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Emergency / Disaster Preparedness - Dependable Home Care

Emergency / Disaster Preparedness

PURPOSE

To assure that the health care needs of the patients and staff safety are met in the event of an
emergency or disaster.

POLICY

The agency is committed to continued services for its patients, however, events may occur which interfere with full implementation of thns commitment.

The agency:

  • Maintains a current written plan of procedures to be followed in emergencies/disasters.
  • Maintains copies of the plan in the office and provided copies for the home of the Administrative and field staff.
  • Posts and distributes "Administrative Phone Tree"
  • Informs the Administrator/designate who manages the overall response.
  • Designates the Supervisor/designate to be responsible for coordinating, directing and delegating The activities of the administrative staff.
  • The Supervisor/Nurses are responsible to identify the classification of each patient on an ongoing basis.
    The Clinical Supervisor triage patients, function as the point of reference for patient/family calls, questions etc. and guide the patient care.
  • Utilizes a patient priority/classification system as the basis for planning care delivery for private patients.
  • Plans for contract patients in collaborative with the contracting agency. Each agency has the After Hours and Emergency Telephone Numbers of the other.
  • Orients all employees at the time of employment and annually the plan, its implementation, and their responsibilities.
  • Communicates with patients and others from the office unless the nature or time of the emergency prohibits it, in which case, it is done from another location i.e. designated staff home, pay phone, borrowed office space).

