Safety & Security Manual

Additional Topics:

  Mission Statement

  • Authorization
  • Patient's Rights
  • Departmental Table of Organization
  • Organizational Overview
  • Introduction
  • Safety Staffing
  • Tours of Duty
  • Departmental Meetings
  • Sergeant - Safety and Security Officer II
  • Duties and Responsibilities
  • Safety and Security Officer
  • General Orders
  • Safety Officer Conduct While on Duty
  • Time and Attendance Policies
  • Two-way Radios
  • Key Policy
  • Identification Badges
  • Basic Field Incident Report
  • ABC Fire Extinguisher Inspection Report
  • Safety & Security
  • Safety Service Records
  • Official Station Blotter
  • Form 254-ADM: Report of Articles Lost, Missing, or Damaged
  • Investigations
  • Missing Patient
  • Escape of CPL Patient
  • Patient Death
  • Drugs in the Work Place
  • Controlled Substance Disciplancies
  • Weapons on the Grounds of Psychiatric Institute
  • Visitors to the Building
  • Non-arrest Detention
  • Arrest Procedure
  • Fire Safety Overview
  • Building Codes
  • Responsibilities in the Event of a Localized Fire
  • Bomb Threat Procedures and Checklist
  • Bomb Threat Checklist
  • Floor Captains
  • Psychiatric Emergency
  • Medical Emergency - Not Cardiac Arrest
  • Medical Emergency - Cardiac Arrest
  • Emergency Medical Services
  • Emergency Tunnel Entrance
  • Elevator Use
  • Elevators Failure
  • Departmental Safety
  • Safety Matrix
  • Appendix B
  • Appendix C
  • Emergency Evacuation Route
  • Appendix D - Right to Know Training
  • Appendix E - Recommended Abbreviations
  • Appendix F - NYS Safety Officers - Police Department Signal Code
  • Appendix G - Phonetics
  • Appendix H - the Miranda Law
  • Appendix I - Ticket and Violation Codes

 


MANUAL EVALUATION AND AUTHORIZATION

The Safety and Security Department is part of an interdisciplinary network of departments which falls under the category of Support Services. It functions in support the Institute's missions of providing clinical care, research and education in the field of mental illness. Its specific mission is to safeguard patients, staff, visitors and property by carrying out the policies and procedures of the Institute's Safety Program. The Safety and Security Department is involved in a Continuing Quality Improvement program which involves the Support Services group.  The Chief Safety & Security Officer serves an integral member of the Environment of Care Committee. He is given special authority by the Director and the Governing Body to take immediate measures regarding the safety and security of the Institute.

The ultimate customer of the services provided by the Safety and Security Department are the Psychiatric Institute patient population. Other customers include all New York State, Research Foundation for Mental Hygiene, and Columbia University Department of Psychiatry employees, and the general public who have business on the Institute grounds.

This manual will detail all of the services rendered to the Safety and Security Department customers, as well as delineate other department procedures pertaining to personnel issues.

The Safety and Security Department manual was developed under the direction of the Psychiatric Institute administration, through periodic meetings with the Safety and Security Department staff, Clinical staff, Quality Assurance staff, Business Office staff, Engineering staff, and Communications Department staff.

This manual, and the activities of the Safety and Security Program, will be reviewed on an ongoing basis by the member of the Safety and Security Department and by the Institute Safety Committee. Changes will be made as necessary.

Authorization





________________________________

John Oldham, M.D.

Director







INTERIM LIFE SAFETY MEASURES

The Institute moved into its new facility in 1998. A "Statement of Conditions" evaluating its compliance with Life-Safety Codes has been completed. Pending resolution of safety-related issues identified in the SOC, the Administration has continued its program of Interim Life Safety Measures to minimize the possibility of injury or damage due to fire, smoke & fumes, or other threat. These measures are in addition to, or exceed, standard Life Safety Practices implemented.

The Institute issues relevant policies procedures to be followed by all staff, regardless of funding sources.

To identify situations which may increase the potential for fire or other hazardous conditions:

  • Trained Safety & Security staff make tours of the facility more frequently than would be the norm in a building which meets Life safety codes
    • Hourly Fire Watches on patient floors nightly from 6 PM to 6 AM
      • Check for existing fire or smoke condition
      • Check for obstruction of egress routes
      • Check for blockage of fire hose cabinets
      • Other hazardous situations which might relate to fire or other emergency
    • Every 2 hours for remainder of the building between 7 PM to 7 AM
    • Once weekly checks of fire emergency egress routes re:
      • Illuminated EXIT signs
      • Auto-closing stairwell doors
      • Positive latching stairwell doors
      • Emergency lighting at & within stairwells/exit doors
  • Safety & Security staff log-in and file reports re observations
  • Safety & Security staff take immediate action to resolve emergent conditions.
    • Chief Safety & Security Officer submits work orders as needed for non-emergency situations.

All Institute staff have been made aware of the need of I.L.S.Ms. and are expected to cooperate in reporting hazardous conditions.

  • All departments are to limit purchases of flammable and combustible materials to the smallest quantity needed to safely and effectively perform their work. Less (or non-) flammable materials will be substituted for highly flammable materials whenever practicable.

(1) These will include furniture, window coverings, bedding, etc in accord with NYS purchasing regulations.

