Safety and Hazard Communication

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Staffing.
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Safety and Hazard
Communication
JCAHO Mandatory
Annual Competency
Chesapeake Medical Staffing

Staffing.
Contents
Universal Codes
Disaster Plan
Bomb Threat Plan
Latex Allergies
Chemical Safety “Right to Know”
Fire/Electrical Safety

Staffing.
Introduction
CMS Associates are expected to practice
the basic principles of hospital safety at all
times in a clinical setting. While hospitals
may vary in specific policies and procedures
regarding safety, universal basic safety
principles should always be a foundation of
clinical practice.

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Universal Emergency Codes
The state of Maryland has passed a law
that requires all healthcare facilities
to adopt universal emergency codes to be
used consistently across the entire state.
The next slides identify universal
emergency codes.

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Emergency Codes
Code Red: Fire
Code Pink: Infant or Child Abduction
Code Blue: Cardiac Arrest – specify
adult, child or infant
Code Green: Combative Person

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Emergency Codes
Code Orange: Hazardous Material Spill
Code Gold: Bomb Threat
Code Grey: Elopement
Code Purple: Security only response
Code Yellow:Code Yellow: Disaster or EmergencyDisaster or Emergency

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Key Elements to Review
• Safety and security
• Medical equipment
• Emergency preparedness
• Utility systems
• Life safety (fire)
• Hazardous materials (haz-mat)

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Safety and Security
Security officers are on duty 24/7. Their
specific duties include:
• access control
• escort service for employees at shift change
• investigation of threats and aggressive actions
taken against the particular facility or its
employees
• maintenance of peaceful visitation periods
• oversight of prisoner patients

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Access Control and ID
Most hospitals require visitors to wear a visitor’s
pass. After visiting hours, the only doors with
public access are usually in the ER. A security
officer should be present 24/7 at the emergency
entrance.
• Maryland state law requires that all health care
providers wear a photo ID in a clinical setting.
• All CMS employees must wear their photo ID
badge while working (please notify the office if
you need a new ID badge).

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Individual Responsibilities
It is the responsibility of every employee to
participate in creating a secure environment.
• Wear your photo ID badge in plain view.
• Lock your car and personal equipment.
• Report all suspicious activities or persons.
• Report threats, stalkings and violent behavior
of employees, visitors or patients to Security.

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Clinical Engineering
Clinical engineering is responsible
for:
• ensuring proper preventive maintenance for
all medical equipment.
• inspecting all new medical equipment.
• evaluating/fixing broken equipment.
• inspecting medical equipment for electrical
safety.

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Medical Equipment Safety
For Your Safety:
• Never use electrical equipment with wet hands.
• Never place liquids above or on top of electrical
equipment.
• Never cover vents/fans on electrical equipment.
• Never pull an electrical cord out from the outlets
by the cord.
• Never use adapters to form a 3 prong socket (only
equipment with original 3 prong plugs may be
used in patient rooms).

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Emergency Disaster Plan
JCAHO requires hospitals to have an
emergency disaster plan which describes
how the facility will respond in the event
of a disaster. Each department must
have a plan outlined in the Disaster
Manual listing specific duties in case of a
disaster.

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Emergency Management
Emergency management policies &
procedure are designed to assure:
• Mitigation: actions to reduce the chance of or
lessen the impact from a disaster event
• Preparedness: equipment, policies & training to
enable quick and effective response
• Response: implementing plan in reaction to an
unplanned event or drill in a coordinated
successful manner
• Recovery: getting back to normal business after a
major disaster event.

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Universal Disaster Plan
Disaster plans (internal or external) have
three stages. The stage is determined by
the resources needed in terms of:
• bed capacity
• staff availability
• equipment/supplies needed

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Internal Disaster
Any internal event or situation which severely
reduces the organization’s ability to function
normally (examples include severe weather,
earthquakes, gas leaks, fire or bomb threats, civil
disturbances, loss of electricity or water).

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External Disaster
Any incident or event occurring outside the
hospital which might result in a sudden increase of
patients being brought to the hospital (examples
include motor vehicle crashes, stadium/prison
accidents, catastrophic fires, airline/train
accidents).

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Implementation
Once a disaster stage has been identified,
the usual procedure is an overhead
announcement by the hospital operator.
Using a code name specific for the hospital,
all staff are alerted of the impending
Disaster. Staff should follow department
disaster plans until the “all clear”
announcement is made.

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Stage I
• Alerts employees that there is a potential
disaster situation.
• Normal routines should be not interrupted.
• Department supervisors will evaluate available
resources.

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Stage II
• Acknowledges that additional resources are
needed and call-ins may occur.
• Hospital supervisors are expected to
calculate the amount of time needed for
additional staff to arrive at the facility.

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Stage III
• Alerts widespread or complete disruption of
normal operations with potential harm to staff,
visitors, or patients.
• Full mobilization of all hospital staff and agency
personnel for a prolonged time should be
expected.
• Potential mass evacuation of the building may be
planned.