PROCEDURE

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  1. Emergency or Disaster Situations Which May Occur:
    1. Staff strike or severe shortage at agency,
    2. Staff strike/shortage or other occurrence which creates an excessively high, discharge rate to community agencies,
    3. Severe weather conditions (non - BBS).
    4. Natural disaster, Civil disorder, Utility Failure
    5. Hazardous chemical accidents or BBS Weather Conditions
    6. Radiological Incidents
    7. Transportation strike.
    8. Extended interruption of agency telephone service
  2. Service Priorities (Patient Classification System) Each patient's classification is determined by the Nurse at the time of admission and change of status.
    1. Acutely ill Patients or those approaching crisis
      Examples:
      Administration of essential medication to control i.e., CHF, HTN.
      Last stages of terminal illness
      Patients in need of respiratory suctioning
    2. Patients Whose Condition Would Be Jeopardized Without Care.
      When a patient is in need of total personal care or is totally dependent upon the services of an aide where no responsible alternative care giver (family, friend) is available or competent.
    3. Urgent New Referrals
      Examples:
      Current informal caregiver unable to continue essential care
      Hospital discharge without home care plan
    4. Moderate to Minimal Care
      When stable patients without help in the home require some but not total agency care and would require some assistance particularly over a prolonged period.
      Example: shopping for food, arrangements for delivery of medications or other supplies, monitoring of specific signs and symptoms.
    5. Stable Patients with Help in the Home.
      When patients live with capable others, have nearby assistance available, are essentially self-care with only housekeeping or other related support needs or a non-essential nature.
  3. General Guide for Dealing with Situations
    1. The Supervisor determines how best to meet patient needs and safeguard the staff to the extent possible within the following parameters:
    2. The day before a natural disaster is predicted, the Administrator attempts to secure employees who will stand-by for emergency coverage should they be needed.
    3. The current Patient Schedule, utilized by both day time and on-call coordinating and nursing staff, includes the priority status of patients.
    4. A battery operated radio, flash lights, extra batteries, and first aid supplies are kept in the office.
    5. A telephone pyramid is in place to notify staff of an emergency.
    6. If adequate care can not be provided at home. Staff assist the patient/family and practitioner with alternative plans.
    7. If the patient has immediate needs, the Supervisor/Nurse makes every attempt o coordinate the necessary service.
    8. If the patient is unattended and requires some assistance, the services may be provided by family members or neighbors.
    9. If the patient is unattended and there is no family member or neighbor available to provide assistance, the Nurse or designate coordinates transport to the nearest hospital or health care facility.
    10. n the event that the patient is clinically stable and is capable of self care or has a care giver present, the Nurse determines if the patient has adequate supplies. If the patient does not have adequate supplies to continue therapy and the therapy is determined to be critical, every attempt is made to provide necessary supplies and equipment.
    11. If streets to the patient's home is impassable, the local Police or National Guard are contacted to assist with delivery of emergency supplies or transport of patient to an acute care facility.
    12. If the elevators in the building are not working the Aide is to call 911 for  assistance.
  4. PLANS FOR SPECIFIC SITUATIONS
    1. STAFF STRIKE or EXTREME STAFF SHORTAGE
      • The Clinical Supervisor contacts and/or visits private high risk patients as needed, arrangements for additional staff and/or transfer of patients to another agency, facility or family/friends home is arranged.
      • Efforts to settle the staffing dispute/shortage are made as soon as possible.
      • Recruitment and orientation of new or temporary staff are processed as swiftly as possible to alleviate the situation.
    2. WORK ACTION at LOCAL HOSPITAL
      •     Current staff are requested to work additional hours to accommodate the influx of patients discharged from the hospital(s).
      •     Temporary staff is recruited and then oriented by the/Nurse to meet the need as soon as practical.
    3. SEVERE WEATHER - No BBS Restrictions
      Management of patient services may be conducted from the office or homes of the management depending upon their ability to come to the office. If from their homes, the agency answering service is used to receive and relay calls to them.
      Staff Responsibilities
      1. All staff who can safely report to work are to do so.
      2. Staff already with patients are to remain until the end of the assigned time unless otherwise instructed by the agency. If staff are to be relieved by another worker they are to remain with the patient until a replacement arrives or until dismissed by the agency.
      3. Staff may be asked to assist with transport of patients to shelters in case of flood, fire, etc.
    4. Management Responsibilities
      1. Maintain a list of the following telephone numbers in the office and at the homes of all administrative, supervisory and on-call staff
        •     individuals or groups with four wheel drive vehicles or snowmobiles
        •     community agencies which assist with food, clothing, transportation, snow removal
        •     state police and highway departments; local police, fire, highway and transportation offices
      2. Arrange, if needed, for transportation of field staff to priority patients. Local patrols may be requested to assist with transportation.
      3. A Nurse or designated other call private patients, according to the priority listing, to determine their status, discuss plans for care and provide reassurance.
    5. NATURAL DISASTER, CIVIL DISORDER, UTILITY FAILURE
      1. When it would be unsafe for staff to enter or leave a specific area they may be instructed to:
        • remain where they are or
        • avoid the designated area and accept assignment elsewhere.
      2. Patients dependent upon electrically powered equipment are to have backup battery packs or generators available at all times. Tills is discussed with the patient/family by the Nurse and arranged for prior to admission to the agency. The appropriate Utility Company is informed.
      3. For further guidance ,the Administrator/designate contacts local authorities to determine community needs, the agency's capabilities in meeting those needs and how best to safe guard patients and staff.
    6. HAZARDOUS CHEMICAL ACCIDENTS or SEVERE (EBS) WEATHER CONDITIONS
      1. Staff are to:
        • listen to neighborhood sirens and/or police car public address systems for instructions;
        • turn on the radio or a television to one of the Emergency  Broadcast Systems (EBS) and follow the instructions of the official EBS messages;
        • EBS Stations Television: CBS Channel 2        Radio: CBS AM #880
        • remain in their home or work place as instructed by EBS;
        • use the telephone only to call for HELP if needed.
      2. Hazardous Accident
        • This may require shelter or evacuation. It may be necessary to avoid toxic fumes or smoke by evacuating downwind or going inside, (refer to section above for instructions).
        • When there is possible hazardous waste/material, avoid  touching or stepping any material. Avoid breathing fumes, smoke or vapors even those which are odorless.
    7. TRANSPORTATION FAILURE or STRIKE
      The employee and agency arrange alternative plans such as walking to patients, clustering assignments, changing service hours, renting cars, hiring car/van services and/or car pooling, when possible.
    8. EXTENDED INTERRUPTION of AGENCY TELEPHONE SERVICE
      1. (1)   Agency Office
        • Administrative staff use cell phones or take the necessary agency records and locate at an alternative site where a working telephone is available.
        • Calls are made to staff/ patients to alert them to the temporary telephone number and to verify that care is being provided.
        • In situations when patients can not be reached by phone the Clinical Supervisor determines if a visit is indicated.
        • Staff/patients are informed of resumption of normal services.
          The Clinical Supervisor/Coordinator notifies the telephone company of the urgency to restore service.
      2. (2)    Service Area
        • In addition to the above activities it may be necessary to:
        • Transport high risk patients to hospitals.
        • Alert local police and fire departments to the locations of patients at risk.

