Emergency Management

Confidential – Not for Distribution 2 Emergency Management

Prepare

Emergency Mitigate Management Respond

Recover Codes

Grey • Internal Disaster Purple • Hostage Taking/Abduction Pink • Neonatal Arrest Blue • Cardiac Arrest Orange • External Disaster White • Violent Situation Brown • Hazardous Spill/Leak Yellow • Missing Patient Yellow Amber Alert • Missing Child Black • Bomb Threat/Suspicious Package Green • Evacuation Red • Fire Code Stages

. The Emergency Management Program utilizes an incident level determination matrix which helps ensure that we have the appropriate level of response to a given incident.

REQUIRED ORGANIZATIONAL STAGE LEVEL RESOURCES DOWN TIME IMPACT

STAGE 3 Outside Agencies Significant Impact Hospital-wide or Site/Org Wide Required or > 24 hrs Site Closure

Within Site + Specific STAGE 2 Outside Site/Incident Specific Site Impact Multiple Departments Vendors/Agencies > 2 hrs but < 24 hrs. Required STAGE 1 Department Within Department Site/Incident Specific Minimal Impact < 2 hrs How to Call a Code

In the event you need to call a code, the following steps should be followed: Call Switchboard at ext. 5555

Inform • Color of code • Stage of code (if known) Switchboard • Location of code of Code • Your Name and Contact Info

Switchboard • Code Color will page • Stage overhead • Location Code Alert Email

When a code is called, an email message describing the type and stage of the code is dispersed by Switchboard. For Example:

From: Code Alert THC or Code Alert CVH Sent to: ALL USERS Subject Line: CODE RED – [LOCATION] – [STAGE]

An “All Clear” message will be sent in the same format once the Code has been resolved.

Emergency Response Station

The Emergency Response Stations are located in most departments and are easily accessible to all staff. Each station consists of:

Binder contains Code Policies, Job Action Sheets, safety vest and no-battery flashlight Code of the Month contains a placeholder for the code of the month poster Evacuation Floor Plan showing location of exits and fire pull station Fire Safety Code Red

Confidential – Not for Distribution 9 Why Training is Important

• At Trillium Health Partners, we have many patients, visitors and staff routinely utilizing various departments and resources

• It is vital for us to be prepared and trained in the event of an Emergency

• We must ensure quick and effective reactions to prevent the loss of life and/or property

• Our duty as staff is to R.E.A.C.T. when an emergency such as a fire, threatens the safety of you and those around immediate area

ClickHow to edit would Master you title R.E.A.C.T.? style

R • Remove those in immediate danger

E • Ensure room door is closed

A • Activate fire alarm (if not already done)

C • Call Customer Support at 5555 or dial 911 (if offsite)

T • Try to extinguish or control the fire Click to edit Master title style What is a Fire Safety System?

A fire safety system is an electronic system that detects fire conditions (smoke and/or heat).

Smoke and/or heat detectors will activate the Fire Suppression System which turns on sprinklers shut down ventilation fans, and activate the fire alarm system.

The fire safety system can also be activated manually by means of Fire Pull Stations. ThereClick a 4to ways edit the Master fire safety title system style can be activated: Click to edit Master title styleFire Alarm Once activated in any portion of the building, the fire alarm will sound throughout the building and initiate the following actions:

Electromagnetic locked doors Air handling will release its units shut down lock and close Local fire in non-critical department is areas. Elevators are notified NOTE: In critical recalled to the areas such as Building ground floor the OR, the unit occupants are and shut down will shut if the fire alerted of a is in that area. possible fire emergency Click to edit Master title style Fire Triangle

A fire requires three elements in order to create the reaction needed to ignite.

Once a fire has started, the resulting chain reaction sustains the fire and allows it to continue until at least one of the elements is removed. heat

What is a Fire Suppression System

Trillium Health Partners employs a Wet Sprinkler System; if the Fire Safety System detects a fire condition it reacts by dispensing water to suppress the fire through sprinkler heads located throughout the facility’s ceilings.

We also have a chemical system located in equipment-sensitive areas (such as the IT server rooms) in order to prevent equipment damage.

Fire Suppression Equipment

• Releases water into the • Should only be accessed • An A,B,C fire zone in which the fire and used by trained extinguisher can be exists. professionals. utilized for all fires including electrical and wiring, wood and paper, and grease and oil.

