HQIN: Simple Strategies for Summer Emergency Preparedness
Posted on
July 2024
Simple Strategies: Summer Emergency Preparedness
Emergency preparedness is important in every season, but it is especially important in the summer. Summer storms, tornadoes and hurricanes often come with damaging winds and rain, and have similar preparations even though they occur in different areas of the country.
Across the nation we have been experiencing heat waves. Extreme temperatures can negatively affect people, especially populations like nursing home residents. Both staff and residents must take necessary precautions to prevent complications related to excessive heat. Nursing home residents are among the most vulnerable to heat exhaustion and heatstroke. Some suggested interventions for your facility may include the following:
Establish a facility protocol with guidance from the medical director about when outdoor activities can/should occur. If residents must be out, such as for transport to medical appointments, etc. be sure they are dressed appropriately for extreme temperatures and be sure to pack them with hydration materials.
Alert staff to monitor residents for the signs and symptoms of heat exhaustion and heatstroke. Notify the resident’s physician of such observations and obtain medical services as needed.
Request clinical pharmacist monthly reviews to highlight potential medications that might create higher risks. Review resident medications and identify those that may cause residents to become more susceptible to harm from heat and sunlight.
Assure that facility policies and procedures for heat emergency situations are current, complete and staff are trained.
Monitor temperatures in care areas and resident rooms.
Monitor residents’ choice of clothing to ensure it is appropriate in extreme temperatures. Loose-fitting, light-colored cotton clothing is best to allow the skin to breathe.
Help decrease temperatures by closing window blinds and turning off unneeded lights in the daytime.
Assist residents to maintain adequate fluid intake. In addition to water, consider popsicles, Jell-O, sherbet and juices to keep residents hydrated.
When outside, encourage residents to sit in shaded areas and to use sunscreen.
Close windows, doors and blinds during the daytime and open them at night after the outside temperature cools sufficiently.
Check out the following resources to take proactive steps in ensuring you stay cool, hydrated and recognize signs and symptoms of heat-related illness:
Dial 211 to be connected to your local/regional call center where they can assist you with a wide range of basic need services, or enter your zip code atwww.211.org to find cooling-off centers near you!
Extreme heat should be treated as a major weather emergency, just like an extreme storm and the possibility of power outages. Now is the time to pull out the facility emergency and disaster plans, ensure they are up to date, and be sure staff are educated about what to do.
Safe Temperatures in Nursing Homes
There are regulations requiring long-term care facilities to maintain safe temperatures.
F-Tag 584 pertains to comfortable and safe temperature levels in nursing homes. According to the regulation, facilities initially certified after October 1, 1990, must maintain an air temperature range of 71°F to 81°F. Ensuring a comfortable environment is crucial for residents’ well-being, minimizing susceptibility to hypothermia or hyperthermia.
Residents with a history of dehydration, cardiovascular disease or pulmonary disease are particularly susceptible to heat-related illnesses and complications. All staff should be aware and monitor for signs, symptoms and consequences of heat exhaustion, heatstroke and heat cramps.
Use this NHICS response guide as a checklist to ensure tasks are addressed and completed regarding severe weather.
Power Outages
Nursing homes across the country may experience power outages for various reasons. Many of these reasons are centered on natural disasters, such as hurricanes and tornadoes. Electrical interruption may also be caused by failing systems, such as electrical grid brownouts or blackouts. When nursing homes lose power, especially for extended periods of time, disaster can strike.
Analyzing risks, particularly those systems and components that can interfere with the ability to deliver care when power outages occur.
Identifying specific at-risk residents, such as those receiving temperature-stabilized medications or who may need power-operated support systems.
Securing temporary power support, including the use of generators.
Setting up redundant cooling systems for food supplies and medications, including off-site or temporary refrigeration facilities.
Establishing a maintenance and resupply chain for emergency power systems.
Establishing a plan to access resident records during power outages.
Establishing communication with organizations like emergency services, local or state health departments, emergency management agencies and evacuation shelter facilities.
Enhanced staff training to develop emergency-response skills and to ensure that all staff members understand their specific duties during a power outage.
Ensuring that nursing home insurance policies provide coverage for natural disasters that result in loss of electrical service.
