WATER LOSS PLAN
“CODE BLACK – WATER”
DEFINITION:Complete or partial loss of water.
MITIGATION / PREPARATION
· Structural Integrity of Facility
· Staff Education
· Preventative Maintenance Program
· Environmental Rounds
· Established Relationships with External Agencies / · Hospital Incident Command System (HICS) Implementation
· Response Plans
· Staff Education
· Equipment and Supplies
· Communications Systems
· Hazard Vulnerability Analysis
· Utilities Risk Assessment
RESPONSE / RECOVERY
· HICS Activation
· Staff Activation
· Emergency Event Announcement
· Communication Systems
· External Agency Activation / · Damage Assessment
· After Action Report / Review
· Inspect and Service Equipment
· Maintain HICS
PURPOSE
To respond to the disruption in the supply of potable (drinkable) water supply to SRMC.
Facilities Department
q The Director of Facilities or designee will alert the Infection Control
Practitioner and the Administrator on Call of a disruption of water supply, sewer availability and the estimated duration of disruption, if known.
q The Facilities department implements their Potable Water Supply operating procedures.
q The Facilities supervisor will advise in sewer availability, "flushing or not.”
q The Facilities department, Environmental Services, and/or other staff may be asked to assist in delivery of supplies to departments at the discretion of the ICP or Supervisor.
q The Facilities supervisor will determine water condition after resumption of supply, including environmental testing by local authorities or EPA, and flushing of the system sufficiently to resume potable water requirements.
Administrator on Call
q Call a meeting of the following individuals as soon as possible. Coordinate
with them to set up the strictest possible rules governing the use of water. Measures may include using waterless hand sanitizer, suspending patient baths, limiting toilet flushing, etc.
q Chief Nursing Officer
q Safety Officer
q Emergency Manager
q Security Manager
q Director of Food Services
q Director of Environmental Services
q Infection Control
q Director of Facilities
Environmental Services
q Environmental Services and/or other staff may be asked to assist in delivery
of supplies to departments at the discretion of Infection Control.
Food Services
q The Director of Food Services will restrict l services to employees and visitors
As appropriate, with the approval of the Incident Commander which in extreme conditions may call for catering services for patient meals.
q Supply water.
Infection Control
q The Infection Control Practitioner will allocate the on hand supplies based on patient census and departments in operation, and request additional supplies based on patient census and expectations of duration of supply/service disruption.
q The Nursing Supervisor will assume the role of the ICP in their absence.
Safety
q A global email will be submitted from the Safety Officer or Facilities on the water shutdown. This email will give information as much information as possible, i.e.- duration, location, and etc.
Security Department
q The Security Manager’s primary concern is to enforce fire safety practices and to monitor fire risk areas.
Water Supplies
Drinking Water
Bottled water supplied by Food Services. At least 36 hour supply to be kept on hand. Recommended: 2 liters per day per patient/worker.
Any water questionable to be fit for drinking may be boiled for 5 - 10 minutes prior to drinking, OR ten (10) drops of bleach per gallon added, mixed thoroughly and allowed to stand for 30 minutes before using. This can be used for 24 hours. After 24 hours, this water must be discarded.
Sterile water may be used for drinking if other supplies are exhausted.
IV solutions and saline may be used for other than drinking if other supplies are exhausted.
Handwashing Water
Expected: 4 handwashes per nurse per hour, 32 handwashes per 8 hr shift.
For waterless cleanser, each use is about 1 ml or rinse. A 4 oz bottle can supply three nurse shifts. Determine how many nurse shifts the facility can anticipate in one 24 hour period. The number of nurse-shifts per 24 hr is the number of 4 oz bottles needed for a 3 day supply. Approximately 12 bottles will be on hand in purchasing.
Purchased gallons of distilled water will be kept on hand by Facilities. A minimum of 30 gallons will be kept on hand. The plastic containers may be refilled from a source of clean water if needed.
Large spout type coolers or coffee urns may be disinfected with bleach solution and set up as handwashing stations on a table with a bucket beneath. This method is useful in long term situations, but may not be feasible for all areas.
Standing water is not acceptable for handwashing purposes. Water collected in containers, bathtubs, etc, may be used for flushing and environmental cleaning.
Toileting
Bed pans and bedside commodes may be lined with small trash bags prior to use, then removed and tied.
Three bags placed in a bucket may substitute for a toilet. Tie all three bags when bucket 1/2 - 1/3 full. Transfer to large garbage cans. Avoid overfilling of either, and be alert for leaking.
A small plastic bag may be used for single use, tied, and discarded.
If sewers are intact, flushing may be allowed in certain situations, if a supply of "gray water" is available to pour into toilets.
Under no circumstances should flushing occur until allowed by Facilities. Flushing a nonfunctional toilet will lead to collection of wastes in sections of the system.
Disposable baby wipes will be kept on hand in purchasing. These may be used for incontinent adult or pediatric patients.
References:
APIC Text of Infection Control, 2000
Infection Control of the Environment, UNC-Chapel Hill, ICP Training, Part II, Sept. 2000
Originated: 8-94
Revised: 6-96, 11-99, 8-00, 3-01, 12-02, 2-7-03
Reviewed: October 2004, November 2005, March 2006, June 2007, December 2008
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