Howard County Home Health and Hospice - NAHC
AGENCY NAME
Disaster Drill
Date __________________________________
10 AM - Office Staff
Start - Declare Disaster in Building.
Administrator assign essential items that must be removed
Closet shelf
Charts
All out
Time activities
All meet at flag pole
Office Manager in charge of counting employees and reporting to Emergency Personnel if someone is missing
3 PM All Staff
Repeat Office Disaster Drill practice
Assign pt care staff to getting pt charts out
All meet at flag pole
Office Manager in charge of counting employees and reporting to Emergency Personnel if someone is missing
Paper Drill
A tornado strikes the area leaving a wide path of destruction. Phone and electric services are lost. The Administrator is notified of this disaster by a call from the Local Emergency Management Services and initiates the disaster calling chain. The Administrator and Assistant Administrator go to the office and the Office Manager and Secretary call the Administrator with the results of their calling. They report to the office to help manage calls.
The Administrator and Assistant Administrator develop assignments of the Agency’s patients and give assignments to the Secretary and Office Manager to pass out assignments to teams of staff.
Break apart into teams and have groups discuss how they will handle each scenario. Have one person stay with the injured patient and the other come to the Assistant Administrator to report condition of patient and needs of patients. That person will need to go back and report to their team member then move to the other patient once the first one receives EMT care.
After teams are done, call groups back together and ask each group to present their results. Once they have done so, ask for any ideas about changes in policy from the attendees.
Team A
Mrs. S - Hospice patient is 78 y/o with cancer of colon with metastasis to bone. Has had recent pain control issues and Duragesic was increased to 100 mcg q 72 hrs 3 days ago. Pt had refill called in today to local pharmacy. Is a resident of CCH and has a daughter who lives in the area.
Mr. V - Home Health patient is 92 y/o with severe dementia, does not respond to questions or comments. Wife or hired sitter stays with him at all times. Wife overburdened with his care. When you arrive, you find the wife lying on the front porch with an obviously fractured leg. Pt is sitting in his geri-chair in living room.
Team B
Mrs. J - Hospice patient is 72 y/o with lymphoma and very debilitated with arthritis and walks with a walker. Lives with daughter but is alone during the day while daughter is at work. When you arrive, pt is alone in the house and lying on the floor. There is broken glass everywhere, windows are out and Mrs. J has multiple cuts and scrapes. She is complaining of pain in her left wrist and it is swollen and misshapen.
Mrs. G - Home Health patient is 80 y/o with severe COPD, easily excitable, which often results in respiratory distress. When you arrive, pt’s respirations are 48 and she has cyanosis of nail beds and lips. She says she can’t get her oxygen tank to work and her electricity is off -so her room air concentrator isn’t working. She also is unable to take a nebulizer treatment.
Team C
Mrs. A - Home Health patient is 95 y/o, frail, lives alone, has severe arthritis. Niece had expressed concern about pt’s ability to remain alone when referral was received 2 months ago. Niece lives 50 miles away. Pt has no other assisting persons in her life. When you arrive, the roof is gone from pt’s trailer, a tree had fallen through the front of her trailer. The wheelchair ramp is destroyed. Pt has bad gash on her arm that is bleeding profusely.
Mrs. M - Hospice patient is 74 y/o who lives alone in an apartment complex. Has cancer of the lung, as well as CHF and other cardiac problems. Pt is weak and it is questionable how much longer she will be able to stay on her own. She was just discharged from the hospital earlier this week due to exacerbation of CHF and had multiple medication changes. A medication box was started this week. When you arrive, you see that some of the apartment buildings by Mrs. M’s apartment are destroyed but her building is not damaged. Pt is lying on couch asleep, awakens easily, doesn’t realize that anything has happened. Things in her apartment are in disarray and pills are found all over the place.
Team D
Mrs. D - Home Health patient who is 94 y/o, frail, lives alone with hypertension and arthritis diagnoses. When you arrive, she is lying on the floor, does not respond to stimuli, has a lump on her head and is bleeding profusely from a wound on her scalp.
Mr. B - Hospice patient who is 72 y/o and has advanced Parkinson’s Disease. Lives with spouse who is very excitable and has hired caregiver with them at all times. Pt is bedfast, not oriented and is incontinent and wears diapers. When you arrive, a tree has fallen on the house with a branch punched through the living room roof. Sitter unconscious on living room floor and pt’s wife hysterical. Pt lying in bed unharmed.
Team E
Mr. L - Home Health patient who is 84 y/o and lives alone in the Senior Citizens Apartments. He ambulates with walker and becomes short of breath when walking longer distances. He has COPD, diabetes, etc. The building next to Mr. L’s is on fire when you arrive, although Mr. L’s building appears uninjured. When you enter his apartment, you find Mr. L in the hallway, lying on the floor with an open compound fracture of the femur. His apartment is in disarray, broken glass everywhere and furniture turned over or moved out of place.
Ms. S - Hospice patient is 72 y/o who lives alone in her own home. She was diagnosed as having cancer of the biliary tree. She has been fairly active the first few weeks after admission but has started to become weaker the past few days, has fallen twice and is working on end-of-life tasks such as having her will made. When you arrive, you find an electrical line that is dancing by her front door and shooting sparks. Tree limbs have fallen all over the yard and several have fallen on the house. When you go to her back door, you smell a strong odor of natural gas.
Team F
Mrs. T - Home Health patient who is 76 y/o and is a blind diabetic who lives alone in a dilapidated house and receives daily skilled nursing visits for insulin injections as she is unable to do them and no one is available to be taught how to do so. When you arrive, pt’s front porch is collapsed. You go around to the back of her house and notice that a number of windows have the glass blown out and you can hear someone moaning. When you enter the home you find Ms. T sitting in her living room bleeding profusely from a cut in which glass is still imbedded into her arm. Her living room ceiling is partially collapsed.
Mrs. K - Hospice patient who is 99 y/o and lives with son in large newer home on edge of town. Has hired sitters who manage her care. Pt is bedbound, has a Foley catheter and confused at times. You arrive to find the son had gone to a nearby town earlier that day. Sitter is alone with pt and home is OK, other than some broken windows. Pt had panicked when the tornado was coming and tried to get out of bed, pulling her catheter out at the time. Pt lying on floor but apparently uninjured. Sitter had been in another room in the house and has some cuts from flying glass.
Volunteer Coordinator
Your assignment is to contact volunteers to determine how many are available to prepare sandwiches and drinks for Agency employees whenever they come back in to report in.
See how many volunteers you can find (phone lines are down in area). See how many can come in and make sandwiches. Assign some to go to grocery store to buy sandwich fixings and cans of soda and bags for the sandwiches. Have them come in to make sandwiches.
(If this were a real disaster, it wouldn’t be over in an hour like a practice session. Employees will come in to report on the status of patients they find. They will need you and the volunteers there to hand them sodas and sandwiches while they rest for a little bit before going back out. It may also be necessary for you to take the food to an assigned site near the disaster, where staff will be reporting to Administrator or Assistant Administrator.)
Assistant Administrator
You are assigned to the Emergency Command Center. Set up near where the Emergency Management Director is and be available for Agency employees to report to you. When an employee comes to you with a report, you will notify the Emergency Management Director of the need for transport of a patient, if it is necessary. If not, send the staff member to their next assignment.
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