Hospital Safety

Presented by :
Dr / Heba El Ghobary
Outline:
• Fire and Evacuation
• Hazmat
• General Safety
• Security
• Medical Equipment
• Utility
• Disaster Preparedness
EFS.01 Hospital facilities Comply with laws,
regulations, fire & national building codes.
• Basic infrastructure
• Permits , licenses and design drawings.
• Budget: for expanding services for safety.
• Safety Committee:
1. An oversight structure
2. Reviews surveillance rounds reports and drill reports
3. Should report to hospital leadership quarterly & receive Feedback.
 1.Safe Fire Planning

• Addresses the following:

A. Prevention
B. Early Detection
C. Response
D. Safe evacuation in case of fire
A. Prevention of fire
• Safety design(furniture and decoration)
• Proactive risk assessment:
Listing of fire alarm systems
Clear fire exits
Clear signage
Safe storage & handling of highly flammable materials
Hospitals perform a training & orientation of all staff in a practical manner to
demonstrate RACE and PASS
B. Early detection of fire and smoke through
detectors
• Call Code Red
 C. Response
• RACE ‫النقاذ المتواجدين في مكان الحريق‬
Rescue, Alarm, Contain and Extinguish or Evacuate
• PASS ‫الخماد الحريق‬
Pull, Aim, Squeeze, Sweep
D. Evacuation
• Education of all staff at least once annually
• Either partial or total evacuation
• Evacuation priorities eg. independent patients prior to dependent
ones, unventilated babies before the ventilated ones
 What?

‫تجارب المحاكاة للحريق‬

Fire Drill Why?

How?

What?
A method of practicing how a building should be evacuated in the
event of fire or other emergencies.
Why?
1. Staff members know how to act rapidly, safely & in an ordered
manner in case of fire.
2. Increase self confidence in performing responsibilities in the event
of fire.
How?
1) An emergency evacuation plan
2) Explain to each person what should he do
3) List of all emergency exits
4) How long does it take to evacuate the place
5) Evaluate
6) +/- Corrective actions
Important Note
EFS.05 NSR.22
Fire drills are performed in different clinical and non-clinical areas,
including at least one unannounced drill annually
 2.Hazmat Safety
NSR.23

• WHO categorized Hazmats and Wastes into:

1) Infectious
2) Pathological or Anatomical
3) Pharmaceutical
4) Chemical
5) Heavy metals
6) Pressurized containers
7) Sharps
8) Genotoxic
9) Radioactive
Hazmat Plan:

 Labelling of hazmat
 MSDS ( physical data/type of hazmat / safe storage/handling/spill management /
first aid measures/disposal)
 Segregation of all categories of hazmat
 Available PPE & spill kits
 Compliance with laws and regulations, availability of licenses and/or permits
 Staff training and orientation
 Evaluate and update the plan annually
 3.Safety Plan
NSR.24
- Aim of plan: To provide a safe environment for patients, staff & visitors.

- First: Identifying Hazards in the hospital according to OSHA classifications:

1) Physical (radiation, electricity, noise)
2) Chemical (anesthetic gases, chemotherapy)
3) Mechanical (ergonomics)
4) Biological (HIV,HCV, HBV)
5) Psychological (fatigue, stress)

- Second: High-risk areas:

1) Lab 2) Radiology
3) Chemical stores 4) Laundry
5) Kitchen 6) Workshops
• Lab: PPE, Biosafety cabinets

• Radiology: - Lead apron

- Neck shield
- Gonadal Shield
- Measure radiation dose
- CBC/6 months
• Chemical Stores:
- Proper labelling and storage - MSDS
- Eye washer - Decontamination shower
- Ventilation systems(toxic fumes) - PPE
- Spill kits - Regular audits&
inspections
- Authorized access - Waste management
Important note
For safe storage:
• 40 cm from ceiling under smoke detector
• 15 - 30 cm from the floor
• Nothing is directly located on the floor
• Temp. < 25°C (medications, food)
• Humidity 30-60%.
Decontamination Shower Eye Washer
 4.Security
- Effective security in hospitals is essential for maintaining a safe environment, So
healthcare providers can focus on patient care without added concern of safety risks.

- Violence, aggression, thefts, harassment, suicide, bomb threat, terrorism, gunshot

and child abduction are common.

- Patients’ belongings.

- Information security.
 Key Components
1) Access control:
Use ID badges, key cards & security personnel
2) Surveillance systems:
CCTV cameras
3) Emergency Response Plans:
e.g. code pink
4) Security personnel:
Employ trained security persons, to respond to any
aggressive or violent behavior
5) Cyber Security Measures:
To protect patient data and the hospital operational systems
from cyber threats
6) Environmental Design
 Restricted areas include:
OR
 ICU
 Server
File room
Roof
Electro-mechanical room
 Vulnerable groups (by GAHAR & JCI)
 Elderly
 Infants
 Those with mental disorders
Handicapped
Special care + more supervision
 5.Safe Medical Equipment
NSR.27

Is critical to diagnosis & treatment of patients.

Key considerations:
1. Develop criteria for selecting new medical equipment.
2. Inspection & testing of newly procured medical equipment.
3. Training of staff on safe usage by a qualified person.
4. Inventory of all equipment, especially critical equipment
5. PPM according to manufacturer's recommendations (PPM : corrective
maintenance is 6:1)
6. Tagging Systems For PPM dates or malfunctioned equipment.
7. Calibration of equipment.
8. Sterilization & infection control
Equipment that comes into contact with patients is cleaned according to
strict protocols, to prevent infection transmission
9. Risk management & reporting Systems
For equipment failure or adverse events to prevent future incidents.
10. Quality assurance & post market surveillance.
By manufacturer (monitors his product, update equipment as necessary).
11. Back up systems
To ensure functionality during power outages or other emergencies.
6) Utility Management(Non Medical Equipment)
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- Utility systems are crucial for day to day functioning of a healthcare facility

- Includes: Electrical power, water supply, gas systems, HVAC and waste disposals
1) Reliable Power Supply
Stable + Back up generators (UPS)
2) Water Quality and Supply
Regular testing for contaminants and proper water pressure & temperature
(GAHAR : cleaning & disinfection of water tanks + sampling at least quarterly)
3) Medical Gas Safety
Proper storage & handling to prevent leaks
4) HVAC
For appropriate temperature, humidity & air quality
5) Waste Management
Proper disposal to prevent infections & environmental contamination

6) Training & Education of all staff

7) Utility Mapping
For easy access to each system for routine
inspection/ emergency/construction or
renovation
 7) Disaster Preparedness
- Is a crucial aspect of H.C. management ,enabling facilities to respond to & recover
from various emergencies, e.g. natural disasters, pandemics or mass casualty events
1) Risk assessment of potential emergencies
HVA ( Hazard Vulnerability Assessment tool)

2) Degree of preparedness is acc.to level of risk

3) Communication Strategies: - Internal

-External ( civil defense – ambulance center-police)
4) Clear duties & responsibilities
5) Identify required resources ( medical & non-medical)
6) Business Continuity: - Triage(for prioritization)
- Alternative care sites
- Back-up utilities
7) ICS team ( Incident Command Staff)
updated with information

8) Drill schedule for emergencies at least

annually +/- corrective actions

9) Debriefing:
Counselling sessions made for all staff