7. All departments will store flammable and combustible materials so as to minimize the chance of fire.

a. Use of sprinkled storage spaces when possible

b. Use of metal cabinets

c. Do not stockpile materials

B. The Institute trains all staff in good safety practices, including formal instruction re I.L.S.M.

C. The Institute provides additional fire extinguishers in excess of the number required in a code compliant building.

D. The Institute conducts fire drills on wards in excess of the number required in a code Compliant building.

1. One per shift per month (rather than one per shift per quarter year).

(1) Nursing

(2) Safety & Security

(3) Engineering

(4) Telecommunications

E. The Chief Safety & Security Officer

1. Maintains records regarding compliance with I.L.S.Ms

2. Reports to the Safety committee on a monthly basis.

F. See other manuals for additional information re I.L.S.Ms. as they pertain to specific departments:

1. Safety & Security Department Manual

2. Engineering Department Manual

3. Housekeeping Department Manual

4. Hazardous Materials Safety Manual

5. Nutrition Services Manual

I. The Institute has initiated a formalized review of structural conditions to better identify areas requiring improvement

A. NYS OMH consultant engineers to assist

1. Design forms for organized capture of information

2. Assist in rounds of entire facility to make observations and recommendations.

B. NYSPI Plant Superintendent completes forms and consults with others in priority approach to improvements

1. Deputy Director for Administration

2. Business Officer / EOC Committee Chairman

3. Chief Safety & Security Officer

C. Follow-up maintained through EOC Committee

1. Plant Superintendent reports regularly to EOC Committee re progress





PATIENT'S RIGHTS

  1. Policy
    1. The New York State Psychiatric Institute recognizes and is committed to the protection of the rights of all persons treated throughout its inpatient and outpatient services. The facility acknowledges the fundamental human, civil, constitutional and statutory rights of patients and supports means by which these rights are protected and exercised. The Institute supports the right of every patient to impartial access to treatment, regardless of race, religion, sex, ethnicity, age, handicap or ability to pay.


    2. The New York State Psychiatric Institute recognizes the right of every patient to considerate and respectful care, which shall include an appropriate level of privacy and a reasonable responses to complaints, requests, and needs for treatment or service within the capacity of the Institute. As individuals, patients shall have a right to consideration of their unique psychosocial, spiritual, and cultural needs in the planning and provision of their care. Patients shall also have the right to make informed decisions about their treatment and participation in research activities, in accordance with OMH regulations, the Mental Hygiene Code of New York State, and applicable federal laws.


    3. The Psychiatric Institute also recognizes the right of patients to register complaints about their care and treatment without prejucide. All such complaints will be thoroughly investigated and appropriate actions taken to resolve complaints. Each patient will be made aware of his/her rights and have procedures for initiating a complaint fully explained upon admission.




  1. Procedures with Respect to Patient's Rights
    1. It is the policy of the Psychiatric Institute that patients know the identity of all persons engaged in their care.
      1. staff will wear proper uniform and identifying badges at all times while on the premises, and enforce this practice with other staff.


      2. As appropriate, each staff member will identify him/herself by name and discipline upon meeting a patient for the first time. The staff member will also explain his/her role in the


    2. All patients will have a level of privacy that is consistent with their clinical needs, the maintenance of staff and patient security, and the availability of resources at the Psychiatric Institute.
      1. staff will knock and/or announce themselves before entering bedroom areas.


      2. Other than in cases of immediate life safety considerations, if the patient refuses entrance, the staff member is to ask a second time.


      3. If the request for entry is still refused, the staff member will obtain clinical intervention.


    3. The Psychiatric Institute will maintain strict confidentiality regarding the patient's presence in the facility.
      1. The Department will not give out the names of patients to any person who is not connected with the Psychiatric Institute. In cases involving the Police Department, the Safety and Security Department will intervene and handle any requests for information.


      2. The Department staff will inform the Safety and Security Department of all media personnel who are found in the building without prior permission.
        1. The Safety Department is responsible for escorting the crew out of the building.


    4. The Psychiatric Institute has an Ethics Committee charged with the responsibility of discussing ethical issues that arise in the performance of work at the Institute. When ethical issues are raised with respect to the Department, their timely consideration and resolution is given high priority


Organizational Overview

Introduction

The Safety Department Headquarters are located at the Atrium Lobby on First Floor of the Main Building (1051 Riverside Drive).

The department operates twenty-four (24) hours a day and seven (7) days a week.

The Psychiatric Institute consists of two buildings (Patients being housed in main building only.):

      1. P.I. Main Building - 1051 Riverside Drive
      2. The Lawrence J. Kolb Research Building (The Annex),
      3. Both buildings are manned 24 hours per day.
      4. Three fixed watch posts are:
        1. Atrium entrance of the Main Building,
        2. Security Control Center
        3. Entrance to the Annex.


The Safety Department phone numbers are:

      1. ext. 5075, Annex Lobby Post
      2. ext. 5100, Main Desk Post
      3. ext. 5087, Riverside Drive Post
      4. ext. 5555, for emergencies.




Organization of Safety Personnel

See Psychiatric Institute Table of Organization and The Safety and Security Table of Organization.

The Chief Safety Officer is designated to manage the day-to-day functions of the Safety Department, and reports directly to the Business Officer.

 

Responsibilities of Safety Personnel

All Safety Personnel shall perform the following functions:

      1. accident prevention and investigation duties,
      2. fire fighting and investigation duties,
      3. fire prevention duties,
      4. security and police functions.


    1. Designation as "Special Policemen"
      1. In accordance with Mental Hygiene Law, safety officers are designated as Special Policemen whose duties are to preserve peace and good order in Office of Mental Health facilities and to fully protect the grounds, buildings and patients.


      2. Such special policemen posses all the powers of peace officers and the right to issue Uniform Traffic Tickets while performing duties in or arising out of the course of their employment.
  1. Safety Staffing
    1. Departmental Employees
      1. One (1) Chief Officer (Safety and Security Chief I),


      2. Four (4) Sergeants (Safety and Security Officer II),


      3. Twelve Officers (Safety and Security Officer I),




  1. Tours of Duty
    1. Tour A: 11:00pm - 7:00am
      1. One (1) Sergeant,


      2. Three (3) Officers.


    2. Tour B: 7:00am - 3:00pm
      1. One (1) Chief


      2. One (1) Sergeant


      3. Six (6) Officers


    3. Tour C: 3:00pm - 11:00pm
      1. One (1) Sergeant


      2. Three (3) Officers




  1. Departmental Meetings
    1. Chief and Sergeant's meeting one (1) time/month,


    2. Chief and all departmental employees six (6) times/year.

JOB DESCRIPTIONS

Chief Safety and Security Officer

The Chief Safety and Security Officer is directly responsible for the day-to-day functioning of the Safety and Security Department.