Automatic Standpipe and Portable Fire Sprinkler System Hose System Extinguisher Using a Fire Extinguisher

The use of fire suppression equipment is primarily the responsibility of the Fire Department. Using a Fire Extinguisher

Fighting a fire is always voluntary act for staff. Using a Fire Extinguisher

To use a fire extinguisher follow these instructions: Pull the pin Aim at the base of the fire Squeeze the handle Sweep back and forth Using a Fire Extinguisher Using a Fire Extinguisher

DO NOT re-use a fire extinguisher which has been discharged or has the pin pulled out. DO NOT place a discharged fire extinguisher in its holder. Fire Prevention

How can we stop a fire from happening and spreading ? • Be proactive and break the Fire Triangle (that is, never allow the three fire elements to have contact) • In the event of a fire, remove one of the elements (for example, use water to eliminate heat, or chemicals to eliminate O2)

If the fire triangle cannot be broken then we must control and confine the fire. Smoke Hazard

Smoke is extremely toxic and spreads rapidly. Smoke causes people to become:

• disoriented • impaired • blinded • confused

Smoke may also prevent search and rescue and firefighting efforts.

Fire Containment

The best way to confine and control the spread of fire is to ensure that all doors are closed and all fire separation doors are never wedged open or obstructed.

A fire separation door is designed to resist fire for a limited period of time in order to contain and confine the spread of fire and smoke.

Stay Safe-WHMIS Your Guide to the Workplace Hazardous Material Information System

Confidential – Not for Distribution 26 What is WHMIS?

WHMIS stands for Workplace Hazardous Materials Information System

It is a national hazardous material classification system designed to provide workplace standards for the control, handling, storage, and disposal of ‘controlled’ products. (Workplace Safety and Prevention Services) WHMIS Requirements

There are 3 WHMIS requirements to being safe in the workplace 1. Product Labeling 2. Material Safety Data Sheets 3. Worker's Education Roles and Responsibilities

The Supplier The Employer The Worker • Determines which • The Employer identifies • The worker participates products fall under and maintains an in education and WHMIS. inventory of all training on hazardous • Provides buyers with a hazardous substances materials. Material Safety Data in the workplace. • Use's the health and Sheet ( MSDS) Ensures • Ensures all containers safety information the product is have proper labels. including PPE to protect appropriately labeled • Ensures no labels are themselves and others removed, changed, or when handling, storing, defaced. or transporting hazardous materials. Controlled Products

A controlled product is any product or ingredient that meets the criteria for one or more classes of hazards established by WHMIS. Generally, consumer products are not covered by WHMIS as they fall under different legislation. Additionally there are some products that are controlled by other regulations (for example, the Explosives Act). Although these products may not be regulated by WHMIS regulations or labelled within an MSDS, these materials may pose a hazard and therefore there is still an expectation that workers be educated and aware of any hazards associated with them. Characteristics of Hazardous Materials • Cylinders with contents under pressure, may Compressed Gas decompress or • a substance capable of easily catching fire and Flammable and Combustible burning • Can cause other materials to burn or explode by Oxidizing providing oxygen • Can cause harm to your body, with immediate and/or Poisonous long term effects • A poisonous substance may harm a worker's health Toxic with over-exposure • Organisms, or the toxins they produce, can cause Infectious diseases in humans or animals

Corrosive • A substance that will burn the skin or eyes on contact

• A substance capable of undergoing a chemical Reactive reaction with the release of energy How Do I Know What Hazardous Materials are in My Workplace?

WHMIS requires all workplaces that may have controlled products in use to: provide workers with information regarding health and safety hazards in their workplace.(1) create a workplace inventory of all hazardous materials in the workplace along with its corresponding Material Safety Data Sheets (MSDS) provide staff with access to the inventory and Material Safety Data Sheets (MSDS). (1) Workplace Safety and Prevention Services

What Information is on an MSDS? The Material Safety Data Sheet (MSDS) will include the following technical information about the product: • Product Name- usually the trade name such as Tide detergent • Hazardous Ingredient- what is in the product and how much • Physical Data- such as gas, solid, or liquid • Description- such as its smell and/or appearance • Fire/Explosion data- the likelihood of the product catching fire • Reactivity- is it stable? does it react to light, heat, or moisture? • Health Hazard- info on the health hazard(s) and/or toxicological data Emergency Response In the event of exposure, the MSDS must be given to the doctor providing treatment, so that the appropriate care is provided. How Can I Identify a Hazardous Material? WHMIS requires at least 1 of the following types of labels to be placed on materials containing controlled products: • Supplier labels are placed on the product before it is sold. • Workplace labels are required on controlled products that are produced and used in the workplace.

