Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
ENSURING QUALITY CARE
SAFETY IN THE HOME ENVIRONMENT
Safety in the home environment
Fire Safety
Emergency preparedness
September 2019 Safety, Oversight and Quality Unit 2
SAFETY IN THE HOME ENVIRONMENT
September 2019 Safety, Oversight and Quality Unit 3
PURPOSE AND KEY TERMS
• Accommodations• Barrier-Free• Privacy• Social Needs
The purpose of this section is to assist the learner in acquiring basic knowledge on how to create a safe home environment while maximizing the resident’s independence and helping them maintain dignity.
September 2019 Safety, Oversight and Quality Unit 4
OBJECTIVES
The learner will be able to: Describe what makes a home safe and barrier-freeIdentify 12 areas of your home that must be evaluated to assure the home is
safe and accessibleDescribe the different types of special needs that require additional
consideration.Explain the importance of providing residents privacy and areas to socialize
September 2019 Safety, Oversight and Quality Unit 5
INTRODUCTION
Creating a homelike atmosphere means providing a:• Safe, secure and comfortable physical, emotional and social environment• Barrier-free home to allow residents to function at their highest levels of
independence
This section outlines basic safety and home comfort issues and specials needs:
• Carefully read the “Facility Standards” section of the administrative rules, which defines minimum safety standards for all AFHs. OAR 411-050-0650
September 2019 Safety, Oversight and Quality Unit 6
DOORS, CLOSETS AND CABINETS
Make sure all exterior and interior locks and handles work properly. Lever-type door handles are easier to use.Doors are balanced and easy to open/close.All sliding/bi-fold doors move easily and stay on their tracks.
• To reduce the risk of accidentally walking into them, large glass doors and windows should be easy to see. Decals at sight level or tinting may be helpful.
Cupboards doors open easily and stay closed to reduce the change of bumping into them and causing head or other injury.
September 2019 Safety, Oversight and Quality Unit 7
ELECTRICAL
Keep electrical cords in good condition, and out of the flow of traffic. Place them against walls to prevent people from tripping over them.Do not place cords under rugs or carpeting.Extension cords cannot be used in place of permanent wiring. If you must use an extension cord, use a power strip with a built-in circuit breaker.
September 2019 Safety, Oversight and Quality Unit 8
ELECTRICAL CONTINUED
Assist residents in safe use of electrical appliances and other items.• Some electric blankets should not be tucked in or covered while in use• Residents may have decreased ability to feel the heat and could be unaware a
heating pad is too hot• Heating pads should be turned off or removed before going to bed (to sleep) -
check manufacturer’s instructions
September 2019 Safety, Oversight and Quality Unit 9
HEATINGOAR specifies minimum high and low temperatures:
Maintain a comfortable temperature for residents. This may be a challenge since a temperature that is comfortable for you some residents may not be for others or for you. Adjust the temperature so it seems comfortable for most residents.Encourage others to wear appropriate clothing for keeping warm (or cool), e.g.; sweaters, warm socks and slacks if temperatures are cool.
September 2019 Safety, Oversight and Quality Unit 10
HEATING CONTINUED
Provide individual temperature controls or heating units in residents’ rooms, if possible. Make sure they are installed properly and meet all building and safety codes.Wall/space heaters must be kept away from flammable items such as bedding or curtains.Wood stoves must be properly installed and meet all local fire and safety codes.
• A barrier 36 inches from the stove is required if any residents are confused or have ambulation problems.
September 2019 Safety, Oversight and Quality Unit 11
HOME DECOR
Use a variety of cheerful, yet restful, contrasting colors when decorating.Break up an all-white wall by hanging pictures or wall hangings. Too much white reflects light and causes glare.Avoid a “one-color” décor, which makes it difficult for older people to distinguish objects/surfaces. Pastels tend to fade into each other and dark colors create shadows.
September 2019 Safety, Oversight and Quality Unit 12
HOME FURNISHINGS
The type of furniture and the arrangement of the furniture needs to be comfortable and ensure placement does not create a fall risk.Arrange furniture throughout the home to allow plenty of space for using and turning a wheelchair, or using a walker or cane, so residents can move through the home without bumping or tripping over obstacles.There must be enough furniture in common areas to accommodate the recreational and social needs of all household members at one time.
