Chapter 15 Security and Disaster Plans Flashcards
Describe the difference between intern emergency readiness and external emergency readiness.
Internal. Includes safety hazardous materials protocols as infection control policies and practices.
External. Includes participation in community-wide emergencies and disasters.
Disasters that health care facilities face include internal and external emergencies. Explain the difference.
Internal include loss of electric power or portable water, severe damage or causalities within the facility related to fire/weather, etc.
External include any outside mass causality experience. Hurricanes, floods, pandemic flu, major accidents.
The Joint Commission and Emergency Preparedness standards mandate that an emergency plan is developed by all health care institutions. And there specific standards are:
Notifying and assuaging personnel
Notifying external authorities of emergencies
Managing space and supplies
Providing security
Isolating and decontaminating agents
Evacuating and setting up alternative care site when institution is compromised.
TJC requires how many emergency preparedness drills a year?
Two. They should include. An influx of clients and either an internal or external disaster.
Also participating in one community-wide drill per year.
What is the process when an alternative care site is necessary?
Client information/care packaging (medications,supplies, admissions)
Inter facility communication
Transportation of clients
Cross-privileging of medial staff
In disaster planning and emergency response plans triage provisions are changed from a normal day to day setting, explain how ?
Causalities are separated in relation to their potential for survival.
What are the categories of triage during mass casualty events?
Emergent (Class I) - highest priority
Urgent (Class II) - second highest priority
Nonurgent (Class III)
Expectant (IV)
Explain Emergent Category (Class I).
Highest priority, given to clients who have life threatening injuries and a high possibility of survival.
Explain Urgent category (Class II).
Second highest priority, given to clients with major injuries which are NOT yet life-threatening and can wait 45 to 60 min for treatment.
Explain Nonurgent category (Class III):
Priority given to clients who have minor injuries that are NOT life threatening and do not need immediate attention.
Explain Expectant category (Class IV):
Lowest priority given to clients who are not expected to live and are allowed to die naturally. Comfort measures may be provided but restorative care is not.
During an emergency like fire or mass casualty what is the criteria to follow regarding discharge and relocation of clients safely?
- Ambulatory clients that require minimal care are discharged or relocated first.
- Clients requiring assistance are next and arrangements are made for continuation if their care.
- Clients who are unstable are not discharged or relocated unless they are imminent danger.
During a fire, if evacuation is necessary in what direction should the evacuation occur in?
Horizontal evacuation is done first. Lateral evacuation is done if client safety cannot be maintained.
During a sever thunderstorm/tornado what are some precautions?
Draw shades and close drapes to prevent glass shattering
Lower beds at lowest position
Place blankets over clients confined to bed.
Monitor for severe weather.
Name some biological pathogens:
Inhalation of Anthrax Cutaneous anthrax Botulism Vital Hemorragic fevers (Ebola/yellow fever) Plague Smallpox Tularemia
What are the security issues faced by health care facilities?
Admission of potentially dangerous individuals
Vandalism
Infant abduction
Information theft
What organization provides recommendations for the development of security plans?
The internal association for Heath care security & safety (IAHSS)
In a security plan nurses should be aware that security measures include:
Identification system (identifies employees, volunteers, physicians, students, etc)
Electronic security systems in high risk areas (maternal newborn)
What are some examples of electronic security systems in high risk areas?
Key code access into and out of areas
Wristbands that electronically link
Alarms integrated with closed circuit tv cameras
In the case of a client coming into contact with a chemical agent what should be the steps to assist client?
Undress client
Remove all identifiable chemical
Provide immediate and prolonged irrigations of contaminated area with running water.
What procedure should be used in the case of a client coming into a dry chemical, such as a lye or white phosphorous?
Brush agent off clients clothing and skin.
In the event of contamination of a biological hazard, how would a nurse decontaminate the client?
Wash skin with large amounts of water and antibacterial soap.
If a bomb threat phone call is received, what should the receiver of the call do?
Extend conversation as long as possible
Listen for distinguishing background noises
Note voice characteristics of caller
Ask where and when bomb is set to explode.
Note whether caller is familiar with arrangement of hospital
What are some clinical manifestations of anthrax?
Sore throat Fever Shortness of breather Severe dyspnea Meningitis
What are nursing interventions for anthrax?
Oral ciprofloxian (cipro)
IV ciprofloxian
Vancomycin or penicillin
What are the clinical manifestations of botulism?
Difficulty swallowing
Double vision
Slurred speech
Descending progressive weakness
What are the nursing interventions for botulism?
Airway management
Antitoxin
Elimination of toxin
What are the clinical manifestations of Pneumonic plague?
Fever Headache Rapidly developing pneumonia Chest pain Bloody or watery sputum Progress for 2 to 4 days.
What are the nursing interventions for pneumonic plague?
Early treatment is essential
Administer antibiotics within 24 hr of first symptom (streptomycin, gentamicin, tetracyclines and chloramphenicol are all effective)
What are the clinical manifestations of tularemia?
Sudden fever Chills Diarrhea Joint pain Dry couch If airborne, life threatening pneumonia and systemic infection.
What are the nursing interventions for tularemia?
Streptomycin IV or gentamicin IV or IM are drugs of choice
In mass casualty use doxycycline or ciprofloxacin.
