5-Diamond Patient
Safety Program
Emergency Preparedness
Everything you need to complete this module is right here! Click on the links below to access the necessary tools and resources available for completion of this module.
OBJECTIVE: |
To increase facility staff's and patients' awareness and knowledge of emergency planning, response, and recovery.
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ACTIVITIES REQUIRED FOR DIAMOND STATUS: |
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Complete and in-service training module (PowerPoint Presentation) on emergency preparedness.
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Complete Patient Emergency Planning Needs Assessment with patients.
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Submit Disaster Contact information to Network.
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OPTIONAL ACTIVITIES: |
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Perform internal disaster drills involving facility personnel AND patients (with pre-drill education and post-drill evaluation)
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Complete a "Hazard Assessment"
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Develop Emergency Management Plan for your facility
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Develop a Facility Emergency Box and Patient Emergency Kit, the latter of which would be displayed in the waiting area for patients to view
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Create a maze of the building and have patients find their way to the nearest fire extinguisher and emergency exit
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Distribute word search to patients
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Furnish all patients with an Emergency Data Set and Emergency Diet instructions
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TOOLS/
RESOURCES: |
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In-Service Training Module:
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Emergency Preparedness for Dialysis Facilities
- Hazard Assessment Form
- Drill Critique Form
- Drill Attendance Record
- Emergency Response Checklist
- Physical Site Damage Assessment Form
- Equipment Damage Assessment Form
- Supply Checklist for Dialysis Treatment
- Home Emergency Equipment & Supplies
- Emergency Evacuation Kit for Dialysis Facilities
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Emergency Preparedness: A Guide for People on Dialysis (Spanish)
- Medical History and Medication List
- Making Alternate Arrangements for Treatment
- Emergency Kit (supplies, meds/medical supplies, food)
- Emergency Diet
- How to Disinfect Water
- Getting off the Dialysis Machine
- Resource List
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MEASURE(S): |
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100% of staff participate in in-service on emergency preparedness and at a minimum, hold biennial staff in-servicing on emergency preparedness.
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90% of patients complete a Patient Emergency Planning Needs Assessment Questionnaire with the assistance of facility staff.
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Facility must submit its Disaster Contact information to the Network.
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Printer-friendly version of the Module Requirements List.
After you have completed the Emergency Preparedness module and have documented the required measures, please complete and submit to the Network Office:
- Completed Project Reporting Form
- In-service attendance log
- Completed Patient Emergency Planning Needs Assessment Questionnaires
- The names of two (2) facility personnel serving as Primary and Secondary Disaster Contacts, along with two (2) non-facility phone numbers for each contact
If you have any questions or need assistance, please contact Heather Cecil, at hcecil@nw5.esrd.net or by fax at 804.794.3793.
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