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Emergency Response Procedures Jerramungup Health Centre Bremer Bay Health Centre WACHS GREAT SOUTHERN

Emergency Response Procedures – Jerramungup and Bremer Bay Health Centres


Printed or saved electronic copies of this policy document are considered uncontrolled. Always source the current version from WACHS HealthPoint Policies.

Date of Last Review: July 2018 of 91 Date Next Review: May 2020

Effective: Approval These emergency response procedures assign responsibilities, actions and procedures that are implemented at Jerramungup Health Centre and Bremer Bay Health Centre, MPS Great Southern, following the occurrence of an emergency.

These procedures have been formally endorsed by the Great Southern Emergency Management Committee as the Standard Operating Procedure to be followed during an emergency response at Jerramungup Health Centre and Bremer Bay Health Centre, MPS Great Southern.

Recommended Leanne Laurie

A/DON/HSM East Great Southern

15 March 2019

Dated

Endorsed Ruth York

Operations Manager MPS

15 March 2019

Dated

Approved David Naughton

Regional Director

12 April 2019

Dated

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/WACHS-Policies-Landing.aspx




Effective: 15 July 2019

WACHS GREAT SOUTHERN Jerramungup Health Centre and Bremer Bay Health Centre

Emergency Response Procedures: Jerramungup and Bremer Bay

Contents

1. Introduction ............................................................................................................... 6

1.1 Description of Service 6

1.2 Service Aim 6

1.3 Emergency Response Procedures 6

1.4 Documentation 6

1.5 Activation Process of Emergency Response 7

1.6 Communication and Media Management 7

1.7 Recovery 9

1.8 Emergency Contact Numbers 10

2. Code Red Emergency Response Procedure ......................................................... 12

2.1 Fire and Smoke Protection................................................................................ 12

2.1.1. Bremer Bay ................................................................................................. 13

2.1.2. Jerramungup Health Centre ........................................................................ 13

2.2. Procedure ......................................................................................................... 15

2.3. Definitions ......................................................................................................... 16

2.4. Roles and Responsibilities ................................................................................ 16

3. Code Purple Emergency Response Procedure .................................................... 21

3.1. Forms of Threats ............................................................................................... 21

3.2. Evacuation Options ........................................................................................... 23

3.3. Procedure ......................................................................................................... 25

3.3.1. Receiving a Bomb Threat by Phone 25

3.3.2. Written Bomb Threat via Mail or Email 25

3.3.3. Conducting a Search 25

3.3.4. Vehicles 26

3.4. Definitions ......................................................................................................... 27






4. Code Black Emergency Response Procedure ...................................................... 36

4.1. Prevention and Preparedness ........................................................................... 36

4.1.1. Personal Duress Alarms 37

4.2. Response to the Aggressive Person ................................................................. 39

4.2.1. Procedure Flowchart 40

4.3. Code Black Alpha - Infant / Child Abduction ..................................................... 41

4.3.1. Response 41

4.3.2. Line Manager 41

4.4. Code Black Bravo – Active Shooter .................................................................. 41

4.4.1. Response by Staff ....................................................................................... 42

4.5. Definitions ......................................................................................................... 43


5. Code Yellow Emergency Response Procedure .................................................... 55

5.1. Chemical Leak (Accidental) .............................................................................. 56

5.1.1. Person Discovering the Leak Responsibilities 56

5.1.2. Health Centre Emergency Coordinator Responsibilities 56

5.2. Failure of External Telephone Lines ................................................................. 57

5.3. Satellite Phone .................................................................................................. 58

5.4. Failure of Water Supply .................................................................................... 58

5.5. Failure of Electricity Supply ............................................................................... 60

5.6. Failure of Nurse Supply .................................................................................... 63

5.7. Earthquakes (Reference Geoscience Australia) ............................................... 65

5.7.1. Earthquake Procedures – All Staff .............................................................. 66

5.8. Severe Weather Procedure............................................................................... 66

5.8.1. Pre Storm Season 67

5.8.2. Pre-Storm 67

5.8.3. Post-Severe Weather 68

5.9. Flood / Storm Surge / Tsunami ......................................................................... 70

5.10. Bushfire ............................................................................................................. 75

5.10.1. Pre Bushfire Season 75

5.10.2. Bushfire Advice 75

5.10.3. Bushfire Watch and Act 76






6. Code Orange Emergency Response Procedure ................................................... 81

6.1. Authority to Evacuate ........................................................................................ 81

6.2. Area Clearing .................................................................................................... 81

6.3. Assembly Point ................................................................................................. 81

6.4. Decanting Patients ............................................................................................ 82

6.5. Emergency Evacuation Locations for Health Centre ......................................... 83

6.6. Procedure ......................................................................................................... 84


7. Compliance .............................................................................................................. 90

8. Evaluation ................................................................................................................ 90

9. Standards ................................................................................................................. 90

10. References ............................................................................................................... 90

11. Related Forms ......................................................................................................... 90

12. Related Policy Documents ..................................................................................... 90

13. Related WA Health System Policies ...................................................................... 91

14. Appendices .............................................................................................................. 91





Effective: 15 July 2019

1. Introduction

1.1 Description of Service The two health centres located in the Shire of Jerramungup are based in the location of Jerramungup and Bremer Bay. The health centres function as nurse led, primary health centres with capacity to provide 24 hours per day on-call capability for emergency care. Outreach services are provided by GS Population Health for child health, school health and allied health services. Telehealth services are delivered for diabetes and respiratory services as contracted primary health services with WACHS. Telehealth services for emergency care is delivered by Emergency Telehealth Services (ETS).

1.2 Service Aim The aim of the Jerramungup and Bremer Bay Health Centres is to support WA Country Health Service - Great Southern to provide quality, primary health services to the people of the Shire of Jerramungup.

1.3 Emergency Response Procedures The Jerramungup and Bremer Bay Health Centres emergency response procedures are governed by the WACHS Emergency (Disaster) Management Arrangements Policy and the GS Regional Health Disaster (RHDC) Handbook. The Great Southern Executive and senior staff participate in an on-all roster in the role of the GS Regional Health Disaster Coordinator (RHDC). The GS RHDC is the single point of notification of any incident or major emergency requiring a regional response.

• Phone: 0437 986 621 Emergency Response Procedures are designed to be invoked immediately following identification of an emergency at a facility to protect people and assets. The Emergency Response Procedures are specific to the health centres and cover:

• Immediate actions to be taken; and

• Follow on actions to be taken by staff.

1.4 Documentation 1.4.2 Emergency Procedure Manuals Two hardcopy emergency manuals are to be kept on-site for each health centre. One in the emergency bay area and one in the administration area. It is the responsibility of the manager for the health centres to ensure currency of the hard copy file.


http://wachs.hdwa.health.wa.gov.au/index.php?eID=tx_nawsecuredl&u=228&file=fileadmin/sections/great_southern/disaster_management/RHDCoord/GS_Regional_Health_Disaster_Coord_Handbook_V1.pdf&t=1531273736&hash=16fb6cf8714fef3d6dd557e573860b6e




1.4.1 Action Cards The action cards for each emergency response team member are to be completed by the relevant team member and are to be sent to the Ravensthorpe Director of Nursing/Health Service Manager for review and reporting at the following committees:

Code Red/Orange and Black – East Great Southern OSH Committee

Code Yellow/Brown – MPS Operations Committee

Code Blue – The MER Form is to be sent to the DON/HSM for review, once reviewed the event and outcome is to be reported as part of Ravensthorpe East Great Southern Clinical Leadership Committee.

The Emergency Controller is responsible for ensuring that new action cards are printed and replaced in the Emergency Response Files on site

1.5 Activation Process of Emergency Response There is a single process of action that is common to all code responses:

Identification of emergency event

Response

Person identifying the emergency raises the alarm by contacting the RHDC and dialing 000 (as appropriate for the code)

Exceptions: code blue: ETS

Alert

Individual recognises or is alerted to an emergency event

Local Health Disaster Coordinator activates local resources and the RHDC for regional response

Stand down / All Clear RHDC in collaboration with LHDC authorises stand down/all clear





1.6 Communication and Media Management Effective communication is essential during an emergency event. There are a range of communication tools available during an emergency event

Any communication with media during an emergency event is coordinated through WACHS Communications.

All media inquiries and calls from journalists must be referred to WACHS Communications, however, key staff may be called on to assist with a response to the media or act as an official spokesperson.

The media are to be given the contact number 6145 4166 which is monitored 24 hours a day, seven days a week (see WACHS Media and Communications Policy)

Note: Staff are NOT to make any comments or provide any information to the media regarding an emergency event unless it has been approved by WACHS Media and the RHDC.

Telephone

Landline The main landline includes both desktop and cordless.

Mobile phone (including SMS and data access)

Health centre mobile phones, used in day-to day communication and allocated to the senior nurse and the nurse rostered on-call.

Used to access emergency services websites for alerts, notifications and warnings

Satellite Phone The satellite phone is a docked phone with an external aerial.

Other

Telehealth Used in day-to-day communication with Emergency Telehealth Service (ETS) and when emergency meetings are being scheduled across the region

Situation Report Situation Reports, also known as sitreps are used by both Department of Health and WACHS to inform others of any incidents.

Outlook and Global emails

Used to communicate across the health service and within the Department of Health

WebEOC WebEOC is the Department of Health’s crisis information management system and provides secure real-time information sharing about an incident, enabling staff within an operations centre to improve coordination of response

Intranet Used to access all Emergency Management and Business Continuity Management Documents and policies.

Important Emergency Preparedness information including regional contact lists: GS Disaster Management – Emergency Preparedness page

Internet Used to access emergency services websites for alerts, notifications and warnings


http://wachs.hdwa.health.wa.gov.au/index.php?id=6175




1.7 Recovery Recovery is the coordinated process of supporting affected areas to return to normal or improved conditions. In this phase three perspectives need to be considered:

• Short term: action to rectify situation, relocate patients, staff and visitors, re-establish services

• Medium term: counselling, debrief and support

• Longer term: review the management aspects of the event and ask the following questions:

o How did we go?

o What did we do well?

o What didn’t work so well?

o What can be improved for next time?

The Nurse Practitioner is the nominated recovery coordinator; if the Nurse Practitioner is involved in the incident then the MPS Operations Manager will nominate the recovery coordinator.

The role of the recovery coordinator is to:

• Restore staff confidence including the provision of debriefs and counselling, including the early involvement of the GS Occupational Safety and Health Coordinator;

• Nominate a suitable liaison officer in situations where WA Police may need to conduct crime scene investigation activities;

• Management of medical and information via the GS Regional Directors office and WACHS Communications;

• Consider appropriate ways to acknowledge any staff, patients or visitors whom may have been injured during the event;

• Activate Business Continuity Plans;

• Repairing and/or replacing infrastructure / equipment in collaborating with the GS Facilities Manager; and

• Capture lessons learnt and actioning as appropriate.

Physical injuries by staff are to be treated and managed as per emergency presentation guidelines.

Refer to the WACHS Kimberley for further information on incident debriefing: Critical Incident Debriefing for Staff Procedure.

All employees will be provided with details of Great Southern Employee Assistant Program (EAP) counsellor contact details found here: Employee Assistance Program (EAP)


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1.8 Emergency Contact Numbers

WACHS – GREAT SOUTHERN SENIOR STAFF:

TITLE: LAND LINE: MOBILE:

Regional Director 9892 2672 0409 200 226

MPS Operations Manager (Ruth York) 9892 1222 0428 758 213

IT / Communications Coordinator 9892 2262 0418 922 262

Disaster Co-Coordinator 0437 986 621

Media Coordinator (24/7) 6145 4166

EASTERN GREAT SOUTHERN SENIOR STAFF:

TITLE: Ext: MOBILE:

DON/HSM 9838 2211 0427 483 604

Business Manager 9892 1222

AHC Nurse Manager - direct 9892 8224

CHSP 0429 386 016

GS Facilities on call 0437 235 815

Radiology 0418 933 726

Quality Manager 9892 2626

Population Health 9821 9845

Mental Health 9892 2440 0417 182 493

Nurse Manager – Jerramungup 9835 1004 0429 351 007

Jerramungup Health Service Satellite Phone & Emergency Contact Numbers

Sat Phone 0147 149 587

Emergency 0429 351 007

Nurse Manager – Bremer Bay 9837 4026

Nurse Manager – Bremer Bay Satellite Phone & Emergency Contact Numbers

Sat Phone 0147 147 586

Emergency 0428 374 026





OUT OF HOURS CONTACT DETAILS – RAVENSTHORPE MEDICAL PRACTITIONERS

DOCTOR: SURGERY: HOME: MOBILE:

Dr Michael Livingstone 9838 1600 0429 633 717

OTHER SERVICES:

TITLE: LAND LINE: MOBILE:

Royal Flying Doctor 1800 625 800

Ravensthorpe Police 9828 1004

Police Transport 9374 4836 Regional WA use only

St John’s Ambulance 13 12 33

Fire Brigade 000

Ravensthorpe Shire – Works Manager 9838 0000

Albany Regional Hospital 9892 2222

Princess Margaret Hospital 9340 8222

Sir Charles Gardiner Hospital 9346 3333

Fiona Stanley Hospital 6152 2222

DoH “On Call Duty Officer” 24 hour emergency cover (business answering machine)

08 9328 0553

Message to state:

Who you want to contact i.e. On Call Duty Officer

The name of the person sending the message

Name of site

Telephone number you require the officer to contact you on

Short message

Advise Operator of the degree of urgency with which you require the message to be handled.





Fire is a danger that every health facility must take seriously. Fire poses particular dangers for incapacitated or unconscious patients. Psychiatric, elderly patients and children may not understand the danger or they may hide.

The four most dangerous things about a fire are:

Time When confronted by a fire you count the time you have to respond in seconds.

