Transcript Impact of Water Outages and Restrictions on Healthcare

Presented by:
Jeremy Jernigan
Emergency Management Coordinator
Columbus Regional Healthcare System
& Columbus County Health Department
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Impacts to healthcare facilities
Causes of restrictions/outages
Actions to take
Lessons learned
Planning documents and guides
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Hand hygiene
Drinking water
Ice machines
Food preparation
Bathing patients
Flushing toilets
Laundry
Cleaning and sterilization
of instruments
◦ Dialysis
◦ Fire suppression
◦ Medical gas systems
◦ HVAC systems
◦ Decontamination/Hazmat
response
◦ Eyewash
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Hospitals
Nursing homes
Assisted living facilities
Dialysis clinics
Dental offices
Doctors offices
Group homes
Home health
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Natural disasters
Fires
Explosions
Construction (on-site &
off-site)
Vehicle accidents
Failure related to the
utility providers
infrastructure
Failure related to the
facilities infrastructure
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Diversion
Evacuation
Cancellation of services
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System Pressure Events – low or no pressure
can cause back siphonage and introduce bacteria
into drinking water.
Coliform Boil Water Advisory – total coliform
bacteria has been detected in the drinking water
system. This can indicate the presence of other
harmful bacteria and until test results show no
coliforms all water for consumption should be
boiled.
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Fecal Coliform Notice – testing has indicated
that fecal coliforms are present and the water may
be contaminated with human or animal waste. All
water for consumption should be boiled.
Do Not Drink the Water – Water has been
contaminated and should not be used for
consumption.
Do Not Use the Water – Water is contaminated
and should not be used for consumption, bathing,
cleaning, etc.
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Consumption
◦ Discontinue use of tap water for consumption
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Turn of ice machines
Soda fountains
Label water fountains and sinks “Do not drink”
Any other uses that would result in consumption
If only a “Boil Water Advisory” water can be boiled
for consumption
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Dishwashing
◦ If a dishwasher does not reach 180 degrees then
disposable eating and drinking utensils should only be
used
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Food preparation
◦ During a boil water advisory
 All food cooked to 165 degrees
 All food service workers use hand sanitizers after washing
hands
◦ Boil water notice or do not use
 Use only prepackaged foods
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Hand washing
◦ Food service workers use hand sanitizers
◦ Healthcare workers use alcohol-based antiseptic hand
rubs***
◦ Do not use contaminated water to scrub for surgeries,
waterless surgical scrubs should be used
***Workers caring for patients with C. Diff need to use soap
and water for hand washing.
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Bathing
◦ Avoid bathing anyone with weakened immune systems,
elderly, and children. Use waterless bath products.
◦ Care should be taken to not get contaminated water into
open wounds
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Columbus Regional Healthcare System – Boil
Water Event – May 2012
◦ Plans were in multiple places and were at differing stages
◦ City quickly notified the hospital but notifications to the
municipality in general were slow and inadequate
◦ Hospital made good use of signage to communicate to
patients, staff, and visitors not to use the water for
consumption.
◦ Hospital has only one water source and only one way for
water to enter the building.
◦ Communicated with local EM
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New Hanover Regional Medical Center – Water
Main Break - July 2010
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Breakdown of communications internally – human error
Reference documents were out of date
Better communications with other facilities
Communicated with local EM
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Mission Hospital, Memorial and St. Joesph
Campus– Water Main Break – May 2008
◦ Quickly moved bottled water to both sites
◦ Coordinated with FD to deliver non-potable water to
facilities for laundry, HVAC, toilet flushing
◦ Order Port-A-Johns for staff and visitors
◦ Delivered “Bath in a Bag” supplies to the facilities
◦ Communicated with local EM
◦ Activated their PIO within the ICS structure to
communicate internally and externally
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NC Drinking Water Section Quick Reference
Guide for Public Notification
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Environmental Health Emergency Preparedness
and Recovery Guidance Manual For North
Carolina
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CDC Healthcare Water System Repair Following
Disruption of Water Supply
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HICS Planning Scenario 10 – Loss of Water
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CDC Emergency Water Planning Guide for
Hospitals and Healthcare Facilities
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California Hospital Association - Hospital Water
Disruption Best Practices
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EPA – Planning for an Emergency Drinking Water
Supply
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Center for Medicare & Medicaid Services (CMS)
42 CFR 482.41
The Joint Commission 2009 Emergency
Management Standards, specifically EM.02.02.09
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Impacts to healthcare facilities
Causes of restrictions/outages
Actions to take
Lessons learned
Planning documents and guides
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Mark Bennett – NHRMC
Ned Fowler – Mission Health System
Jeremy Jernigan
(O) 910-640-4649
(C) 910-398-0223
[email protected]