The Chief Safety and Security Officer will be a member of the following committees which attempt to foster interdisciplinary communications:

1. The Environment of Care Committee,

a. reports to committee all accidents, incidents, and safety related issues on a monthly basis,

2. The Education and Training Committee,



II. Duties and Responsibilities

A. Plans, directs and supervises Safety Services activities:

1. maintains accurate records of the Safety and Security Department activities, and prepares reports as needed,

2. ensures that security inspections are conducted as scheduled, and that corrections are made as needed,

3. trains new employees regarding fire safety which includes the use of fire extinguishers at the biweekly New Employee Orientation,

4. manages safety related contracts,

5. checks safety equipment to ensure proper usage and storage, and assures that all safety equipment is in working condition,

6. develops departmental schedules,

7. develops departmental budgets,

8. ensures proper training of Safety personnel,

9. plans for the training and development of departmental staff,

10. reviews all logs and reports to ensure that performance standards are met,

11. manages disciplinary problems,

12. approves all time sheets, and time off requests,

13. periodically gives seminars for Safety Officers from all down state psychiatric facilities.

B. Functions as a Peace Officer:

1. possesses all powers of a peace officer pursuant to Section 2.10 of the Criminal Procedure Law,

2. protects the life and property of patients and Institute employees,

3. enforces all local rules and regulations,

4. establishes working arrangements with the local police department

C. Functions as the facility expert on Fire Safety:

1. conducts a fire prevention training program for all new employees,

2. periodically retrains staff (especially on patient care floors) with respect to fire safety,

3. coordinates fire drills with the Quality Assurance and Clinical staff,

4. directs fire fighting activities in absence of the fire department,

5. establishes working arrangements with the local fire department.

D. Functions as the Liaison between the Safety and Security Department and the Administration:

1. participates in interdisciplinary hazardous surveillance rounds of the building to identify hazardous conditions,

2. monitors and reports all accidents and incidents to the EOC Committee,

3. is part of an interdisciplinary team which develops safety policy and procedures,

E. Provides education related to safety issues to all Institute employees:

1. conducts a bi-weekly fire safety training course during New Employee Orientation,

2. with the Department of Education and Training, conducts an annual Fire Safety Refresher and Right to Know course,

3. conducts laboratory safety classes with the research departments as necessary and appropriate.



III. Minimum Qualifications

A. One (1) year as Safety & Security Officer II

Sergeant - Safety and Security Officer II

I. Introduction

A. The Sergeant, under the general direction of the Chief Safety and Security Officer, is the shift supervisor responsible for the activities of the officers on a particular shift.

B. The Sergeant is designated as the investigating officer, and will conduct and/or direct complex investigations.

II. Duties and Responsibilities

A. Plans directs and supervises shift activities:

1. acts as desk sergeant responsible for the performance of the security force on his shift,

2. supervises the patrolling of buildings and grounds, and ensures all areas are properly covered during shift,

3. presents a positive public image and maintains good relations with the patients, staff, and visitors,

4. receives reports of law violations and traffic accidents, and ensures that prompt investigations are carried out,

5. reviews all patrol and activity reports to ensure proper preparation,

6. makes all entries into the security blotter,

7. submits patrol activity reports to the Chief Safety Officer,

8. provides on-the-job training to the Safety Officers.

B. Functions as a Peace Officer:

1. possesses all powers of a peace officer pursuant to Section 2.10 of the Criminal Procedure Law,

2. protects the life and property of patients and Institute employees,

3. enforces all local rules and regulations,

4. the primary contact with outside law enforcement agencies when their assistance is needed,

5. organizes and directs special security and surveillance operations,

a. sets up and monitors electronic intrusion detection devices,

6. investigates the more serious crimes against persons and property,

a. interrogates witnesses;

b. collects and preserves evidence,

c. works with local law enforcement agencies,

d. makes arrests as necessary,

e. attends arraignments and testifies in court as situation warrants

C. Functions as the shift expert on Fire Safety:

1. supervises shift fire security and safety inspections ensuring that hazards and violations are corrected.

2. schedules shift fire drills and practice evacuations with clinical staff and patients

a. ensures that drills are carried out rapidly and efficiently,

b. directs improvements where needed,

c. reports results to the Chief Safety Officer.

3. directs or participates in fire fighting.

III. Minimum Qualifications

A. One (1) year as a permanent Safety & Security Officer I.

Safety and Security Officer

I. Introduction

A. The Safety and Security Officer, under general direction from the Sergeant, is the front line defense of the Safety and Security Department. These officers have patrol duties and conduct ongoing inspection of the facility and grounds.

II. Duties and Responsibilities

A. Shift activities:

1. patrols on foot an assigned area including both building and grounds,

2. inspects doors and other portals to insure that all areas are appropriately locked and secured and to detect evidence of theft, burglary, or hazardous conditions,

3. questions suspicious persons to ascertain the legitimacy of their being on the grounds,

4. assists patients who are lost, confused, frightened or angry,

a. Officers must recognize fear and confusion expressed by patients and respond to alleviate fears,

5. summons medical assistance and applies first-aid, including the operation of resuscitator,

6. transports in the patrol car sick or injured employees or patients to the appropriate treatment facility,

7. searches for and returns missing patients to the institution,

8. assists treatment personnel to subdue over-active, disturbed or assaultive patients,

9. enforces State, Municipal, and institution traffic and parking laws and regulations by issuing tickets.