Within only a few minutes, the smoke could stop you from seeing your hand in front of your face.

Smoke and Fumes More people are killed by the smoke than by the actual heat from the flames.

Smoke from a fire is so lethal because carbon monoxide can’t be seen or smelt.

It can disorientate and confuse you before you even know it is happening, render you unconscious and kill you. It is so important to remove people from immediate danger as quickly as possible.

Visibility As the smoke spreads, the 30 – 50 centimetres above the floor will be the clearest of smoke, but eventually even that will shrink to only a few centimetres. To escape a fire it’s best to get down as low as you can go!

Heat The heat from a fire can stop you in your tracks. The heat in a fire can rise to hundreds of degrees Celsius within a few minutes, easily hot enough to melt metal, and sear your lungs in an instant – impossible to “run through”.

2.1 Fire and Smoke Protection The following means of fire detection/control are installed at the Health Centres

• Remote monitoring for fire - should an alarm be activated, the primary manager for each site will be telephoned, if no response, the fire brigade are alerted.

• Hand held fire extinguishers - Detailed Instructions are written on or above each extinguisher, please refer to Appendix 1: fire extinguisher types, use and where to use

• Fire smothering blankets - used for cooking fires (smothering) and smothering burning persons.

Refer to Appendix 1: which outlines use and precautions of fire extinguishers and blankets.

2. Code Red Emergency Response Procedure





2.1.1. Bremer Bay

Fire Extinguishers

AREA TYPE SIZE

Nursing administration office CO2 2 KG

Kitchen Flame stop fire blanket 1M X 1M

Emergency department CO2 2.KG

Emergency department Dry chemical powder 2.5KG

Smoke Detectors

AREA NUMBER

ED room 2

Waiting room 2

Nurse admin room 1

Nurse treatment room 1

Administration office 1

Hallway near laundry 1

2.1.2. Jerramungup Health Centre

Fire extinguishers

AREA TYPE SIZE

Hallway near ED Water 9.1LTR

Hallway near ED CO2

Nursing admin office CO2 2 KG

Kitchen Dry chemical powder 1KG

Kitchen Flame stop fire blanket 1M X 1M

Hallway near laundry entrance door Powder 2.5KG





Waiting room Fire board

Smoke Detectors

AREA NUMBER

ED ROOM 3

XRAY ROOM 1

HALLWAY NEAR ED ROOM 1

WAITING ROOM 2

NURSE ADMIN ROOM 1

NURSE TREATMENT ROOM 1

TELEHEALTH ROOM 1

ADMIN OFFICE 1

HALLWAY NEAR TELEHEALTH and ADMIN OFFICE 2

LAUNDRY 1

HALLWAY NEAR LAUNDRY 1

KITCHEN 1

HALLWAY NEAR PUBLIC TOILETS 3

DRS SURGERY 1

DRS ADMIN 1

For location on the above, see the fire plan on the wall at the Health Centre.





2.2. Procedure

Observe fire or smells/

observes smoke

Identify cause / assess the risk

Are people in danger? NoYes

REMOVEPersons from immediate danger

Turn of medical gas and electrical equipment if possibleR

ACE

ALERTVerbally inform staff

Dial 000CHIEF WARDEN /SENIOR STAFF

CONTAINClose doors and windows in area

EXTINGUISH FIRE IF TRAINED AND SAFE TO DO SO

Fire Out?

Yes No

Commence EVACUATION Code Orange

CHIEF WARDEN gives ALL CLEAR

Assist patient and visitors affected by incident





2.3. Definitions

Remove Remove people/ patients from immediate danger

Alert Alert staff in vicinity / alert fire brigade

Confine Confine fire and smoke by closing doors/ windows

Extinguish Extinguish fire if only safe to do so and if only waste paper bin size

2.4. Roles and Responsibilities

Health Centre Emergency Coordinator

Senior Nurse or senior staff member at time in the health centre, who is responsible for the local health centre's response to the incident. All staff numbers kept locally

Regional Health Disaster Coordinator

Is the Regional Director or delegate, who is responsible for coordinating the health response to an operation within the Great Southern region. Mobile contact: 0437 986 621 Generic Email: [email protected]

Nurse Practitioner

Is the line manager for the nursing service for the health centres, and if present, acts as the Health Centre Emergency Coordinator. The Nurse Practitioner is responsible for: • updating and maintaining current emergency procedure • ensuring practical testing of emergency procedure and evacuation is

undertaken at least yearly, and that evidence is provided to Learning and Development of attendance lists

• monitoring annual staff compliance of mandatory training (online learning modules)

• ensuring appropriate actions are taken / escalated as identified by the OSH audits

• Prepare prior to fire season each year with communication with staff and Nurse Director regarding risks raised and action plans to resolve risks.

• Member of LEMC and liaise as required

All Staff

All staff are responsible for: • completing annual core essential training as outlined in WACHS

Workforce Learning and Development Policy • completing duties as instructed by the emergency plan and/or as

instructed by the Health Centre Emergency Coordinator.





OSH Representative

The Occupational Safety and Health Representative is responsible for: • in liaison with the Nurse Practitioner, scheduling at least annual fire

and evacuation practical training at each of the Health Centres • completing the OSH audits relating to safety and security as prescribed • liaising with the Nurse Practitioner to develop and document action

plans • raising risks at the quarterly staff meetings and status of actions taken

to resolve issues/risks • ensuring completion of Safety Risk Report form.

Other personnel

All Lessee personal are responsible for: • following instructions of staff during an emergency • ensuring all personal are available to attend and participate in at least

an annual practice fire and evacuation drill.


https://healthpoint.hdwa.health.wa.gov.au/policies/_layouts/DocIdRedir.aspx?ID=TS4KSNFPVEZQ-89-1762




CODE RED Action Card 1

PERSON DISCOVERING FIRE / SMOKE – ALL HOURS REMOVE ................................... Persons from immediate danger

ALERT ........................................ Alert staff, lessee and patients in building of fire/smoke

CONFINE ................................... The fire and smoke, close doors to confine the fire, leave

lights on

EVACUATE/EXTINGUISH ......... Evacuate building only fight the fire IF IT IS SAFE TO DO SO (fire must be smaller than a small waste paper bin)

1. Do not take any unnecessary risks.

2. Safety Points to follow:

• DO NOT attempt to extinguish a fire larger than a waste paper basket.

• Carbon Dioxide and Dry Chemical Powder Extinguishers should be used in the following situations:

- Combustible fires (wood, paper and textiles)

- Flammable liquids (petrol, kerosene)

• Electrical fires: Switch off at source if safe to do so. Use appropriate extinguisher or smother with fire blanket (only if turned off at source).

• Fire in persons clothing: Smother person in a blanket as soon as fire detected. Do not attempt to remove clothing until inspection and necessary treatment commenced.

• Remain calm and do not shout “fire”

• Reassure patients and visitors. Move briskly but do not rush.

• Evacuate building and await fire brigade response

• Wait for further instructions.

3. Review Evacuation Procedures (CODE ORANGE)

4. The Fire and Emergency Services will take over primary responsibility as soon as they arrive and become the Emergency Controller.





CODE RED Action Card 2 AREA WARDEN / EMERGENCY CONTROLLER

The Senior Nurse or HACC Coordinator acts as the Emergency Controller

ON ALERT 1. Assess the situation and determine:

• actions completed by person discovering alerting fire/smoke

• ongoing risks to staff, patients, visitors

• ongoing risk to property.

2. Collect and keep mobile phone with you.

3. Designate two (2) people, if available, to check area of reported smoke/fire if not already done.

4. Compile a list of staff and patients at hand and ensure that are all accounted for. Make arrangements for the removal of parry pack (to treat injured) only if safe to do so.

5. Determine if triple zero is required to be notified. If false alarm ensure an investigation of the cause of the alarm occurs (i.e. burning toast). Complete OSH Safety Risk Report form.

6. If smoke is not able to be easily identified with cause i.e. burnt toast, then you must assume fire and initiate a confirmed fire response.

CONFIRMED FIRE 7. Ensure that triple zero 000 has been called.

8. Coordinate the removal of patients and visitors from the building: initiate CODE ORANGE 9. If there are causalities assess injuries and identify safe location to move causalities to

outside the building.

10. On arrival of Fire and Emergency Services relinquish control.

11. Ensure Nurse Practitioner and/or Nurse Director is informed.

12. Maintain communications with staff and Fire and Emergency Services.

ALL CLEAR – STAND DOWN 13. Confirm safety status of incident with Fire and Emergency Services.

14. Assess the impact of the incident on the ability to provide normal services in the building.

15. Work with other key staff to plan for resumption of normal services as applicable.

16. Coordinate the re-occupancy of the area by staff, patients and visitors as applicable.

17. Participate in formal debrief of the incident. Review procedures and provide information as required for reports/briefings.






Effective: Appendix 1: Fire Extinguisher Types, Use and Where to Use





Effective: 3. Code Purple Emergency Response Procedure

While this procedure is ostensibly related to bomb threats, the advice from police is that all threats can be treated in the same way, at least in the initial stages. The threat may be against the organisation, for example threats to business continuity or release of harmful or damaging information, against an individual, as in threats of violence, or against a number of personnel as in a bomb or chemical threat.

An accurate analysis of a threat can provide valuable information on which to base recommendations, action and subsequent investigation.

3.1. Forms of Threats Serious threats may be in one of the following forms: (a) Written threat

If a threat is received in writing it should be kept, including any envelope or container. Once a message is recognised as a bomb threat, further unnecessary handling should be avoided. Every possible effort should be made to retain evidence such as possible fingerprints, handwriting or typewriting, paper and postmarks. Such evidence should be protected by placing it in a large envelope.

(b) Telephone threat An accurate analysis of the telephone threat can provide valuable information on which to base recommendations, action and subsequent investigation.

The person receiving the threat by telephone should not disconnect the call and, as soon as possible, should complete the information required on a threat checklist. The telephone threat checklist should be held by telephonists and other persons who regularly accept incoming telephone calls.

(c) Suspect object A suspicious object is one deemed a possible threat by virtue of its characteristics, location and circumstances.

(d) Suspect mail All staff responsible for handling mail and incoming goods are to be trained in the identification and subsequent handling of suspect mail items and incoming goods.

A threat is not a designated hazard under state legislation however as there is potentially a criminal element WA Police (WAPOL) will take overall command. DFES act as a support

A threat is not considered to be an emergency until it has been assessed by a competent person.

A threat is merely words that are designed to elicit a response. It is the intent, motivation and capability of the person

making the threat that could indicate a real risk to staff safety.





agency under the control of the WAPOL Incident Controller (IC). DFES will generally stand-off from the site and report to the Police IC, they will not always communicate with the site directly. As soon as possible, WAPOL will initiate an Incident Command structure, with a nominated person in charge. The Hospital Emergency Coordinator is to identify the Incident Controller (IC) and liaise with them. This will not only ensure that the Hospital Emergency Coordinator is getting advice and information in a timely fashion, but ensures that the police know who is in charge at the site and so limit any false or confusing information that may come from other occupants. Remember that the first arriving police officers are operating in an evaluation mode and are not necessarily in a position to provide authoritative advice on the best course of action. There are many considerations when evaluating whether to evacuate or not and the safety of all persons within the hospital must be paramount. WAPOL can advise the Hospital Emergency Coordinator that an evacuation is recommended, but the responsibility for deciding on an evacuation lies with the Hospital Emergency Coordinator. The Hospital Emergency Coordinator can determine that alternative arrangements are more appropriate and carry those out contrary to the advice of WAPOL. The responsibility of the Hospital Emergency Coordinator encompasses the complete evacuation of patients, visitors and staff from the building to a nominated assembly area and for communication with the assembly area during an emergency. WAPOL do not have the power to order an evacuation unless an emergency is declared or the site becomes a crime scene. Under the Emergency Management Act 2005 the State Emergency Coordinator (normally the Commissioner of Police) must declare an emergency in writing. If a suspicious object or package has been located a realistic assessment of the risk to building occupants should be undertaken. The size of the object will provide clues as to the potential damage that may be expected, depending on the nature of the package the danger may be from explosion or from the release of a substance.

Where the contents are unknown a possible explosive should be assumed.

If the object is a vehicle, then it is possible that significant damage to the building could be caused should it explode, so a full evacuation would be appropriate. If however the object is contained in a bag or box and there is evidence that it was carried to the site then it is unlikely that structural damage to the building would occur. Damage is likely to be restricted to glass breakage or localised minor damage. In this instance it may not be necessary to fully evacuate the building.

If there is no physical package or device evident or if something is found outside it may be safer to keep people inside the building. In this instance moving people away from windows or to the opposite side of the building may be the best response.

When assessing the actual risk associated with a threatening phone call or suspect package it is advisable, if sufficient time is allowed, to form a threat assessment committee to review the data available then determine appropriate actions. This ensures that no one person has to shoulder the responsibility for making what is an extremely complex decision.

The threat assessment committee should be small and available and would usually consist of three to five people, suggested members are:





• the Health Centre Emergency Coordinator

• a member of the Executive Team

• the Health Service Facilities Manager

• an emergency services representative (normally police).

The assessment should always err on the side of caution, however evacuation of the hospital is an extremely time consuming activity, and the interruptions to patient care may place them at greater risk than remaining in the hospital.

3.2. Evacuation Options The need to evacuate a hospital should be made based on an evaluation of the threat/object and should take into consideration the following factors:

• Is there specific information in the threat that makes it credible?

• What is the maximum size of the potential explosive charge, based on the size of the object if the contents are not known? This will determine how far away the assembly area should be.

• How much time is there to make a decision? If a timeframe is given in the threat, decision time is calculated by subtracting a safety factor of 30 minutes, and then subtract the time it will take to evacuate. Any time left is decision time.

