop a list of victims, i.e., 5 adults, 2 children; age and sex; with conditions noted as serious, critical, stabilized, etc. using general terms (no specifics) to relay extent of injuries.  Do no release names.

SPECIAL DEPARTMENTAL RESPONSIBILITIES:

PLANT OPERATIONS

Assist with transporting and setting up equipment in the ER and treatment centers as directed by the Plant Operations Supervisor or Administrative staff.

Assist in transfer and relocation of inpatients by improvising ramps and hoists as needed.

Assist with additional bed and cot installation and expansion of facilities as needed.

Assist with security responsibilities as required.

Make available, if needed, the Emergency Elevator keys.

Inspect medical equipment in treatment areas as requested.  Equipment temporarily located in treatment areas should not block passageways.  Electrical cords or accessories should not pose a tripping hazard.

Maintain continuity of essential services and utilities.

RESPIRATORY THERAPY

Return patients to their rooms as procedures permit and suspend non-emergency procedures.

Check availability of oxygen portable supple and procure as needed

Position all available stretchers near the department entrance for use by ER or other treatment centers.

Respiratory Staff will be assigned to the ER to assist with triage and critical immediate care as directed by the ER physician or nurse.  Additional assistance can e obtained from the employee/volunteer pool located in the Business Office.

The ER is used for victims requiring immediate, critical care.  Other victims will be sent to appropriate treatment areas as they are triaged.

Explain to non-disaster, non-emergency ER patients reasons for delay in treatment and assure them of prompt attention as soon as possible.

FOOD SERVICES

Stand by to supply emergency food services to hospital workers and disaster victims in addition to normal hospital meals.

Dispatch employees to Central Sterile Supply to deliver supplies as needed, except during peak hours of food preparation and delivery.

HOUSEKEEPING/LAUNDRY

Perform accelerated removal of wet and soiled linens and materials from triage and treatment areas.  Continue only essential housekeeping tasks.

Dispatch two employees to the ER to serve as transporter and messenger, and to assist in securing wheelchairs and stretchers for patient transfer (essential on evenings until relived by other available personnel).

In the event of a nuclear accident, one Housekeeping employee will secure and deliver gowns, blankets, plastic bags and gloves to the shower area located in the employee showers in the basement.

Operate elevators as directed by Plant Operations Supervisor until relived by other personnel or volunteers.

Assist with responsibilities of Plant Operations personnel.

LABORATORY

Dispatch one technician to the ER

Suspend non-essential functions if needed for personnel in other areas require it.  Perform routine lab functions as time allows

Inventory all available blood and plasma and forward this information to the Triage nurse, Operating Room and Disaster Control Area in the Business Office.

If available, a lab technician will assume control of the Morgue and assume correct disposition of personal effects of those casualties.

MATERIALS MANAGEMENT

The Materials Management Director will contact the ER, Treatment areas, Central Supply Department, Laboratory and Radiology to determine need for supplies.

Assess increased supply requirements and make arrangements for replenishment as needed.

Contact outside agencies, state and local, to request additional equipment and supplies as indicated

Coordinate the movement of additional beds and mattresses from storage/unoccupied patient rooms if needed

Only calls of any emergency nature will be accepted by Materials Management

In case of radiation or tear gas contamination, a supply of gowns, blankets, plastic gloves and biohazard bags should be delivered immediately to the ER

HEALTH INFORMATION

Suspend non-essential functions as needed and assist with ER/Admissions

Coordinate location of medical charts as needed

NURSING SERVICES

The Nursing Disaster Call list will be activated as designated by Administration and/or the House Supervisor

All Nursing personnel shall report to their regularly assigned stations

Nursing personnel will be specifically assigned by the Nursing Manager or Director of Nursing to supplement staff and/or supervise the treatment areas:

Emergency Department
OR/PACU
3rd floor
2nd floor
Cafeteria/Small Dining Room

Each area will maintain a log of disaster victims treated and their disposition.

Each Nursing unit will quickly list all patients capable of discharge and all empty beds and forward this information to the Disaster Control Area in the Business Office

One of more employees should be dispatched to collect stretchers and wheelchairs and deliver to the ER area

STRETCHERS are located as follows:   
TOTAL = 10

1 - OB
1 - 3rd floor
7 - Surgical Services
1 - Radiology


WHEELCHAIRS are located as follows:
TOTAL = 10

3 - 3rd floor  
1 - OB
2 - Surgical Services  
3 - Radiology
1 - Physical Therapy

SURGICAL SERVICES

When a CODE BLUE is announced DURING normal working hours, all surgery personnel including anesthesia, will report to the Surgical Services Manager or Senior charge nurse.

They will maintain sufficient personnel on duty to respond to patients= needs.

Call in extra personnel if indicated

During a disaster, personnel will be expected to stay and continue to work until the situation is under control.

Prepare to receive disaster casualties in need of immediate surgical intervention.

Suspend scheduled non-emergency surgery if indicated to care for disaster casualties.  If disaster is sever, premature completion of cases in progress may be necessary.

When a CODE BLUE is announced AFTER normal working hours, the ACall Back Plan@ is initiated.  

An updated list of personnel and their telephone numbers will be located in the department.

The Surgical Service Manager, Nursing charge nurse and all OR personnel will keep a copy of numbers at home

Three (3) Aon call@ personnel are immediately notified by the 3rd floor nursing personnel.  

The first Aon call@ person is to notify Surgical Services manager, and Senior charge nurse for further instruction on extra call-ins.

Central Supply Department will be responsible for maintaining supplies, sterile dressings sheets, etc. and provide personnel to sterilize items as needed.

PASTORAL CARE

The Volunteer chaplain on call will report to the ER after notification.

If not needed in the ER, any other volunteer chaplains will report to the Wing Conference Room to comfort disaster victims= relatives.

HUMAN RESOURCES

The Human Resources director will report to the Wing Conference Room to help with visitors and relatives.

PHARMACY

Prepare to supply emergency medications to each Treatment Center as needed

Suspend non-essential routine services as indicated.

PHYSICAL THERAPY

Discontinue all routine therapy and return non-disaster patients to their rooms.

Stand by with assigned Medical Staff and nursing personnel to receive orthopedic injuries not requiring surgery.

Orthopedic cart, with supplies and cast materials, will be moved from 3rd floor to 2nd floor and PT personnel will assist in immobilizing fractures as indicated and assist with cast application.

Assist physician and Radiology staff with portable x-ray as time allows.

Maintain a log of disaster victims and their disposition.

RADIOLOGY

Prepare to receive disaster victims from Triage area

Suspend non-essential services as indicated.

Deliver portable radiology equipment to ER or 2nd floor with necessary technical staff

If appropriate, locate one employee in ER with radiation counter to identify radiation exposed victims.

Disaster victims exposed to radiation or tear gas should be transported from the Triage area to the employee showers located in the basement.  The victim=s clothing should be removed, placed in a plastic bag and placed outside the building.  A supply of gowns, blankets, plastic gloves and biohazard bags will be delivered to the area by Housekeeping.

Process x-rays at an accelerated rate