Identifying shelters that are able to maintain healthcare services for residents if they are forced to evacuate.
By taking these steps in advance of a power outage, nursing homes will be better equipped to provide continuous and safe care to residents, all without subjecting residents and staff to the risks associated with electrical service interruption.
Hurricanes
Hurricanes are dangerous and can cause major damage from storm surge, wind damage, rip currents and flooding. They can happen along any U.S. coast or in any territory in the Atlantic or Pacific oceans. Storm surge historically is the leading cause of hurricane-related deaths in the United States.
Hurricane season is here, take time to understand and prepare for how a hurricane could affect you. You can start your hurricane preparedness efforts by downloading FEMA’s Hurricane Hazard Information Sheet.
Visit Ready.gov/hurricanes for more information and tips about hurricanes. You can also download the FEMA app (free of charge) to learn how to prepare for common hazards, receive real-time alerts from the National Weather Service and search for additional disaster preparedness guidance.
Tornadoes
Tornadoes are violently rotating columns of air that extend from a thunderstorm to the ground. Tornadoes can destroy buildings, flip cars and create deadly flying debris.
A tornado can:
Happen anytime and anywhere.
Bring intense winds, over 200 miles per hour.
Look like funnels.
The National Weather Service (NWS) provides numerous tornado safety resources. They can be accessed directly at Tornado Safety.
Shelter In Place: A Critical Component of Your Emergency Operations Plan: Updates from an Expert
by HQIN Consulting Subject Matter Expert Jordan Rennie, Owner and Principal of Rennie Consulting
Jordan assists the Health Quality Innovation Network (HQIN) as a subject matter expert working with nursing homes on emergency preparedness plan reviews and emergency preparedness education.
In the face of emergencies, healthcare facilities must be prepared to make quick and informed decisions to protect residents, staff and resources. A well-crafted Shelter in Place (SIP) section within your Emergency Preparedness Plan (EPP) is essential to ensuring operational continuity and safety. Here is a concise guide on key elements your SIP strategy should cover:
1. Preparation and Planning
Risk Assessment: Conduct a thorough risk assessment to identify potential scenarios that may necessitate SIP, such as severe weather, hazardous materials incidents or infrastructure failures. Tailor your SIP plan to these specific threats. This can be done while completing your annual Hazardous Vulnerability Assessment (HVA).
SIP Locations: Identify and designate safe areas within the facility where residents and staff can gather. These areas should be protected from external hazards and have access to necessary resources.
Supplies Inventory: Ensure a robust inventory of emergency supplies, including medications, food, water and medical equipment. Stock enough to sustain operations for at least 72 hours.
Upstaffing: Plan for increased staffing levels in anticipation of an SIP event. Arrange for additional clinical and support staff to be on site to handle increased demands and resident care needs.
Family: Ensure your family is prepared at home with their own shelter in place plan. You will not be able to adequately respond to an emergency at your facility if you are worried about folks at home.
2. Decision-Making: Shelter or Evacuate?
Criteria for SIP vs. Evacuation: Establish clear criteria to guide the decision on whether to shelter in place or evacuate. Consider factors such as the nature and scope of the threat, the condition of the facility and the safety of evacuation routes.
Decision Authority: Define who has the authority to make the SIP or evacuation decision. Ensure this individual or team is trained and has access to real-time information and communication channels.
Communication Plan: Develop a communication strategy to relay the decision to staff, residents and their families. Ensure everyone understands the protocol and their specific roles during an SIP event.
3. Proactive Measures
Resource Management: Maintain increased levels of critical supplies. Establish relationships with vendors to ensure quick resupply of essentials such as food, water, fuel and medical supplies. In addition, consider having a list of vendors both in your area and outside. This will increase resilience should vendors in your area be impacted as well.
Generator Capacity: Verify that your backup power systems, including generators, are functional and can support critical operations for extended periods. Regularly test these systems and ensure fuel supply arrangements are in place. Consider installation of generator “quick connects” that allow easy deployment of external generators.
Environmental Controls: Ensure that HVAC systems and other environmental controls can be managed during an SIP to maintain safe and comfortable conditions for residents and staff.