Supplier Label Requirements

The supplier label must have a WHMIS hash border around it. It must also contain the information you in this diagram.

Workplace Label Requirements

Required: if the supplier label becomes illegible or if the product was received and transferred to another container.

Not Required: if the transferred material is used in its entirety prior to the end of the work shift, for example a mixed solution of floor cleaner that will be emptied at the end of the shift.

Controlled Products and Precautions

Categories of Controlled Products There are six main categories of controlled products. Each class has at least one symbol associated with it. These categories include:

Class A: Compressed Gas

Description Precautions • identified by a symbol of a • Transport and handle with compressed gas cylinder. care Compressed gases: • Secure cylinders properly • are under pressure; • Store away from sources of • may explode if heated or heat or fire damaged; and • Use proper regulator • may puncture skin and cause fatal embolism with a sudden release of high pressure gas Examples in the streams. workplace include oxygen and nitrogen.

Class B: Flammable and Combustible Material

Description Precautions • Flammable and combustible • Store away from Class C materials: (oxidizing materials) • may burn or explode when • Store away from sources of exposed to heat, sparks, or heat, sparks, and flame flames; • Do not smoke near these • burn readily at room materials temperature; and • burn when heated. Examples in the workplace include alcohol, acetone, and methanol. Class C: Oxidizing Material

Description Precautions • can cause other materials to • Store away from Class B burn or explode by providing (flammable and combustible) oxygen; materials • may burn skin and eyes on • Store away from sources of contact; heat and ignition • Wear recommended protective equipment and clothing

Materials in this class might include bleach or perchloric acid. Class D: Poisonous & Infectious Material

Class D- Division 1: Materials Precautions Causing Immediate and Serious • Avoid inhaling gas or vapours Toxic Effects • Avoid skin and eye contact Identified by a skull and crossbones • Wear recommended protective symbol. It represents materials equipment and clothing causing immediate and serious • Do not eat, drink, or smoke near toxic effects. these materials These materials may cause • Wash hands after handling immediate death or serious injury if inhaled, swallowed, or absorbed through the skin.

Examples of Class D - Division 1 materials are methanol and phenol.

Class D: Poisonous & Infectious Material

Description Precautions • Cause death or permanent injury • Avoid inhaling gas or vapours following repeated or long-term • Avoid skin and eye contact exposure; • Wear the recommended protective • Irritate eyes, skin, and breathing equipment and clothing passages: may lead to chronic lung • Do not eat, drink, or smoke near problems and skin sensitivity; and these materials • Cause liver or kidney damage, • Wash hands after handling cancer, birth defects, or sterility.

The examples shown here are: • Formalin 10% (used to fix tissues for laboratory examination) • Klean n’ Shine Multi Surface Cream Cleanser Class D: Poisonous & Infectious Material

Description Precautions Identifies bio-hazardous infectious • Wear recommended protective materials. The symbol displays three equipment and clothing intertwined circles over a single circle. • Handle these materials only in Contact with bio-hazardous infectious designated areas materials includes contact with • Disinfect work area after handling microbiological agents which may • Wash hands after handling cause illness or death.

Examples of materials in this class might include bacteria like tuberculosis, viruses like influenza, and fungi-like mould's and their toxins. Class E: Corrosive Material

Class E identifies corrosive materials. Precautions The symbol displays a hand, and a line Store acids and bases in separate which represents a hard surface. There areas Avoid inhaling these materials are test tubes of materials shown • Avoid contact with skin and eyes pouring over and altering the surface. • Wear recommended protective equipment and clothing. These materials will burn: • Eyes and skin on contact • Tissues of the respiratory tract if inhaled

Examples you might find in the workplace are Crew Super Blue Bowl Cleaner and acetic acid. Class F: Dangerously Reactive Material

Description Precautions The symbol displays a capital letter R, • Store away from heat with a superimposed test tube showing • Avoid shock and friction a reaction above its opening. These • Wear recommended protective materials may: equipment and clothing • be unstable, reacting dangerously to jarring, compression, heat, or exposure to light; and • burn, explode, or produce dangerous gases when mixed with incompatible materials.

