Disaster Preparedness at Nursing Homes Plays Role in Patient Safety
A recent article in the New York Times highlighted what can happen when a disaster hits a nursing home. The article cited a center in Arlington, Texas which was hit by hailstones the size of golf balls. Mayhem erupted with residents crying and praying, as the residence was hit by one of several tornadoes that tore through the Dallas/Fort Worth area. No one was injured, including 131 residents and 40 workers, fortunately.
But there was more than just luck at play here. Good planning, systems, and staff responsiveness were key in getting all the patients safely out of their rooms, away from windows, and rapidly triaged residents’ injuries once the tornado had moved on. Within five hours, according to the Times article, all residents were evacuated to other nursing homes or a nearby hospital, most with bags on their laps containing medical records and medications.
This facility obviously had a clear plan in place, which saved everyone’s lives. Yet disaster planning at many nursing homes is not a practice well practiced. According a report by the Department of Health and Human Services, 92% of nursing homes have plans for handling tornadoes, hurricanes, floods or fires, and 72% have staff members trained in emergency procedures, as required by federal law. That’s the good news. The bad news is that after conducting in-depth inspections at 24 institutions, officials found significant gaps in preparations. Each of the homes had experienced a flood, a hurricane or a wildfire from 2007 to 2010, and 17 reported substantial challenges responding to these disasters. Yet 22 homes failed to document the way in which the medical records and medications of patients would be dealt with in the event of an emergency. There was no plan for handling the illness or death or a resident in a disaster at 23 locations.
What’s more, in the emergency plans there were no measures ensuring an adequate supply of drinking water for workers and patients. At 19 of these nursing homes, a strategy to ensure an adequate fuel supply for backup generators didn’t exist. Ten homes had not addressed the need for adequate staffing during emergencies; 15 didn’t document how patients’ needs for items such as feeding tubes, ventilators or oxygen would be handled. One home, which was in a flood plain, had no procedures for dealing with floods. And, incredibly, none of the homes had participated in drills or exercises run by community emergency preparedness managers.
This is discouraging news, to say the least. The possibility of human loss is great without disaster preparedness plans that are fully fleshed out and implemented, not to speak of the tremendous exposures a nursing home facility faces. Administrators and staff of nursing facilities must not only know how to protect themselves, but also how to assist their patients when a disaster affects the facility. Furthermore, disaster plans should be reviewed every year, and disaster drills practiced on a regular basis. The plan should include verification of the evacuation shelter with which the nursing home contracts.
Other key plan components include: having a written contract in place for bus service to evacuate residents. Emergency supplies should always be kept separate from regular supplies and regularly inspected. A pharmacy provider for the facility should be chosen that maintains backup electronic pharmacy records in a separate geographic location to enable access to vital information after the disaster. Emergency kits for each bus should be prepared in advance. A staff person should be designated to be the first one arriving to the evacuating site to direct activities. Other staff should be designated to stay to close up the facility and to be there to reopen it before the residents return after the disaster. Families should be notified about the evacuation using notification technology available.
There are so many other critical issues to an effective disaster preparedness plan, too many to touch upon here. At Caitlin-Morgan we can assist you in helping your nursing home clients with their disaster planning, risk management, and insurance needs. Please give us a call at: 877.226.1027.