4. Communication with External Entities
Local Emergency Management: Establish and maintain open lines of communication with local emergency management agencies. Share your SIP plans and seek alignment with community emergency response strategies. Local emergency management leaders can assist you in making the decision to shelter in place or facilitate evacuation.
Vendor Coordination: Develop agreements with vendors for emergency delivery of essential supplies, including fuel, water, food and medical goods. Ensure contact information is current and establish protocols for rapid response.
Information Sharing: Implement mechanisms to share and receive information with external partners during an SIP event. This includes updating local authorities on your facility’s status and needs and receiving critical updates from emergency management agencies.
5. Training and Drills
Regular Training: Conduct regular training sessions for all staff on SIP procedures. Ensure everyone understands their roles and responsibilities during an SIP event.
Drills and Exercises: Perform regular SIP drills to test your facility’s preparedness. Use these exercises to identify gaps in your plan and refine your strategies.
6. Regulatory Requirements and Resources
Planning and preparation are great practices. They can assist in creating a more resilient and safer environment for staff and residents. However, it is also important to keep regulatory requirements in mind. The following E-Tags are covered by the CMS Emergency Preparedness Rule relating to SIP and Evacuation.
A comprehensive SIP plan is vital to the resilience of healthcare facilities during emergencies. By focusing on preparation, clear decision-making processes, proactive measures and robust communication with external entities, you can ensure that your facility is ready to protect and care for residents and staff when the unexpected occurs.
Training and Education Importance
Emergency Preparedness Plan training and education is crucial for both staff and residents in nursing homes.
You want your staff to be prepared and you want your residents to feel safe.
You can accomplish this by providing staff with:
Knowledge and Skills: Staff need to be well trained in emergency procedures, including evacuation, communication and response protocols. Training ensures they know what to do during various emergencies.
Drills and Exercises: Regular drills and exercises help staff practice their roles, understand evacuation routes and learn how to handle different scenarios.
Trained staff can respond efficiently, minimizing risks to residents and themselves.
For resident safety, providing residents with:
Awareness: Residents should be informed about emergency plans, evacuation routes and safety measures. Training helps them understand what to expect during emergencies.
Shelter In Place and Evacuation Readiness: Residents need to know how to safely shelter in place, evacuate safely and how to follow instructions from staff.
Reducing Panic: Proper training reduces panic and confusion during emergencies, ensuring residents can follow procedures calmly.
Remember, ongoing training, exercises and evaluation are essential to ensure staff and residents respond appropriately during emergencies.
Is Your Emergency Preparedness Plan Survey Ready?
See What People Are Saying About Our EPP Review Assessment Tool:
“I truly appreciate your insights. This was extremely helpful as I get my EPP updated.”
“Thanks for your insight and expertise.”
“I’m so grateful for your help. This review was exactly what I needed.”
“Time well spent.”
Are You in Need of a Turnkey,
Ready to Implement, Tabletop Exercise?
The team of experts at the Health Quality Innovation Network (HQIN) is offering free support to ensure your facility’s emergency preparedness plan meets all the necessary criteria. Take our online assessment, which guides you through a series of questions that will quickly identify what could be missing in your current emergency preparedness plan. After you submit your responses, an HQIN quality improvement advisor will review your responses and provide you with tools and resources to help support survey readiness. In addition, we will send you a complete, ready to implement, Tabletop Exercise and After-Action report.
Ready to get started? Scan the QR code or click the button below:
Download our After Action Report Improvement Plan Template, which is a tracking form that allows teams to record real emergency events and exercises to document the scenario, capabilities tested, strengths, areas for improvement and more.
Nursing Home Excellence: Prepare, Prevent, Protect (3P) Top Performer Program
The Health Quality Innovation Network’s (HQIN) Prepare, Prevent, Protect (3P) Top Performer Program recognizes participating nursing homes who are proactive in delivering high quality care to their residents and ensuring a safe environment for residents, staff and visitors.
The 3P Top Performer facilities achieve success in the following three designations:
PREPARE: Implement planning, policies and training on emergency preparedness and infection prevention.
PREVENT: Prevent avoidable resident emergency department visits, readmissions and hospitalizations.
PROTECT: Commit to ongoing, proactive immunization program.
Congratulations on achieving success in all three designations! Share with your staff and recognize them for their contributions.