• How good is the overall security of the site? Is it likely that someone could access and place a device?

• Is there additional information available within the organisation that may validate the threat? (A history of conflict with someone, activities that may attract issue motivated groups.)

• Where are occupants likely to be safest? At the very least nominate an assembly area that is different from the normal fire evacuation assembly area.

Remember that one of the key goals of a threat is to disrupt business and create anxiety and confusion. Automatic evacuations can provide instant gratification to the person making the threat and possibly invite further threats. Additionally, if security at the site is good, the threat may be an attempt to get the targets out into the open where they are more easily targeted.

It is becoming common practice around the world to keep staff inside the building during a potential bomb incident, or to only evacuate staff that are at immediate risk. Depending on the size and location of the device the building can actually provide significant protection to occupants. If evacuation is to be considered the distance that all personnel need to be evacuated is dependent on the size of the potential device, this is called the stand-off distance.

Additionally, there is a large distance between what should be considered the mandatory and preferred distances to evacuate for any given size of device.

The recommended stand-off distance for the most likely potential devices in open air is 520m. This is the minimum distance that the assembly area should be away from the health centre for explosive incidents if no physical cover is available. Where physical cover is available the distance can be reduced, depending on the type of cover.





Prior to any evacuation, the Health Centre Emergency Coordinator is to satisfy them self that all relevant egress routes and assembly areas are searched for suspicious objects. Doors and windows should be left open to assist in venting any possible explosion.

Immediate and total evacuation would seem to be the most appropriate response to any bomb threat, however there are significant safety and economic factors associated with a bomb threat that may weigh against an immediate evacuation. These are as follows:

• Risk of injury As a general rule, the easiest area in which to plant an object is in the shrubbery sometimes found outside a building, an adjoining car park or in an area to which the public has the easiest access. Immediate evacuation through these areas may increase the risk of injury. Car parks should not normally be used as assembly areas. The Area Warden shall ensure that egress routes and assembly areas are searched for suspicious objects, prior to any evacuation.

• Response impairment Total and prompt evacuation will remove personnel who may be required to make a search.

• Panic A sudden bomb threat evacuation may cause panic and unpredictable behaviour, leading to unnecessary risk of injury.

• Patient dependency At least some of the patients in an area under bomb threat may be dependent upon building services for survival.

• Impact on patient care Although the evacuation of patients to an assembly area may ensure their safety, repeated threats and evacuations would compromise patient care.

The above factors may make immediate total evacuation an undesirable response to the bomb threat. NOTE: Total and immediate evacuation, although risky, is the easy decision. After taking the

easy way, the hard decision of when to return still has to be made, how long do you wait until you can safely determine that there is no further danger?

An area around the device or package of at least 35m in all directions, should be cleared of all personnel, but people further away should take cover behind structural walls. If a bomb explodes, depending upon the extent of injury or damage (or both), the Health Centre Emergency Coordinator shall notify the relevant external emergency services for assistance e.g. Police, DFES, Ambulance or other health care facilities. Building damage is covered under Code yellow, fire by Code Red.

The Health Centre Emergency Coordinator will be required to evacuate the building Emergency Operations Centre once the entire building has been cleared, but should remain in liaison with the Incident Controller until the all clear is given.





The Health Centre Emergency Coordinator should attempt to maintain communications with the assembly area and keep Area Wardens informed regarding the potential duration of the incident, etc. If the situation is likely to continue for an extended period it is to consider patient and staff welfare.

Alert

Two way radios and mobile phones SHOULD NOT be used during any "bomb threat" alert, as operation of this type of equipment may well initiate a bomb blast, should a bomb be present.

3.3. Procedure Upon receipt of a threat or discovery of a suspect object, the Health Centre Emergency Coordinator is to follow the procedures on Code Purple Bomb Threat Action Card 1 and immediately inform the police. No details are to be given to anyone other than the police unless authorised.

The decision to evacuate the health centre or to search for the bomb is to be made by Health Centre Emergency Coordinator in liaison with the police (Incident Controller).

No action to search or evacuate is to commence until the order to do so is given by the Health Centre Emergency Coordinator or police.

The aim of the search is to identify any object which is not normally found in that area of location, or for which an owner is not readily identifiable or becomes suspect for any other reason e.g. suspiciously labelled (similar to that described in the threat), unusual size, shape and sound, and presence of pieces of tape, wire, string or explosive wrappings. If any suspect object is found, the senior staff member on duty is to ensure that it is not touched or moved, and that the area is kept clear.

3.3.1. Receiving a Bomb Threat by Phone In the event of receiving a telephone call bomb threat, the procedures to be followed are on Code Purple Bomb Threat Action Card 2.

An accurate analysis of the telephone threat can provide valuable information on which to base recommendations, action and subsequent investigation. The person receiving the bomb threat by telephone should not disconnect the call and, as soon as possible, is to complete the information required on the Bomb Threat Checklist located in the emergency manual.

3.3.2. Written Bomb Threat via Mail or Email In the event of receiving a written bomb threat, the procedures to be followed are on Code Purple Bomb Threat Action Card 3 and 4.

If a bomb threat is received in writing, it is to be kept, including any envelope or container it was found in. Once a message is recognised as a bomb threat, further unnecessary handling is to be avoided.

3.3.3. Conducting a Search All searchers are to proceed with the utmost caution and upon finding a suspicious package, the procedures to be followed are on Code Purple Bomb Threat Action Card 5.





Staff selected for search duty are to be familiar with the particular sections of the health centre and are to follow these guidelines:

• Commence at the outside of the room and work towards the inside

• Once completed, the searcher is to start at the lowest level and work to the top.

• Look for objects which are foreign to their surroundings, unusual in appearance, obviously hidden or of questionable nature.

• Explosive devices are most likely deposited in public areas such as:

- Foyers/waiting rooms

- Toilets

- Passageways

• Searchers are to look in the following likely hiding places:

Inside building:

- Look for carry bags and packages left in waiting areas - Look in furniture, potted plants and bins - Toilets to which the public has access - Toilet tank reservoirs - Lockers and filing cabinets - Behind pictures and clocks - Behind sinks and plumbing (devices could be suspended) - Inside stoves, refrigerators, TV set, radios and cupboards - Cleaner’s cupboards, storage cupboards etc. - Ventilation and exhaust ducts, and - False ceilings. Outside building: - In rubbish bins. - In electrical mains/meter boxes - On window ledges - Behind signs - In pump enclosure, and: - In garden trees and bushes.

3.3.4. Vehicles Parked motor vehicles are also suspect. Ownership of vehicles parked in close proximity to the health centre is to be ascertained as soon as possible.





3.4. Definitions

Bomb A device of any size or shape, which can look obvious or be camouflaged, may vary in its sophistication and my not necessarily explode (i.e. incendiaries, toxic/noxious substances, sharps, animals/reptiles). May be referred to as an improvised explosive device (IED).

Bomb Threat A threat, written or verbal, delivered by electronic, oral or other medium, threatening to place or use an explosive, chemical, biological, or radiological device at a time, date, place or against a specific person or organisation. It is not necessary for any other action to be taken by the offender.

Incident Controller The person designated by the relevant Hazard Management Agency, responsible for the overall management and control of an incident and the tasking of agencies in accordance with the needs of the situation. For Bomb Threat, Police are the Hazard Management Agency.







Senior Nurse or senior staff member at time in the health centre, who is responsible for the local health centre's response to the incident.


Is the Regional Director or delegate, whom is responsible for coordinating the health response to an operation within the Great Southern region.

Nurse Practitioner Is the line manager for the nursing service for the health centres, if present acts as the Health Centre Emergency Coordinator.

The Nurse Practitioner is responsible for: • updating and maintaining current emergency procedure • ensuring practical testing of emergency procedure and

evacuation is undertaken at least yearly, and that evidence is provided to Learning and Development of attendance lists.


• ensuring appropriate actions are taken / escalated as identified by the OSH audits.

• written communication with staff and Nurse Director regarding risks raised and action plans to resolve risks.

All Staff All staff are responsible for: • completing annual core essential training as outlined in

WACHS Workforce Learning and Development Policy • completing duties as instructed by the emergency plan and/or

as instructed by the Health Centre Emergency Coordinator

OSH Representative The Occupational Safety and Health Representative is responsible for: • in liaison with the Nurse Practitioner, scheduling at least

annual fire and evacuation practical training at each of the Health Centres

• completing the OSH audits relating to safety and security as prescribed

• liaising with the Nurse Practitioner to develop and document action plans

• raising risks at the quarterly staff meetings and status of actions taken to resolve issues/risks

• ensuring completion of a Safety Risk Report form.

Other personal All other personal are responsible for: • following instructions of staff during an emergency • ensuring all personal are available to attend and participate in

at least an annual practice fire and evacuation drill.


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CODE PURPLE BOMB THREAT Action Card 1 HEALTH CENTRE EMERGENCY COORDINATOR

The senior nurse or senior staff on duty acts as the Health Centre Emergency Coordinator.

1. Declare Code Purple Emergency 1.1 Ensure staff at Health Centre notified of Code Purple (verbal notification)

1.2 Ensure police and other emergency services have been notified (do not use mobile phone).

1.3 Ensure the GS Regional Nurse Director is informed - who is to inform the Great Southern Regional Health Disaster Coordinator (Regional Director). If the Nurse Director is not available, the Health Centre Emergency Coordinator is to undertake this notification.

2. Evaluate the information received and assess the risk to staff, visitors and document.

Note: Evaluation of risk may require Nurse Director, Facilities Manager, Health Centre Emergency Coordinator and police

3. Identify the WA Police Officer in charge (Incident Controller) and establish communications as soon as possible.

4. Instruct staff available of details and plan of action, including if necessary a search. Indicate, if possible, the location of the device.

5. Instruct staff to report any suspicious device or package. Should such a device be found, under no circumstance should it be tampered with and the area should immediately be cleared and the Health Centre Emergency Coordinator notified.

6. Under direction of the police check all escape paths, e.g. doorways, assembly areas, rubbish bins, trees, etc. for suspicious packages before evacuation.

7. Once escape paths and assembly areas have been checked, "Evacuation CODE ORANGE" is undertaken.

8. In this situation it is usual when evacuating to take all personal belongings with you e.g. handbags, cases, parcels including any personal object which could appear to represent a bomb. The removal of personal objects will assist police, Fire and Rescue and Emergency Officers to carry out a search by having fewer objects that may represent a "bomb".

Note: Should an explosion occur, staff must not tamper with the debris.

9. Casualties are to be evacuated and the area secured for police investigations. No one is to enter the area after evacuation, as structural damage may have occurred.

10. Activate Code Blue if casualties sustained in explosion.

11. Await ALL CLEAR from police as the Incident Controller.





CODE PURPLE BOMB THREAT Action Card 2 STAFF MEMBER RESPONSE WHEN A THREAT IS RECEIVED BY TELEPHONE (All

hours)

Keep Calm – DO NOT HANG UP

While talking, if possible, seek the attention of another staff member – request the staff member to contact the police by dialling 000 and advising of threat

Record the information on the Bomb Threat Card

Using another phone (not mobile), notify:

• Health Centre Emergency Coordinator who must ensure activation of Code Purple response

• Police, if not already notified

Complete the Bomb Threat Card and place under the phone hand piece

Search immediate area if advised to do so. If object found:

• Do not touch • Report find

• Keep area clear

• Prepare to evacuate

Await instructions from the Health Centre Emergency Coordinator

Await ALL CLEAR from the police.





Bomb Threat Checklist – REMEMBER KEEP CALM - DON’T HANG UP (place this card under the phone)

DATE

QUESTIONS TO ASK TIME THREAT LANGUAGE

1. WHEN is the bomb going to explode? well spoken

incoherent

irrational

taped

message read by caller

abusive

2. WHERE did you put the bomb?

3. WHEN did you put it there?

4. WHAT does the bomb look like? BACKGROUND NOISES

Street or house noises

Aircraft

Machinery

Music

Call Noises – STD / Mobile

5. WHAT kind of bomb is it?

6. WHAT will make the bomb explode?

7. DID YOU place the bomb?

8. WHY DID YOU place the bomb?

9. What is your NAME? OTHER

Sex of caller 10. WHERE are you?





Bomb Threat Checklist – REMEMBER KEEP CALM - DON’T HANG UP (place this card under the phone)

11. What is your ADDRESS? Accent of caller

Estimated age

EXACT WORDING OF THREAT

ACTION

Call Reported to: Phone no:

Duration of Call:





CODE PURPLE BOMB THREAT Action Card 3 STAFF MEMBER RECEIVING THREAT via MAIL

(All hours)

On detection of threat by letter keep handling of letter to a minimum DO NOT PHOTOCOPY THE LETTER

Digital camera copy can be taken Place letter and envelope in separate envelope or zip-lock plastic bag

Staff member opening the letter notifies the Health Centre Emergency Coordinator

Health Centre Emergency Coordinator DIALS ‘000’ to notify police Do not use a mobile phone or photocopy the letter States: Name, job title, location and details of the letter

Health Centre Emergency Coordinator ensures that other staff are notified. If off-site, contact the Nurse Practitioner, Bremer Bay.

If not available, contact the Director of Nursing & Midwifery. Prepare for next actions including arrival of police and review of evacuation

procedures.

Staff member receiving letter is to await further instructions and review evacuation procedures (Code Orange)





CODE PURPLE BOMB THREAT Action Card 4 STAFF MEMBER RECEIVING THREAT via E-MAIL

(All hours) It is possible that a threat may be received via e-mail, in which case evidence is still obtainable; however it is not physical in nature. Every e-mail has a header, which is often hidden by your mail reading software, which details a range of information including the sender’s IP address, any mail servers that have routed the mail, and other information that may help trace the sender.