September 2019 Safety, Oversight and Quality Unit 13
HOME FURNISHINGS CONTINUED
Provide sturdy, firm and stable furniture that is a comfortable height and not likely to tip or move if used for support.Chairs without arms are difficult for residents to use.Overstuffed furniture maybe too low or soft to get out of without help. Provide chairs and couches with firm cushions and stable legs; these items should not have casters.
September 2019 Safety, Oversight and Quality Unit 14
HOME FURNISHINGS CONTINUED
If a resident has difficulty getting up from a chair, raise the seat height to 18 to 20 inches by firmly attaching blocks to each leg.
• Adding more cushions sometimes helps.
Ask a physician for a referral to PT/OT if an individual is having difficulty getting up from the bed or chair. They can evaluate the resident and your home to make suggestions.Tables should be at least 30 inches high for residents in wheelchairs.
September 2019 Safety, Oversight and Quality Unit 15
LIGHTING
Proper lighting is essential for residents to be able to see well and reduce accidents:
• Provide adequate, non-glare, even lighting throughout the home. • Older people need more light due to normal vision changes, but it is
important to increase lighting without creating more glare.
Reduce glare. Use frosted bulbs, indirect lighting, and shades or globes on light fixtures. Use window coverings that can be adjusted to reduce the sun’s glare.
September 2019 Safety, Oversight and Quality Unit 16
LIGHTING CONTINUED
Avoid shiny plastic furniture or slipcovers, glass-top tables or highly polished flooring.Provide lamps that can be adjusted to focus upon a resident’s task. Take into consideration individual resident’s visual impairments.Use the correct wattage and type of light bulb indicated on the lamp or fixture. If you are not sure about the correct wattage, use a bulb no more than 60 watts.
September 2019 Safety, Oversight and Quality Unit 17
RUGS
Rugs and other floor coverings must not create a tripping or fall risk: • Secure all rugs and other floor coverings. They should lie flat and not be
slippery. • Walkers and canes can catch on the edge of rugs, increasing the chance of a
fall.
Avoid using scatter rugs and runners. • If you do use scatter rugs or runners, they should have a slip resistant backing
or be made slip resistant with double-sided carpet tape or rubber matting. Check regularly to see if backing needs to be replaced.
September 2019 Safety, Oversight and Quality Unit 18
BATHROOMSInstall secure grab bars for toilets, tubs and showers for residents’ safety:
• Bars should be at least one inch in diameter and be attached to structural supports (studs) in the wall.
• Bars mounted only to the wall surface do not provide secure support.
• Bars designed to attach to the side of the bathtub are acceptable if they meet the needs of the residents.
September 2019 Safety, Oversight and Quality Unit 19
BATHROOMS CONTINUED
Make sure all bathroom fixtures such as sinks, toilets towel bars and shower rods are in good repair and properly installed.
Bathroom fixtures are not designed to provide support; however, residents may use them to support themselves. Consider reinforcement or providing other fixtures to provide support.
Standard bathroom fixtures are not designed to provide support.Equip all bathtubs and showers with nonskid mats, abrasive strips or appliques. Glass shower doors must be made of tempered safety glass.
September 2019 Safety, Oversight and Quality Unit 20
BATHROOMS CONTINUED
Mirrors should not be chipped or cracked.Be sure water faucets work well and adjust easily. Single handle, lever-type faucets are easier for weak or arthritic hands to operate.Provide a bench/seat for use in the tube or shower. It should have removable legs/back and nonskid feet. A transfer bench allows a person to sit down outside the tub (or shower) and then move across into it.
September 2019 Safety, Oversight and Quality Unit 21
BATHROOMS CONTINUED
Equip all bathtubs and showers with hand-held showerheads.• Should be lightweight, easy to grasp and hold, and have a
control to turn water flow on and off.• A hand-held shower can make bathing easier and help
residents maintain independence and dignity.Place toilet paper dispenser within easy reach. A person should not need to twist, reach back, lean over or stretch too far to get the toilet paper.
September 2019 Safety, Oversight and Quality Unit 22
BATHROOMS CONTINUED
Provide a raised toilet seat and support for residents who use a wheelchair or who have difficulty sitting or standing to use a toilet of normal height (16 inches). In the example here:
• The seat is molded plastic and four inches high.• The front legs stand on the floor, and the height can be
adjusted to provide support and assistance for residents.
September 2019 Safety, Oversight and Quality Unit 23
IS THE HOT TAP WATER TOO HOT?