The Emergency Protocol was developed in 2007 for communication between long-term care homes and the Section for Long-Term Care Regulation (SLCR), in the event a disaster occurs resulting in a loss of a necessary service (electricity, water, gas, telephone, etc.). This protocol was established to streamline communication so that homes can focus on what is most important – the safety and well-being of the residents.
This protocol provides the cellular telephone number corresponding to the region in which your home is located if you experience a loss in a necessary service that has the potential to affect resident safety or well-being. You are encouraged to contact the regional office main office telephone number during normal business hours because survey staff carry the cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.
This protocol is NOT to be used to self-report incidents normally reported to the Elderly Abuse & Neglect Hotline (1-800-392-0210).
If you have any questions about the Emergency Protocol for Long-Term Care Homes, please contact the Section for Long-Term Care Regulation at 573-526-8524.
Learning Opportunities
Facility Assessment: More Than a Regulatory Requirement
Learn CMS Required Regulatory Components Due by August 8!
July 17 at 10 a.m. ET
Join us on July 17 where we will focus on the new facility assessment requirements from the Centers for Medicare & Medicaid Services (CMS). You will not want to miss this opportunity to learn what needs to be done by August 8 to ensure your facility assessment meets all required regulatory components. The facility assessment is referenced 172 times in the 329-page staffing rule and is also the first requirement in preparation for the staffing requirement. F838 has been in play since 2016 but is taking on a new shape and focus with less than a month to make the required updates by August 8. At the end of the session, you will:
Understand the revised facility assessment requirements and regulatory updates.
Understand how to complete the facility assessment process with your team.
Understand how to identify resources that are necessary to care for residents competently during normal day-to-day operations and emergencies.
Understand how to link the facility assessment to your emergency preparedness plan (EPP) and QAPI program.
Learn how the Health Quality Innovation Network (HQIN), as your Quality Improvement Organization, can provide assistance.
Learning Modules for Nursing Home Staff, Visitors and Residents Teach Infection Prevention
Infections can be deadly in nursing homes. Solid infection prevention practices, coupled with the COVID-19 vaccine, are key to protecting those who live and work there.
Download our flyer and post it in your nursing home to encourage staff, visitors and residents to learn how to prevent infections. The brief learning modules, which are accessible through a link on the flyer or by scanning the QR code, review the dangers of infections and how to prevent them.
Newly Updated CMS Training for Frontline Nursing Home Staff and Management – Modules 5 and 8
Learn about the impact of dementia in caring for nursing home residents with COVID-19 and how to protect the emotional health of nursing home staff through this no-cost, updated Quality, Safety & Education Portal (QSEP) online training developed by the Centers for Medicare & Medicaid Services (CMS).
View scenarios In Module 5:Caring for Residents with Dementia to gain more understanding of the special needs that residents with dementia have and how to best care for them. Master content at your own pace, learning anytime and anywhere, even on your mobile devices.
While many concerns rest on the physical health and well-being of nursing home staff and residents, emotional health is also important. Module 8: Emotional Health, is designed for nursing home managers to learn how to develop creative strategies to promote and support emotional health for staff and residents.
New Learning Modules on Diabetes Available Now!
We are pleased to announce the release of our comprehensive new learning modules on diabetes. These modules are designed to enhance your knowledge and skills in identifying, treating and managing diabetes, providing you with the latest best practices for optimal resident care. To access these modules, and others on a variety of topics, visit HQI Academy, our online learning management system. New to HQI Academy? After you follow the link, click “SIGNUP” in the upper right. Fill out the short form to create your account. Once logged in, you’ll have access to a variety of courses on the main dashboard. Simply click on the cover of any course to start learning.
About the Health Quality Innovation Network Led by Health Quality Innovators and its quality improvement partners, Constellation Quality Health, KFMC Health Improvement Partners and the Kansas Healthcare Collaborative, HQIN is the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Kansas, Missouri, South Carolina and Virginia. To learn more about HQIN visit https://www.hqin.org.
The Health Quality Innovation Network’s (HQIN) Prepare, Prevent, Protect (3P) Top Performer Program recognizes participating nursing homes who are proactive in delivering high quality care to their residents and ensuring a safe environment for residents, staff and visitors.
