UNIVERSITYHOSPITAL

UNIT-SPECIFIC DISASTER PLAN

FOR

(Unit) – (Date)

I.INTRODUCTION

This plan provides a system to identify what actions will be taken in the event of an internal or external disaster for the above-mentioned unit at UniversityHospital. This plan works in conjunction with the Emergency Operations Plan and the University Hospital Fire Safety and Emergency Evacuation Plan.

In the event of an actual disaster situation on this unit or affecting this unit, the Unit-specific Disaster Plan and the Hospital's Emergency Operations Plan will be activated. While the Unit-specific Disaster Plan addresses what action would be taken by the staff on this unit, the Emergency Operations Plan addresses the action that would be taken hospital-wide during an internal or external disaster situation.

II.PURPOSE

This plan promotes a safe environment for our patients, staff, visitors and the community in the event of an internal or external event and exists to identify unit-specific evacuation and disaster features.

III.ACCOUNTABILITY

The Vice President and Chief Executive Officer has ultimate responsibility for ensuring compliance with this plan. The Vice Presidents have delegated implementation of this responsibility to the Executive Directors and Directors who in turn have delegated to the Nurse Managers.

IV.ROLES AND RESPONSIBILITIES

  1. NURSE MANAGER (OR DESIGNEE) will:
  1. Assist in the coordination of all activities.
  2. Ensure that this plan is reviewed at least annually.
  3. Ensure that all staff under their supervision receives annual training on the Hospital's Emergency Operations Plan and the unit-specific disaster plan and that this training is documented.
  4. Account for all staff and patients under their supervision. Whenever a patient is transferred the following items will accompany the patient: chart, addressograph plate, kardex, medex, medications, and all personal effects.

Cheryl Getkin, HEM

Revised 8/2002

B.NURSING STAFF will:

1.Be responsible for familiarization with and complying with the requirements in the Hospital Emergency Operations Plan and their unit-specific disaster plan.

2.Assist with evacuation and other disaster procedures as necessary.

V.PROCEDURES

A.EVACUATION: In the event of an evacuation, all staff and patients will be accounted for. The following exit route(s) and designated relocation area will be used as necessary:

Horizontal Evacuation relocation area: Vertical Evacuation relocation area:

Primary Exit Route:

Secondary Exit Route:

Unit relocation area:

**In the event of a complete hospital evacuation, the designated meeting place is the DOC circle. The alternate meeting place is the open area by the George F. Smith library.

B.MEDICAL GASES: Medical gases will only be turned off after approval and direction from the Department/Nurse Manager (designee) or the Fire Department.

MEDICAL GAS / Location of Emergency Shut- off Valve / Patient Rooms that are tied into emergency shut-off valve

C.FIRE ALARM PULL BOX STATIONS: The nearest fire alarm pull box station will be activated when a fire is suspected or confirmed and any time that evacuation is deemed necessary. The following are the nearest fire alarm pull box stations:

Location:

Location:

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D.FIRE EXTINGUISHER: Staff will use a fire extinguisher only if they are trained and confident about using one. The following are the nearest fire extinguishers:

Primary: Type

Secondary: Type

  1. NURSING STATION FIRE ANNUNCIATOR PANEL: These fire panels will beep and flash whenever there is an alarm in the hospital and will display the general location of the alarm. If the alarm is on your unit, the fire panel will display 1) the type of alarm, and 2) the exact location of the alarm.

Location(s):

F.HAZARDOUS EQUIPMENT AND/OR MATERIALS

MATERIAL / LOCATION / SPECIAL INSTRUCTIONS

G.PHYSICALLY CHALLENGED STAFF

Name(s):

Response Buddy:

  1. EMERGENCY ELECTRICAL OUTLETS: Identified by a red cover plate marked “emergency”.

Location(s):

I.TELEPHONE TREE

Location:

Note: The telephone tree will be activated by (include title here). Once activated, staff will report to (include location here).

J.SUPPLIES

Flashlight and extension cords: Call Physical Plant at ext. 5400.

Other supplies: Contact Command Post at 2-5800/5801.

  1. OTHERinformation specific to the unit:

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Date Plan developed:

Date reviewed:

Reviewed by:

Title:

Signatures:

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