Health Occupation Student
Orientation Module 2:
Environment of Care
Section 1
FIRE AND LIFE SAFETY
Safety/Emergency Resources – Fast Facts

Fast Facts is a quick
reference response guide
to

Codes, e.g Code Grey,
Pink, Orange

Other events e.g.
System Failures,
evacuation, disasters,
emergency
communication
systems

Form Samples e.g.
bomb threat, abduction
record.
Emergency Codes
TO CALL ANY CODE:



Dial 8211 – activates the
overhead paging system
Identify type of code and
location
Repeat the message.
CODE RED
Fire
CODE BLUE
Adult medical emergency
Pediatric Code Blue
Pediatric medical emergency
CODE PINK
Infant abduction
CODE PURPLE
Child abduction
CODE YELLOW
Notification of a bomb on
campus
CODE GRAY
Combative person
CODE SILVER
Hostage or weapon
CODE ORANGE
Hazmat spill or release
CODE TRIAGE
Internal or external disaster
Life Safety – Fire Safety

Action to Take for
Code Red
Department
Response Plan
You should know the following:

Evacuation routes and location of
exits and stairs

Location of smoke/fire doors

Location of fire alarms/extinguishers
Life Safety – Fire Safety
Immediate Response Plan

Action to Take for
Code Red
R
A
C
E
REMOVE
all persons in danger
ACTIVATE ALARM
use pull station or
emergency # 8211
CONFINE fire
close doors and windows
EXTINGUISH
the fire if manageable
Life Safety – Fire Safety

Action to Take for
Code Red
Student Response
When You Hear Code Red Paged:

Follow the instructions or your
Clinical Instructor or Charge
Nurse guidance.
Never prop doors open with trash cans,
chairs etc – prevents automatic door
closure in event of fire.
Life Safety - Fire Safety

Action to Take for
Emergency Evacuation:

Move patients beyond nearest
fire doors – “area of refuge”

Place an “X “on door with tape

Take meds and medical
record with patient

Follow instructions of the
Charge Nurse
Order of Evacuation
•
Ambulatory / Non-ambulatory
patients closest to danger;
•
Ambulatory patients, visitors
and staff;
•
Non-ambulatory patients in
wheelchairs, Isolettes and
cribs;
•
Non-ambulatory patients in
their beds
•
Critical Care and ventilator
patients using gurneys/beds;
Section 2
SECURITY MANAGEMENT
Security
We have Security / Engineering
staff that provides security 7 days
a week, 24 hours a day for our
facility. We use interior /exterior
close circuit monitoring of strategic
areas and 2 way communication.
Even with these measures,
Security cannot be everywhere at
all times. You are actually the
extra “eyes and ears” of our
Security / Engineering staff.
The key to providing effective
security for our facility is
prevention, and prevention begins
with you.
Your Role in Security

Always wear your ID badge

Keep personal belongings out of
sight

Main doors are locked between
8p – 5:30a. Use ED entrance
during those times.

Be alert and observant of people
that normally should not be in an
area.

Report all suspicious activity to
the Charge Nurse on your unit.
Security: EMERGENCY CODES
The hospital has 4 emergency
security codes (shown at right)
that you need to be aware of.
In the event of an emergency,
report to your Charge Nurse for
direction.
CODE
SILVER
Hostage or weapon
CODE
GRAY
Combative person
CODE
YELLOW
Notification of a
bomb on campus
CODE
PINK
Infant abduction
(<1 year)
CODE
PURPLE
Child abduction
(<18 years)
Security Management – Hostage / Weapon Situation
C
O
D
E
S
I
L
V
E
R
Action to Take:
Staff / students:

DO NOT go to announced location

This is an extremely dangerous and sensitive
situation that should only be handled by local
police agencies.
Staff / students who see person with weapon:

Seek cover/protection; warn others

Report “Code Silver” to Operator including
location, number of suspects/hostages, number
and type of weapons
Security Management – Combative Person
C
O
D
E
G
R
E
Y
Action To Take:
Student Response:

Stay clear of announced location

Reassure other patients

Follow directions of your Clinical Instructor
or Charge Nurse
Security Management - Bomb Threat or Suspicious
Package
C
O
D
E
Y
E
L
L
O
W
Action to Take:
Students - IMPORTANT:

Do not use radios, pagers or cell phones.