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Bomb Threat Plan
In the event of a telephone bomb threat, the plan
advises team members how to respond over the
telephone.
• Try to keep the caller on the phone as long as possible.
• Ask questions to gather information, such as, “Where
exactly is the bomb located?”
• Write down as much information as you can remember
about the caller as well as specific information
regarding the bomb.
• Dial, or have a co-worker dial, the operator to
immediately report the situation.

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Utility Systems
Red outlets in the patient care areas are connected
to the emergency generator power systems to
support any emergency situation.
• Always use these outlets for such equipment as ventilators,
IV drips for life-maintaining medications and other life
maintaining equipment.
• Never unplug vital life-saving equipment from the red outlet
without clinical engineering approval.
• All patient care employees should know where the power
panels and medical gas shut-off valves are located.
• Any hospital employee is allowed to shut off medical gases
under the direction of a Respiratory Therapist.

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Closing Oxygen Valves
• Respiratory care team members will report to
clinical setting to assist with O2
valve shut off.
• Charge nurse or clinical coordinator will take
charge of O2
issues until Respiratory Therapist
arrives.
• Oxygen shut off priorities:
• Identify any patients with a life critical need for O2
• Assess the proximity of fire and risk to piped O2
• Balance the risks.

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Water Loss
In the event of a water loss,
antiseptic wipes or hand gels should
be available

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Latex Allergies
• Healthcare workers are at risk for developing a
latex allergy because they frequently use or are
exposed to products containing latex.
• Detecting symptoms early, reducing exposure
and obtaining medical advice are necessary to
limit an allergic reaction.
• It is recommended to use non-latex gloves for
activities which do not involve contact with
infectious materials (i.e. food preparation,
routine housekeeping, and general maintenance
work).

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Latex Reaction Prevention
To limit the chance of a latex reaction, it is
recommended to use the following work practices:
• Do not use petroleum-based hand creams or
lotions (such as Vaseline Intensive Care) when
wearing latex gloves -- instead, use a water
based lotion (such as Eucerin).
• Wash your hands and dry them completely
after taking off latex gloves.

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Latex Reactions
Types of latex reactions to latex:
• irritant contact dermatitis: the development of
dry, itchy skin
• allergic contact dermatitis: dry, cracking,
peeling skin
• latex allergy: symptoms may appear from a
few minutes to several hours including: skin
rash; flushing; nasal, eye, sinus problems;
difficulty breathing, coughing spells, and
wheezing

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Latex Screening
• All patients admitted to the hospital should be
evaluated for latex allergies.
• A stock of latex-free equipment and supplies
should be available for staff.
• All CMS employees should disclose a history of
latex allergy during the new-hire application
process to assure availability of latex-free gloves
at assigned clinical sites.

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Hazard Communication and
Right to Know
OSHA Hazard Communication/Right-to-Know
standards ensure health care workers are
informed about chemical labeling, material safety
data sheets (MSDS) gathering and chemical
hazards in clinical settings.

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Material Safety Data Sheets
All hospitals are required to keep a
current chemical inventory and keep
Material Safety Data Sheets (MSDS)
in the Safety Office.

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Chemical Containers
Chemical containers must have the following
information on the label:
• chemical identity (name)
• ingredients
• hazard statement (tells the physical and health
hazards of the chemical)
• precautions to be taken when working with the
chemical and the PPE required

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Hazard Identification
The Hazardous Material Identification
System (HMIS) label is typically
square in shape and may not be
substituted for a product label.

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Health Hazard
The color blue represents the health hazard
class for a specific chemical product. The
degree of the health hazard is designated
through the use of a number rating system.
The range is from 1 - 4. The zero
represents a minimal health hazard and the
number 4 represents an extreme health
hazard.

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Fire Hazards
The color red represents the flammability
hazard class for a specific chemical product.
The degree of the flammability hazard is
designated through the use of a number
rating system.The range is from 0 - 4. The
zero represents a minimal fire hazard and
the number 4 represents an extreme
flammability hazard.

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Reactivity
The color yellow represents the reactivity
hazard class for a specific chemical product.
The degree of the reactivity hazard is
designated through the use of a number
rating system. The range is from 0 - 4. The
Zero represents a minimal reactivity hazard
and the number 4 represents an extreme
reactivity hazard.

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Special Hazards
The white diamond in the placard is used
for information purposes and can include a
number of symbols.
• W Do not use water with the material.
• OX The material has oxidizing properties.
• Radioactive The material is radioactive.
• P The material requires the use of protective
equipment.
• HazMat There are hazardous materials in the area.
• Laser During use of the equipment, eye
protection must be worn in the immediate
area.

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Fire/Electrical Safety
One of the most serious safety issues in hospitals is the
threat of fire. The risk is increased because work
conducted in clinical areas, laboratories and
operating/special procedure rooms may involve
flammable liquids and other hazardous substances. In
addition, the use of specialized equipment such as
lasers and other ignition sources utilized in oxygen-
enriched atmospheres increases the threat of fire. This
threat is far more critical in patient care areas since
patients are often incapable of self-preservation.

