Biomedical Engineering Reference
In-Depth Information
The Agency for Healthcare Research and
Quality (AHRQ) has produced numerous useful
references and guidelines for hospital prepared-
ness [38A], including models for decontamina-
tion, PPE, and isolation and quarantine [38B],
and California's Emergency Medical Services
Authority has updated their Patient Decontam-
ination Recommendations for Hospitals [38C].
These and similar references represent substantial
resources in planning an training for single-patient
and mass decontamination.
et al. [39] effectively summarized healthcare-
specific needs and goals for decontamination
training that incorporate recent OSHA interpre-
tations [40-43].
•
Let clinicians be clinicians
: There are a few
positions within a HEICS organization that
should be filled by physicians, but in general
the most important function for physicians in a
disaster is that of a clinician. As many hospi-
tals contract with physician groups, particularly
for ED coverage, ensuring training is difficult.
Therefore, hospitals should include select staff
physicians in HEICS and other disaster training
and provide brief orientations to the bulk of
physicians, so that they understand the roles,
responsibilities, and function of the emergency
organization.
1.15 Staff Training
Hospital training staff tend to be overloaded with a
wide variety of responsibilities, including clinical
competencies, continuing education, community
education, and non-clinical staff training. Most
hospital staff have little expertise in developing
and providing training for disaster procedures,
particularly patient and facility decontamination.
Although “train-the-trainer” classes are popular
and readily available, newly minted trainers
commonly find themselves with few resources and
little or no experience, with a resultant dearth of
cascaded training. The following steps can help
compensate:
Move some training to the schools
: New guide-
lines from the Association of American Medical
Colleges [44] suggest a
curriculum
for future
physicians in medical schools. Several nursing
schools have been offering disaster courses for
a year or more.
•
1.16 Staff Protection
No emergency plan can be implemented without
staff. The most important provision for staff protec-
tion is irrespective of specific issues, procedures,
or equipment.
Staff protection must be an exec-
utive priority, and it must be communicated as
such
. To enable operations to continue under emer-
gency conditions, staff protection measures must
be designed with the intent of demonstrating an
institutional commitment to employee safety. This
is as much an exercise in trust as in deed; facilities
with strained labor-management relations will face
greater difficulty in this pursuit than those with
smooth partnerships.
An effective training program requires
executive support
: A directive, backed up by
appropriate resource allocation, is the basis on
which a successful program progresses.
•
Contract for specialized training
: Rather than
attempting to develop and maintain such
expertise, hospitals, hospital groups, or—even
better—communities should strongly consider
contracting for expertise. As with any contract
service, it is essential to select reputable,
competent providers. Contracts should include
follow-up services (refresher training and assis-
tance with exercise development as needed) and
provide the option of developing internal capa-
bility for conducting informal training and drills
within individual units. This approach requires
the same degree of executive commitment as
internally derived training, particularly with
respect to initial and recurring expenses. Hick
•
•
PPE must meet realistic needs
: There is
no consistent standard for PPE for incidents
involving hazmat or weapons of mass destruc-
tion. These incidents would send potentially
contaminated patients to hospitals. Personal
protection standards defined by OSHA [45] and
the National Fire Protection Association [46]
