I look for a title page, abstract page, key words, and page numbers. There should be a reference page at the end. There should be citations within the body of the paper for any quotes or statistics. Papers should also be double-spaced. Please note that Wikipedia is not considered an authoritative resource for academic writing; do not use this website in your papers. Townsend Text: Domain IV, pp. 306-322 Life Safety Code – pp. 415 National Fire Prevention Association – pp. 416 Hazard Vulnerability Analysis Exercises & Drills for Long-Term Care https://www.cahfdisasterprep.com/exercises Emergency Preparedness Rule https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule Lesson 7 Lecture Notes Lecture Notes The safety and comfort of the residents in a nursing home are of utmost importance. In this lesson, we look at how that is achieved through management of the physical environment. As in previous lessons, we will not attempt to address each of the issues covered in the assigned text but will add comments only when they are needed. The physical environment in which care is offered requires a great deal of the administrator’s time and attention. This is due not only to the seriousness of the consequences of any problems with the physical environment but also because this area is so closely regulated. The physical environment is probably regulated more closely than any other sector of facility operations. Although most applicable regulations are included in or referenced by OBRA (the Omnibus Budget Reconciliation Act), they are actually created and implemented by one or more agencies. In addition to federal and state regulations, there are also local zoning and fire safety rules to follow. OBRA and life safety code specifications sometimes vary, and it is up to the administrator of the facility to see that both are met. SAFETY AND SECURITY As we look at the various areas involved in the safety and security of residents, let us begin with those that mandate the construction and safety provisions of nursing homes. The first is the Life Safety Code, which covers buildings where large numbers of people gather and particularly where they take up residence. The most visible of the building conditions covered is fire safety. This is particularly critical for nursing home residents who are often old, frail, and physically or mentally handicapped. The regulations determine the types of materials used in building construction and in furnishings, the extent of fire alarm systems, and the use of sprinkler systems. They also cover such seemingly small details as the distance between fire doors, the direction in which resident room doors open, and the width of those doors. This is not, however, a minor matter. Lives have been lost because such rules were not followed. In addition to ensuring that all facilities meet at least the minimum protection levels, adherence to life safety rules also assists in case of emergency. It does so by allowing both facility staff and emergency personnel to know in advance what to expect in terms of building construction and layout. Safety and security also require that all nursing homes have an emergency electrical power supply that takes over automatically if regular power sources fail. This does not mean that all electrical service must be covered by the emergency system, but it does pertain to certain specific electrical needs. DISASTER PREPAREDNESS AND SAFETY TRAINING The best possible construction, alarms, and emergency systems are of little use if the facility’s employees do not know how to use them efficiently and properly. For that reason, OBRA regulations require both training and regular practice for disaster response. This is an area that is of particular consequence for the administrator. While much of the work involved in emergency training and preparedness can be performed by others, the administrator must emphasize its importance by personal involvement and by seeing that regulations are met. It is not easy to get employees to take this seriously. They may resent being taken away from their other duties for emergency training and disaster drills since in most cases they will still have the work to do afterward. It is also human nature to assume that no disaster will strike. However, there are several methods that will elicit, if not guarantee, their enthusiastic involvement. First, the administrator must take an active part. While there may be an inclination to think that other administrative tasks are too important to forgo for a fire drill, if employees see the administrator participating, they will follow that example. They must see an absolute commitment to the procedure by administration. Second, you should get the staff involved in the process of designing the training and the preparedness drills. Give them some ownership of the process. They will be proud to have contributed to a successful disaster prevention system. Third, make the training and drills as realistic as possible. Local fire departments are usually more than willing to assist as are other emergency agencies. If possible, cooperate in joint disaster drills with other health care facilities and agencies in the area. This can stimulate both cooperation and a bit of competition to see who performs best. Last, find someone who has been through an actual disaster in a nursing home (or other health care facility). Ask that person to explain why training and preparedness are so critical. If every employee in the facility had been through such an experience, there would be no lack of interest and enthusiasm. Bringing such experiences to them secondhand through someone who has been there is the next best way to convince them. HAZARD ASSESSMENT AND DRILLS An additional article from the California Association of Health Facilities is in your required reading list regarding how to design, conduct, and evaluate emergency drills. At a minimum, two drills per year (besides fire drills) are required by federal regulation. A Real World Event can be substituted for a drill. One of the two required drills may be a table-top drill, but the other must be a live drill. Each nursing home is also required to conduct and update a Hazard Vulnerability Assessment. Ideally, your drills should be designed based on the types of emergencies you are likely to encounter. An example, developed by Eastern Maine Healthcare System, is included as an Excel spreadsheet; there are many other formats for such an assessment, too. The Eastern Maine Healthcare spreadsheet includes a note about IT failure. An area of increasing vulnerability for all businesses, nursing homes included, is cyber-attacks. Ransomware has captured medical records, personnel records, and payroll records of long-term care organizations. Be sure to work with your IT vendors to assess and mitigate any areas of vulnerability. Optional Video: The Big Uneasy (48 minutes) Optional Resource: Nursing Home Command System Optional Resource: National Criteria for Evacuation Decision-Making in Nursing Homes Disaster Planning In a one to two-page essay, explain when it is appropriate to evacuate residents in the event of a fire and when it is not. NOTE: This question has many issues that you should consider in your response. Consider the different types of facilities that are in existence today and the risks they face. Often in disaster planning, we tend to overlook multiple simultaneous system failures. For example, in the following article describing a nursing home struck by a tornado, the roads were blocked and the facility’s van was demolished, leaving no option for immediate evacuation. Despite having a good disaster plan, the simultaneous failures were not anticipated. Read this article: Alabama tornadoes: Nursing home disaster plans under review Regarding La Rocca Nursing Home, what went well? What didn’t go well? Based on this experience, if you were the administrator, how would you modify your disaster preparedness policy for the future? In 2-3 pages, explain what the Administrator’s role should be in developing, activating, and evaluating the nursing home’s disaster and emergency preparedness plan. Why is this role important? Outcomes Identify the importance of planning for disasters and other types of emergencies. Discuss the significance of the administrator’s involvement in disaster planning.