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Guide for Developing an EMS Agency Safety Program

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Guide for Developing an EMS Agency Safety Program National EMS SAFETY COUNCIL Guide for Developing an EMS Agency Safety Program A roadmap for EMS agencies to develop and implement a comprehensive workplace safety program, customizable to their agency type, size and needs. Introduction to the EMS Safety Program Guide National EMS Safety In 2013, the National EMS Culture of Safety Strategy was published. Funded by Council Mission the National Highway Traffic Safety Administration (NHTSA), the initiative brought Statement together the EMS stakeholder community to identify what constitutes a safe environment for EMS patients and practitioners; barriers to achieving a safe EMS • Develop practical environment; and a strategy to overcome these challenges. ways to implement the recommendations The strategy envisioned the establishment of a national level organization to included in National coordinate national EMS safety efforts and serve as a repository for information, EMS Culture of Safety data and resources. In 2015, leading national EMS and safety organizations came Strategy. together to form the National EMS Safety Council. The goals of the council are to: • Review the latest information, research • Ensure that patients receive emergency and mobile healthcare with the highest and best practices standards of safety. on EMS patient and • Promote a safe and healthy work environment for all emergency and mobile practitioner safety. healthcare practitioners. • Develop and publish consensus statements This Guide for Developing an EMS Agency Safety Program is an initiative of the on the issues of EMS National EMS Safety Council. Its members saw the need to provide tools and patient and practitioner resources that EMS agencies could use to put the concepts outlined in the Culture safety. of Safety Strategy to use in their daily operations. • Raise awareness of The purpose of the guide is to serve as a roadmap for EMS agencies to develop the importance of EMS and implement a comprehensive safety program. Recognizing that EMS agencies patient and practitioner have differing levels of resources available for safety programs, the guide contains safety within the EMS sample policies EMS agencies can adopt or readily customize to their particular industry. agency type, size and needs. • Identify additional steps Acknowledgments that the EMS industry can take to improve EMS In developing the guide, the National EMS Safety Council relied on the generous patient and practitioner contributions of the National Association of Emergency Medical Technicians safety. (NAEMT), the American College of Emergency Physicians (ACEP), American Medical Response (AMR), MedStar Mobile Healthcare and the Richmond Ambulance Authority. These organizations provided financial support for this project and/ or shared their safety protocols and policies to assist the entire EMS profession in improving safety for our patients and practitioners. We extend our deep gratitude. National EMS Safety Council Organizations: American Ambulance Association (AAA) National Association of EMS Physicians (NAEMSP) American College of Emergency Physicians (ACEP) National Association of Emergency Medical Technicians (NAEMT) Association of Air Medical Services (AAMS) National Association of State EMS Officials (NASEMSO) Center for Patient Safety National EMS Management Association (NEMSMA) International Association of Fire Chiefs (IAFC) National Registry of Emergency Medical Technicians (NREMT) National Association of EMS Educators (NAEMSE) National Safety Council Council Advisor: NHTSA’s Office of EMS Editor: Jenifer Goodwin 2 TABLE OF CONTENTS Introduction 2 What is an EMS Safety Officer? Roles and responsibilities 5 Chapter 1 Facility Safety and Security 13 Chapter 2 Vehicle Operator Safety 25 Chapter 3 Scene Safety 57 Chapter 4 Infection Control 87 Chapter 5 Personal Health and Safety 131 Chapter 6 Patient Safety 155 GUIDE FOR DEVELOPING AN EMS AGENCY SAFETY PROGRAM 3 Why Every EMS Agency Should Have Why implement a safety program? a Safety Program • Protect the physical and EMS is an inherently risky job. On any given shift, EMS practitioners may be called mental health of EMS to respond to emotionally charged, potentially life-threatening situations. These practitioners. may be quickly followed by a routine patient transport, with little time for recovery. • Protect patients. Research shows that rapidly cycling between high and low intensity, routine work • Protect the public at can lead to exhaustion and errors – whether it’s forgetting to be careful when large. lifting a gurney or making a small driving error that leads to serious consequences. • Lower operational costs Even when fully alert, long hours spent driving on roadways, in all