An example found in Trillium’s laboratory is picric acid Accessing WHMIS Information in the Hospital

Access to WellNet through the hospital intranet is the best way to get a current product MSDS. WellNet provides a service to obtain and update the MSDSs and make them available in the database. This database is always up to date and is automatically updated every three years. Workers can access WellNet at any site which has access to one of our hospital’s intranet.

Mississauga Hospital or Queensway Health Centre : iCare

If you work at the Mississauga or Queensway Hospital you can access WellNet as follows:

iCare, under My Life > Health and Wellness

You will see an online WHMIS link that takes you to WellNet as well as site and department specific records. Credit Valley Hospital: iShare

If you work at the Credit Valley Hospital Site, go to Applications within the intranet.

Next expand the Administrative tab.

Once you have clicked on this tab, expand the WHMIS tab and then click on WellNet- MSDS. Master MSDS Library

The hospital’s master MSDS library can be found in the Employee Health, Safety and Wellness department and contains information for all departments. Each hospital site receives a disk (CD) copy of their respective master book on a monthly basis. Copies are also kept in the Corporate Emergency Operations Command Centre should they be required.

WHMIS Department Binders

Your department may also maintain a WHMIS Binder available for referencing a department specific inventory list and corresponding MSDS. This can be handy in the event of a power outage. It is the responsibility of Employers to ensure that this binder is kept up to date with the information available on WellNet as Canadian MSDSs are revised every three years by the manufacturer of the material/product.

Precautionary Measures for Controlled Products

When dealing with controlled products, you may be required to wear personal protective equipment, sometimes also known as PPE.

The symbols shown on the next page will indicate how to protect yourself from various hazards. These may include: • face mask • gloves • full face respirator • self-contained breathing apparatus • safety glasses • face shield

Personal Protective Equipment Symbols

The symbols shown here indicate protective equipment that should be used when handling certain materials. Some chemical labels may include PPE symbols Working with Chemicals Safely

Only trained employees may use chemicals in the workplace. It is important that you know: • what you are working with • where the MSDS are located • how to use them

Additionally: Ensure all containers are properly labeled Use the proper protective equipment (PPE) Store chemicals only in approved areas. Report all leaks and spills immediately Dispose of used chemicals and containers properly

If you have questions or concerns speak to your teamleader or manager Staying Safe in the Workplace

First check the MSDS, then ask questions! If you can't find an MSDS, STOP! Do not use the product until you know how. Ask your team leader, supervisor, or manager before using any product for the first time. Consult with Employee Health, Safety, and Wellness when you and/or your supervisor need further assistance

Chemical Safety

Be sure to stay safe at all times when working with chemicals. Only trained employees may use chemicals in the workplace. It is important that you:

• Know what you are working with • Know where the MSDS are located and how to use them • Ask you team leaders or supervisors if you have questions

In addition: • Make sure all containers are properly labeled. • Use the proper protective equipment • Store chemicals only in approved areas • Report all leaks and spills immediately • Dispose of used chemicals and containers properly Protect Yourself in the Workplace

Personal Protective Equipment (PPE) may be needed to protect yourself from chemical hazards. Use the PPE that your manager, or team leaders have instructed you to use for each chemical. Before using the PPE, inspect it to make sure it is not damaged.

Use a face shield and goggles if there is a splash hazard. Make sure you know where your eyewash and/or emergency shower is located. Use the proper respirator for biological hazards, dusts, mists, fumes, and vapours. Use the right gloves when handling chemicals ( blue nitrile or rubber gloves). Properly clean and store, or dispose of your PPE after use. Responding to a Chemical Spill

In the event of a chemical spill, follow these instructions in a CONTROLLED and CAREFUL manner: DO NOT attempt to clean-up without assistance from qualified personnel. touch electrical equipment. DO safely evacuate and secure the immediate area. close doors to stop the spread of vapours. use the appropriate spill kit. initiate the appropriate spill procedure. locate information about the chemical and act according to the guidelines provided. stand by to provide assistance and information. dial 2700 for the THC Site or 6500 for the CVH if you need a chemical spill kit. Responding to an Uncontrolled Chemical Spill– Code Brown A Code Brown indicates a hazardous spill or leak. Dial "5555" to initiate an additional response to your location.