B. Functions as a Peace Officer:

1. possesses all powers of a peace officer pursuant to Section 2.10 of the Criminal Procedure Law,

2. protects the life and property of patients and Institute employees,

3. enforces all local rules and regulations,

4. investigates felonies, misdemeanors, and traffic violations,

5. interrogates witnesses, collects and preserves evidence and writes reports,

6. arrests suspects and takes them to court for arraignment,

7. works with local or state law enforcement officers in the follow-up investigations, and arrest and arraignment of suspects,

a. testifies in court as appropriate,

8. interviews patients, victims, witnesses and suspects in order to collect needed information to recover stolen property and to assist in criminal prosecution.

C. Functions as the shift watchman for Fire Safety:

1. conducts fire security and safety inspections,

a. reports hazards to Sergeant,

b. follows up reports to ensure violations are corrected,

2. conducts periodic fire drills, instructing employees, and patients in evacuation procedures,

3. instructs staff in the operation and use of fire fighting equipment such as fire extinguishers, standpipe system components,

4. responds to and inspects the scenes of fires and accidents.

III. Minimum Qualifications

A. Officers must posses a valid class 5 Motor Vehicle Operator's license,

B. Officers must be at least 18 years of age and be physically able, as determined by the Employee Health Service Section of the Department of Civil Service to perform the activities and tasks of this position.

C. Officers must have a High School Diploma or equivalent.

TRAINING OF SAFETY PERSONNEL

I. Introduction

A. All newly appointed Safety Officers will participate in a 12 month Traineeship.

B. The traineeship incorporates agency policies and achieves full compliant with provisions of Section 7.25 of the Mental Hygiene Law and Section 2.30 of the New York State Criminal Procedure Law.

C. All probationary Safety Officers must receive this certification prior to attaining permanent status as a Safety Officer.



II. In House Traineeship

A. An appointed officer goes through an In-House Traineeship Program for Five (5) weeks, which includes:

1. proper use of department equipment,

2. departmental operations,

3. Officers' function and duties,

4. proper use of restraints,

5. conducting an investigation,

6. basic criminal law,

7. lawful use of force,

8. orientating at the Office of Mental Health,

9. first aid,

10. CPR.

B. There is ongoing in-house training on the following:

1. lawful use of force (annually),

2. CPR (annually),

3. first aid (every two years),

4. fire and safety equipment (on going).

III. Safety Officer Academy Training

A. The Basic Course is offered by the Safety Officer Academy. The course outline is as follows:

1. fire/safety equipment,

2. origin of fire,

3. report writing,

4. police and penal law,

5. patrol procedures/police tactics,

6. self defense.



IV. Additional Training

A. Additional training of Safety Officer is obtained through various sources:

1. Psychiatric Institute In-Service Training by the Education and Training Department,

2. CPR

3. First Aid.

V. Safety Officer Training Manual

A. Other policies, rules, regulations and techniques with which all Safety Officers must be familiar can be found in the Safety Department Training Manual.

B. Topics included in the manuals are:

1. techniques and use of police baton,

2. Section 35.00 P.L. Justified Force,

3. defense tactics,

4. disorder control,

C. The Safety Officer Training Manual also covers the Office of Mental Health Polices and procedures on:

1. report writing,

2. telephone techniques,

3. powers and authority of the Safety Officer,

4. safety, restraint, seclusion and handcuff policy,

5. patrol function,

6. fire chemistry and extinguishers.

FACILITY SAFETY & SECURITY



D. Handcuffs

1. Safety officers are the only facility staff allowed to use handcuffs.

2. to temporarily restrain a patient whose actions are dangerous to self or other, if others restraints are not available.

3. to prevent the escape of a patient or to aid in the return of an escaped patient when called for by The Mental Hygiene and Criminal Procedure Law.

4. to transport a patient whose actions are dangerous to self or others , if other restraints are not available.

5. no safety officer will transport a patient without clinical staff present.

6. handcuffs must be removed from patient when treatment staff are available to care for patient and safety officer feels it is safe to do so, or if other restraints are available.

7. at no time will a safety officer leave the scene while a patient is in handcuffs.

8. outpatients and inpatients when escorted to emergency room must be accompanied by a clinician and if cuffs are necessary the cuff will be removed when CPMC Security takes over the patient or the patient is admitted.

 

SAFETY AND SECURITY DEPARTMENT RULES OF CONDUCT

I. General Orders

A. Safety Officers must leave their home phone numbers with the Chief of Security for emergency purposes.

B. All Safety Personnel must report for duty fifteen (15) minutes before the start of the shift (line-up time).

C. Safety Officers will be thoroughly familiar with locations of fire alarm boxes, and fire hose cabinets within PI buildings.

D. Safety Personnel must maintain a daily log book of activities.

1. The log book is to be kept up to date showing the activities of the officer during each tour of duty.

2. The daily log book - containing general orders - will be reviewed daily by officers of each shift.

3. The Senior Safety Officer of the shift will inspect and initial the book when making rounds checking post conditions.

E. Safety Officers will remain at the assigned post leaving only with permission from the Sergeant or Chief Safety Officer.

1. Meal breaks and "Personals" must be noted in the log book. In the event of an emergency, the shift command must be aware of the location of all officers.

F. Officers who become ill while on duty must contact either the Sergeant or the Chief Safety Officer.

1. The Sergeant or Chief Safety Officer will respond to the fixed post immediately.

2. If appropriate, the ill officer will be seen by a physician or sent to Presbyterian Hospital Emergency room for a clinical evaluation.

G. Safety Officers will not permit anyone other than departmental members to enter or remain in the headquarters or State car unless such person is on official State business.