On detection of threat by email you must print the original for reference and save the e-mail and any attachments

Staff member opening the email notifies the Health Centre Emergency Coordinator

Health Centre Emergency Coordinator notifies: 1. Police 000 2. ICT Department (on 1800 794 748) and asks them to back up the mail server

logs 3. Regional Health Disaster Coordinator

Health Centre Emergency Coordinator ensures other staff are notified. If off-site, contact the Nurse Practitioner, Bremer Bay

If not available, contact the Nurse Director. Prepares for next actions including arrival of police and review of evacuation

procedures.

Staff member receiving email awaits further instructions and reviews evacuation procedures (Code Orange)





CODE PURPLE BOMB THREAT Action Card 5 RESPONSE AFTER LOCATING A SUSPICIOUS PACKAGE

Do not touch or disturb object Do not immerse object in water

Ensure that the Health Centre Emergency Coordinator has been notified, and the alert has been raised.

Isolate the object by removing non-essential person and equipment

Prepare for Code Orange - Evacuation: Open windows and doors and turn or leave lights on.





4. Code Black Emergency Response Procedure

The threat of verbal and abusive behaviour is becoming a common experience in today's society. The WA Country Health Service (WACHS) has a responsibility under the Occupational Safety and Health Act to hold the safety of all patients, visitors and staff as paramount. These incidents generally have little or no warning and those affected may be chosen at random.

Staff should ensure that medications are stored securely and that cash is not kept on site. Personal handbags are to be secured away from the public view.

The threat at nursing posts may be unarmed or armed.

An unarmed confrontation is less likely to result in an assault if staff are aware of effective ways to manage aggressive, agitated, violent or threatening people. At all times, your first consideration must be the preservation of human life. The safety of staff and patients is uppermost. Staff members, patients or visitors must not place themselves at risk.

Note: In addition to Code Black Personal Threat emergencies, the following codes are used to facilitate the identification and communication of additional risks. For these, emergencies sub-plans have been established

• Code Black Alpha – Infant or Child Abduction

• Code Black Bravo – Active Shooter Procedure should be referred to in the event of a person(s) armed with a firearm(s) who is actively engaged in killing or attempting to cause serious harm to multiple people in the health centre.

Important Note: • Should there be a loss of all telecommunications (landline, mobile and satellite) the clinic

should be closed as there is no capacity for the health service to monitor staff safety and keep staff informed of changes, nor for staff to escalate medical care issues.

• If there is a mobile phone outage then the clinic should be closed as there is no capacity to escalate a code black response

4.1. Prevention and Preparedness Prevention encompasses activities that may reduce the severity or impact of a personal threat event.

The Bremer Bay and Jerramungup Health Centres facility have:

• Lockable windows and external doors

• CCTV at entrance to emergency and front entrance, to enable viewing of attendees prior to allowing access

• Egress from a separate point to the main entry

• Personal duress alarms

• Annual preventative maintenance service to the security systems and CCTV systems





4.1.1. Personal Duress Alarms All staff when working on site are to wear the provided personal duress alarms, either wrist attachment or lanyard. The personal duress alarms are to be used to summon assistance in the event of imminent risk of harm to a staff member.

Photo: Personal Duress Alarms dated 15 September 2014

Once activated, the duress alarm initiates an off-site response by monitoring security service, it does not automatically summon the police. ABA Security phone number: 9841 7828

Monitoring Service phone number: 9494 9111

Phone Numbers for each site to be emailed to [email protected].

If the alarms are triggered, the monitoring station Monitoring Excellence 1300 884 111 will ring the contacts until they reach someone. The Monitoring Station advises which zone has been triggered so you can make a decision as to what actions to take.

If there are multiple zones, instruct health centre staff to call emergency services.


mailto:[email protected]




Jerramungup Health Centre Contact List in Order of Priority

9835 1004

Remote Area Nurse Please refer to hard copy kept on site

Nurse Practitioner Please refer to hard copy kept on site

Bremer Bay Health Centre Contact List in Order of Priority

9837 4026

Nurse Practitioner Please refer to hard copy kept on site

Administration Officer Please refer to hard copy kept on site

Cleaner/Admin Please refer to hard copy kept on site

4.1.1.1. Checking the Personal Duress Alarm This occurs on a monthly basis:

Inform the Security monitoring service on 94949111 that a check is about to take place. Security Monitoring Service will activate the test status and speak to the security person as the checks are being undertaken to check that each duress is being picked up by them and working.

Press the 2 buttons at the same time on each duress alarm until all have been tested.

Contact the security monitoring service to advise testing is complete. They will advise if all alarms were recorded as tested. Discuss with the security monitoring re outcome of each test. If any duress alarm fails this will need replacement as soon as possible the business coordinator/OSH are to be notified to commence the replacement. Inform security monitoring that the test has been fully carried out and go back to full monitoring not test status.

Document in the nurses checklist that the monthly check has been carried out on that particular date, and notify the Business Coordinator of completion and any issues for follow-up.





4.2. Response to the Aggressive Person When confronted, staff are to follow the RRRR steps when safe to do so:

Raise the alarm

• Press the 2 blue buttons at the same time to raise an alarm.

• If the alarms are triggered the monitoring station Monitoring Excellence 1300 884 111 will ring the contacts until they reach someone.

• Monitoring Excellence will notify police if unable to reach contacts.

• Notify Nurse Practitioner / Nurse Director as soon as practicable

Remain calm

• Listen and hear

• Acknowledge the feelings of the person

• Separate the person from others

• Sit the person down

• Indicate options the person has

• Encourage the individual to choose a safe plan of action

Retreat to safety

Retreat to safety as soon as it is safe to do so or use physical barriers wh maintaining a clear escape route.

If a weapon is involved and you cannot escape immediately, ask the person not to use the weapon, lower it, place it on the floor and walk away Never attempt to grab the weapon or the offender.

Initiate crowd control – instruct as many people as possible to leave the area or building quietly.

Record the details

Complete the Offender Identification Form





4.2.1. Procedure Flowchart

Threatened or observed threat

to others

Can you get away safely No Yes

Retreat to safety:• create physical

separation• Evacuate

immediate area / building

Contact Police 000

Activate personal/clinic duress alarm if safe to do so

Remain calm DO NOT volunteer any information

Hand over whatever is being demanded

Mentally note distinguishing features to assist with an accurate

description later

Do NOT give chase or attempt to stop the assailant

Complete a CODE BLACK Hold Up Checklist

Liaise with Health Centre Emergency Coordinator

to determine further actions

Assist with keeping patients and visitors calm

Further action may include evacuation of the area or building, to preserve a

crime scene.

Staff members may be required to give statements to police post incident

Commence Evacuation

Follow the RRRR steps:

• Raise the alarm

• Remain Calm

• Retreat to safety

• Record details

Activate personal/clinic duress alarm if

safe to do so





4.3. Code Black Alpha - Infant / Child Abduction Any person can be abducted. Infants and/or children are the most venerable to be abducted. The definition of ‘abduction’ is the criminal act of taking someone by way of force or deception. Although an unlikely event, the Health Centre has a role in keeping children/infants in their care secure.

The most likely abduction event is one by a non-custodial parent or family member.

To minimise the risk of abduction, staff are to adhere to existing security precautions:

• Ensure that all infants/children presenting for treatment are identified as outlined in WACHS Policy

• Ensure that a record of the legal guardian is recorded for all infants/children presenting for treatment;

• Ensure that the parent/ responsible adult attending with the infant / child stays with the child/infant as appropriate; and

• Staff are to wear the official health service identification badge with photo and name of staff member.

4.3.1. Response When child/infant identified as missing and/or abducted the nurse in charge of the clinic is to:

1. Respond by ensuring that a rapid search of the clinic and immediate grounds, to confirm that child is missing.

2. Raise the alarm – as soon as possible notify local police or dial 000.

3. Inform line manager (during hours) or GS Regional Health Disaster Coordinator on-call (after hours).

4. A member of staff to stay with the parent / guardian

5. Protect the crime scene – no one enter area including parents/guardian or staff.

6. Follow the Action Card 4: Code Black Alpha Child Abduction

7. Complete Child/Infant Information Form

8. All media inquiries and calls from journalists must be referred to WACHS Communications, however key

4.3.2. Line Manager 1. Confirm identification details of the child/infant ie name, date of birth, gender, parents

details. Actions taken to date and police notification.

2. Notify the GS Regional Health Disaster Coordinator and GS MPS Operations Manager

3. Follow the Action Card 5: Code Black Alpha – Child Abduction Line Manager

4.4. Code Black Bravo – Active Shooter An active shooter is a person(s) armed with a firearm(s) who is actively engaged in killing or attempting to cause serious harm to multiple people in a populated location. The Health Centres do not generally qualify as a populated location, however country people attending the health centres are more likely to have access to firearms.





The aim of this procedure is to:

• Ensure the safety of patients, staff and visitors

• Notify the policy , staff, patients and visitors of the threat; and

• Contain the scene and minimise the number of potential victims

The Health Centres operate on a manual key-lock down process, with between two – three exit routes.

The most senior nurse or staff member on site becomes the incident commander, to coordinate activities until Police arrive

4.4.1. Response by Staff Response by staff is based on the three (3) elements of escape, see and tell

4.4.1.1. Escape

If under immediate gunfire take cover initially (on the floor and behind objects) and then attempt to leave the area as soon and if safe to do so. Try to confirm that your escape route is safe.

If gunfire is nearby within the health clinic, leave the area immediately moving away from the gunfire, if this can be achieved safely; try to maintain cover from gunfire and view.

If gunfire is outside the health clinic, remain within the clinic, if possible secure the entrances and try to maintain cover from gunfire and view.

• Leave belongings behind

• Do not congregate at evacuation points

• Try to maintain cover from gunfire and view

• Provide guidance to other staff, patients and visitors on safe routes for self –evacuation if able via non-verbal communication methods, such as hand signals.

4.4.1.2. See

The more information that you can pass onto police the better, but NEVER risk your own safety or that of others to gain it. If safe to do so, the following information may be useful:

• Exact location of the incident

• Whether the perpetrator is stationary or moving in any particular direction;

• Number and description of offenders;

• Details of any firearms being used or possessed;

• What else they are carrying

• Their motives or intent (if known or apparent);

• Number of other people in the area; and

• Number of causalities.





4.4.1.3. Tell

Activate the Code Black Bravo procedure by notifying Police on 000

4.4.2. Response by Senior Staff Supporting emergency response activities to save and protect life and assist with emergency services investigations

• Notify GS Regional Health Disaster Coordinator

• Use the building environment to restrict or deny access

• Identify a safe triage / first aid location to treat the wounded, this may include being off-site such as the SJAA location

• Where possible, facilitate access for Police and emergency services vehicles

• Restrict physical access to the site or general vicinity.

• Transfer incident management to Police.

• Provide ongoing support to the emergency response action as requested, such as ambulance and RFDs evacuation of the injured.

4.5. Definitions

Unarmed Verbal or abusive behaviour, wilful damage to property and/or physical aggression.

Armed As above, but with use of a weapon.

Abduction is the criminal act of taking someone by way of force or deception.

Active Shooter An active shooter is a person(s) armed with a firearm(s) who is actively engaged in killing or attempting to cause serious harm to multiple people in a populated location



Senior Nurse, or senior staff member at time in the health centre who is responsible for the local health centre's response to the incident.


The Regional Director or delegate, who is responsible for coordinating the health response to an operation within the Great Southern region.

Mobile contact: 0437 986 621

Generic Email: [email protected]

Nurse Practitioner If present, the line manager for the nursing service for the health centres acts as the Health Centre Emergency Coordinator. The Nurse Practitioner is responsible for: • updating and maintaining current code black procedure





• undertaking testing and audit of the code black procedure • monitor annual staff compliance of mandatory training (online learning

modules) • ensuring appropriate actions are taken / escalated as identified by the

OSH audits • written communication with staff and Nurse Director regarding risks

raised and action plans to resolve risks. • Undertaking risk assessment as prescribed at least annually and to be

reviewed by the GS Director Nursing & Midwifery • Completing the Safety Risk Report Form once an employee reports

an incident or potential incident. • Is the nominated recovery coordinator

All Staff All staff are responsible for: • wearing personal alarms. • Completing testing, documenting testing outcome and escalating to

the Business Coordinator and Nurse Practitioner if failure of system occurs.

• ensuring medications a safely secured, nursing post is safely locked up upon leaving, and that personal valuables are secured away from public view.

• completing annual core essential training as outlined in WACHS Workforce Learning and Development Policy and WACHS Working in Isolation – Minimum Safety and Security Standards for all staff Policy.

• completing duties as instructed by the emergency plan and/or as instructed by the Health Centre Emergency Coordinator.

• Completing the Safety Risk Report Form which is to be returned to the Nurse Practitioner and Business Coordinator once completed.

OSH Representative The Occupational Safety and Health Representative is responsible for: • completing the OSH audits relating to safety and security as

prescribed, including within the WACHS Working in Isolation – Minimum Safety and Security Standards for all Staff Policy

• liaising with the Nurse Practitioner to develop and document action plans

• raising risks at the quarterly staff meetings and status of actions taken to resolve issues/risks.

• Works in collaboration with the line manager to complete the Safety Risk Report Form once an employee reports an incident or potential incident.

Other Personnel All other personnel are responsible for: • ensuring medications are safely secured, nursing post is safely locked

up upon leaving, and that personal valuables are secured away from public view

• follow instructions of staff during an emergency.


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ALL STAFF CODE BLACK Action Card 1

Threatened Personnel: Unarmed Confrontations

Do not place yourself in further danger

Actions – Threat to yourself Date/Time occurred / completed

Raise alarm if safe to do so by attracting the attention of another staff member to dial police on 000.

If you are in area with a duress alarm, activate it as soon as possible.