When you hear that a Code Brown is called, locate your nearest spill kit. The kit holds the appropriate materials to contain, absorb, and collect the spill safely.

If a spill kit is not available, you can obtain one from our hospitality/environmental services department.

Workplace Violence

Confidential – Not for Distribution 60 We commit to you

Ensure the health, safety and well-being of all employees, patients, physicians, volunteers, students, visitors and contractors by enforcing

Zero Tolerance for Violence

Every individual has the right to respect and dignity and freedom from violence and harassment in the workplace

THP’s Responsibilities

. Take the appropriate actions to safeguard all employees through the enforcement of organizational protocols where the employee must abide by such guidelines

. Ensure that all employees receive related education and training in Workplace Violence and Harassment

. Conduct a workplace assessment of the risks of workplace violence that may arise from the nature of the workplace

. Advise any employees involved in a violent situation of the resources available to assist them (e.g. Security, EHSW, Employee Assistance Program, Human Resources, Police, etc.)

What is Workplace Violence?

The exercise of physical force by a person against a worker, in a workplace, that causes or could cause physical injury to a worker.

An attempt to exercise physical force against a worker, in a workplace, that could cause physical injury to a worker.

A statement or behaviour that is responsible for a worker to interpret as a threat to exercise force against the worker, in a workplace, that could cause physical injury to the worker. What is Workplace Harassment?

Use of comments that are known, or ought to be known, to Verbal be unwelcoming, embarrassing, offensive, threatening, or Abuse degrading of another individual.

Emotional/ Any act that instills fear or diminishes an individual’s Psychological dignity or self-worth, intentionally inflicting Abuse psychological trauma on another person.

Sexual Unwelcome verbal or physical advance with sexual Abuse undertones between two or more individuals. Types of Violence or Harassment

Psychological Threatening Physical Acts Verbal Abuse Emotional Behaviours

Embarrassing Hitting Shaking fists Comments Yelling

Throwing Gossiping Pushing Using vulgar or objects offensive language Destroying Exclusion Punching property Verbal or Humiliating Other anger Kicking written threats Comments related acts Did you know

Bureau of Labour and Statistics reports 48% of Healthcare workers face 16 all occupational assaults times more risk of happen in a health care experiencing a violent act and social work setting

Workplace 50% of all Violence incidents workplace account for 8% of violence incidents lost time injuries Workplace go unreported in Ontario Violence Occurrence Are you at Risk? Are you at Risk?

Clinicians have to be mindful of the risks associated with working with patients one-on- one, especially when physical contact is necessary

Always introduce yourself and explain any interaction or procedure to your patient Signs that may lead to Violence

A person may be on the path to a violent act if you observe one or more of the following signs:

. Verbal or written threats . Argumentative, uncooperative . Sudden personality changes . Deteriorating appearance . Easily frustrated, short tempered, rude language or swearing . Suspicious of others, cannot take criticism, low self esteem . Changes in mood or behaviour, becomes withdrawn If you experience violence

From a patient or visitor, ensure the following steps are taken:

Seek Ensure all Report Complete an medical who are in Object and In a crisis incident to on-line attention direct care of let the situation, your incident through patient/visitor patient / call Code Manager / report and are aware of EHSW or visitor know White ext. Team Leader document in behaviours. Emergency it’s not okay. 5555 and EHSW the patient Revise care Dept. if immediately chart plan as after hours required If you experience violence

From a colleague or staff member, ensure the following steps are taken:

Complete Contact Seek an on-line Human Object and In a crisis medical Report incident Resources let the staff situation, attention incident to report and for support member call Code EHSW or your or if you Emergency Manager document know its White ext. wish to file Dept. if and EHSW in the not okay. 5555 a formal after hours patient chart complaint Quality Care & Service Exercise

1. Using note pad in your folders 2. Draw a tiger…. 3. Share your tiger with your table partners

Now let’s try it together…. Step by Step

And the details!

What do you notice about your second attempt? What is ‘Best Practice’?

Best Practice a method or technique that has consistently shown superior results as compared to other means, and is recognized as a benchmark across the industry.

Usually stems from: • evidence-based practice and research; • service level agreements (SLA’s) and/or; • Standard Operating Procedures (SOP’s).

Not intended to take away our ability to think critically but rather a way to ensure we are demonstrating a uniform practice. Why do we need ‘Best Practice’?

