CNA - Prevention and Management of Catastrophe and Unusual Occurrences

Emergency and Safety in Healthcare

Risks to Healthcare Workers

• Healthcare workers face risks:

  • Moving and transferring residents.

  • Stress of the healthcare environment.

  • Exposure to pathogens.

  • Exposure to chemicals.

  • Natural and human-made disasters.

• To ensure safety:

  • Stay calm.

  • Follow facility policies.

  • Maintain strong communication with residents and coworkers.

General Safety Rules

• Long-term care (LTC) facilities must have:

  • Fire safety plans: fire doors, working sprinklers, alarm systems, and evacuation plans.

  • Emergency power plans, often using backup generators.

  • Failure to have emergency plans can result in severe penalties.

Physical Environment Requirements

• LTC facilities must have:

  • At least one fully equipped common room for dining and activities.

  • Handrails on both sides of hallways.

  • Constant, safe water supply.

  • Pest-control system.

  • Ventilation system via windows, A/C, or both.

Exposure to Bloodborne Pathogens and Chemicals

• Bloodborne pathogens include:

  • Blood

  • Vomit

  • Saliva

  • Urine and feces

  • Vaginal secretions

  • Wound drainage

• Protection measures:

  • Follow standard precautions.

  • Use appropriate PPE (Personal Protective Equipment).

  • Receive vaccinations.

  • Ensure needles are placed in sharps containers promptly.

  • Obey facility policies if exposure occurs.

• If exposure occurs:

  • Immediately wash the area with soap and water.

  • Flush mouth, nose, or eyes with water if involved.

  • Report the event to supervisor.

  • Obtain medical evaluation promptly.

  • Follow facility protocol regarding documentation.

  • Obtain an HIV test if exposure is due to needlestick injury.

• If a chemical exposure occurs:

  • Alert supervising nurse immediately.

  • Nurse will follow procedures listed in SDS or directives from poison control center.

  • Nurse may transport the person exposed to hospital for advanced care.

  • If resident is exposed, do not leave them alone until directed by the nurse.

Safety Data Sheets (SDSs)

• SDSs provide detailed information on chemicals used in the facility, including:

  • First aid measures for exposure.

  • Instructions on how to use, store, and dispose of the product.

  • SDSs must be up-to-date and accessible to staff.

Latex Allergies

• Allergic Contact Dermatitis:

  • Usually seen 6 to 8 hours after contact with latex.

  • Symptoms may include redness, itching, blisters, and oozing.

  • May lead to secondary infections.

• Immediate Hypersensitivity Reaction:

  • Occurs immediately after exposure.

  • May be life-threatening.

  • Symptoms include hives, shortness of breath, and wheezing.

Workplace Violence

• Risks:

  • Working with volatile or unstable people.

  • Contact with the public.

  • Late night and early morning shifts.

  • Working in community-based settings.

• Prevention:

  • Remaining alert to potentially dangerous situations.

  • Safety devices such as locked doors.

  • Good lighting in facility and parking lots.

  • Employee assistance plans (EAPs).

  • Therapeutic communication.

• How to handle workplace violence:

  • Remain calm and use therapeutic communication.

  • Allow one person to speak at a time.

  • Acknowledge feelings.

  • Avoid personal attacks.

  • Stick to the facts.

  • Ask the person to leave or remove yourself from abusive situations.

  • Always ensure safety of resident and self.

  • Call authorities if you feel threatened.

Fire Safety

• Safeguards to prevent fire spread:

  • Metal fire doors separating units.

  • Sprinkler systems.

  • Pull-down fire alarms.

  • Wall-mounted fire extinguishers.

  • Alarms coordinated with fire department.

• Duties during a fire:

  • Rescue residents.

  • Activate the alarm.

  • Confine the fire.

  • Extinguish or evacuate.

• Using a fire extinguisher (P.A.S.S.):

  • Pull the pin.

  • Aim at the base of the fire.

  • Squeeze the handle.

  • Sweep at the base of the fire.

Natural Disasters

• Evacuation plans include:

  • Where to evacuate.

  • How to give continuous care without error.

  • How to transport wheelchair- or bed-bound residents.

  • How to maintain communication among residents, family members, and receiving facility.

• Nursing assistant responsibilities:

  • Accompany residents.

  • Have a backup plan for you and your family.

  • Additional caregiving duties may be necessary.

  • Remain at your post.

Bomb Threats

• When receiving a bomb threat:

  • Keep caller on the phone as long as possible.

  • Gather information regarding the bomb.

  • Note background noise.

  • Identify caller characteristics.

  • Write down clues.

  • Immediately report threat to the supervising nurse.

Roles and Procedures for CNAs

• The nursing assistant must:

  • Follow the chain of command.

  • Complete delegated tasks in a timely manner.

  • Obtain clear instructions.

  • Maintain strong communication with coworkers.

Individual Room Requirements

• Requirements include:

  • No more than four people in a room.

  • At least one window to the outside.

  • Minimum of 100 square feet for individual rooms.

  • Floor at or above grade level.

  • Accessible closet with shelves and clothing racks.

  • Direct access to exit corridor.

  • Functioning call-light system.

  • Access to toileting facilities.

  • Equipped with items needed for resident care.

  • Full visual privacy.

  • Call-light button for each resident.

  • At least 80 square feet for each resident in shared rooms.

  • Ceiling-suspended privacy curtains in shared rooms.

Noise Control

• The nursing assistant should:

  • Encourage visitors to use common rooms or private areas.

  • Limit loud noise during activities and sleeping hours.

  • Anticipate resident needs.

  • Manage resident behavior with redirection or 1:1 interaction.

  • Engage disruptive residents in quiet activities.

  • Use overhead paging only when necessary.

  • Tend to sounding alarms promptly.

Odor Control and Cleanliness

• The nursing assistant should:

  • Toilet or tend to incontinent residents at least every 2 hours.

  • Immediately remove used incontinence products from the room.

  • Empty and clean commodes promptly.

  • Ensure toilets are clean and flushed.

  • Change soiled clothing and linens promptly.

  • Empty soiled linen hampers and garbage cans when ¾ full.

  • Remember that a clean environment is everyone’s responsibility!