Hospital-based special needs patient decontamination: Lessons from the shower

Authors

  • Julie Bulson, MPA, BSN, RN
  • Timothy C. Bulson, MS
  • Kathi S. Vande Guchte, FRO-T, HERT-T

DOI:

https://doi.org/10.5055/ajdm.2010.0041

Keywords:

hospital decontamination, special needs patient, pediatric decontamination, tabletop drill, functional exercise

Abstract

Objectives: A hospital-based decontamination team tested whether it could (1) perform effective technical decontamination while maintaining safety of staff and patients; (2) safely accommodate unique needs in the showers, including guide dogs and motorized wheelchairs; (3) identify needs of special needs populations by patient type, including blindness, hearing loss, and cognitive learning disabilities; (4) outline effective use of federal preparedness funds to support planning and execution of tabletop and mock victim drills; and (5) demonstrate the ability of a community hospital to act as a catalyst for community-wide disaster response improvements.
Design: A series of five disaster exercises were used to test hypotheses and to generate quality improvement results.
Setting: Fixed emergency department decontamination facilities.
Patients/participants: A total of 39 hospitalbased decontamination team members, 40 other drill staff, and 35 mock victims were included.
Main outcome measures: Three priority decontamination operations changes resulted from each of the five completed drills.
Results: Formulated prioritized list of decontamination team procedural changes to improve patient safety and technical decontamination and to generate a table of best practices to share.
Conclusions: With enhanced training, disaster drills participation of community response agencies and special needs patients, community hospitals can improve safety while accommodating unique patient needs.

Author Biographies

Julie Bulson, MPA, BSN, RN

Director, Emergency Preparedness, Spectrum Health Hospital Group, Quality Department, Spectrum Health, Grand Rapids, Michigan.

Timothy C. Bulson, MS

Grants Developer, Spectrum Health Research Department, Spectrum Health, Grand Rapids, Michigan.

Kathi S. Vande Guchte, FRO-T, HERT-T

Project Coordinator, Safety and Training, Quality Department, Spectrum Health, Grand Rapids, Michigan.

References

American Hospital Association: Talking with Your Community about Disaster Readiness. Disaster Readiness Advisory #7. Washington, DC: American Hospital Association, 2002.

Rubin J: Recurring pitfalls in hospital preparedness and response. J Homeland Secur. 2004: 1. Available at http://www. homelandsecurity.org/journal/articles/rubin.html

Hick J, Penn P, Hanfling D, et al.: Establishing and training health care facility decontamination teams. Ann Emerg Med. 2003; 42(3): 381-390.

The Joint Commission: The Emergency Operations Plan describes the following: How the hospital will provide for radioactive, biological, and chemical isolation and decontamination. Joint Commission EM 02.02.05 EP 5. Terrace, IL: The Joint Commission, 2010.

Occupational Safety and Health Administration (OSHA): OSHA standards: First responder operations level: 29 CFR 1910.120 (q) (6) (ii).Washington, DC: Occupational Safety and Health Administration, 2007.

Agency for Healthcare Research and Quality (AHRQ): Development of Models for Emergency Preparedness: Personal Protective Equipment, Decontamination, Isolation/Quarantine, and Laboratory Capacity. Rockville, MD:AHRQ Publication, 2005.

OSHA: OHSA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances.Washington, DC: OSHA, 2005.

Capitol Region Metropolitan Medical Response System: The history of MMRS in emergency planning. Available at http:// www.crcog.org/homeland_sec/cr_mmrs_features.html. Accessed November 17, 2009.

Hilton C, Allision V: Disaster preparedness: An indictment for action by nursing educators. J Contin Educ Nurs. 2004; 35(2): 59-65.

Institute of Medicine: Chemical and Biological Terrorism. Research and Development to Improve Civilian Medical Response. Washington, DC: National Academy Press, 1999.

HSEEP Exercises. Available at https://hseep.dhs.gov/pages/1001_About.aspx. Accessed July 30, 2010.

Published

11/01/2010

How to Cite

Bulson, MPA, BSN, RN, J., T. C. Bulson, MS, and K. S. Vande Guchte, FRO-T, HERT-T. “Hospital-Based Special Needs Patient Decontamination: Lessons from the Shower”. American Journal of Disaster Medicine, vol. 5, no. 6, Nov. 2010, pp. 353-60, doi:10.5055/ajdm.2010.0041.