Ensure Patient and Staff Safety Improve Overall Reduce Quality Best Errors of Care Practice is to…..

Reduce Improve Waste Efficiency What is Quality Service?

Quality Service is…..delivering “highest quality care and [providing an] exceptional [patient] experience” (Strategic Plan)

So how does this apply to what we do?

Quality Service Looks Like

G reet your customer; say “good morning” , “good afternoon”

I ntroduce yourself; say “Hi, my name is ___ and I am___”

V erify the reason for your communication / interaction

E xchange information through good communication techniques

S ign-off on your conversation; say “good-bye”, “thank-you” What can cause our message to NOT be received as intended or anticipated? The Challenging Customer

What should you do when confronted with a challenging customer? STOP the issue! S tay Calm and Composed T ake time to Listen O bserve and Acknowledge the Customer’s Emotions P ut Closure on the Issue through Action How would you provide Quality Service?

Scenario 1: Scenario 2: Visitor and Staff Member Visitor and Staff Member • You are on your way out of • You have just arrived to the unit for your break work and been given an when a visitor stops you. urgent task to complete • The visitor’s mother (a within the hour. patient) has been ill and • On your way to put your needs assistance cleaning coat away, you encounter a up. They have rang the call visitor who stops you and is bell several times over the looking for the Fracture past hour and no one has Clinic. come to check in with the patient. Slips, Trips, and Falls Prevention Employee Health, Safety & Wellness Legislation

Occupational Health & • Regulation for Health Care Safety Act and Residential Facilities • Employers must “take every (Reg. 67/93): precaution reasonable in the Applies to a hospital as defined in circumstances for the the Public Hospitals Act protection of a worker.” [Section 25(1)(h) and 27(2)(c)] • Regulations for Industrial Establishments (Reg. 851): Section 11 requires floors and other surfaces used by any worker, to be kept free of obstructions, hazards and accumulations of refuse, snow or ice

Did you know

Canada-wide about ______workers are injured annually due to falls.

About _____ occur in Ontario.

______lost time injuries in Ontario are caused by a fall Did you know

Falls can result in critical injuries Most frequent such as fractures, unconsciousness, permanent disability or death

Most severe

Falls on the same level

Falls from heights Did you know

• What % of lost time injuries result from Slips, Trips, and Falls at Trillium Health Partners each year? Be Safe…Avoid These Situations

The majority of falls happen as a result of Slips and Trips on the same level due to: • Wet or oily surfaces as a result of spills or weather (rain, sleet, snow) • Loose, unanchored or wrinkled rugs and mats • Uneven surfaces (ex. steps, thresholds) or walking surfaces which do not have the same degree of traction in all areas • Walking while carrying large objects that block your view • Poor lighting, clutter in areas, uncovered cables • Cabinets doors left open • Walking and texting • Improper workplace footwear Your Responsibilities

You are responsible for reducing your own Slip, Trip and Fall hazards

Report all Be aware of incidents and your Wear proper hazards to Use proper surroundings: footwear and your carrying look before use proper supervisor techniques and while you equipment and submit a walk Riskpro Walking Technique is Important

• Take short deliberate steps, in which the mid-foot strikes the ground first, not the heel • Always centre the body over the feet. This allows you to ensure the mid- foot strikes the ground first, since most slips occur at the heel strike phase of gait • Walk whenever possible, don’t run or rush. Take the time to be safe by slowing the walking pace • Change direction slowly when walking on slippery surfaces or look for a less slippery path if possible

Carrying Technique

• Carry objects close to your body and below chest level so you can see over or around what you’re carrying • Do not carry too much at one time • Make more than one trip, ask for assistance, or use assistive devices (e.g. carts, dollies) The above is especially important when slippery conditions exist or when using stairs. The above principles are also important for MSD prevention. Infection Prevention and Control and Hand Hygiene Education

Confidential – Not for Distribution 91 Infection Control and Hand Hygiene Practices What is a Microorganism?