Older people are susceptible to hot water burns and they may not react quickly enough to prevent burns. To prevent scalds and burns:
• Run the hot tap water between three and five minutes; then use a candy, meat or water thermometer to measure the temperature. If the temperature is over 125 F, the water heater is set too high.
• For information on how to safely adjust your water heater, call your local utility representative.
September 2019 Safety, Oversight and Quality Unit 24
SEVERE BURNS
Water Temperature (F) Amount of Time to Sustain Burn
156 Degrees 1 Second
149 Degrees 2 Seconds
140 Degrees 5 Seconds
133 Degrees 15 Seconds
127 Degrees 60 Seconds
124 Degrees 3 Minutes
September 2019 Safety, Oversight and Quality Unit 25
ENTRYWAYS, HALLWAYS AND STAIRS
Keep entryways, hallways and stairs clear of objects that could cause falls or block passages.
• These areas and windows used as emergency exits must remain unobstructed at all times.
• Clearly mark exits.
Install fixtures to provide light for the entire length of the hallway.
September 2019 Safety, Oversight and Quality Unit 26
ENTRYWAYS, HALLWAYS AND STAIRS CONTINUED
Adapt entryways so they are accessible for the residents who use canes, walkers or wheelchairs.
• Doorways must be large enough to accommodate mobility equipment used by residents
• Ramps must meet all ADA requirements• The incline of ramps should not exceed one inch-per-foot in length• Ramps must have a non-skid surface
Place light switches at both the top and bottom of inside stairs and at both ends of a long hallway.
September 2019 Safety, Oversight and Quality Unit 27
ENTRYWAYS, HALLWAYS AND STAIRS CONTINUED
Install handrails on both sides of all steps, stairways and ramps, inside and outside.
• Make sure they extend the full length of the flight of stairs• Use smooth, round railings at least one and one-half inches in diameter• Attach them so they are strong and sturdy and may be used for support• Stairways must be unobstructed and appropriate for the needs of the
residents
September 2019 Safety, Oversight and Quality Unit 28
ENTRYWAYS, HALLWAYS AND STAIRS CONTINUED
Make sure stairs provide secure footing.• Repair or replace broken steps, worn treads or loose carpeting• For better visibility, make edges of each step a contrasting color, and make the
top and bottom steps a different color than the floor• Provide light so that each step, particularly the step edges, can be clearly seen • Provide lighting that does not produce glare or shadows - use non-glare
fixture covers and the maximum wattage recommended for the light fixture; there should be no bare bulbs
• Any incandescent lightbulbs must be protected with appropriate light covers
September 2019 Safety, Oversight and Quality Unit 29
KITCHEN
The kitchen must be in good working condition and free from unnecessary clutter:
• Provide water faucets that work well and adjust easily• Provide adequate cupboard space so food, dishes, utensils and other items
can be stored out of the way, rather than stacked on countertops or the floor• Store items to reduce the risk of objects falling or dropping when being taken
off the shelf - for example, put lighter weight items (e.g. cereal boxes) on the higher shelves
September 2019 Safety, Oversight and Quality Unit 30
KITCHEN CONTINUED
If possible, use a stove with controls at the front so you and others won’t have to stretch across burners to reach controls. Provide adequate ventilation to remove humidity and cooking odors.Have locked storage areas available in your home.
• Residents experiencing confusion may rummage in drawers or cupboards, and it may be necessary to lock up knives or other sharp objects
September 2019 Safety, Oversight and Quality Unit 31
KITCHEN CONTINUED
Store cleaning supplies and chemicals in a place not accessible to residents and away from food storage and preparation areas. Keep these supplies in their original containers, or carefully label the containers’ contents.
September 2019 Safety, Oversight and Quality Unit 32
ALERTUse of infant/child safety devices may be an effective solution for:
• Securing drawers or cabinets• Covering stove knobs• Locking the oven• Creating soft corners with bumpers• Strapping furniture to walls• Winding-up cords for window
coverings
Child safety devices are not acceptable for locking medications.
Safety, Oversight and Quality Unit September 2019 33
RESIDENT ROOMS
Personalized space for residents can make your house feel more like a home to residents. Having familiar objects visible or easily accessible can give great comfort and pleasure to residents who feel they have lost so much by the time they come to live in your home.
• Your home must be furnished with an appropriate bed and dresser and have individual closet space for each resident.
• Some residents may want to bring their own furniture, however you cannot require that they do so.
• Each bedroom must have closet space for the resident.