If you are by yourself and doors can be closed, lock them to create a barrier between you and the threat.

If possible manoeuvre yourself to place a physical barrier between yourself and the aggression, e.g. a desk, bench, chair.

Use de-escalation techniques, and try to keep the aggressor engaged in conversation. Let them know what you can do for them in this situation

Comply with the aggressor’s instructions only if this does not place you in further danger. Do not volunteer anything that the person does not ask for.

If you can leave the area safely, do so and dial police 000 and say “physical threat in progress” and give your name and location.

If you are out of danger - stay out of danger.

Write down everything you observe when it is safe to do so. Complete Description of Offender Form (Appendix 2) as soon as possible.

Actions – Threat to Others Date/Time occurred / completed

If you witness a threat to someone else but are yourself away from the area of threat dial police on 000 and say “unarmed threat in progress” and give the location.

If you are in an area with a duress alarm, activate it as quickly as possible

If you are out of danger - stay out of danger.

If you can leave the area safely, do so

Write down everything you observe when it is safe to do so.

Complete Offender Description Form as soon as possible.

Complete a Safety Risk Report Form when able.






ALL STAFF CODE BLACK Action Card 2

Threatened Personnel: Armed Confrontations

Do not place yourself in further danger

Actions – Threat to yourself Date/Time occurred / completed

Obey the offender’s instructions if you can do so without putting yourself in further danger.

If you are out of danger – stay out of danger.

If you are able to do so, raise alarm discreetly. Preferably this should be done using the duress alarm pendant. If possible, avoid using an audible alarm to attract other staff to the area.

If Use LASSIE de-escalation techniques and try to keep the person engaged in conversation.

If you are out of the area of threat, dial police 000 and advise of “armed threat in progress” state your name, position and location. Do Not hang up.

Preserve the scene for evidence – do not touch or move anything.

Observe any vehicle used by the offender(s) registration / colour / type.

Write down everything you observe when it is safe to do so.

Complete the Offender Description Form as soon as possible.

Ask any witnesses to stay until police arrive

Complete a Safety Risk Report Form when able

Await debriefing instructions

Make no comment to media






Action Card 3 OFFENDER DESCRIPTION FORM

A separate form is required for each person. To be compiled immediately after the incident by each staff member and also by bystanders if possible. Place tick as applicable.

If answer is unknown write UK against heading. Do not consult with others during compilation. Emergency Controller to collect forms and hand to police.

Surname: First Name:

Address: Postcode:

Home Phone: Business Phone:

Name/Nickname Used:

Teeth: Good / Spaced / Uneven / Bad / Missing / Protruding

Sex: Male / Female Estimated Age:

Race:

Moustache: Yes / No

Colour:

Type:

Height: metres cm

or: feet inches

Weight: Kg: ________ Stn/Lbs: __________

Build: Thin / Solid / Medium / Obese

Beard: Yes / No

Colour:

Type:

Stature: Erect / Slouched / Stooped

Voice: Soft / Clear / Slangy / Accented / Loud / Slurred

If Accented – state type:

Hair: Colour: Medium / Wavy / Thin / Short / Straight / Thick / Normal / Thick / Long / Curly / Bald

Eyes: (Colour) (Size) Squint Starry

Hands: Size: Missing Or Deformed Fingers:

Spectacles: Yes / No








Hairy Soft Callused

Gloves: Yes / No

Frame Colour: _______________ Thick / Tinted / Bifocal

Nails: Short / Long / Medium / Bitten Walk: Normal / Limp / Pigeon Toe / Quick / Springy

Complexion: Fair / Fresh / Pale / Suntan / Pimply / Freckled / Dark / Ruddy Ears: Shape Size

Nose: Shape Size Disguise:

Mouth: Shape Size

Other Distinguishing Features: (Scars or marks, tattoos, skin discolouration, location, etc.) Describe

in full:

Jewellery (describe):

Clothing (Including hat, tie, shirt, coat, trousers, dress, skirt, sweater, shoes, etc.):








Weapon (type):

Method and Direction of Escape:

Make of Car:

Model:

Registration

Colour

Method of Operation (What did offender do, say, touch, etc.):








Name: Signature:

Date: Time:





CODE BLACK ALPHA CHILD ABDUCTION Action Card 4 Any person can be abducted. Infants and/or children are the most vulnerable to be abducted. Children should never be left unattended in the clinic area. Staff should be vigilant and report immediately unusual suspicious behaviour displayed by individuals.

REMOTE AREA CLINIC STAFF

When child identified as abducted Comments / Times

Raise the alarm As soon as possible alert local community authorities and local police or dial 000. Advise line manager (during hours) or Regional Disaster Coordinator (after hours) when possible

Respond appropriately and rapidly to search the clinic and surrounds. Obtain a clear description of the even from witnesses All relevant staff should be briefed Provide privacy and monitor condition of parents As soon as police are present, follow their directions and assist where possible Do not leave the clinic

Record details Where possible, observe the offender or obtain information from witnesses so you can complete the Child Abduction Information Form (Action Card 6) after the incident is over If offender is unknown, as a rough guide, use NAB HECTOR: Name – Age – Build Height – Eyes – Complexion – Thatch (hair) – Oddities – Rig (clothing) Also note details such as accomplices, vehicle, weapon, equipment, direction and method of escape etc

All clear Comments / Times

Consult with your line manager regarding restoration of clinic and/or accommodation to normal services

Protect but do not touch any evidence left by the offender and restrict access to the area until the police have given permission to return





REMOTE AREA CLINIC STAFF

Ensure witnesses remain in the area or are able to be contacted when police attend – their view, however fleeting, could provide vital information when pieced together with other evidence

Consult with your line manager as to whether a debriefing is required. If so, any findings or recommendations are to be reported to the GS Director of Nursing & Midwifery for reported to the GS OSH Committee

Incidents impact on people in many different ways and staff have a duty to look out for the wellbeing of themselves, fellow workers and patients. Counselling is available to people adversely affected and may be instigated in several ways eg if you require counselling, inform your line manager Your line manager will consider what counselling and support may be offered Staff also need to have an increased awareness of possible behavioural changes in people around them who have been involved in an incident and who may be suffering from stress and discuss any concerns with your line manager

For quality improvement purposes, ensure that pertinent actions / issues and comments from actual or training events have been recorded for the review process and forward completed Action Card and Child Abduction Information Form to your line manager in time for the debriefing or by the next day

Completed by

Name: Date:





CODE BLACK ALPHA CHILD ABDUCTION Action Card 5

LINE MANAGER

When child identified as abducted Comments / Times

Inform the GS Director of Nursing (during hours) or Regional Disaster Coordinator (after hours) and keep them updated on progress. The GS Director of Nursing or Regional Disaster Coordinator will notify the Regional Executive members to confirm alert and briefing on severity and nature of code black child abduction

Provide clinic staff with appropriate support as required

Consult with clinic staff and GS Director of Nursing regarding restoration of clinic and/or accommodation to normal services

Consult with clinic staff as to whether a debriefing is required. If so, any findings or recommendations are to be reported to the GS Director of Nursing for presentation to the GS OSH Committee

Incidents impact on people in many different ways and staff have a duty to look out for the wellbeing of themselves, fellow workers and patients. Counselling is available to people adversely affected and may be instigated in several ways eg if you require counselling, inform your line manager Line manager will consider what counselling and support may be offered Staff also need to have an increased awareness of possible behavioural changes in people around them who have been involved in an incident and who may be suffering from stress and discuss any concerns with your line manager Discuss any media enquiries with the GS Director of Nursing. Access to WACHS Media Communications is 9222 6499, 24 hours a day, 7 days per week

For quality improvement purposes, ensure that pertinent actions / issues and comments from actual or training events have been completed for the review process in time for the debriefing or by the next day.

Collect completed Action Cards and Child Abduction Information Forms and table at the debriefing or forward to the GS Director of Nursing

Completed by

Name: Date:

GS Director of Nursing

Signature: Date:





CODE BLACK ALPHA CHILD ABDUCTION INFORMATION FORM Action Card 6 Please circle or write response as applicable. Do not guess – if you are not sure about any

aspect, leave blank

PERSONAL DESCRIPTION OF ABDUCTOR

Name/Nickname (if known):

Sex: Male / Female

Race: Build: Thin / Solid / Medium / Obese

Height: metres cm Hair: Colour & Style:

Clothing (Including hat, tie, shirt, coat, trousers, dress, skirt, sweater, shoes, etc.):

Other Distinguishing Features: (Scars or marks, tattoos, skin discolouration, location, etc.) Describe in full:

PERSONAL DESCRIPTION OF ABDUCTED CHILD

Name

Age

Sex:

DOB

Race: Build: Thin / Solid / Medium / Obese

Last Seen Time: Last Seen by Whom:

Height: metres cm

Hair: Colour & Style:

Clothing (Including hat, tie, shirt, coat, trousers, dress, skirt, sweater, shoes, etc.): Other Distinguishing Features: (Scars or marks, skin discolouration, location, etc.) Describe in full: Medical Conditions: Social Background: Does the child have any money and if so, how much? What are the child’s interests / hobbies?





5. Code Yellow Emergency Response Procedure

This procedure includes emergencies that directly impact on the operations of the facility and include:

• chemical leak (accidental)

• Business Continuity Plans for essential services failure:

- failure of external telephone lines - electricity - water - Staffing.

Important Note: • Should there be a loss of all telecommunications (landline, mobile and satellite) the clinic

should be closed as there is no capacity for the health service to monitor staff safety and keep staff informed of changes, nor for staff to escalate medical care issues.

• If there is a mobile phone outage then the clinic should be closed as there is no capacity to escalate a code black response.

• Staff will be required to drive to the nearest health centre/hospital to check in (if roads safe to travel) and provide a situation report.

In addition, a major emergency external to the site could impact on the health centre and require response or evacuation. Major external emergencies include:

• bushfire

• severe storm / cyclone

• earthquake

• flood / storm surge/ tsunami (Bremer Bay) Alerts and warning information can be found for natural disasters can be found: • on the Department of Fire and Emergency Services (DFES) website

• by calling the DFES information line on 13 DFES (13 3337)

• on ABC radio and other news bulletins.

It is a situation where the health centre’s normal function may be compromised and where a declaration of internal emergency will initiate a planned response to bring the situation under control. The situation is to be investigated and the immediate safety of staff, patients and visitors is to be ensured. In the event of a Code Yellow, the Health Centre Emergency Coordinator is to decide on plan of action in consultation with relevant staff and the emergency services. The primary concern is life safety, and immediate action may need to be taken to ensure that this can be maintained whilst a suitable response strategy is developed, including:

1. Ensuring the immediate safety of patients/staff, by evacuating from danger


http://www.dfes.wa.gov.au/alerts




2. Activating the internal emergency contingency plan by phoning the Health Centre Emergency Controller and advising them of the nature and scope of the emergency

3. Advising the WACHS GS Regional Disaster Coordinator on 0437 986 621 with email SitRep Report to: WACHS.GSHealthDisasterCoordinator and Director of Nursing & Midwifery

4. Treating any casualties

5. Preventing further damage.

Should a significant natural disaster require a full evacuation of the health centre away from the site, then the evacuation procedures (Code Orange) are to be enacted.

5.1. Chemical Leak (Accidental) All chemicals available on-site are recorded in Chem Alert, and Safety Data Sheets (SDS) held for all substances. Full copies of all SDS are kept in the cleaning cupboards of each Health Centre.

Supporting this, health centre occupants must ensure that the labelling, handling, storage, transport and use of chemicals are adequate. Spill Kits are located in the emergency area of each health centre.

5.1.1. Person Discovering the Leak Responsibilities If a chemical leak occurs, the person who discovers it is to:

• identify the type of chemical and source of the leak if possible.

• contact the Health Centre Emergency Coordinator

• if trained, and it is safe to do so, utilise a spill kit to contain or control the leak.

• complete the Safety Risk Report form.

5.1.2. Health Centre Emergency Coordinator Responsibilities If a chemical leak occurs, the Health Centre Emergency Coordinator should:

• identify the type of chemical and source of the leak if possible.

• contact the Hospital Engineer.

• establish scope of emergency and whether safe containment can be speedily achieved.

• if in doubt, commence evacuation of immediate area.

• ensure Fire Brigade are notified and ambulance if required.

• ensure injured are removed to a place of safety and no one is exposed to further risk of injury.

• notify staff of situation; ensure they are prepared for possible evacuation.

• complete Situation Report (SitRep) as soon as possible.







5.2. Failure of External Telephone Lines This procedure applies to all nursing staff and clerical staff when working.

Important Information: If total failure of all communication occurs the clinic is to be closed as there is no capacity for the staff to safely manage themselves or patients to escalate and receive a response for safety issues or care concerns.

Actions of Staff / Emergency Health Coordinator (Failure of Telephone Lines)

Date/Time and details / comments once completed

Document • Name and position completing this report • Date and time of telephone outage • Details of how outage (if known) • Details of impact for Health Centre

Notify ICT Manager 9892 2262 during hours or IT Helpdesk 1800 794 748 after hours. Advise local staff. Complete Situation Report (SitRep)

Ring Telstra Service Delivery Team (1800 036 132). Advise Telstra: • Your full name, job title and where you are from • That it is urgent • You will need to provide the full Health Centre phone

number, including area code. o Bremer Bay: 9837 4027 o Jerramungup: 9835 1004

• you want to report a fault on your line.

Once Telstra has recorded the fault, request the main number be diverted to site mobile phone Bremer Bay:

• First preference (mobile phone): 0428 374 029 • Second preference (satellite phone): 0147 147 586

Jerramungup Health Centre • First preference (mobile phone): 0429 351 007 • Second preference (satellite phone): 0147 149 587

Once done all incoming calls will come through mobile or second preference.