. Microorganisms are How do microorganisms grow? very small forms of life that require ideal Water Source of physical and chemical moisture & Chemical nourishment Compounds environments to (O2, N, C, H) develop, grow and flourish. Reservoir . This can include a or Host human host or inanimate object and can easily be spread Warmth and Proper pH through contact Darkness levels transmission Types of Microorganisms

Normal Are non pathogens that live & grow in a certain area. Harmless or even Flora beneficial to the body

Pathogen and non pathogens. Pathogenic can cause serious infections. Bacteria Treated with antibiotics. (e.g. Pneumonia, MRSA, C-Difficile, VRE, E-Coli)

Smaller than bacteria. Grows inside of cells and take over cell. Not Viruses affected by antibiotics. Some can cause serious illness.(e.g. influenza, measles, rubella)

Grows on plants/animals and can be difficult to kill. Often starts growth in the Fungal lungs or on the skin (e.g. ringworm, athlete’s foot, yeast infections)

Most common Multi-Resistant Organisms (MROs):

. All 3 MRO’s can be easily passed if proper MRSA hand hygiene is not VRE performed and precautions not taken C-Diff . It is everyone’s responsibility to ensure we eliminate the spread of infection Multi-Resistant Organisms The Chain of Infection

1. Infectious Agent bacteria, virus, fungi

6. Susceptible 2. Reservoir Host By breaking one part people, water, people who already equipment have underlying illness of this cycle with proper hand hygiene and/ or cleaning of equipment, the risk of transmission is 5. Portal of eliminated 3. Portal of Entry Exit open skin, GI tracts, secretions, excretions, mucous membranes, droplets respiratory

4. Means of Transmission direct contact, airborne, ingestion Routes of Transmission

Preventing Infection

The #1 way to prevent the spread of infection is in your hands: Proper Hand Hygiene

Hand Hygiene

Hand Sanitizing Hand Washing

This the PREFERRED method of hand hygiene Is the BEST method of hand hygiene when before and after handling a patient, eating coming into contact with any body fluids, your food, handling equipment, or moving between hands are visibly soiled, or handling equipment departments that is known to be contaminated.

A hospital grade sanitizer that is a minimum of If done correctly, REMOVES all visible soils and 70% alcohol concentration will KILL most harmful agents from the surface of your skin; harmful agents does not kill

Must be rubbed for a minimum of 15 seconds Utilizes soap, water, and drying of hands; or until dry. Not to be used on visibly soiled requires a minimum of 15 seconds under hands. running water Hand Hygiene Stops Transmission

• Transmission of organisms by hands of health care providers between two patients can result in health care associated infections (HAIs)

• Hand hygiene with alcohol-based hand rub , correctly applied, kills organisms in seconds

• Hand hygiene with soap and water, done correctly, removes organisms

4 Moments of Hand Hygiene

1) Can include direct AND indirect patient contact. 2) Can include wound care and contact with openings to the body such as nasal, mouth and eye care. 3) Can include exposure to blood, urine, feces, vomit and saliva. 4) Conducted immediately upon leaving patient environment Protective Measures

Personal Protective Equipment (PPE): . Specialized clothing or equipment worn by an employee for protection against infectious materials. . This includes sanitizer, gloves, face and eye protection . Personal Protection Equipment (PPE) is meant to protect NOT prevent

Donning of PPE

Hand Gown Mask Eyewear Gloves Hygiene Doffing of PPE

Hand Hand Gloves Gown Eyewear Mask Hygiene Hygiene Privacy & Security

Confidential – Not for Distribution 105 Privacy & Security

Personal health information is one of the most highly sensitive types of information that can be collected about a person.

It includes any identifying information about an individual’s health or health care history, such as family medical history, details of a recent visit to your doctor, test results, or your Ontario Health Card.

Personal Health Information Protection Act (PHIPA)

Healthcare Allows an providers individual must Balances a the right to protect all patient’s access their information right to own and share Governs privacy vs. information details only the the need to and request as required collection share corrections PHIPA, and use of information 2004 personal health info Consent and Right to Access

In order to collect, use and disclose Personal Health Information, the Health Information Custodian (HIC) must obtain consent through a formal procedure for access rights via:

Expressed Consent Implied Consent • This can be both written and verbal • Occurs when the patient discloses • Occurs when a HIC discloses Personal Health Information in the information to another Custodian for a normal course of receiving care purpose other than providing health • HIC discloses health information to care another Custodian for the purpose of providing health care to the individual Privacy Breeches

. Faxing / e-mailing Personal Health Information to an unintended recipient

. Discussion of Personal Health Information in public areas

. Searching for a friend / relative on a clinical system out of curiosity or concern

. Saving Personal Health Information onto a USB drive

Computer Security

By employing computer safeguards, we are able to protect the confidentiality, integrity, and availability of systems and data. Good computer security enables privacy and protects: . Personal Health Information (PHI) . Corporate confidential information, including financials and HR data . Research . Intellectual property . Privileged legal information How to Avoid Phishing Scams

Requests for Passwords Links Forms Information • Do not give • Be suspect of • Do not open • Do not fill out your requests for unexpected out forms password financial or links in embedded in personal info emails e-mails Clean Desk Policy

. A clean desk policy reduces the threat of a security incident as confidential information will be locked away when unattended.