September 2019 Safety, Oversight and Quality Unit 34
RESIDENT ROOMS CONTINUED
Provide residents with adequate space to store and display personal items.
• Locate and arrange storage spaces so residents do not need to stoop, reach or stand on something to get things from cupboards, shelves or closets
Adjust the height of the bed so a resident’s feet touch the floor when sitting on the edge.
• This height enables the resident to get out of bed easier and helps prevent falls and other accidents
September 2019 Safety, Oversight and Quality Unit 35
RESIDENT ROOMS CONTINUED
Arrange the room so a lamp or light switch is within reach of each bed.Provide night-lights in each room so residents can see to use the bathroom at night.
• Research shows that orange to red hues do not interfere with sleep – avoid using lights with blue hues
Encourage/assist residents to arrange furniture to permit maximum mobility and ensure the door and windows are barrier-free.
Seating should be available for visitors and residents
September 2019 Safety, Oversight and Quality Unit 36
RESIDENT ROOMS CONTINUED
Arrange beds at least 18 inches from walls and with at least 36 inches between beds to ease bed-making and caregiving.
• Allow at least 48 inches on one side of the bed if a resident uses a wheelchair
September 2019 Safety, Oversight and Quality Unit 37
YARD/OUTSIDE AREA
Outside areas, including the landscape, must be free of clutter and debris and provide a safe environment for residents.
• It is important to provide flat and even walkways, driveways and yard areas• Trim shrubs and bushes in front of windows to allow a clear line of vision to
the outside• Trim shrubbery near doors and under windows used as emergency exits• Provide areas where residents can sit and visit that offer shade and protection
from the sun and mild rain
September 2019 Safety, Oversight and Quality Unit 38
YARD/OUTSIDE AREA CONTINUED
Locate outside lighting so sidewalks and entrances are well-lit. Install sturdy fencing around the yard to provide security for residents who wander. Make sure gates can be locked.Arrange for a well-lit parking area close to the entry.
September 2019 Safety, Oversight and Quality Unit 39
YARD/OUTSIDE AREA CONTINUED
Provide adequate drainage so sidewalks and other walkways are not slippery when wet.Store chemicals (e.g.; pesticides, paint thinner) safely in a locked storage area. Keep them in their original containers, or carefully labeled storage containers that have been manufactured for the storage of chemicals.
September 2019 Safety, Oversight and Quality Unit 40
SPECIAL NEEDS
The preceding discussion focused on making your home safe and comfortable for all residents. The following discussion will your respond to residents with special needs.
September 2019 Safety, Oversight and Quality Unit 41
BLIND, LOW VISION, VISION LOSS
It is important to:• Try to arrange the resident’s bedroom the same way it was at in the last
home.• When cleaning the room, replace items exactly where they were found.• Use “soft white” light bulbs, or “full spectrum” fluorescent lights, to reduce
glare.• Use color contrast to aid vision. E.g., paint walls and doorways different
colors; use dark switch plates on light colored walls.• Color-code faucet handles in the bathroom and kitchen (red for hot, blue for
cold).
September 2019 Safety, Oversight and Quality Unit 42
BLIND, LOW VISION, VISION LOSS CONTINUED
Use color-coded schemes to help residents identify their belongings and person items.
• Allow residents to pick their color preference. For example, if a resident chooses yellow, color-coded items could include yellow bedspread or pillow, dresser with yellow handles, closet with yellow door, and yellow towels.
• Use a different color for each resident.
September 2019 Safety, Oversight and Quality Unit 43
BLIND, LOW VISION, VISION LOSS CONTINUED
Avoid lighting that changes in intensity or makes patterns of light and dark on the floor.
• Carpeting with large patterns or obvious shading may cause problems.• A person with limited vision may mistake light/dark variations for obstacles or
steps that could lose balance or fall.
Avoid clutter and do not change the location of objects without letting the person know.
September 2019 Safety, Oversight and Quality Unit 44
BLIND, LOW VISION, VISION LOSS CONTINUED
Provide a telephone with jumbo-size push buttons or a dial with enlarged numbers.Provide a clock with large, black numbers and hands, and a calendar with large, black numbers. Place them in a location that is easy for residents to see.Provide reading material in large print:
• Make all notices and required posted materials easy to read
• Print them on light yellow or white paper;• Use large, black letters with a minimum 14
point font
September 2019 Safety, Oversight and Quality Unit 45
BLIND, LOW VISION, VISION LOSS CONTINUED
Make available large-print books and magazines or “talking” books:• Large-print items are available for purchase or from local libraries.• Books on tape and special tape player are available through the mail from the
state library in Salem.• Some playing cards and games (e.g., Monopoly and Scrabble) also are
available in large print.• The Oregon Commission for the Blind is a good resource to help you and/or a
resident.
