Safety in LTC

Oh man, I have a good one because of what happened to me last Saturday!

On the weekends in my assisted living facility (huge facility 2 stories, two connected buildings of elder apt living and our dependant resident side) I am the only RN on duty...I am also considered in charge because no admin comes in on weekends.

Well...here I am at the front desk doing some faxes, and all the sudden the receptionist's phone board lights up big time! It seems that their was a burning smell coming from between the buildings in the north end of the facility. But just about then, I smelled it in the central hub of the facility. Smelled like burning plastic or even wax! Then I saw a light white smoke haze! OH CRUD!!!!!

Now this was lunch time, whew...most everyone was in the dining room which is located by the front doors. However or immoble patients on hospice or people that declined lunch are still in their rooms, and most upstairs!

I gathered a few of the ladies I work with and called 9-11. I had a crew of CNA's investigate the north hall and close the fire doors and mark rooms where people were inside. Lucky for me 9-11 came quickly and the firemen and I went through the entire facility and never found the source. All was cleared luckily...no fire found!

But that reminded me of the importance of having a real REAL fire excape plan! Our residents are checked for ablility to escape, but what about patients that have w/c or or in bed upstairs when you can't use the elevator??? We also have fire drills but no evacuation drills!

I am going to head up a real evacuation drill...and my hubby suggested the facility make a BBQ so that when folks are done, we all have a fun picnic!

I am going to ask the help of the local Fire Department, and you should check with them for safety issues! They will come in free to look at facilities and help form plans, they also know safety rules via the state and federal agencies (ask for fire prevention team)....

Lucky for me I took fire prevention classes, and already had people working on getting blankets to lower patients down the central stairs in case of a real fire! And since no alarm ever sounded, I was prepaired to use smoke to trigger the alarm (not fire, that sets off sprinklers)....

Hope that helps, and all of us really should be very aware of escape plans and actually have real drills in it!!!!

perhaps the rules and regulations are different from state to state and from facility to facility.

i'm working in a ltc facility ... we have a fire drill every month, never know when, could be at any time, on any shift. i think the facility contacts the local fire department to let them know that it is only a drill and to find out if the time might be convenient as the fire and rescue trucks appear as though it is the real thing.

" what about patients that have w/c or in bed upstairs when you can't use the elevator??? "

i don't remember anything about an escape/evacuation plan/drill ... i'll pay more attention at the next yearly inservice.

we move residents, tables, everything, from corridors and hallways, into the resident's room or the dining room and close the door. there are doors that close automatically and we are never to open or go thru those doors. an escape/evacuation would be then be thru the dining room doors to the outside or thru the windows in their rooms to the outside. with the numerous walker, w/c, immobile residents here ... just thinking ... if the residents, staff, and fire department were in the corridors and hallways became filled with smoke ...

at an assisted living facility nearby, residents (all ambulatory, no wheelchairs) and the staff, leave the building and go to a designated area (the far end of the parking lot). the staff has been told not to stay, reverse their direction, go to another floor or go back into the building. at the designed area a head count is done and the fire department is notified if all are accounted for or if any residents are missing. if anyone is missing, the fire department will search for them.

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I am working on a presentation for safe environment in LTC, some of my suggestions are, continue ed for staff on safety, use of lifts and gait belt, proper lighting, sliding doors for bathrooms, nightlights at floor level built into wall. Any ideas appreciated. Any web ref for design of ltc helpful. I have been searching and searching with little luck. I have the OSHA and DOL guidelines and some from my facility but need additonal resource.

ITHINK IT'S IMPORTANT THAT ANY LTC FACILITY HAS PSYCHIATRIC APRN'S/PSYCHIATRISTS AVAILABLE FOR CONSULTS ON RESIDENTS DUE TO THE POTENTIAL VIOLENCE, DETERIORATING HEALTH. STAFF AND FAMILY STRESS THAT ACCOMPANIES UUNTREATED PSYCH. ILLNESSES IN RESIDENTS.