H. Safety Officers will be familiar with all current forms and records.

1. Officers will make entries in departmental log books, and complete designated forms accurately and concisely.

2. Officers will be familiar with all related policies and procedures concerning forms and records.

3. Erasures will not be made on any official form or record.

a. An ink line is drawn through the incorrect matter, and correction entered directly above and initialed.

I. Safety Officers will not release information to the news media unless authorized by the Director or his designee.



II. Safety Officer Conduct while on Duty

A. Safety Officers will obey all lawful orders, instructions, directions, and requests made by the Chief Safety Officer or the Sergeants.

B. Safety Officers will maintain an alert and business-like manner.

1. Officers will not loiter in the building nor lean against objects.

2. Officers will not conceal him/herself from view.

C. Safety Officers will maintain a faithful, diligent and continuous tour of assigned post.

1. Officers will inspect every part of assigned tour area as frequently as possible, giving particular attention to areas of high incident activity.

D. Safety Officers will have communication radios turned on at all times

E. Safety Officers will not indulge in intoxicants while in uniform.

1. Officers will not bring and will not permit the possession of any intoxicants into any Psychiatric Institute building or vehicle.

F. Safety Officers will not loiter while on duty at the Safety Office, at other sites within the facility, or on facility grounds.

G. Safety Officers will not litter any area in or about the Safety Department, the facility buildings, or any vehicle assigned for departmental use.

H. Safety Officers will not indulge in games of chance or cards while on duty.

I. Desk Officer responsibilities:

1. maintenance, condition and accuracy of all entries in all authorized records and reports during tour of duty,

2. reception of all telephone calls and taking of prompt action as needed.

3. maintenance, security, cleanliness of the Safety Office area.

4. transmission of all orders and instructions from the Chief or higher authority affecting any safety officer.


III. Use and Maintenance of Departmental Equipment

A. Safety Officers are responsible for the care, condition, and proper maintenance of any issued or assigned departmental property.

1. Officers will immediately report to the Chief or Senior Officer on duty any damage or loss of departmental property.

B. Safety Officers will carry only designated equipment issued by the Chief Safety Officer.

C. Safety Officers will not carry, or use departmental equipment when off duty or away from the facility on unofficial business.

a. If damage or loss results from carelessness or negligence, the Chief Safety Officer may pursue disciplinary action.

 


TIME AND ATTENDANCE POLICIES

I. Daily Attendance Record

A. All safety personnel must report for duty 15 minutes before the start to the shift (line-up time).

B. Safety personnel are required to time punch clock in and time out as indicated on the daily attendance record from (39BUS).

II. Time Off Request

A. All time off, Personal Leave or Vacation must be submitted for prior approval on Form 69 ADM.

1. The Chief of Security will review and take action on requests.

a. Vacation Leave will be scheduled in advance in accordance with required staffing. The Senior Safety Officers will schedule vacations on their respective shifts.

(1) Seniority will be used when there is a conflict selecting vacations or personal leave.

2. Employees working on a shift that want the next day off must submit their request two hours prior to the end of the shift.

B. Emergency Personal Leave:

1. May be approved by telephone.

2. The officer will submit Form 69 ADM. when returning to work.

3. The Senior Officer or Chief Safety Officer will sign the form and indicate emergency call-in.

4. When there is no supervisor on duty, the coordinator (desk officer) can approve emergency personal leave.

C. Call In:

1. At the time of the call-in the appropriate information is to be recorded in the official blotter.

D. Sick Leave: Must be called in a minimum of two hours before the reporting shift begins.

1. Safety personnel going on sick leave during a shift should be checked out by a nurse or doctor when available.

E. Overtime

1. Certain fixed posts must be maintained. Overtime is needed when four or less officers are present on the shift. A staff of not less than five officers must always be maintained.

2. Overtime requests other than coverage must be screened by Safety & Security Officer II who will submit appropriate overtime forms to Chief Safety Officer for final approval.

3. The Senior Officer on each shift assigns officers at the direction of the Chief Safety Officer.

a. Other than coverage duties include:

(1) patrols

(2) inspections

4. Other than coverage duties are assigned by the Senior Officer and must be prioritized depending on the number of Safety Staff available.



TWO-WAY RADIOS

I. Introduction

A. Due to the nature of the Safety Department, each member of the Safety Staff has a remote two-way radio for communications.

B. The Safety Department uses an FM solid state transceiver capable of transmitting and receiving in the same compact and durable housing.

II. Radio Distribution

A. Each officer is assigned their own personal radio.

B. Supervisor will inspect periodically to assure the walkie-talkie is properly maintain.

C. The shift supervisor will submit a report to the Chief Safety Officer on any damaged radio by.

D. The Chief Safety Officer will make provisions to have the radios repaired when necessary.

III. Radio Antennas

A. Three different types of antennas are available and each has a given application.

KEY POLICY

I. Introduction

A. All keys are issued by the Engineering Key Shop and are the property of the Psychiatric Institute. Therefore, issued keys must be returned upon separation of service.

B. All employees, State, Research or Columbia University, must sign for their keys in the Engineering Department Key Shop.



II. Key Policy

A. The following are procedures for processing requests for keys at Psychiatric Institute:

B. The distribution of all keys will be controlled by the Work Control Center under the supervision of the Maintenance Supervisor - Work Control.

C. Keys, sets of keys and replacement keys will be authorized by either the Plant superintendent, of Security and made under the direction of the facilities Locksmith.

1. A Work Order Bus. 24 form, signed by the Department Head, must be presented to one of the above persons before authorization is given.

2. In the event that the key is a replacement for a lost key, authorization for reissue will not be given until receipt of payment for lost keys.

D. The Work Control Center will review and evaluate the key request to determine its compliance to the facilities key policy.

E. The Work Control Center will forward all approved key requests to the Locksmith who will make the necessary keys. The Locksmith will enter the Key number and room location data into the Key Control Log Book located in the Lock Shop.