September 2019 Safety, Oversight and Quality Unit 46
DEAF OR HARD OF HEARING
Being hard of hearing can interfere with quality of life and leave the resident feeling isolated. There are simple things that can you can do to assist them in your home:
• Provide amplification devices on telephones.• Provide a sitting/conversation area away from the high background noise
(e.g., television, dishwasher, air conditioner, laundry area)• Reduce background noises in your home as much as possible• Avoid using fluorescent lights that emit a buzzing sound• Be aware of any acoustical problems in your home and make adjustments if
possible
September 2019 Safety, Oversight and Quality Unit 47
DEAF OR HARD OF HEARING CONTINUED
Adjust the TV, stereo or radio to increase lower tones. Most stereos and many radios have adjustments for treble and bass.
Many people that are hard of hearing find lower tones easier to hear
Earphone units may be helpful for persons who need the volume louder than is comfortable for others.
• Purchase a TV set or add-on adaptor that allows viewing of closed-caption programs
• Use wireless headsets to avoid the use of long connection wires • Purchase a TV set or add on adaptor that allows viewing of closed-captioned
programs
September 2019 Safety, Oversight and Quality Unit 48
DEAF OR HARD OF HEARING CONTINUED
Install smoke alarms that emit sound and signal with flashing strobe light or vibrate the resident’s bed.
September 2019 Safety, Oversight and Quality Unit 49
AMULATORY NEEDS
Tripping hazards need to be identified for all residents, not just those that have ambulatory needsUse a commercial-type carpet or carpet with low pile or nap
• Wheelchairs are hard to use plush or soft carpets• A firm carpet is also desirable for persons who have difficulty walking on
uneven surfacesItems must be within reach:
• Place the telephone on a counter or table, rather then mounting it high on a wall
• Place a mirror in the person’s room at a level that be can be used from a wheelchair
September 2019 Safety, Oversight and Quality Unit 50
MEMORY CARE NEEDS
Caring for residents who have memory care needs can be challenging. Here are some recommendations on how you can ready your AFH for these residents. • Decorate a bulletin board for each season or holiday as reminder for
residents:• The date and special events could be added• Make the information large and easy to read
• Identify rooms by putting names or pictures on doors. Color-coding may help.
• Label or color-code closets and dressers in the room to help residents locate clothes and personal items.
September 2019 Safety, Oversight and Quality Unit 51
MEMORY CARE NEEDS CONTINUED
• Maintain a calm atmosphere in the home.• Playing soft, soothing music may be helpful• Be aware, however, that prolonged use of music can create agitation
• Install security alarms on all outside doors.• The alarms will alert you to a person going out (as well as coming in) and
thereby help you provide safety for residents who wander
• Fish tanks can provide a soothing experience and have been found to help reduce wandering behavior
• An alternative is a fish tank DVD such as “Marine Aquarium”
September 2019 Safety, Oversight and Quality Unit 52
MEMORY CARE NEEDS CONTINUED
• During normal awake times, the lighting in the AFH should be bright:• The level of brightness should be similar to that of a bright, sunny day• Appropriate use of bright lights during awake times helps to provide better
nighttime sleep
• There should also be a secured patio or outdoor area available so the resident can safely spend time outside.
September 2019 Safety, Oversight and Quality Unit 53
SOCIAL/PRIVACY NEEDS
Provide a place for socializing, visiting and special activities:• Special events that bring others into the home make life more interesting and
can help you and your residents feel a part of a larger community
Group furniture into seating arrangements that tend to increase communication:
• For example, placing chairs at right angles rather than side by side allows people to hear better and encourages visiting
September 2019 Safety, Oversight and Quality Unit 54
SOCIAL/PRIVACY NEEDS CONTINUED
Respect the residents’ need for privacy:• Be especially sensitive to the privacy needs of residents who share a room• Sometimes furniture can be arranged to meet privacy needs• All resident rooms must have a lock on the inside, released by a single action
September 2019 Safety, Oversight and Quality Unit 55
SOCIAL/PRIVACY NEEDS CONTINUED
The licensee must support the resident’s right to furnish and arrange their room as they like.The licensee must also ensure the home remains in compliance with fire and life safety requirements.The Residency Agreement may provide more specific policies that are consistent with rental agreements within your community.