Telstra will give you a ticket number or job reference number which you will need to record and reference when corresponding with Telstra throughout the incident.

Record of ticket number or job reference number file here:

During office hours contact the GS Executive Services Assistant or 98922672, to ensure a global message is sent notifying other sites.

After-hours send email to line manager or contact the Albany Health Campus Nurse Manager on 9892 8224 (direct number)







Once the incident has been resolved and the main telephone lines are functional, you will need to call Telstra (1800 036 132), quote the ticket number or job reference number they gave you on reporting the incident and request that calls be diverted back to the main Health Centre line. Test clinic phone line to ensure correct.

Ensure a copy of this report is sent to line manager and ICT Manager at AHC.

Any problems please call the IT Helpdesk 1800 794 748 (all hours)

5.3. Satellite Phone The nurse at each centre is responsible for ensuring that the satellite telephone is charged and working each week. The testing/re-charging of the satellite phone must be documented in the book kept with the satellite phone.

Site Satellite Number

Bremer Bay Health Centre 0147 147 586

Jerramungup Health Centre 0147 149587

Refer to Hardcopy manual for Instructions On Testing And Using Satellite Phone.

Setup of Satellite Phone Dock for use indoors: Sat Phone Instructions

5.4. Failure of Water Supply This procedure applies to all nursing staff and clerical staff when working.

Water interruptions occur for any number of reasons and can be planned or unplanned.

For planned water interruptions water corporation will advise the Health Centre. Actions for Health Centre staff

• notify Nurse Practitioner

• notify AHC maintenance of planned water outage

• ensure adequate supply of bottled drinking water for hydration

• prefill containers to enable hand washing

• two (2) x buckets of water to refill cistern for toilet flushing.

If planned water outage is for six (6) hours or longer, consider rescheduling clinic appointments to another day or to the other health centre and closing clinic. Discuss with line manager prior to making a decision.

For unplanned water interruptions, Water Corporation can be contacted on 13 13 75 to report a fault. Updates on outages can be found on the Water Corporation web site.



http://wachs.hdwa.health.wa.gov.au/index.php?eID=tx_nawsecuredl&u=228&file=fileadmin/sections/great_southern/disaster_management/Useful_Docs/Sat_Phone_Instructions.pdf&t=1483089034&hash=380d8dc92121b816ea921dc280abb616

http://watercorporation.com.au/faults/report-a-fault




Actions of Staff / Health Centre Emergency Coordinator (Unplanned Water Outage)

Date/Time and details/comments once completed

Document: • name and position completing this report • date and time of mains WATER outage • details of water outage interruption (if known) • details of impact for Health Centre.

Notify: • Advise staff on site • Facilities Manager on call via Albany Health Campus

Switchboard 9892 2222 • Line Manager

Health Centre Emergency Coordinator to DECLARE Code Yellow (if unplanned outage > 4 hours or health centre activity impacted): water supply failure and notify:

• staff on site • Regional Health Disaster Coordinator (RHDC) 0437 986 621

and line manager • complete SitRep (Situation Report (SitRep) and send to

RHDC and line manager.

Ensure: • Purchase sufficient bottled water for hydration and hand

washing. • Use stock of alcohol hand wash as required. • Limit use of toilet.

Discuss with line manger requirement to close the health centre. Document decision. If yes:

• redirect Health Centre phone to HealthDirect • notify SJA local sub-centre contact person • signage on Health Centre door advising clients of closure and

options.

Yes / No

Health Centre Emergency Coordinator to ALL CLEAR Code Yellow: water supply failure and notify:

• staff on site • Regional Health Disaster Coordinator (RHDC) and line

manager • advise key contacts that Health Centre is re-opened.

Ensure a copy of this report is sent to line manager and Manager of Facilities.






5.5. Failure of Electricity Supply This procedure applies to all nursing staff and clerical staff when working.

Power interruptions occur for any number of reasons and can be planned or unplanned.

For planned power interruptions, ensure that:

• the Nurse Practitioner is notified

• AHC maintenance are notified of planned power outage

• the emergency generator is full of fuel

• essential clinical equipment (i.e. defibrillators) are fully charged.

For unplanned interruptions Western power can be contacted via 131351 or the Western Power web site.

If power disruption is estimated to be longer than four (4) hours, and/or emergency generator does not automatically connect in contact the Albany Health Campus, Facilities and Maintenance team, if after-hours contact AHC switchboard and ask to be put through to the on-call maintenance person.

Bremer Bay Health Centre has an emergency generator that should automatically cut in when mains power is disconnected

Fuel requirements Takes a total of 80 ltrs, DIESEL fuel

If full the generator will operate for an estimated: 10 hours

Access for generator Located on south side of Health Centre and is accessed via key

Photo: Bremer Bay Health Centre emergency generator 12/09/2014


http://www.westernpower.com.au/customer-service-power-interruption-information.html

http://www.westernpower.com.au/customer-service-power-interruption-information.html




Jerramungup Health Centre has an emergency generator that should automatically cut in when mains power is disconnected

Fuel requirements Takes a total of 40 ltrs, DIESEL fuel

If full the generator will operate for an estimated: 10 hours

Access for generator Secured in shed, west of the Health Centre and is accessed via key

Photo: Jerramungup Health Centre Emergency Generator 12/09/2014





Actions of Staff / Health Centre Emergency Coordinator (Unplanned mains power failure)

Date / Time and details / comments

once completed

Document: • name and position completing this report • date and time of power outage • details of how long power outage occurred for or is expected to

occur for • details of impact for Health Centre

Health Centre Emergency Coordinator to DECLARE Code Yellow: Unplanned Power Failure, if power outage likely to be greater than four (4) hours • Notify on-call Maintenance Officer via Albany Health Campus

Switchboard 9892 2222 • Notify line manager • Notify Regional Health Disaster Coordinator 0437 986 621 • Complete SitRep report and send to RHDC and line manager.

If greater than four (4) hours ensure adequate supply of diesel for generator and check generator fuel level every hour.

Switch off non-essential power items Ensure essential clinical equipment plugged into emergency power points Ensure mobile and satellite phones fully charged or plug into emergency power points for charging

Ensure adequate supply of torches Discuss with line manger requirement to close the health centre. Document decision. If yes: • redirect Health Centre phone to HealthDirect • notify SJA local sub-centre contact person • signage on Health Centre door advising clients of closure and

options.

Yes / No

Health Centre Emergency Coordinator to DECLARE ALL CLEAR Code Yellow: Unplanned Power Failure. On return of power: • notify on-call Maintenance Officer via Albany Health Campus

Switchboard 9892 2222 • notify line manager • notify Regional Health Disaster Coordinator • complete SitRep report and send to RHDC and line manager. • re-open Health Centre and advise HealthDirect, line manager, local

SJA contact person, remove signage from door

Ensure a copy of this report is sent to Nurse Director and Maintenance Manager at AHC.





5.6. Failure of Nurse Supply Planned or unplanned leave can result in disruption of nursing services to the Health Centres.

Key decision considerations:

• The activity at Bremer Bay Health Centre is generally greater than at Jerramungup Health Centre.

• The General Practitioner operates two days per week at each site.

• Key community events such as football grand finals being played locally.

For unplanned leave or to manage fatigue:

• attempt to call in casual nurses

• reschedule booked clients

• internally deploy nurse from other Health Centre

• close clinic

For long-term unplanned leave (greater than one week):

• advise line manager and seek authorisation for shortfall with NurseWest

• utilise casual nurses where possible

• monitor activity at Health Centres and within communities and internally deploy nurse/s between sites

• when the community has access to the local GP, deploy health service resources to the alternative health clinic within the Shire of Jerramungup.

• Line Manager to advise: MPS Operations Manager and ensure that Health Direct, SJA Manager for Great Southern and Shire CEO of Jerramungup of contingency plan and dates/times of health centre opening details.





Unable to staff Health Centre

Is the local GP going to be at the Health Centre? Yes

No

Advise local GP of absence of Nurse

Determine likely activity for Health Centre, consider local community events. If greater

than other Health Centre consider deploying nurse from

other Health centre

Yes Deploy Nurse, amend rosters

No

• Advise HealthDirect• Redirect Health Centre

phone to HealthDirect• Advise booked clients

and reschedule or offer alternative contact

• Notify line manager• Advise local SJA contact

person of closure• Advise local GP practice

(if opened)• Post signage on door of

Health Centre

Close Health Centre

Flowchart: Failure of Nurse Supply





5.7. Earthquakes (Reference Geoscience Australia) Australia does not sit directly on a plate boundary, the nearest being through Indonesia to our North, and so the risk faced is caused by slightly different forces. This type of earthquake is called an intraplate earthquake and is thought to occur along weaknesses in the tectonic plate itself. It is thought that pressure that is built up in the plate from actions along the boundary can be transmitted through the plate and at certain locations be released to the surface. Intraplate Earthquakes are typically less frequent and less destructive than earthquakes at the plate boundary, but should still be taken seriously. The most active region in Western Australia is called the South West Seismic Zone and encompasses the bulk of the Wheatbelt Region, but earthquakes can be felt anywhere in WA. Hundreds of earth quakes are recorded annually but the vast majority are too small to be felt. Large earthquakes are rare but can occur. An earthquake near Meeberrie (250km NE of Geraldton) in April 1941 measured a magnitude level (ML) of 7.2 and was felt from Port Hedland to Albany. More recently the Meckering Earthquake of 1968 (ML 6.9) and the Cadoux Earthquake of 1979 (ML 6.2) have done damage to buildings and infrastructure and were felt over an area of thousands of square kilometres. The Earthquake Magnitude Scale refers to the force of an earthquake, it does not indicate level of damage however it is possible to infer likely damage from past experience. The magnitude scale rises exponentially, so a 7.3 magnitude quake is 50 times more powerful than a 6.3 and 2,500 times more powerful than a 5.3 quake.

Earthquake Magnitude vs Potential Damage

< 3.4 are recorded only by seismographs;

3.5 – 4.2 are felt by some people who are indoors

4.3 – 4.8 are felt by many people and windows rattle;

4.9 – 5.4 are felt by everyone, while dishes break and doors swing;

5.5 – 6.1 cause slight building damage with plaster cracking, and bricks falling;

6.2 – 6.9 cause much building damage and houses move on their foundations;

7.0 – 7.3 cause serious damage with bridges twisting, walls fracturing, and many masonry buildings collapsing;

7.4 – 7.9 causes great damage and most buildings collapse more than 8.0 cause total damage with waves seen on the ground surface and objects are thrown in the air;

> 8.0 cause total damage with waves seen on the ground surface and objects are thrown in the air.

Generally, the SAFEST PLACE to be is in the OPEN - away from buildings. However, if you are in a building when the earthquake strikes, you should NOT attempt to run from the


http://www.ga.gov.au/earthquakes/index.jsp




building. Outside the building, you may be met with falling debris and power lines. It is much safer for you to remain in the building. 5.7.1. Earthquake Procedures – All Staff

STATE EMERGENCY SERVICE guidelines for earthquakes are as follows:

• Remain calm.

• Move away from windows and outside walls.

• Keep away from mirrors, light fittings, bookcases and other furniture, which may fall or slide.

• If possible, take cover beside furniture or move to an internal corner of a room, sit down and protect your face and hands.

REMEMBER: DO NOT ATTEMPT TO RUN FROM THE BUILDING.

ONCE THE TREMOR HAS STOPPED

1. Look around for injured persons and reassure others in your area. 2. It may be safer to remain within the property if it has not suffered substantial

damage. 3. Ensure emergency exits are safe before moving through them. 4. Keep all persons away from windows at all times. 5. Beware of aftershocks. The Health Centre Emergency Coordinator should call the Regional Health Disaster Coordinator, as soon as possible after the earthquake.

The duties of Health Centre Emergency Coordinator include:

• assessing their area for injured personnel and damage to the property.

• enacting medical response as required

• notification of the relevant authorities

• initiating controlled evacuation from danger areas if required.

Members of the public, in the building at the time of the earthquake, must be located and assisted as far as practicable.

5.8. Severe Weather Procedure (Reference WA State Emergency Service) Normally there would be community level arrangements and emergency plans relating to the preparation for a severe weather event and Albany Health Campus will have role to play in those plans. These procedures do not relate to these community safety plans, but are designed for impacts on the Hospital itself. Whilst severe weather can be experienced at any time of the year, storms are most likely during the winter months from June until September. Great Southern regularly experiences winds in excess of 90km/h and rainfalls of tens of millimetres in short periods of time, which could cause localised flooding and damage.





There is an extremely low risk of a cyclone travelling down the coast from the north-west and impacting on southern WA, TC Alby in 1978 and TC Bianca in 2011 both affected weather in the Great Southern Region, but were well below Cyclone intensity by the time they got here.

Note: Advice from DFES is that if a cyclone were to affect the area, cyclone advices may be issued, but due to the lack of understanding of the Cyclone Warning System it is likely that the standard severe weather warnings and alerts would be issued for the area.

5.8.1. Pre Storm Season The Manager of Facilities is to ensure that the site and all buildings are assessed for storm risk prior to the season starting in May. This assessment should encompass:

• tidiness – Look for loose items, especially building materials and prune large trees especially those close to buildings

• sturdiness – Inspect sheds and buildings, check for rusted fixings holding down corrugated tin, rotted timber beams or bearers, etc.

• preparation – Updated response plans and contacts, sufficient operational plant and equipment to fulfil obligations under various plans

In addition, all staff are to ensure that the site and buildings are maintained in a clean and tidy state throughout the storm season.

Staff are to monitor the Bureau of Meteorology and DFES websites for information related to storm warnings or severe weather alerts.

5.8.2. Pre-Storm If a Storm or Severe Weather Alert is issued for the area, the nurse at the site is to begin to prepare for a possible storm. These preparations would include:

• ensuring that sufficient essential medical supplies are available to continue patient care for the period of the storm and subsequent recovery.