    Note: If a patient is advised to evacuate help them prepare by gathering items for a three day period:

    •     blankets, sleeping bags, clothing, personal items
    •     diversionary items
    •     money, check book, credit cards, important papers, health insurance card, personal telephone book, keys
    •     food for people and pets taken along
    •     portable radio, flashlight, batteries, candles, matches
  5. PATIENT EDUCATION
    1. Planning
      Patients are oriented to the necessity of developing contingency plans and  having emergency numbers available for contact persons and other services.
      Plans are developed by the nurse at the time of admission in conjunction with the patient/family.\
      The FIRE/EMERGENCY PLAN developed by the agency with the patient is kept in an accessible location, known to all concerned, near the telephone for easy access. Copies are also kept in the patient record.
    2. ProLective Devices/Measures
      Patients who would benefit from security measures such as a Telephone  Emergency Alert System or the Vial of Life are informed of their availability, benefit and methods of acquiring the service.
    3. Disaster Prevention or Control
    4. Staff are to be alert to and reinforce to patients/family means of reducing disasters or discomforts in the following ways:
      1. Fire
        • maintain functional smoke alarm
        • repair/replace frayed cords/damaged outlets
        • keep key available for window grates
        • be aware of location of fire escapes/stairways
      2. Loss of Electricity/Heat
        • maintain working flashlights
        • have supply of candles and safe holders
        • be aware of location and access of fuse box, have supply of fuses
        • battery powered radio
        • have extra blankets, heater
        • have superintendent's number available
        • have back-up for operating life support equipment (hand / pump, generator)
      3. Severe Weather Emergenc
        • have a few days of emergency supplies on hand: bottled water, food which does not require refrigeration or cooking
        • have a few days supply of necessary medications
        • have day to day necessities in supply
      4. Re-entering a Potentially Damaged Building
        • do not touch fallen/damaged electrical wires/lines
        • check for gas leaks
        • call utility company as indicated
        • inspect for apparent structural danger
        • inspect food and water supply for contamination/damaged containers before use
  6. COMMUNICATIONS AND DOCUMENTATION
    1. The management is responsible for maintaining communications with patient/family, staff and others during emergency or disaster situations by
      1. attempting to contact patients/families and authorized practitioners to advise them of the situation, service plans, seek alternative coverage and resolution of the situation;
      2. when at all possible, establishing periodic telephone reassurance contact with patients who are alone and
      3. maintaining telephone contact with staff who also are responsible to keep the agency informed of their situation as it changes
    2. Documentation of all communications and plans must be maintained in the appropriate records. Staff providing care during an emergency are to document in the patient clinical record according to routine procedure and submit a written report to the DON about the situation as soon as possible.
    3. Any refusal by a  patient/family to comply with recommended security planning or actions is documented in the patient record and discussed with. the DON to insure that the overall safety of the patient's home care status is not compromised.
  7. STAFF ORIENTATION Documentation must be in each personnel file that staff have been oriented to their responsibilities at me time of hire and annually there after.

NY Metro Service Area

Our nurses, aides, therapists, and social workers are caring for patients in all of the boroughs of NY city and the surrounding region including:

  • Manhattan
  • Queens
  • Brooklyn
  • Bronx
  • Staten Island
  • Nassau County

We provide service 24 hours a day, 7 days a week.

In Home Evaluation

Every patient has different needs and situation. It is important to have a qualified professional help decide the services needed. Take advantage of our no-cost, no-obligation patient needs assessment.

  • We come to you to evaluate the patient's needs in the home setting.
  • We bring all the forms necessary, and handle insurance and medicaid processing.
  • It costs you nothing.
  • Please fill out our pre-assessment form or call

718 499 6066

to shedule a free no obligation appointment in the home

Find out more ...

Multilingual Staff

We have many nurses and aides on staff that are multilingual. We recognize that communication is key to quality health care, so we will be sure to send staff that can communicate with the patient and family and understand all the patients needs. We have staff members that speak: 

  • English
  • Spanish
  • French
  • Italian
  • Cantonese (Chinese)
  • Mandarin (Chinese)
  • Creole

Specially Trained Staff

Our staff is trained to provide care patients with special needs such as:

  • Geriatric Care
  • HiV/AIDS
  • Palliative Cancer Care
  • Psychiatric Care
  • Dialysis Care
  • Rehabilitative Care

We Accept These Plans & Programs

We have experience with approval and billing management for all third party pay arrangements. Our payment staff will help organize and expedite the application process, and we'll get caring staff providing service as the approval process progresses. We accept:

  • Insurance
  • Worker's Compensation
  • No Fault
  • Disability
  • Managed Care
  • Private Pay