• See the Department’s sample Residency Agreement
September 2019 Safety, Oversight and Quality Unit 56
EMERGENCY EVACUATIONS
September 2019 Safety, Oversight and Quality Unit 57
PURPOSE
The purpose of this section is to assist the learner in acquiring the knowledge on meeting fire safety requirements. Additionally, it is expected the AFH provider fully understands the details of fire safety as outlined the administrative rules.
• Code requirements• Construction• Evacuation drills• Flammable material • Fire evacuation plan• RACE
September 2019 Safety, Oversight and Quality Unit 58
OBJECTIVES
The learner will be able to:List the areas that must be evaluated when determining if the AFH meets fire
and safety requirementsList the components of a floor plan and develop a labeled floor plan for fire
evacuationState when the fire evacuation plan must be reviewed with residents and
frequency of fire drillsDescribe components of fire evacuation and develop written fire evacuation
procedures
September 2019 Safety, Oversight and Quality Unit 59
INTRODUCTION
Your AFH must meet fire safety requirements of:• Oregon Administrative Rules• All applicable state and local building, mechanical and housing codes for fire
and life safety. • County and city codes vary• If you have questions – talk with your licensor.
The following discussion will help you review and keep in mind basic fire safety as you manage your home on a daily basis.
September 2019 Safety, Oversight and Quality Unit 60
EMERGENCY EVACUATIONS
All caregivers must demonstrate the ability to evacuate:• Family members, other occupants and residents
• To the initial point of safety within three minutes• To the final point of safety within an additional two minutes• Refer to OAR 411-050-0725 for details.
Within 24 hours of employment in your home, all new caregivers must be shown how to respond to a smoke alarm and how to evacuate all occupants in an emergency.
September 2019 Safety, Oversight and Quality Unit 61
EMERGENCY EVACUATIONS CONTINUED
You must have a written emergency evacuation plan:• This plan and procedures must be reviewed regularly and updated as
situations change• All staff members must be trained on the emergency procedures to follow in
your home• See the specific requirements for your emergency evacuation plan in OAR
411-050-0725.
September 2019 Safety, Oversight and Quality Unit 62
EMERGENCY EVACUATIONS CONTINUED
Take into consideration that conditions in an actual emergency may be different than in a routine drill situation:
• Smoke or fire may be blocking principal exit routes• People may be asleep when the alarm is raised• Electric power may fail• Cell phones may not function
Appropriate first responses vary according to the situation. For example:
• If grease in a frying pan catches on fire while you are cooking, you should act immediately to extinguish the fire — Do not shout “fire,” which may panic residents.
September 2019 Safety, Oversight and Quality Unit 63
R.A.C.E.
Remember the four basic steps to follow in a fire emergency – RACE:• Rescue• Alarm• Confine• Extinguish
September 2019 Safety, Oversight and Quality Unit 64
R.A.C.E. CONTINUED
Step 1• Rescue residents and others
• Remove everyone from the immediate area of the fire • Assess the fire if possible• Call our for help if necessary
September 2019 Safety, Oversight and Quality Unit 65
R.A.C.E. CONTINUED
Step 2• Alarm initiation – call for assistance.
• Smoke alarms sound a local alarm; however, calling aloud provides for the immediate aid of any endangered person and confirms the alarm
• Call 9-1-1• Total evacuation of the home must be started at this time and
everyone must be evacuated to the final designated point of safety away from the structure
• A staff person should stay with the residents at the designated safe for their safety and to help avoid panic
• Upon arrival of the fire department, the senior fire authority will coordinate decisions for resident safety
September 2019 Safety, Oversight and Quality Unit 66
R.A.C.E. CONTINUED
Step 3• Confine the fire• Once the area is evacuated:
• Close doors to confine smoke, heat and toxic gases, and limit the spread of the fire
• Close all doors, if possible
September 2019 Safety, Oversight and Quality Unit 67
R.A.C.E. CONTINUED
Step 4• Extinguish the fire• Assess the fire
• Is it small enough for you to extinguish?• Do you know its source and how to extinguish that type of fire?• Try to extinguish the fire only if you are confident in your ability
to do so• Contact your local fire department to learn how to extinguish
small fires safely
September 2019 Safety, Oversight and Quality Unit 68
EMERGENCY PREPAREDNESS
September 2019 Safety, Oversight and Quality Unit 69
PURPOSE AND KEY TERMS
The purpose of this section is to assist the learner in acquiring basic knowledge on how to prepare for emergencies, medical emergencies or natural disasters.
