Everyone should be familiar enough with all department or equipment emergency procedures...
by Wilbur T. Workman, MS, CAsP, CHT-A, FAsMA, FUHM and James Bell, CHT, EMT, CFPS
(This is a continuation of
A Multifaceted Program to Managing Your Hyperbaric Facility Safety: Part 1)
Multifaceted Program
A safety program is multifaceted. Although there can be a variety of program elements depending on the specific setting and need, there are several common aspects elementary in program design and execution. These basic elements are as follows:
- Preventive maintenance: Keeping all equipment in peak working order depends directly on a comprehensive preventive maintenance program. In general, hyperbaric equipment is well designed and highly reliable, requiring relatively little maintenance (except perhaps for large multiplace hyperbaric complexes). As a result, in times of fiscal restraint, preventive maintenance may be relegated to a lower priority. Such management decisions usually prove to be costly in the long run. Senior management must fully support routine maintenance expenditures, since it is generally cheaper to keep equipment in good working order than to face the higher cost of repairing a component after a major failure.
- Proper training: The importance of this element cannot be overly stressed. Safety awareness begins in the classroom and is applied in the facility. Mishap data clearly points to the dominance of operator errors in hyperbaric accidents. Proper initial instruction, timely continuing education, and regular competency assessments can help mitigate these tragic findings in the future. Minimum training standards must be developed, adopted, and enforced throughout the international hyperbaric community. Training outcomes should be focused at providing all staff members with sufficient information for them to know when to question an action or situation. It is neither practical nor desired to educate every staff member to be an expert on every aspect of hyperbaric operations. However, if a person notes that something does not seem right, stops, and investigates the situation, then a major training objective has been met. This person may have broken the chain of events leading to an accident. The team member(s) that should cause concern are those whose knowledge level is not high enough to recognize something is not right and who may continue to allow the situation to exist, perhaps ending in a tragic mishap.
- Practice, practice, practice: The proper response to an emergency should be calculated and immediate. Although it is not practical for each staff member to memorize every emergency procedure, it is important for them to routinely practice planned reactions to a range of emergency situations. Everyone should be familiar enough with all department or equipment emergency procedures to allow them, with the aid of emergency checklists, to deal with any quick response situation. Being aware of others' responsibilities is crucial. Anyone can be in a position of having to respond to an incident when the staff member normally responsible for that function is not immediately available. Practicing as a group helps the staff to better appreciate the responsibilities of others and fosters development of the hyperbaric team. As difficult as it is, time should be set aside on a recurring basis for focused unit safety training. Although monthly staff safety training is recommended, the minimal interval should be no more than quarterly. An example of this is the timed evacuation drill required at least annually by NFPA 99, Health Care Facilities Code, Chapter 14: Hyperbaric Facilities.3 The first time a staff member conducts an emergency drill should NOT be in response to an actual event.
- Safety mindset: Attention to the above elements helps cultivate a culture of safety mindset for the entire hyperbaric facility staff. This obvious safety attitude becomes evident to the patient, helping to instill confidence and easing any fears. Safety must be an overriding philosophy that guides the attitudes and actions of the entire staff.
Excerpted with permission from the publisher.
Source Reference: Hyperbaric Facility Safety: A Practical Guide, 2nd Edition by Wilbur T. Workman and James Bell
Chapter 6.4 How to Manage Your Hyperbaric Facility Safety Program
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