Emergency Management Supplies for Region L Hospitals

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Decon equipment

• How long can you sustain a decon operation before you would need mutual aid?

  Yes

  No

  N/A

• Decon tent?

  Yes

  No

  N/A

• Is it serviceable?

  Yes

  No

  N/A

• Does it fit the needs of your hospital

  Yes

  No

  N/A

• Do you have a Hospital Decon policy?<br>copy must be attached with this audit.

  Yes

  No

  N/A

PAPR's

• How many does your hospital have?

  Yes

  No

  N/A

• When are they checked?

  Yes

  No

  N/A

• Who checks them? (Name)

  Yes

  No

  N/A

• Where are the inspection sheets kept?

  Yes

  No

  N/A

• Does your hospital have an adequate amount?

  Yes

  No

  N/A

• Do you have filters that are still in date?

  Yes

  No

  N/A

• Do you have infection control PAPR'S?

  Yes

  No

  N/A

• List serial numbers of all PAPR's

  Yes

  No

  N/A

• Where are they kept?

  Yes

  No

  N/A

• How many batteries do you have?

  Yes

  No

  N/A

• What model # are they?

  Yes

  No

  N/A

• What model charger do you have?

  Yes

  No

  N/A

• Do you have enough batteries for your hospitals usage in an event

  Yes

  No

  N/A

Surge Supplies

• Do you have a portable cots for surge?

  Yes

  No

  N/A

• If yes how many?

  Yes

  No

  N/A

• Where are they located?

  Yes

  No

  N/A

• Do you have linen assigned for them?

  Yes

  No

  N/A

• Have you ever set them up ?

  Yes

  No

  N/A

• How many ventilators does your hospital have?

  Yes

  No

  N/A

• Does your hospital have a surge plan?<br>A copy must be attached to this audit.<br>

  Yes

  No

  N/A

• Has your hospital signed a draft of the regional Crisis Standard Of Care plan?<br>A copy must be attached to this audit.

  Yes

  No

  N/A

Mass Fatality Supplies

• Does your hospital have post Mortum kits?

  Yes

  No

  N/A

• How many?

  Yes

  No

  N/A

• Does your hospital have any other mass fatality supplies?

  Yes

  No

  N/A

• What is the morgue space of your facility?

  Yes

  No

  N/A

• Does your county Public Health have a mass fatality trailer?

  Yes

  No

  N/A

• Does your hospital have a mass fatality plan?<br>A copy must be attached to this audit.<br>

  Yes

  No

  N/A

• Does your county have a mass fatality plan?<br>A copy must be attached to this audit.

  Yes

  No

  N/A

Isolation supplies

• Do you have a Mintie Isolation unit?

  Yes

  No

  N/A

• Where is it located?

  Yes

  No

  N/A

• Have you ever set it up an trained with it?

  Yes

  No

  N/A

Generators

• How many kilowatts does your hospital generator produce?

  Yes

  No

  N/A

• Do you have any portable generators?

  Yes

  No

  N/A

• If so, how many?

  Yes

  No

  N/A

• What is their wattage?

  Yes

  No

  N/A

• How often do they get checked?

  Yes

  No

  N/A

Communications

• Where is your southern link located?

  Yes

  No

  N/A

• Does it work?

  Yes

  No

  N/A

• Do you have radios other than the ER EMS radio that you can use to talk to the county EOC?

  Yes

  No

  N/A

• If so where is it located?

  Yes

  No

  N/A

• When was it tested last?

  Yes

  No

  N/A

• Does your hospital have other radios you use?

  Yes

  No

  N/A

• Do the staff know how and when to use them?

  Yes

  No

  N/A

• Have you used your regional radio?

  Yes

  No

  N/A

• Can you reach all of the region L hospitals with it?

  Yes

  No

  N/A

Evacuation

• If your hospital had to evacuate where would you go?

  Yes

  No

  N/A

• How long would it take to remove all of you patients to another location?

  Yes

  No

  N/A

• Have you ever exercised this process?

  Yes

  No

  N/A

• Do you have adequate equipment for a total evacuation?

  Yes

  No

  N/A

Water shortage

• Do you have water stored for emergency usage?

  Yes

  No

  N/A

• How long can you sustain yourself before you would need mutual aid?

  Yes

  No

  N/A

• Do you have a plan for sewage disposal in the event of a prolonged water outage?

  Yes

  No

  N/A

• Does you hospital have a water outage plan?<br>A copy must be attached to this audit.

  Yes

  No

  N/A

Pharmacitucal

• Do you have a cache of drugs that used only in the event of an emergency?

  Yes

  No

  N/A

• If so list type and quanity

  Yes

  No

  N/A

• Are you a Chem-PAC location?

  Yes

  No

  N/A

• What is the procedure for requesting a Chem PAC to be sent to your hospital?

  Yes

  No

  N/A

Alternate care sites

• How many do you have an MOU with?

  Yes

  No

  N/A

• When was the last time the MOU was updated?

  Yes

  No

  N/A

• Have you visited the sites lately to see if they still meet your needs?

  Yes

  No

  N/A

• How long will it take you to open up a Surge site when the need for one becomes a reality?

  Yes

  No

  N/A

• What equiptment do you currently have on hand that is designated for surge site operations?

  Yes

  No

  N/A

• Do you have staffing to support a surge site operation past 24 hours?

  Yes

  No

  N/A

• Do you have electronic device operations in these surge sites?

  Yes

  No

  N/A

• If not how do you plan on keeping clerical and clinical records?

  Yes

  No

  N/A

• Have you trained staff on this procedure?

  Yes

  No

  N/A

RCH role

• In a disaster what are your hospitals expectations of the RCH?

  Yes

  No

  N/A

• What supplies do you need the region to stock pile for an emergency?

  Yes

  No

  N/A

• How can the RCH help you more efficiently on a daily basis in an non emergency role.

  Yes

  No

  N/A

Regional command center

• Would a member of your organization be willing to become a part of a regional ICS structure in the event of an emergency?

  Yes

  No

  N/A

Public health roles

• What is you're expectation of pubic health in an emergency?

  Yes

  No

  N/A

• Have you worked with your local health department in stock piling supplies for your hospital in the event of a disaster?

  Yes

  No

  N/A

• What do you expect from the public health HCL person in our region?

  Yes

  No

  N/A

Receiving patients

• Has you hospital per accepted patients from the coastal area if there is a hurricane evacuation?

  Yes

  No

  N/A

• If so how may can you recieve?

  Yes

  No

  N/A

• Could your local EMS provider respond to the coast and pick those patients up if needed.

  Yes

  No

  N/A

• What type of supplies would you need to receive these patients?

  Yes

  No

  N/A

Medical supplies

• Do you have a cache of medical supplies for disaster use only?

  Yes

  No

  N/A

• If so, have these supplies been rotated and inspected within the past year?

  Yes

  No

  N/A

• What supplies do you stock pile?

  Yes

  No

  N/A

• Can these supplies be used by other healthcare facalities if needed?

  Yes

  No

  N/A

• What supplies do you need stock piled in the region for this?

  Yes

  No

  N/A

Percentage

• Yes

  No

  N/A

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