. Sensitive documents left in the open can be stolen by a malicious entity.

. Take a few moments at the end of each day and put sensitive information in a locked drawer or filing cabinet.

Providing Accessible Customer Service/Diversity

Confidential – Not for Distribution 114 Diversity and Accessibility What is Diversity?

Diversity is: o Recognizing we live in a society that embraces a wide variety of people who coexist in practicing different beliefs, values and cultural systems

How do you differ from the person sitting beside you?

What does Diversity look like?

Family

Faith and Social Religion Organization

Ethnicity Diversity Language and Race

Can you think of other examples of Diversity in our communities? Why be Diverse?

Did You Know? Trillium Health partners caters to a population in the Peel Region that has: a. a 40% immigrant base b. a 50% immigrant base c. a 60% immigrant base d. a 70% immigrant base

In 2006, the population of the Peel Region was 1,159,405 (last census in 2011, the population was at 1.3 million people). Of that, almost 700,000 people are immigrants to Canada. Why be Diverse?

Did You Know? In 2006 census, how many people in the Peel Region viewed themselves as a visible minority? a. 30% b. 40% c. 50% d. 60%

In 2006, the population of the Peel Region was 1,159,405 (last census in 2011, the population was at 1.3 million people). Of that, almost 600,000 people saw themselves as visible minorities. Why be Diverse?

Did You Know? Excluding English, the next 3 top languages spoken in the Peel Region include: a. Urdu, Chinese, Portuguese b. Punjabi, Urdu, Chinese c. Punjabi, Portuguese, Polish d. Chinese, Polish, Punjabi

In 2006, other than English, Punjabi was the next highest spoken language in the Peel Region (8% or 93,000 people), followed by Urdu (3.7% or 43,000 people) and Chinese (3.6% or 42,000 people).

Services We Offer

Translation Services

Spiritual Food Care Options Office Services We Offer Non- Multi-faith denominat Chaplain ional chapel Onsite religious services What to Avoid

Discrimination Prejudice Stereotype

A behavior that Forming an opinion Belief that everyone unfairly ‘pre-judges’ of a person or group in a group is alike people based on without knowing and acts the same group membership them way

e.g. all people with e.g. not providing e.g. a person who an intellectual quality care due to wears a hat disability can’t take religion or race backwards is a thug care of themselves What is Accessible Customer Service?

. Where all people are able to access our services free of barriers that may inhibit someone with a disability or impairment to fully participate in the activity or service being offered. . At Trillium Health Partners, our ‘customers’ are the patients, visitors and families we serve on a daily basis.

Examples of Barriers Assisting those with a Disability

• Ask before you assist Physical • Be patient, receptive, and understanding • Avoid touching any assistive device without Disability permission

• Speak in a regular tone of voice Communication • Keep your questions short and simple; • Clarify / rephrase if misunderstood; try Disability communicating in the “mother language”

• Be supportive and patient; Intellectual • Consider using written language if verbal communication is difficult for the person Disability • Keep it simple; share one piece of info at a time Types of Impairments

A person with A person with Visual Hearing Impairments… Impairments...

…may be hard-of-hearing, …has a reduced ability to deafened, or culturally/ see clearly orally deaf.

…usually has some degree …may use sign language to of vision to assist them (i.e. assist with the tunnel, cataracts) communication process

…may require assistance …may utilize drawings, with their surroundings illustrations or key words and require detailed when explaining directions information. Remember

. Treat a person with a disability / impairment the same as anyone else – be comfortable, relax and smile! . Offer to assist an individual BUT don’t insist – people with disabilities and impairments have various levels of independence and needs . Don’t raise your voice unless asked and don’t be afraid to repeat or rephrase a statement / question