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CHAPTER 28
Code Blue Health Science Edition 4
Safety in the Hospital
 As the administrator of an aging hospital, Wes
Douglas is responsible for taking the steps needed to
assure that patients, visitors, and employees are safe
while in his hospital.
 He will be helped in these efforts by a
number of governmental agencies.
Government Agencies
 Occupational Safety and Health Administration
(OSHA) – The purpose of this agency is to prevent
work-related injuries, illnesses, and deaths.
 The agency was created in 1971.
 It is been credited with reducing occupational deaths
since that time by 62%, and injuries by 42%.
Government Agencies
 Center for Disease Control and Prevention (CDC) –
This federal agency is charged with protecting the
health and safety of the American people.
 It serves as the source of credible information on disease
prevention and control, environmental health, and
health promotion, and education.
The CDC in Atlanta
Center For Disease Control and
Prevention (CDC)
 The CDC plays an important role in identifying and
controlling infectious diseases, including HIV/AIDS
and tuberculosis.
 In addition to identifying outbreaks, the agency uses
“fingerprinting” technology to classify strains of
thousands of infectious diseases that impact
populations around the world.
Clinical Laboratory Improvement
Amendments (CLIA)
 Congress passed the Clinical Laboratory Improvement
Amendments in 1988 to set up quality standards for
laboratory testing in the United States.
 The focus of the legislation was on accuracy, reliability,
and timeliness of patient test results.
Clinical Laboratory Improvement
Amendments (CLIA)
 CLIA legislation defines a laboratory as a unit that
performs laboratory testing on specimens taken from
humans for diagnosis, prevention, or treatment of
disease.
The Hospital Fire Plan
 Another important component of hospital safety is the
fire plan.
 Usually, this is a written document that all employees
must understand.
 Many hospital fire plans use the acronym RACE in
training employees.
RACE Stands for . . .
 Rescue
 Alarm
 Contain
 Extinguish
The Hospital Disaster Plan
 Hospitals are designed to
handle patients who are
admitted one at a time.
 What happens when a plane
crashes, or an earthquake
occurs, and the hospital is
suddenly deluged with 150
patients?
The Hospital Disaster Plan
Questions that must be
answered . . .
 Who is treated first?
 How are the patients
admitted?
 Who handles the flood of
family members that may
storm the hospital
demanding information
about their loved ones?
Communication
 Communication is an important component of the
disaster plan.
 Switchboards often use code language to communicate
with employees.
Code Language
 Code Red – announces a hospital fire
 Code Blue – solicits help for cardiac arrest at a specific
location
 Code Orange – announces that the disaster plan is
being activated
Components of the Disaster Plan
 Line of authority – a list of persons who will be in
charge
 Often the following persons, in the order listed, will be
in charge
 Administrator
 Director of nursing
 Nursing supervisor
 Emergency room supervisor
Components of the Disaster Plan
 Communication – The plan will specify where each of the
following communication centers will be established, and
who will be in charge.
 Public Communication Center – This is a communication
center for receiving outside calls, and giving information to
the press, radio, and relatives of the injured.
 Internal Communication Center – This is a center to
coordinate and handle internal communications.
 Emergency Room Radio Communication Center – This is the
center that receives and sends messages to ambulances,
police, fire vehicles and government agencies.
Triage
 Triage is the process of sorting people to determine
who receives treatment first.
 The goal is to “do the most for the most.”
 Triage is usually performed by a triage officer, who
sorts patients, but does not give care.
 Patients are sorted into casualty categories which
indicates the priority in which patients will receive
care.
 Categories are assigned using numbered or colored
tags.
An Example of Triage Categories
Category
Definition
1
Color
Treatment
Example
Life
Red
threatening
Immediate
Severed
artery
2
Urgent
Yellow
Urgent
3
Minor
White
Delayed
Broken
femur
Twisted
ankle
4
Dead
Black
Temporary Morgue Facilities
 The disaster plan will specify where dead on arrival
(DOA) patients will be taken.
 It will also specify whether personal belongings will be
removed from the dead, and how the Command
Center will be notified for casualty list purposes.
The End
Hospital Disaster Drill