• cleaning up of site

• storing non-essential plant and equipment in a safe location

• inspecting, maintaining and testing emergency generator

• reviewing Great Southern Global messages for travel restrictions or advisories

• monitoring BOM/DFES advices regularly regarding the location and intensity of the storm

• ensuring vehicles, plant and machinery are fully fuelled and that additional supplies are available

During a severe local weather event, the Health Centre Emergency Coordinator is to liaise with the Local Emergency Management Committee (LEMC) and determine if there is a role for Health Centre staff to play in the local response.

During a severe weather event the Regional Health Disaster Coordinator is to liaise with DFES staff and determine if there is a role for health staff to play in the response.





5.8.3. Post-Severe Weather Immediately that the all clear is given staff would assess any damage to the Health Centre and undertake the following actions:

• Assess infrastructure for damage

• Ensure essential systems are operating effectively

• Contact Albany Facilities to make arrangements for detailed infrastructure assessment of damage, assistance with clean up/repair/maintenance.

Severe Storm Preparations

Stage Preparation: During April each year prepare for Severe Storm season (generally May to October)

Preparations Comments / Times

Submit EAWMS to trim all treetops and branches well clear of Health Centre and accommodation (at least 2.5 meters from building with no branches/leaves hanging over roof of buildings) if required.

Clear away any loose material that could blow around during extreme winds, possibly causing injury and damage.

Ensure adequate Health Centre supplies of consumable items:

• Oxygen supplies • Stores imprest items including dressings materials, IV fluids and

sutures Pharmacy items • Parry Pack items • Clean water in containers

Prepare your home with an Emergency Kit including:

• portable radio, torch, spare batteries, satellite and/or mobile phones. • supply of non-perishable food and fresh water. • first aid kit and personal medication (including sanitary items). • waterproof bags for clothing, personal documentation, and

valuables. a copy of the current Severe Storm Emergency Response Plan.

Personalise your Emergency Kit with items such as a can opener, pocket knife, utensils, matches, etc.

Store irreplaceable items safely. Ensure any LPG bottles are secure. Ensure Health Centre and accommodation roofs, external doors,

and screens are in good condition.

Confirm with Remote Maintenance Officer that pre-storm Maintenance inspection has been completed or booked in prior to storm season. Any noticeable maintenance issues should be reported as they occur throughout the year





Severe Storm Preparations

Stage Preparation: During April each year prepare for Severe Storm season (generally May to October)

Make sure you know where to turn off electricity, gas and water supplies.

Check portable generator is operational and that there are sufficient fuel supplies. Ensure full knowledge of manufacturer's operating and storage instructions.

Ensure you are familiar with the Community severe storm procedures.

Identify the Community safety shelter, suitable refuge points, and safe access routes - safe from wind damage and storm surge.





5.9. Flood / Storm Surge / Tsunami Australia has a history of floods, causing devastating human and economic impact. Floods are a natural process influenced largely by the weather and driven by the amount of rainfall and length of time it falls. After heavy rainfall, rivers, creeks and catchments may overflow this type of flooding is most common in Australia and is known as riverine flooding.

Western Australia (WA) is the largest state in Australia with a vast range of climatic conditions and seasonal changes that influence and increase the potential for flooding.

A tsunami is a series of waves that can travel very fast, across the ocean due to the sudden movement of a large body of water. They are caused by undersea earthquakes, landslides on the sea floor, volcanic eruptions and even asteroid impacts.

While the threat in WA may be less than those experienced in neighbouring countries, our coastline remains particularly vulnerable as we are close to the Java Trench, a very active earthquake area.

The impact of a tsunami may be limited to foreshore areas and local waters as a marine threat or may extend beyond the foreshore and become a land threat. A tsunami in WA is more likely to cause dangerous rips and currents and travel up river systems and estuaries rather than flood low lying land. These dangerous rips and currents can last for more than 24 hours and beaches and marinas may be closed for several days.





Flood / Storm Surge Action Card 1

Problem Flooding caused by tropical storms (possible coastal or storm surge flooding), torrential rain (possible flash, creek/river, or backwater flooding), and earthquakes (possible tsunami).

Contacts State Emergency Service (SES) 1300 130 039 - Police/Fire/Ambulance 000

Warning NEVER drive into water of unknown depth and current – there may be submerged obstacles or road damage

Note Avoid entering flood waters. If you must, wear solid shoes and check depth and current with a stick – stay away from drains, culverts and water over knee-deep, and be aware of poisonous snakes and other hidden dangers

When Alerted Comments/Times

When the official alert is issued:

• Liaise and cooperate fully with Community Local Emergency Management Committee (LEMC) and SES regarding action to be taken (including the necessity to empty fridges and freezers, leaving doors open).

• Advise Line Manager of how the Clinic will be affected in the short and long term, and any existing or potential difficulties. Monitor the situation locally or via radio, television, the internet or call for Flood Warning information WA 1300 659 213. If called out to an emergency, consult with Line Manager.

• Consult with Line Manager about safety concerns and/or other issues.

Prepare Health Centre and accommodation:

• Where possible, elevate valuable items such as medical records, medical equipment, medications, chemicals, sharp containers and rubbish if possible

• Raise furniture, clothing and valuables onto beds, tables, etc. (electrical items highest) and place items such as personal papers, photos, valuables, medications, and mementos into waterproof bags and elevate them. If time permits, ensure outside areas are cleared of objects and move vehicles to higher ground if possible.

• If flooding is imminent, turn off power, water and gas services, and place sand-filled bags in the toilet bowl and over all laundry/ bathroom drain-holes to prevent sewage back-flow.

Ensure you have an Emergency Kit at hand

• Portable radio, torch, spare batteries and mobile phone /satellite


http://www.dfes.wa.gov.au/safetyinformation/warningsystems/Pages/default.aspx




Flood / Storm Surge Action Card 1 phone (if appropriate)

• Supply of non-perishable food and fresh water

• First aid kit and personal medication

• Waterproof bags for clothing, personal documentation, and valuables Spare keys and cash.

All Clear Comments/Times

After a flood:

• Check for cracks/damage in roof, walls, etc.

• Evacuate if the building is damaged.

• Do not eat food which has been in flood waters, and boil tap water or drink bottled water (use stored water cautiously – use chemical hand-wash solution). If general store runs out, consult with Line Manager regarding activation of local emergency plan.

• Do not use gas or electrical appliances which have been in flood waters until they're checked for safety.





Tsunami (Bremer Bay only) Action Card 2

Problem If a strong earthquake has occurred offshore or overseas, stand by for a possible tsunami emergency, and be prepared to evacuate at short notice. Tsunamis may also be caused by under-sea events such as landslides and volcanic eruptions.

Contacts State Emergency Service (SES) 1300 130 039

Warning When an official alert is issued, it means a tsunami actually exists – do NOT dismiss an official alert! A tsunami may be preceded by a rapid rise or fall in sea-level and nature's warning should be heeded.

A tsunami may have several waves (that are NOT surfable), so stay out of danger areas until the official All Clear is announced.

When Alerted Comments/Times

When the official alert is issued:

• Liaise and cooperate fully with Community Local Emergency Management Committee (LEMC) and SES regarding action to be taken.

• Prepare for evacuation to higher ground or well inland in flat areas.

• Do not go to the shore to sightsee – if you can see it, you are too close to escape!

• Advise Line Manager of how the Health Centre will be affected in the short and long term, and any existing or potential difficulties.

• Monitor the situation via radio, television, the internet on www.bom.gov.au/weather/wa. Weather by Fax for Marine Forecasts WA 1902 935 290, or call WA 1300 659 213.

• Consult with Line Manager about safety concerns and/or other issues

• If called out to an emergency, consult with Line Manager

If time permits - prepare an Evacuation Kit – place items in waterproof bags

• Personal documentation, photos and valuables

• Change of clothes including some warm clothing.

• Spare keys and cash.

• Large or heavy valuables could be protected in a strong cupboard.





• Charge up utilities and mobiles

If evacuating:

• Wear long sleeved shirt, long pants, and sturdy shoes for protection – natural fibres, if possible.

• Advise the Line Manager.

• Divert Clinic phone calls to satellite phone.

• Turn off power, water, and gas supplies as appropriate.

• Collect Emergency and Evacuation Kits.

• Close and lock Health Centre and accommodation

All Clear Comments/Times





5.10. Bushfire (Reference: Department of Fire & Emergency Services) Bush fires are a natural part of the Australian environment; however, given the right conditions they can be extremely dangerous. Western Australia has a significant risk of bush fire throughout the year, but there is a specific season in the South West (Geraldton – Esperance) which is December – April.

Bush fires may still occur outside of the specified season, but are generally less intense and easier to control. Specific localities may have extended or additional seasons based on harvest patterns or local weather conditions, always check with DFES or the Local Government for specific information.

The Health Centres maybe directly affected by bushfire, it is possible that smoke from a fire in the area might impact the health centre. In this event, the most likely response would be to shutdown air-conditioning systems and close windows, to prevent smoke being drawn into the Health Centre itself.

The most likely scenario involving bushfire affecting the Health Centre’s would be a major fire within the Shire of Jerramungup requiring the transfer of patients to the Health Centre for initial assessment and treatment for transfer to Perth or Albany.

Should the Health Centre be threatened and DFES advise that evacuation is necessary, then the Health Centre Emergency Coordinator should liaise with LEMC for an alternative site to establish emergency aid centre or complete town evacuation under the direction of the Incident Controller.

5.10.1. Pre Bushfire Season The Premier issued a Circular in September 2012, instructing all public sector bodies to assess their Building Protection Zones (BPZ), this assessment and action is to take place prior to 1 December annually (Situation Report (SitRep).

This assessment is to be undertaken by Facilities and Maintenance and sent to the:

• Nurse Practitioner – responsible for actions as required and tabling at quarterly meeting

• Nurse Director – responsible for tabling at the GS Emergency Management Committee

• OSH Representative – responsible for tabling at the OSH Committee meeting

5.10.2. Bushfire Advice A fire has started but there is no immediate danger, this is general information to keep you informed and up to date.

All staff are to:

• monitor the DFES site or news bulletin alerts

• reconsider requirements to travel through this area if not essential

• ensure vehicles, plant and machinery are fully fuelled and that additional supplies are available.






5.10.3. Bushfire Watch and Act A fire is approaching and conditions are changing, you need to leave the Health Centre and possibly the town.

• The Health Centre Emergency Coordinator should liaise closely with the LEMC and determine if there is a role for Health Centre staff to play in the local response and to establish the safe routes out of the community.

• Ensure that sufficient essential medical supplies are available to continue patient care for the period of the fire and subsequent recovery.

• Storing non-essential plant and equipment in a safe location

• Monitor DFES advices regularly regarding the location and intensity of the fire.





Bushfire Action Card 1

Problem Living close to or in bushland areas comes with the high risk of bushfire

Contacts • DFES Important Numbers

• Department of Fire & Emergency Services 13 3337 for emergency information

• State Emergency Service (SES) 132 500

• Police/Fire/Ambulance 000

• WACHS GS – Regional Health Disaster Coordinator 0437 986 621 • Emergency Preparedness

Warning Bushfires can start suddenly and are unpredictable.

When Alert Comments/Times

During a bushfire emergency services will provide as much information to you as possible through a number of different channels.

There will be three levels of warning. These will change to reflect the increasing risk to life and the decreasing amount of time you have until the fire arrives:

• An ADVICE will provide you with information on a bushfire that is not threatening lives or property but may be causing smoke near homes

• A WATCH AND ACT message will be issued when there is the potential for lives and property to be threatened. These messages will update you on the changing conditions.

• An EMERGENCY WARNING means you need to take immediate action to survive.

You can get information on bushfires from:

• DEFS information line on13 3337 (13 DEFS).

• DFES website

• Radio, TV, newspapers and news websites (each media outlet determines how often they will broadcast information).

• During the EMERGENCY WARNING phase ABC local radio broadcasts updates at quarter to and quarter past the hour in addition to news bulletins.

During a bushfire the safest place to be is away from the fire.

If you are driving and come across a fire with smoke across the road


https://www.dfes.wa.gov.au/contactus/Pages/importantnumbers.aspx


http://www.dfes.wa.gov.au/alerts/Pages/default.aspx




Bushfire Action Card 1 slow down at once. Don't drive through smoke when visibility is severely impaired. Consider whether your journey is really necessary. Drive slowly and switch on your headlights. Watch out for vehicles and trees which may have fallen across the road.





Bushfire Action Card 2

If caught in a vehicle during a bushfire Don't leave your car. Park your vehicle in an area that is bare and away from dense vegetation. For example: against an embankment in a cutting in an old gravel pit or roadside clearing on the section of the road which has the least amount of scrub alongside. Close all windows, vents and turn your headlights on. Lie down on the floor and cover yourself with anything that will shield you from radiant heat (e.g. coat or blanket). Stay in your car till the fire front has passed.

Keep the Line Manager updated throughout the emergency

All Clear: Comments/Times

Consult with the Line Manager regarding restoration of Clinic and/or accommodation to normal services

Being involved in a fire may be one of the most traumatic experiences of your life. Consult with the Line Manager as to whether a debriefing is required.

Participate in any operational debriefing.

Cooperate with external investigations.

Organise replacement of spent equipment, e.g. extinguishers, etc.

Incidents impact on people in many different ways and staff have a duty to look out for the wellbeing of themselves, fellow workers and patients. Counselling is available to people adversely affected and may be instigated in several ways, e.g.:

• If you require counselling, inform the Line Manager

• The Line Manager will consider what counselling and support may be offered.

• Staff also needs to have an increased awareness of possible behavioural changes in people around them who have been involved in an incident and who may be suffering from stress, and discuss any concerns with the Line Manager.