F. The requester will go the Lock Shop to obtain the keys.

1. Employees picking up keys must show their Identification Badges and sign for each key.



III. Returning Keys

A. All keys must be returned to the Engineering Department Lock Shop.

B. When separating from service, complete the following steps:

1. obtain form EES-83 from the Personnel Department,

2. return keys to the Lock Shop between 1:00pm and 3:00pm Monday - Friday,

a. the Locksmith will sign form EES-83 and keep returned keys.

3. return form EES-83 to the Personnel Department.

IV. Lost Keys

A. Report all lost keys immediately to the Safety and Security Department. Safety will evaluate the need for security changes.

B. To receive replacement keys:

1. fill out Work Order Bus. 23 Form and obtain department head signature,

2. bring Work Order Bus. 23 Form to the Chief of Security for authorization,

3. bring authorized work order to the Business Office and pay key replacement fee,

4. bring approved work order and replacement receipt to the Engineering Department,

5. the Lockshop will issue a replacement key.

C. Key Replacement Fees

1. Padlock or Mailbox key $ 2.00

2. Corbin Keys (Kolb Annex) $ 4.00

3. Best Lock System (Main Building) $ 6.00

 

D. Employees who lose keys more than one time will be expected to pay double the above fee.

E. And is subject to disciplinary action.



V. Safety and Security Department Keys

A. The Safety Department has one (1) Master key for both the Main Building and the Annex.

B. The master keys remains at the 1st floor safety desk in the Main Building.

C. The senior Safety Officer in charge on a shift is responsible for the master set of keys. He/she will receive the set of keys from the senior Safety Officer from the previous shift, and pass them on to the next shift.

D. If an Officer on foot patrol needs the master keys for any reason, he/she will sign-out the keys from the Desk Officer, and return them to the desk when finished

IDENTIFICATION BADGES

VI. Policy

A. All employees of Psychiatric Institute are required to wear identification badges while on duty. These badges are to be displayed in a on plain sight to allow for ready identification by other staff members, patients and visitors.



VII. Procedures

A. Pursuant to the above requirement the following procedures have been established and are to be strictly adhered to:

1. Identification badges will be issued to new employees by safety & security staff during their employment processing.

2. In the event an employee loses his/her identification badge, the badge will be replaced upon paying a fee. The steps to be taken in such a case are:

a. Employee calls at the Safety Department and completes an I.D. Card Renewal Requisition.

b. Employee takes the completed Requisition to the Cashier's Office and pays the required fee.

c. Employee returns to the Chief Safety Officer with a copy of the requisition bearing the Cashier's initials, presents it to the staff and is issued a replacement badge.

3. Temporary Identification badges may be issued to non-employees who are engaged in legitimate business. Such badges will be issued for the duration of the person(s) business at the Facility. Temporary ID badges must be approved by the Director of Administration or designee.

4. Identification badges are to be returned to the Safety Department by the employee upon his/her separation from service. Failure to comply with this requirement will result in the withholding of the employee's final pay check.

SAFETY INSPECTIONS

I. Policy

A. The Safety and Security Department conducts a number of different Safety Inspections on a routine basis to ensure that the Psychiatric Institute is a safe facility for all patient, staff and visitors.



II. Safety Inspections

A. Safety Inspections are conducted every monthly in both buildings of the facility.

B. The Officer conducting the Safety Inspection will note any hazardous conditions in hallways, common areas, offices, and laboratories on the Safety and Fire Inspection Report (Form 248 ADM) found on page 40 of this manual.

1. 248 ADM forms will be submitted to the Chief Safety Officer and the Environment of Care Committee

C. The Chief Safety Officer (or designee) will give reports of Safety Inspections at the Safety Committee Meetings. The EOC Committee will suggest corrective actions to departments where unsafe conditions exist.

D. Correction of unsafe conditions will be given priority status.



III. ABC Fire Extinguisher Inspections

A. The Chief Safety Officer will assign departmental staff to inspect all of the building fire extinguishers on a monthly basis, and complete the ABC Extinguisher Inspection Report found on pages 42 - 50 of this manual.

B. Fire Extinguisher Inspections will follow these procedures:

1. The extinguisher will be in its designated place.

2. Access to or visibility of the extinguisher will not be obstructed.

3. The operating instructions on the extinguisher nameplate will be legible and face outward.

4. Any seals or tamper indicators that are broken or missing will be replaced.

5. Any obvious physical damage, corrosion, leakage, or clogged nozzles will be noted.

6. Pressure gauge readings, when not in operable range, will be noted.

7. Corrective Actions.

8. When an inspection reveals that tampering has occurred, or that the extinguisher is damaged, impaired, leaking, undercharged, or has obvious corrosion, the extinguisher will be subjected to applicable maintenance procedures.



C. Record Keeping

1. Personnel making inspections will keep records for those extinguishers that were found to require corrective actions.

2. At least monthly, the date the inspection was performed and the initials of the Officer performing the inspection will be recorded.

D. Maintenance

1. During maintenance inspections, the Officer completes a thorough check of the extinguisher. Maintenance checks are intended to give maximum assurance that an extinguisher will operate effectively and safely.

2. Maintenance will include a thorough examination of the three (3) basic elements of the extinguisher:

a. testing of all mechanical parts,

b. testing of the extinguishing agent,

c. testing to ensure extinguishing agent is expelled.

3. After a thorough inspection of an extinguisher, any necessary repairs will be made to ensure the proper functioning of the unit. At times, the only repair which can be made is complete replacement of the extinguisher unit.

4. Maintenance will be conducted on all extinguishers at least one time each year (more often if indicted by inspection reports).

a. It is not necessary during every annual maintenance to internally examine stored pressure extinguishers equipped with pressure indicators or gauges.