• CPR• Disaster preparedness• Emergency procedure plan• Natural disasters• Power outage• Sheltering in place
September 2019 Safety, Oversight and Quality Unit 70
OBJECTIVES
The learner will be able to:Explain steps taken to create an emergency procedure planUnderstand there are different steps to take for different types of emergencyExplain why being prepared is importantDescribe what to do in the event of a power outageExplore the type of natural disasters likely to occur in your area and what type
of emergency procedure plan needs to be developed
September 2019 Safety, Oversight and Quality Unit 71
INTRODUCTION
Basic first aid and CPR training classes are required within the first year of being licensed as an AFH provider:
• CPR recertification classes must be taken annually.• Check with your local community college, fire department, hospital or
American Red Cross office.
Only classes taught by American Heart Association or American Red Cross certified instructors will be accepted.
September 2019 Safety, Oversight and Quality Unit 72
FIRST AID
First aid supplies and first aid manual must be available in your home:• Keep the kit and manual in a place that is easily accessible and labeled “First
Aid”• Routinely check the first aid kit to make sure everything is intact and in good
condition• Be sure residents do not have access to the kit
September 2019 Safety, Oversight and Quality Unit 73
FIRST AID CONTINUED
The American Red Cross recommends that a first aid kit should contain:
• Sterile gauze squares• Roller gauze• Sterile adhesive bandages• Triangle bandages• Adhesive tape• Scissors• Tweezers
• Thermometer• Safety pins• Soap• Hydrogen peroxide• Rubbing alcohol• Splinting materials• First aid book
September 2019 Safety, Oversight and Quality Unit 74
GETTING HELP
There are different steps to take for different emergencies:• Be sure you have a plan in place for all of them• If you or staff members are not sure whether a situation is an emergency,
don’t wait! call 9-1-1!• Knowing how to respond in an emergency can save valuable time and
possible a resident’s life
September 2019 Safety, Oversight and Quality Unit 75
EMERGENCY PREPAREDNESS PLAN
An emergency preparedness plan must be developed and maintained:• FEMA and American Red Cross have materials that can assist you with
creating your emergency preparedness plan:• Both have a short survey to help you identify potential natural disasters for
your area.
September 2019 Safety, Oversight and Quality Unit 76
EMERGENCY PREPAREDNESS PLAN
September 2019 Safety, Oversight and Quality Unit 77
Find online resources at theAPD Adult Foster Home
Provider Information website
MEDICAL EMERGENCY PLAN
Call for help immediately:• Call the appropriate emergency number - if calling 911, state what kind of
assistance is needed
Briefly describe the problem:• Give your address and the nearest major street or intersection
Stay calm and speak clearly:• Remain on the phone and answer all questions
September 2019 Safety, Oversight and Quality Unit 78
MEDICAL EMERGENCY PLAN CONTINUED
Follow the emergency operator’s directions:• The emergency operator will tell you what to do until the ambulance, police
or fire personnel arrive
Provide basic first aid and/or CPR until emergency help arrives. • If a resident has a Physician Order’s for Life-Sustaining Treatment (POLST) that
states do not perform CPR, then DO NOT PERFORM CPR and provider a copy of the POLST to emergency personnel
September 2019 Safety, Oversight and Quality Unit 79
POWER OUTAGE
When the power goes out for a short period of time it can be a nuisance, but it usually doesn’t threaten anyone’s health or safety. Be prepared before the lights go out in the event of a longer power outage:
• Know the location of your fuse or circuit breaker box and how to replace a fuse or turn on a breaker that has been tripped
• In case of a circuit overload or blown fuse, be sure to turn off electrical items before restoring power
September 2019 Safety, Oversight and Quality Unit 80
POWER OUTAGE CONTINUED
Prepare an emergency kit and keep it in a drawer or cupboard. Label it “Emergency.” It should contain the following items:
• Battery operated flashlight(s)• In addition to the plug-in rechargeable flashlights required on each floor
• Battery-operated radio• Extra batteries to fit the flashlights and radio Change batteries periodically Candles and wide-base holders Matches Hand-operated can opener Bottle opener Wind-up clock
September 2019 Safety, Oversight and Quality Unit 81
POWER OUTAGE CONTINUED
Provisions and supplies to shelter in place without electricity and running water should last for at least 3 days.Other items to have on hand include:
• Paper plates, plastic utensils, thermos-type bottle• Blankets• A fondue/chafing dish, cans of Sterno or other canned heat, camp stove and
appropriate fuel• Sanitary containers for water (especially if you rely on electricity to pump
water)• If you have a fireplace or wood stove, keep heavy-duty pots and pans,
firewood and kindling
September 2019 Safety, Oversight and Quality Unit 82
POWER OUTAGE CONTINUED
Maintain a small supply of non-perishables on hand ready-to-eat foods that can come in handy in an emergency:
• Dry Cereals, breads• Dried and canned meats• Cheese and peanut butter• Meal-in-a-can items such as stews, soups, beans and spaghetti are easily
heated on a camp stove
September 2019 Safety, Oversight and Quality Unit 83
POWER OUTAGE CONTINUED
If any residents are on oxygen concentrators, have portable oxygen tanks available for each person or a gas-powered generator for the household.