For quality improvement purposes, ensure that pertinent actions/issues and comments from actual or training events have been recorded for the review process, and forward completed Action Card to the Line Manager in time for the debriefing or by the next day.







Senior Nurse or senior staff member at time in the health centre, whom is responsible for the local health centres response to the incident. All staff contacts kept locally


Is the Regional Director or delegate, whom is responsible to coordinate the health response to an operation within the Great Southern. Mobile contact: 0437 986 621 Generic Email: [email protected]

Nurse Practitioner

Is the line manager for the nursing service for the health centres, if present acts as the Health Centre Emergency Coordinator. The Nurse Practitioner is responsible for: • updating and maintaining current emergency procedure • ensuring practical testing of emergency procedure and evacuation is

undertaken at least yearly, and that evidence is provided to Learning and Development of attendance lists.




All Staff All staff are responsible for: • completing annual core essential training as outlined in WACHS


instructed by the Health Centre Emergency Coordinator

OSH Representative

The Occupational Safety and Health Representative is responsible for: • in liaison with the Nurse Practitioner, scheduling at least annual fire

and evacuation practical training at each of the Health Centres • completing the OSH audits relating to safety and security as

prescribed. • liaising with the Nurse Practitioner to develop and document action

plans. • raising risks at the quarterly staff meetings and status of actions taken

to resolve issues/risks • ensuring annual review of MDS.

Other personnel All other personnel are responsible for: • following instructions of staff during an emergency • ensuring all personal are available to attend and participate in at least

an annual practice fire and evacuation drill.





6. Code Orange Emergency Response Procedure

Evacuation involves the movement of patients, staff and other persons away from a source of danger to a safer place remote from the site in as rapid and safe manner as possible.

Where possible, the situation is to be assessed by a senior staff member present in the area at the time, before the decision to evacuate is made, having regard to the:

• seriousness and relevance of the threat to human safety

• proximity of hazards which may be relevant to the situation; and

• nature and type of patient in the involved area.

The Health Centres do not contain fire compartments as such there are only two (2) stages of evacuation:

STAGE 1: IMMEDIATE

Stage 1 evacuation is the most important part of the rescue process.

It is the rescue of an individual or group of people from the immediate area of danger into a corridor.

Due to the possibility of smoke, ask people to move along the floor.

If fire is the cause, then this is the time to attempt to extinguish the fire if safe to do so.

STAGE 2: FULL Is the complete evacuation of all areas of the health centre to the outside assembly area, away from the building.

6.1. Authority to Evacuate

• The senior person in the immediate vicinity of an emergency can initiate stage 1 evacuation and if necessary Stage 2.

• The Health Centre Emergency Coordinator can initiate full evacuation. This may occur after consultation with emergency services, or key staff.

6.2. Area Clearing Where it is safe to do so, it is important that a minimum of two staff search the entire area to ensure that everyone has been evacuated safely. This search is to include toilets, store rooms and service areas where people may be present. If two staff members are not present on site, then this cannot occur, the Health Centre Emergency Coordinator is to advise the Fire and Emergency Services that the building has NOT been declared CLEAR of all people.

6.3. Assembly Point The assembly point for the Health Centre’s are the car park.





6.4. Decanting Patients In some circumstances it may be necessary to decant patients to other health care facilities due to the likely duration of the incident, or the clinical condition of patients.

Emergency Telehealth Service (ETS)

Royal Flying Doctor Service (RFDS): 1800 625 800

Site Options Distance and Duration

Jerramungup Perth RFDS Approximately one hour by fixed wing aircraft

Gnowangerup Small hospital 96 km, approximately 1 hour duration

Albany Regional Resource centre

180 km, approximately 1 hour, 53 minutes duration

Bremer Bay Health Centre

Nursing Post 95 km, approximately one hour duration

Bremer Bay Perth RFDS Approximately one hour by fixed wing aircraft

Jerramungup Health Centre

Nursing Post 95 km, approximately one hour duration

Albany Health Campus

Regional Resource Centre

178 km, approximately 1 hour, 52 minutes





6.5. Emergency Evacuation Locations for Health Centre Confirm evacuation location with LEMC, as depending on the reason for evacuation the hazard management agency will determine which sites are considered to be safe to evacuate to.

Site Address

Bremer Bay Health Centre

1. Community Resource Centre Mary Street, Bremer Bay

9837 41 71

[email protected]

2. FESA Bremer Bay John Street, Bremer Bay

9837 4299

3. Bremer Bay Sports Club Frantom Way, Bremer Bay

9837 4031

4. Boxwood Hill (locate out of town)

Jerramungup Health Centre

1. Roe Park Memorial Rd Jerramungup

2. Jerramungup Sports Pavilion Derrick Street, Jerramungup

9835 1058

3. Boxwood Hill (located out of town)






6.6. Procedure The order to evacuate will be communicated via verbal instruction by the Health Centre Emergency Coordinator.

Advised by Health Centre Emergency Coordinator that

evacuation is required

Determine where to evacuate based on advice

or observed risks

Begin evacuation in order: Ambulant, need assistance,

incapacitated

Prepare patient, visitors and staff for evacuation

Complete evacuation triage: ambulant need for assistance,

incapacitated

Gather immediate patient information required medication

charts

Gather and prepare necessary equipment for evacuation,

portable oxygen, parry pack etc

Advise Health Centre Emergency Coordinator when ready to

evacuate

Immediate evacuation required YESNo

Delegate staff in pairs (if available) to CLEAR AREA, confirm name and

head count of evacuation


instructs EVACUATION

Health Centre

Emergency Coordinator nominates

external ASSEMBLY

AREA

At ASSEMBLY AREA confirm head name and head count reassure

evacuees, monitor patients, maintain communication with

DEFS/ Nurse Practitioner/Nurse Director

If duration exceeds 60 minutes consider welfare of persons at assembly area, consider decanting patients to

for care.

Health Centre Emergency Coordinator receives information from DFES relating to

duration of incident

Once ALL CLEAR has been given communicate to

Assembly Area

Coordinate re-entry to building

Complete incident reports

Schedule Debrief

Liaise with Fire and Emergency Services when

they arrive and follow instructions given

If not already completed, ensure the following people are notified:

• Regional Health Disaster Coordinator : 0437 986 621

• Ravensthorpe Director of Nursing/Health Service Manager and Midwifery







Senior Nurse, or senior staff member at time in the health centre who is responsible for the local health centre's response to the incident.


The Regional Director or delegate, who is responsible for coordinating the health response to an operation within the Great Southern region. Mobile contact: 0437 986 621 Generic Email: [email protected]

Nurse Practitioner

If present, the line manager for the nursing service for the health centres acts as the Health Centre Emergency Coordinator. The Nurse Practitioner or delegate represents the health centres on the Local Emergency Management Committee (LEMC) meeting, and is responsible for: • updating and maintaining current code black procedure • ensuring practical testing of emergency procedure and evacuation

is undertaken at least yearly, and that evidence is provided to Learning and Development of attendance lists.




All Staff All staff are responsible for: • completing annual core essential training as outlined in WACHS


instructed by the Health Centre Emergency Coordinator.

OSH Representative

The Occupational Safety and Health Representative is responsible for: • in liaison with the Nurse Practitioner, scheduling at least annual

fire and evacuation practical training at each of the Health Centres • completing the OSH audits relating to safety and security as

prescribed • liaising with the Nurse Practitioner to develop and document

action plans • raising risks at the quarterly staff meetings and status of actions





taken to resolve issues/risks • ensuring completion of Safety Risk Report form

Other personnel Other personnel are responsible for: • following instructions of staff during an emergency • ensuring all personal are available to attend and participate in at

least an annual practice fire and evacuation drill.






CODE ORANGE: Action Card 1 Health Centre Emergency Coordinator

Immediate Evacuation Required with Little Preparation

A Code Orange will usually be triggered by one of the other codes. The Health Centre Emergency Coordinator is to ensure that they have an understanding of the current situation and the potential dangers to patients, visitors and staff.

The Chief Warden is to determine which of the evacuation stages is most appropriate based on information related to the emergency.

STAGE 1: IMMEDIATE It is the rescue of an individual or group of people from the immediate area of danger into a corridor.

STAGE 2: FULL Is the complete evacuation of all areas of the nursing post to the outside assembly area, away from the building.

Once the location and scope of emergency has been identified, determine:

• who needs to evacuate?

• where do they need to go?

• if there are any considerations on how they get there.

If possible, always give staff time to prepare.

Health Centre Emergency Coordinator – Immediate Evacuation Required with Little Preparation

Date/Time occurred / completed

Alerted of potential to evacuate & the type of emergency

Ensured 000 notified

Instructed staff to prepare to evacuate?

If yes, what time?

Yes / No

Instruction given to staff to evacuate to assembly area (car park)

Roll call completed as leaving building

Roll call at arrival to assembly point

Advised Regional Health Disaster Coordinator 0437 986 621

Advised by DFES safe to re-occupy building?

Name of DFES personal authorising re-entry:

Yes / No

Organise the clinic return to normal operation





CODE ORANGE: Action Card 2 Health Centre Emergency Coordinator

Planned Evacuation due to External Disaster A Code Orange will usually be triggered by one of the other codes. The Health Centre Emergency Coordinator is to ensure that they have an understanding of the current situation and the potential dangers to patients, visitors and staff.

The Chief Warden is to determine which of the evacuation stages is most appropriate based on information related to the emergency.

STAGE 1: IMMEDIATE It is the rescue of an individual or group of people from the immediate area of danger into a corridor.

STAGE 2: FULL Is the complete evacuation of all areas of the nursing post to the outside assembly area, away from the building.

Once the location and scope of emergency has been identified, determine:

• who needs to evacuate?

• where do they need to go?

• if there are any considerations on how they get there.

If possible, always give staff time to prepare.

Health Centre Emergency Coordinator – Planned Evacuation due to External Disaster

Time occurred / completed

Alerted by DFES/Police & type of emergency

Alerted of potential for evacuation

Instructed staff to prepare to evacuate?

If yes, what time?

Yes / No

Advised Regional Health Disaster Coordinator 0437 986 621 and written SitRep report provided

Instruction given to staff to prepare for full evacuation

Charge all satellite, mobile phones and laptops

Ensure all vehicles are fully fuelled and keys easily accessible

Prepare emergency clinical equipment (ensure fully charged):

• Defibrillator

• Parry pack (including essential drugs)

• Depending on emergency - prepare additional clinical equipment





Health Centre Emergency Coordinator – Planned Evacuation due to External Disaster

Time occurred / completed

and consumables

Secure medical records - only take records for patients being transferred

Arrangements to decant existing patients as required

Number of patients, patient location for decanting, method of transfer recorded and reported to the RHDC

Advised of alternative location to evacuate to site by:

Alternative site location:

Yes / No

Regional Health Disaster Coordinator advised of site and details of off-site evacuation

Drive to evacuation site, advise departure and arrival time to RHDC





7. Compliance

Failure to comply with this policy may constitute a breach of the WA Health Code of Conduct (Code). The Code is part of the Employment Policy Framework issued pursuant to section 26 of the Health Services Act 2016 (HSA) and is binding on all WACHS staff which for this purpose includes trainees, students, volunteers, researchers, contractors for service (including all visiting health professionals and agency staff) and persons delivering training or education within WACHS.

WACHS staff are reminded that compliance with all policies is mandatory. 8. Evaluation

Name: Nurse Practitioner

Time frame: Every third year, or

- if there is a change in the infrastructure or fire system

- should a code red or orange incident occur as part of the written debrief

Using the following means / tools:

• Third yearly review of this procedure

• Monitoring annual staff compliance of mandatory training (online learning modules and fire walk-throughs).

9. Standards EQuIPNational Standards – Standard 15.8, 15.19, 15.21, 15.23

10. References Australian Standard (2010) AS 4083-2010 Planning for emergencies – Healthcare facilities. SAI Global Limited, NSW, accessed online 09 September 2014

Australian Standard (2010, incorporating Amendment No.1) AS 3745-210 Planning for emergencies in facilities. SAI Global Limited, NSW, accessed online 09 September, 2014

Australian Standard (1997) AS 4485-1997 Security for health care facilities Part 1: General requirements. SAI Global Limited, NSW accessed online 10 September 2014.

Australian Standard (1997) AS 4485-1997 Security for health care facilities Part 2: Procedures guide. SAI Global Limited, NSW accessed online 10 September 2014.

11. Related Forms WACHS Safety Risk Report Form

12. Related Policy Documents

WACHS Emergency (Disaster) Management Arrangements Policy WACHS Working in Isolation - Minimum Safety and Security Standards for all Staff Policy WACHS Workforce Learning and Development Policy WACHS Kimberley: Crucial Incident Debriefing for Staff Procedure.


http://www.health.wa.gov.au/CircularsNew/frameworks/Employment.pdf

https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13761_homepage.html

http://trim/hptrimwebclient/download/?uri=85561










WACHS – Great Southern (2012). Albany Health Campus Emergency Manual and Action Cards

13. Related WA Health System Policies MP0073/17 Emergency Management Policy

14. Appendices Appendix 1 - Situation Report

This document can be made available in alternative formats on request for a person with a disability

Contact: Operations Manager (R. York) Directorate: Operations EDRMS Record # ED-CO-19-53663

Version: 1.00 Date Published: 16 July 2019

Copyright to this material is vested in the State of Western Australia unless otherwise indicated. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the provisions of the Copyright Act 1968, no part may be reproduced or re-used for any purposes whatsoever without written permission of the State of Western Australia.


https://ww2.health.wa.gov.au/About-us/Policy-frameworks/Public-Health/Mandatory-requirements/Disaster-Preparedness-and-Management/Emergency-Management-Policy