kinds of weather (fewer collisions, time off and traffic conditions, at all hours of the day and night, exposes EMS practitioners due to injury, sick days). to the potential of motor vehicle collisions. EMTs and paramedics have also been • Lower worker’s injured while responding to accidents by the side of the road. compensation costs. EMS practitioners are also potentially put into harms way every time they • Lower insurance costs. respond to a call that involves interacting with members of the public who are • Fewer liability claims. highly stressed, under the influence of drugs and alcohol or in a mental health crisis. Surveys of EMS practitioners have found that assaults, either intentional or • Improved employee unwitting, are all too common. satisfaction and reduced burnout. Mitigating fatigue, reducing the risk of collisions, promoting scene safety and preventing violence against practitioners are among the major issues that an EMS safety program can and should address. But there are many others, including facility safety and security, infection control, substance abuse prevention and all aspects of personal safety, from lift injury prevention to the mental health of practitioners. In this guide, you will find a range of resources to assist in developing a safety program: • Specific steps and guidance on recommended policies and protocols to be included in a comprehensive safety program. • Sample policies currently in use by some of our nation’s most highly respected EMS agencies. • Other resources for educating yourself and your workforce about safety issues and injury prevention. The National EMS Safety Council encourages EMS agencies to use this guide to develop and implement safety programs that keep EMS practitioners and all of their employees safe and healthy, mentally and physically. In doing so, agencies ensure that their employees can continue in their chosen line of work and continue to serve our nation’s communities for many years to come. The development of these policies and protocols related to operational safety directly impacts the safety of our patients as well. 4 What is an EMS Safety Officer? Roles and Responsibilities Achieving a culture of safety begins by getting employees at all levels of an agency to commit to the idea of safe practices for patients and practitioners. One of the key roles for an EMS Safety Officer is educating staff about the benefits of a culture of safety. By achieving buy in at all levels, the safety officer creates the conditions for a successful roll out of safety policies and procedures. EMS safety officers have both operational and administrative responsibilities. • Oversee safety and risk management initiatives. • Identify, investigate, analyze, and evaluate potential operational and clinical risks. • Develop policies and procedures to reduce risk. • Conduct training and continuing education on procedures, protocols and safety best practices. • Work with the medical director and operational leadership to develop, implement and measure safety-related quality improvement initiatives. • Keep up to date on the latest protocols/standards from voluntary and standards- setting organizations, accrediting organizations, and infection control and prevention Job Titles organizations, including but not limited to: National Fire Protection Association (NFPA), Full-time safety officers Commission on Accreditation of Ambulance Services (CAAS), Joint Commission, aren’t yet common at Occupational Safety and Health Administration (OSHA), National Institute for many EMS agencies. Occupational Safety and Health (NIOSH), Federal Emergency Management Agency Realistically, many (FEMA), Centers for Disease Control and Prevention (CDC), the Food and Drug agencies won’t be able Administration (FDA) drug alert and medical equipment error reporting. to support one. But to the extent it’s possible to • Encourage participation in EVENT, an anonymous incident reporting tool. have a designated safety • Monitor workplace injuries and worker’s comp/liability claims, and identify ways point person, the role is to mitigate and prevent those situations in the future. indispensable. Potential titles for this key member • Work with human resources to review driving records on an ongoing basis and of EMS personnel include: conduct criminal history checks for new employees. • Safety Specialist • Collaborate on new equipment purchases, vehicle operator system reports and • Health & Safety Officer/ fleet maintenance to verify safe driving practices and mechanically sound vehicles. Manager • Implement infection control policies and conduct education and training to • Safety & Compliance prevent exposure. Have an exposure response plan in place and ensure each Officer employee understands what to do in case of suspected exposure. • Safety and Risk Management Director • Promote
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