5. Extinguishers out-of-service for maintenance or recharge will be replaced by a spare extinguisher having the same or equal classification rating.

IV. Sprinkler Valve Inspections

A. Sprinkler System Control Valves will be inspected on a monthly basis in all Psychiatric Institute Buildings which have a functioning sprinkler system.

B. The check will include the following:

1. checks of all main sprinkler valves, and all zone valves,

2. checks will assure that the valves are locked in the open position, and that there is no apparent damage to the valves.

C. Test Procedures

1. The Desk Officer will notify the Facility staff in the affected areas prior to testing the system.

7. The Holmes Protection Services will be notified by the Desk Officer (302-2850) prior to the beginning of the test. The system will be put on "Out of Service" status for the duration of the test.

8. The Safety Officer conducting the test will:

a. open the valve at the end of the sprinkler branch line,

b. verify that the automatic alarm system is activated,

c. verify the local alarm (Watergong) activates,

d. close the Inspector's Test Connection,

e. open the sprinkler system Main Drain Valve to the wide open position,

f. close the Main Drain Valve,

g. return sprinkler system to service, reset automatic alarm system,

9. if the system functions properly, the Safety Officer will return the sprinkler system to service,

10. if the system does not function properly, the Safety Officer will notify the Chief Safety Officer who will contact the Engineering Department for emergency maintenance.

11. The Safety Officer will document the result of the test on the sprinkler inspection form.

12. Once all of the sprinkler heads have been tested, the system will be put back on "Active" status, and Holmes Protective Services will be notified that the equipment is back in service.

13. Reports are kept on file in the Safety Department.

FIRE DRILL REPORT

(See Hard Copy Manual)



SAFETY and FIRE INSPECTION REPORT

(See Hard Copy Manual)



BASIC FIELD INCIDENT REPORT

(See Hard Copy Manual)


ABC FIRE EXTINGUISHER INSPECTION REPORT

(See Hard Copy Manual)



SAFETY & SECURITY

I. Policy for Patient and Staff and Visitors Security

A. The Institute recognizes its responsibilities to provide a secure environment for patients, staff and visitors.

1. All staff must wear photo identification at all times

2. Safety and security officers will check at each entry point to see that all staff comply.

3. Visitors passes are issued at the main desk to all visitors who must enter the patient's floors.

4. All other visitors and out patients must sign a visitor's log at the main desk before going beyond the lobby.

5. Elevator operators will not take anyone without an I.D. or visitor's pass to patient's floor.

6. Visitors passes are monitored by ward staff upon entry to the wards.

II. Patients' Pass System

A. In order to keep account of all patients at all times the following steps have been taken:

1. Ward Staff will issue passes approved by the Clinical Director and the EOC Committee to all patients leaving the wards.

SAFETY SERVICE RECORDS



I. Introduction

A. Reports are an official record of activities; they convey factual information and provide a permanent record of such facts. Accurate and complete records are a necessity if any sort of statistics or conclusions are to be drawn as to the number of activities participated in by a department and the time spent on each specific activity.

B. Police and in-house reports should include all facts pertinent to the matter reported and should be completed in the most accurate way.

1. Personal conclusions or opinions included in a report, should be clearly labeled as such.

C. All reports, forms, etc., having to do with a specific case should be filed in such as manner as to be readily located for review and analysis as desired.

D. Every report should be reviewed by a supervisory officer to ensure that proper investigation was conducted and to correct any incorrect handling.



II. General Instructions

A. All forms must be printed or typewritten. Hand printing is to be in block letters and in black ink only.

B. All forms are to be filled numerically by blotter entry number in three hole binders kept in the Safety and Security Office.

C. All Safety reports will have a blotter entry number.

1. Safety Officer leaving for an inspection enters the fact in the station blotter.

2. This blotter entry number becomes the report file number and is entered on the report.

D. If necessary to make a delayed entry (e.g., fire call), the entry may be made at a subsequent time, and marked as a delayed entry.

E. When necessary to make a report on an incident not entered in the official station blotter (i.e. discovered by member on patrol). The member on patrol radios the desk officer and requests that a blotter entry be made, thereby obtaining a blotter entry number which is entered on the appropriate form.

F. The Forms No. 254 (Lost, Missing, Stolen or Damaged) shall have an index, in the front of the binder, containing the names, dates and official blotter entry number. This is to be an alphabetical index such as used in the official station blotter.

OFFICIAL STATION BLOTTER

I. Introduction

A. It is the responsibility of the Safety Staff to keep in good order and proper form The Official Blotter is used to record all official activities.


II. Procedures

A. All blotter entries shall be consecutively numbered according to the time of their call or notification to the headquarters.

1. At 12:01 A.M. January 1 each year, the numbering shall commence with "1".

2. All subsequent entries shall be numbered consecutively up to 12:00 Midnight, December 31, the year.

3. Unfinished station blotter on January shall automatically revert to Blotter entry number "1", and continue until blotter is complete.

4. A completed blotter shall be retained at the Security Office for a period of five years from the date of completion.

B. Each day, entries shall begin on the next new page at 12:01 A.M., with a caption showing the day of the week and the date, with the month spelled out.

1. Weather condition, including the temperature, shall be indicated in the upper right hand corner of this page.

2. Where it takes more than one page to complete a day entries, the next page caption will show the day of the week, date with the month spelled out and the word "continued" in the upper right hand corner.

C. All official activities of the Safety Department (except routine duties) and all information pertaining to police, fire and safety activities, whether received in person, by telephone, or by any other means, shall be made the subject of a blotter entry.

D. All blotter entries shall be PRINTED in BLACK.

1. When a mistake is made, a line is drawn through the mistake and initialed by the office, no erasures are to be made.

2. Entries shall contain necessary details concerning activity. Full name of principals involved in activity as well as police departments and other agencies shall be printed in block letters underlined in RED, and properly indexed.