If you see a suspicious package, don’t touch it
– notify the Charge Nurse

Follow the directions of the Charge Nurse.
Security Management - Infant or Child Abduction
I
N
F
A
N
T
C
O
D
E
P
I
N
K
C
H
I
L
D
C
O
D
E
P
U
R
P
L
E
Action to Take:
Staff Response:



Go to nearest unmanned exits, stairwell, or
parking lot
Politely ask for ID of people exiting hospital
Do NOT go to area of abduction.
Student Response:



DO NOT give out any information about a
possible abduction.
DO note any suspicious activities, persons or
vehicles and report to Clinical Supervisor.
DO NOT participate in facility wide response
Infant= up to 27 days
Child = 28 days and older
Security Management - Protected Health Information

What Must be Protected? an
individual’s health
information that…

Includes at least 1 of the 18
personal identifiers

Is created, received, or
maintained by a health care
provider or health plan

Is written, spoken, or electronic
Personal Identifiers
Name
Date of Birth
Address
Phone Number
Email Address
Medical Record Number
Social Security Number
License Number
Facial photos
Account Numbers
And more . .
Security Management - Protected Health Information

Steps to ensure Privacy and
Security of PHI

Position WOWs and bedside computer
screens out of sight of visitors or casual
viewers

Lock computer screen or log out when done
working

Manage/secure all printed patient census
sheets e.g. use cover sheet to hide PHI

Manage/secure all patient identification
stickers

Minimize work conversations in hallways and
public areas
Security Management -Protected Health Information 
HIPPA Requirement - Minimum
Necessary Standard

This standard provides guidance
for use of PHI while maintaining
security and privacy

Use / disclose the minimum
amount of identifiable patient
information needed by your job
regardless of access

Applies to all users of PHI in the
workplace
Section 3
OTHER EMERGENCY
RESPONSE
Emergency Management – CODE BLUE
Pediatric Code White
C
O
D
E
B
L
U
E
P
E
D
I
A
T
R
I
C
C
O
D
E
W
H
I
T
E
(ADULT) /
Action to Take:
Staff Response:

Code Team goes to announced location (ED MD &
RN, ICU RN, RT, Admin Sup, Compressor, recorder)

Unit / department staff bring crash cart
If YOU discover the patient:

Identify signs/symptoms of cardiac / respiratory
distress.

Call the code

Begin first responder CPR until staff arrive to relieve
you.

Note: after the first response, students may only
observe a Code Blue if first approved by their
instructor.
Emergency Operations Plan - Code Triage
Each of the Emergency
Situations shown at right
could result in activation
of the Emergency
Operations Plan (EOP),
Code Triage.
The EOP enables us to
effectively respond to
these emergencies
regardless of scope. The
hospital adopted the
Hospital Incident
Command System (HICS)
model for its plan.
Emergency Operations Plan - Code Triage
About the Hospital Incident Command
System (HICS) Model
The HICS model provides a standardized
response to all kinds of emergencies regardless
of magnitude.
Hospital Command Center (HCC)
In the event of a Code Triage, the HCC serves
as the clearinghouse for all information and all
instructions during the disaster.
Incident Commander (IC)
The IC is responsible for ALL decisions
regarding resources, personnel, patient flow,
safety and security issues during the disaster.
Action to Take for Code
Triage:
Students:
Follow the directions of your
immediate supervisor.
Section 4
UTILITIES / MEDICAL
EQUIPMENT MANAGEMENT
Utilities - Utility Failure
Action To Take:
• In the event of a utility failure, follow the
directions of the charge nurse on your unit.
• Emergency power outlets have a RED cover
or outlet connections. These receive power
from the emergency generator and are used for
critical equipment only
Medical Equipment – Safety Inspections

Patient Care Equipment

Look for inspection sticker with
last date noted

OK to use if within 12 mos. of
date

Non Patient Care Equipment


Look for the “OK to use
Sticker)
Patient Owned Equipment

Physician order required
 Must be inspected by
Engineering before use
 RCP can inspect respiratory
therapy equipment from home
Medical Equipment – Safe Use Basics

DO NOT plug in any patient care equipment
without the third grounding prong in place.