• If the AFH license is approved to provide ventilator-assisted care, the home should have a gas powered generator in case of a power outage
September 2019 Safety, Oversight and Quality Unit 84
POWER OUTAGE CONTINUED
Report the outage to your electric company.Leave on an outside light, such as the porch light, as well as one light inside your home:
• Service crews can tell by your outside light if the power has been restored• You will know when your inside light comes on again
Turn off all electrical equipment or appliances (such as furnace controls, heaters, water heater, heat pump or air conditioner, stove, toaster oven) that were being used when the outage occurred.
• Equipment that is left on could be damaged by a power surge, or start a fire unattended, when electricity is restored
September 2019 Safety, Oversight and Quality Unit 85
POWER OUTAGE CONTINUED
Do not use camp stoves or charcoal briquettes as a cooking or heating source indoors.
They give off dangerous carbon monoxide that can be fatal.
September 2019 Safety, Oversight and Quality Unit 86
POWER OUTAGE CONTINUED
Keep freezer and refrigerator doors closed:• Food in the freezer will usually stay frozen for about two days in a full freezer
or about one day if the freezer is less than half full• Use dry ice if the power is out for several days, or try to borrow freezer space
from friends or neighbors
September 2019 Safety, Oversight and Quality Unit 87
POWER OUTAGE CONTINUED
Food in the refrigerator is much more likely to spoil:• If you must open the refrigerator door, know what you want to get and where
it located before you open the door• Take out several things at one time to minimize how long the door is open• If the power outage occurs in very cold weather you may store some
refrigerator foods outdoors in covered containers
September 2019 Safety, Oversight and Quality Unit 88
POWER OUTAGES CONTINUED
Encourage residents to conserve body heat by wearing loose layers of clothing, wrapping up in a blanket and wearing a hat even for sleeping. Encourage residents to move around and do gentle exercises to generate body heat, and avoid staying in one position too long. Use extra bed covers and hot water bottles (if you are able to heat water).
September 2019 Safety, Oversight and Quality Unit 89
POWER OUTAGES CONTINUED
Pick one room on the warm side of the house for everyone to stay in, preferably one with a fireplace or wood stove:
• Close the doors to the rest of the house and use blankets to insulate windows• Use blankets over openings to other rooms if there is no door to close
September 2019 Safety, Oversight and Quality Unit 90
POWER OUTAGES CONTINUED
Keep fire-fighting materials on hand such as salt, baking soda or a heavy blanket made of wool, cotton or treated with fire retardant:
• Keep the fire extinguisher handy• Fire retardant blankets can be found online on websites such as Amazon
Be creative with lighting:• Candles will reflect more light when used in front of a mirror or foil; a
flashlight will provide more light if aimed toward the ceiling• Don’t forget battery-powered camp lights and lanterns - they are useful and
safer then candles
September 2019 Safety, Oversight and Quality Unit 91
POWER OUTAGES CONTINUED
Stay away from downed power lines.Be patient with residents:
• A power outage can be difficult to understand, especially for persons who experience confusion and they may become frightened or agitated
• Remain calm and reassuring• Take time to listen• A comforting touch will often help
September 2019 Safety, Oversight and Quality Unit 92
DISCUSSION/QUESTIONS
September 2019Safety, Oversight and Quality Unit