1. FIRE DRILLS David McMahon, RS, MPH Phoenix Area Indian Health Service

2. Fire Drills - Purpose ä Prepare ä Prepare staff for actual events ä Save ä Save lives ä Reduce ä Reduce panic, makes response a routine matter ä To ä To test the efficiency, knowledge and response response of personnel in implementing the facility fire emergency plan

3. Fire Drills - Purpose ä To exercise the plan ä Evaluate, modify plans as needed ä Meet accreditation and/or regulatory requirements

4. Fire Drills - NFPA ä “Emergency Egress and relocation drills” ä Think about the focus of your drills, why are having them?

5. Fire Plan Requirements ä The administration of every healthcare occupancy shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of fire and for their evacuation from the building when necessary ä (NFPA 1 - 8-4.2.1.1, LSC 101 - 18, 19-7-1.1 )

6. Written Fire Plan Components ä Use of Alarms ä Transmission of alarm to fire department ä Containment of smoke and fire ä Transfer to areas of refuge ä Fire extinguishment ä Specific fire response to duties ä Preparation of Building for Evacuation

7. Training (JCAHO 2000 revision) ä ä All personnel are trained in fire response according to the facility fire plan ä ä The effectiveness of this training shall be evaluated at least annually ä ä The training shall include: ä ä General facility protocols ä ä All aspects of response that may be unique to the individual’s duties and work site

8. RACE ä R escue ä A larm ä C ontain ä E xtinguish /Evacuate

9. Fire Drill - Frequency JCAHO and AAAHC Require : Hospitals and Ambulatory Care facilities ä Quarterly on each shift to familiarize facility personnel with signals and emergency action required under varied conditions

10. Fire Drill - Frequency JCAHO Requires: Freestanding business occupancies ä Annually per shift

11. Occupancy Definitions ä Hospital ä Provides medical or other treatment or care of four or more persons ä Occupants are mostly incapable of self- preservation due to: ä Age, physical or mental disability ä Because of security measures not under the occupants’ control

12. Occupancy Definitions ä Ambulatory Care - outpatient services ä A building / portion thereof used to provide services or treatment simultaneously to four or more patients ä Providing treatment or anesthesia for patients that renders them incapable of taking action for self-preservation under emergency conditions without the assistance of others

13. Occupancy Definitions ä Free-standing Business Occupancy ä All others ä Not attached to a hospital or ambulatory care facility

14. Remember This! ä These are minimal standards ä You can always do more drills if needed

15. Fire Drills - Patient Transport ä Actual patient transfer, transport or building evacuation is not required to be performed during the drills.

16. Fire Drills - Timing ä Drills shall be held at expected and unexpected times ä JCAHO now requires that 50% of the annual drills be unannounced (2000) ä Under varying conditions to simulate the unusual conditions that can occur in an actual emergency.

17. Fire Drills - Use of Alarms ä NFPA requires activation of alarms for each drill ä Exceptions: ä When drills are conducted between 9:00 p.m. and 6:00 a.m., a coded announcement is permitted to be used instead of audible alarms

18. Fire Drill Location ä Drills should be conducted in different areas of the facility, so that all staff participate and such that various fore exit routes are used in each drill

19. Fire Drills - Area of Refuge ä Not all facility have to evacuate to the outdoors ä Hospitals or ambulatory care facilities often can evacuate to areas of refuge inside the building through smoke or fire barriers and compartments

20. Fire Drills - Area of Refuge ä In total evacuation: Drill participants shall relocate to a predetermined location and remain at such location until a recall or dismissal signal is given.

21. Fire Drill - Evaluation ä What is a good drill? ä Orderly vs. Speed

22. Fire Drill - Evaluation ä ä JCAHO EC 2.10 - 2000 revision ä ä All fire drills are critiqued for the purpose of identifying deficiencies and opportunities for improvement.

23. Fire Drill - Evaluation ä Monitor elevations ä You can document actual or false alarms as drills, but only 50% of required drills

24. Patient Safety ä Patient education and rights