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Know the Fire Code
A team effort is required when a fire emergency
arises. Everyone is needed to protect the lives of
the patients.
• Know the fire plan for each hospital and department
where you accept an assignment to work
• Know the fire emergency code for each facility
• Know the location of the following:
fire alarms
extinguishers
fire doors
patient transport equipment

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Code Red
• Every team member must know and understand what to
do when a Code Red is called.
do if they discover a fire or smoke.
do if they smell or see smoke or feel excessive heat in an
area that should not be hot.
• Treat every Code Red as an emergency, even if you think
it is a drill (drills save lives as they help hospital personnel
rehearse emergency procedures).
• All departments must clear hallways and close all doors
during fire drills (even if the drill is not in your department
or work area).

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Electrical Safety
• Inspect electrical equipment and power cords
for signs of wear or damage damage before use.
• Report any damaged or malfunctioning equipment.
• Do not use the equipment that is not working
properly.
• Remove it from use and put a “defective equipment”
tag on the equipment so that it is not used, write
down what is wrong with name and date.
• Notify facilities services or bio-medical engineering
(informing them what is wrong with the
equipment/cord).

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Fire Pull Stations
Fire pull stations are usually located at the
stairwell entrances and exits of most hospital
units. Pulling the alarm box will activate the ball,
voice page, and/or flashing lights to warn the fire
team, staff, patients and visitors of a fire event as
well as automatically close magnetic fire doors. It
is your responsibility to note the locations of fire
pull stations in every clinical setting.

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R A C E
The acronym RACE is used to remind HCWs to:
R Rescue/remove anyone in immediate danger
A Sound the ALARM and get fellow team members to help.
Pull the fire alarm and dial the emergency code. Tell the
operator the exact location of the fire. Get fellow team
members involved to help respond (pull stations are at
doors to stairs or outside, and nursing stations).
C Contain the fire by closing doors and windows.
E Evacuate if necessary/extinguish the fire if possible (if the
fire is is no larger than a waste basket and you have been
trained or you can do so without endangering yourself).

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Components of R A C E
Remove the patients
from danger. Patient
safety is always the first
consideration.
Alarm: Activate the fire
alarm. This is done by
pulling the alarm box
located at the stairwells,
exits to the building, and
other key places.
Close all doors and windows.
By closing the doors you can
gain 20 to 40 minutes of safe
time. The fire doors located
throughout the hospital close
automatically when the fire
alarm sounds.
Extinguish the fire if possible.
If the fire is in the wastepaper
basket or on a patient’s bed, an
extinguisher can be used to put
out the fire. If extinguishing
the fire is not possible,
evacuate as directed.

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Keep Doors Closed
If a door is hot, there is most likely
a fire on the other side. Do not open
a hot door. Opening a door may feed
the fire by giving it more oxygen!
DO NOT DELAY in notifying the Fire Department.
The faster the Fire Department arrives, the faster
the fire can be contained and extinguished.

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Patient Evacuation
In the event of patient evacuation:
• Do not use the elevators unless directed to do so by the
fire department.
• When possible, have patients move under their own
power.
• Only attempt to save records or equipment after the
patients are safely evacuated.

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Extinguishing a Fire
NEVER fight a fire if it is larger than the size of a waste
basket or if there is excessive heat or smoke. Activate the
emergency alarm immediately.
Know the universal classification of types of fire :
Class A: common combustibles: paper, wood, cloth,
rubber, plastic
Class B: combustible liquids or gasses, oil, grease
Class C: electrical equipment, surgical equipment,
computer equipment
Class D: combustible metals including magnesium,
potassium, sodium

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Types of Extinguishers
Class A: These extinguishers are good for
fires comprised of dry materials.
These silver extinguishers contain water.
Class B: These extinguishers are for fires involving
liquids and oils. They contain dry chemicals or
CO2 (carbon dioxide). If a water extinguisher
was used on this type of fire, it could cause the
fire to spread.
Class C: These extinguishers are good for live or
energized electrical fires. They also contain
CO2 (carbon dioxide).

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Using an Extinguisher
Remember the pneumonic PASS:
Pull: Pull the pin before you approach the
fire
Aim: Aim the nozzle (at the base of the fire)
Squeeze: Squeeze the handle (start 6-10 inches
from the fire)
Sweep: Sweep side to side

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Fire Safety Guidelines
• Exit doors and stairwells should never be blocked by clinical or
construction equipment.
• Do not use door stops (chocks) in the building.
• Do not stack anything within 18” of the ceiling, especially near
sprinklers.
• Keep stairs and corridors clear at all times- never store objects in
halls even if objects are on wheels.
• Reassure patients and visitors that Code Red is in effect and
appropriate action is being taken.
• Team members assigned to non-patient care areas should remain in
their department (if not the fire zone).
• Team members assigned to patient care areas should return to their
unit. Be prepared to evacuate to another “smoke compartment” on
the same floor or to another floor if an evacuation is necessary.

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Conclusion
Fire and life safety responsibilities are shared among a
multi-disciplinary group. Each has specific
responsibilities for design, implementation, testing,
maintenance or monitoring of part of a fire
prevention management plan in all health care facilities.
The goal is to provide a safe, functional, supportive,
and effective environment for patients, staff members,
and other individuals in the healthcare facility.

Safety and Hazard Communication

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