DO NOT use extension cords.

DO NOT unplug devices by pulling on the cord.

DO NOT use wet, damaged or obviously defective
equipment.

DO NOT use equipment without first being trained

Always inspect equipment before using it on
patients.

Notify the staff of any malfunctioning equipment –
describe exactly what the problem is.
Section 5
HAZARDOUS MATERIALS AND
WASTE STREAM MANAGEMENT
Hazardous Materials– Your Right to Know
When in the hospital, you may be exposed to
hazardous chemicals. You have the right to
know and be informed of these potential
hazards. This information is available from 2
sources:


Warning Labels on Containers:
Material Safety Data Sheets
(MSDS) - written information supplied by
the manufacturer or distributor of the
product.
The MSDS lists chemical composition,
protective equipment, types of exposure
and effects, spill clean up and more.
Your Role in
HazMat

Carefully read and follow
warning labels and
MSDS.

Ask staff for help if you
are unclear about what
safety measures to take.
Material Safety Data Sheets (MSDS)
To Access MSDS
Information:

Call the toll free number shown at
right and have the following
information available:

Product name and number
 Manufacturer Name
 UPC code if applicable
 Your fax number

Emergency requests are
responded to within 15 minutes

Urgent requests are responded to
within 30 minutes.
MSDS
on Demand
1-800-451-8346
Hazardous Materials – Spill Procedure
C
O
D
E
Action To Take:
O
R
A
N
G
E
If You Witness a Spill:

REMOVE all persons in danger

NOTIFY hospital staff immediately

Keep others away from spill area

DO NOT clean up the spill
If You are Exposed:

Notify your clinical instructor and
hospital staff.

Follow emergency first aide
measures as directed.
Waste Stream Management
Special attention must be given to disposal
of hospital generated wastes. Follow the
disposal guidelines listed below.
Biohazardous waste Red bags
All Soiled linen
Yellow bags
Pathology waste
Labeled Red
containers
Chemotherapy
Waste
Labeled
containers
Sharps and broken
glass
Red sharps
containers
Pharmaceutical
waste
Blue and white
containers
PHARMACEUTICAL WASTE – Any
unused medication must be
discarded in the pharmaceutical
waste containers including
narcotics and fentanyl patches
o Electrolytes/TPN may be
discarded in sink
Module 6
RADIATION SAFETY
Radiation – About Radiation

Radioactive Materials
 Continuously emit radiation.
 They are made from
radioactive elements.

Radiation Producing Devices
 Emit zero radiation when they
are turned off.
 Devices are not a safety
concern when they are not
being used.

Look for the signs shown at
right.
Radiation - Radiation Sources
Radiation sources are present in
many areas of the hospital as shown
below:
Location
Radiation Source
Radiology
Devices - X-Ray
Machines
Cardiology
Devices - Portable X-ray
Surgery
Devices - Portable X-ray
ED
Devices -Portable X-ray
Nursing Units
Devices - Portable X-ray
Ways To
Reduce Your
Exposure
TIME
Spend as little time
around radiation as
possible.
Distance
Maximize your distance
from radiation.
Shielding
Shielding yourself behind
a wall or high density
material can substantially
reduce the dose
received.
Radiation – Radiation Sources
Portable x-rays are routinely
taken on the nursing units. Please
observe these precautions:

When you hear the x-ray tech
announce – “X-Ray” – get
clear of the room.

Only the patient and essential
personnel remain in the room.

Personnel remaining in the
room must:
 Wear a lead apron
 Not be pregnant
 Stay out of the path of the
x-ray beam.