Transcript Hurricane Ike

Hurricane Ike
Virginia Kennedy, RN, MS, CIC
Infection Prevention & Management
Associates
Pre-event
The hospital was successfully evacuated on
Friday prior to the hurricane's landfall.
There were no patients or staff in the
hospital during the hurricane.
Pre-event
• Communication to receiving facility regarding
isolation patients
• Plans for sterile supplies
– Temperature and humidity issues
– Transportation of sets and supplies
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CSPD
OR
Cardiac lab
Labor and Delivery
• Facility Expectations of Infection Prevention
• Communications
Pre-event
From All Nurses….
Going to the lock down at the hospital I had all
my essentials: air mattress & pump, battery
operated tv (although after Feb it won't work
anymore), toiletries, enough clothes and
scrubs for three days
Pre-event
• Facility expectations
– A team to be present in facility for event
– B team to provide immediate relief or
– C team for clean up and recovery
• Communications
– Cell phone – numbers, chargers, hand crank
charges
– Text messaging
Pre-event
• Know facility water source
– City
• Dependent on electric pump?
– Well
• Meets potable water standards?
• Pump?
• Determine if water will need to be tested
– Have contract service on standby
– Alternative source
– Implications for ice machines
Pre-event
• Water supplies
– Drinking/cooking
– Toileting (fill bathtubs)
– Hand hygiene
• EVS additional supplies
– Linen
– Sharps containers
• Ensure supplies for isolation
– Gowns
– Gloves
Pre-event
• Sterile supplies
– Storage in controlled temperature/humidity
– Instrument processing
• Additional high level disinfectant?
– Sufficient disposable sterile supplies
• Contract for dehumidifiers and wet vacs
• Contract construction workers on hand to
build emergency containments
• Establish childcare and pet care guidelines
• Vaccine storage (occupational health)
Flooding over access road 523 to Surfside beach, caused by Hurricane Ike forming in the Gulf of
Mexico, is seen near Surfside Beach, Texas September 12, 2008. (REUTERS/Carlos Barria) #
During
• Observe floors for condensation (slippery)
• Round on bathroom facilities (for families and
others) to ensure cleanliness
• Observe for floods and damage
(ceiling/windows etc)
• Complete all risk assessments for containment
• Potentially implement alternative high level
disinfection
• Review food preparation
After
30 inches of water in the building after Ike struck
……….
Sept. 13.
Water damage
• Inventory all water damaged areas, building
materials and furnishings.
– Special attention should be given to identify carpet under
cabinets, furnishings
• Use moisture meter to identify extent of water
damage to drywall
– Cut 12 inches above
– Remove wet walls and insulation within 24 hours
– If >24 hours, or previous water damage has caused
microbial/fungal growth
• Extensive controls
• Ceiling tiles
– Remove wet tiles within 24-48 hours
Major storms or other natural disasters sometimes
cause major outages - affecting a large number of
customers over an extended period of time.
After
• Boil water ban
– Alternative sources
• Have testing completed asap
– Ice machines
– Sterilizers
– Steris 1
• Conflicting statements given to various hospitals
– Issues with water
– Sterile supplies
– When operating rooms would be opened
• Key learning: Infection Preventionists should
be part of decision making group
After-CSPD
• Autoclaves inspected,
cleaned and recommissioned?
• Does steam system
meet AAMI standards?
• Sterile supplies
compromised?
– Reprocessed
– Replaced
• Steris I filter replaced?
After - Laboratory
• Emergency power
available ?
• Has essential
equipment, including
biological safety
cabinents, been
inspected, cleaned and
disinfected?
• Have damaged or
contaminated reagents
and supplies been
replaced?
After – Operating Room
• Any damage to sealed flooring
and ceilings?
• Do sterile supplies need
reprocessing?
• Autoclaves inspected?
• Have System 1 machines had a
couple of loads run (if under boil
water order) then filler changed
before running BI loads?
• Evaluation for electrical hazards?
• Scrub sinks functioning properly?
• Enough air exchanges per hour?
• Particle counts or cultures been
performed and results
acceptable?
• Air filters changed?
After-Pharmacy
• Have damaged or contaminated
meds/solutions been replaced?
• Refrigerators at proper
temperature?
– Clean and disinfected?
• Had admixture room hood
been recertified and filters
changed?
• Has the medication
compounding area been
thoroughly disinfected?
After – Food Service
• Has stored food been
inspected for damage and
discarded if unsafe?
• Ice-machines and
refrigerators cleaned and
sanitized?
• All food contact surfaces
cleaned and sanitized?
• Pest control systems been
restored?
• Does Health department
need to inspect?
After- All Patient Care
• Porous furniture and
mattresses that were wet
been discarded?
• Linens laundered?
• All patient care surfaces
cleaned and disinfected?
• Medications and supplies
that were damaged or
contaminated discarded?
• Ice machines flushed,
cleaned and disinfected?
Patient Education
Keep Food and Water Safe after a
Natural Disaster or Power Outage
INFECTION PREVENTION TIPS FOR
FLOOD AND HURRICANE SEASON
Critical Resources
• CDC
– Natural Disasters Remediation and Infection Control
Considerations for Reopening Healthcare Facilities Closed
Due to Extensive Water and Wind Damage
– Disaster Safety – Patient Education
• AAMI ST79
• University of Minnesota
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Fungal abatement
HVAC System
Decontamination
Managing Water Infiltration
• APIC
Chance favors only the prepared
Louis Pasteur