E. Each entry shall be initialed in the right hand corner by the initiating officer.

F. When necessary to dispatch a Safety Officer, patrol vehicle, or to notify an the police or Fire Department, the next line shall be left blank and red ink line shall be drawn along it (using a ruler) from the inside to the outside of the page.

1. The blank line following each blotter entry should be used to enter referrals of other blotter entries pertaining to the same case. If form 250, or 254, or case book entry are completed this should also appear on this line.

2. Index: Last name, first name and the page of the entry number. It is not necessary to repeatedly enter the same name.

G. All members who leave headquarters on assignment such as; fire inspection, fire drills, or other extraordinary occurrence, etc., shall so indicate by an entry in the official station blotter, before leaving.

1. Members in-charge shall also indicate entry on duty in daily attendance record showing his Tour. Members in-charge of an installation on each tour of duty shall sign in on the blotter, indicating the tour of duty, and attesting that all blotter entries were reviewed to their last tour of duty.

H. At the completion of each page, and each day the blotter shall be ruled off in red ink (diagonal line from the lower inside of the last entry to the lower outside of the page) Indexing (in the blotter index pages) of all proper names shall be done by the member assigned to the desk duty on tour "A".

FORM 254-ADM: REPORT OF ARTICLES LOST, MISSING, OR DAMAGED

I. Procedures

A. Form 254 ADM. is to be made out in quadruplicate for any property lost, stolen, damaged, or found. When State property is involved, the Form 254 shall be made by the supervisor of the department. When private property is involved, the form may be filled by the owner.

B. In the upper right hand corner enter date of report, supervisor's name or private owner's name, title, building and telephone extension.

C. Name and state of person making the discovery.

D. Home address and telephone number of discoverer or patient, building in which they reside.

E. Describe article in detail, give color, size, serial number, etc., and the estimated value. If State property, value may be obtained from Business Officer. If private property, use current cost of article.

F. Name and address and phone number of owner of missing or damaged article.

G. Describe exact location from which article is missing or damaged.

H. Date and time discovered as well as date and time last seen.

I. State whether or not article was locked up.

J. Enter any other information available, lighting of area, names of all personnel interviewed.

K. Report the incident immediately to the Safety Headquarters; enter the name of the Safety Officer accepting the call, plus the date and time of the call.

L. The Safety Officer contacted must immediately enter the call in the station blotter. The Safety Officer shall instruct the caller to enter the blotter entry number in the lower right hand corner of the Form 254 ADM.

M. Form 254 ADM. should be filed numerically by blotter entry number and to be retained with the appropriate blotter for a period of five (5) years.

N. Distribution of Form 254 Adm.:

1. Original Safety Supervisor's file

2. Department in which loss occurred.





INVESTIGATIONS

II. Introduction

A. The Safety and Security Department acts as Peace Officer for the Psychiatric Institute. As such, the Officers from time to time will be involved in situations where an unlawful act has been committed.

1. The Safety Department staff may have witnessed the act, come upon the scene of threat, or been informed of the act.

B. In the event an unlawful act has been committed, the Safety Department staff will initiate an investigation to gather the facts related to the event.

1. The facts will be used to form conclusions and make recommendations to appropriate administrative staff.

III. Interviewing

A. One of the principle aspects of an investigation is interviewing.

1. The term interviewing as used herein means police questioning of anyone in an investigation, whether subject, witness, source of information or informant of any kind.

B. The basic necessity in an interview is to get the person being interviewed talking. The best approach to an interview is one of frankness and openness; bare in mind that a planned and careful courtesy is necessary in all interviews.

C. Any intelligent interview requires preparation. The officer should be sure of his facts. It is important that the officer make a list of the specific information desired from an interview. The officer must approach each interview having clear in mind (or in notes) exactly what he wants from it.

D. When an officer conducts an interview, he/she will write down notes including the question asked and the response.

1. In the case of hostile witnesses, suspects, and subjects, the officer should use discretion as to whether note taking is essential.

E. The essence of the interview is the fact-finding. The correct basic procedure is:

1. let the interviewee tell the story

2. ask direct questions

3. in most cases, it will only be necessary to ask one or two questions and then let the interviewee tell the story.

F. Direct questions are asked when the interviewee has finished volunteering information or when he/she fails to do so.

1. Direct questions are clear, short and specific questions.

2. All questions should be phrased to require other than a "yes" or "no" answer. In other words, ask "who was there?" not "Did you see anyone?" Such affirmative phrasing helps keep control of the interview and puts some pressure on each question.

G. To maintain accuracy, the officer should keep influence or direction out of his questioning.

1. The officer should not ask, "Did you see a black person" but instead "What exactly did you see?"

2. At times it will be necessary to intentionally condition questions, to block evasive replies. For example, it may be necessary to ask: "What time did Jones enter the building last night?" instead of "When did you last see Jones?"



MISSING PATIENT

I. Introduction

A. A patient will be considered missing who has not been accounted for when expected to be present and has not been found on the facility grounds or who has been known to have left the grounds of the facility without the permission of a staff member.

B. All missing patients shall be placed on one of the following statuses:

1. Escape

a. Considered dangerous to self or others.

b. Judged to be unable to care for self and presents an actual or potential threat to his/her life because of physical, mental, or environmental factors.

c. Has been committed to Psychiatric Institute by a court order pursuant to the Criminal Procedure Law, Corrections Law, Family Court Act or Executive Law 517, (CPL Patients).

d. Has criminal charges pending in court and there is a warrant for arrest upon release from the facility.

2. Leave Without Consent (LWOC)

a. A patient who is missing and does not meet the criteria set forth in 1A above.

C. Any time a patient is missing, it will be reported as an incident.

II. Procedure

A. The following procedure is to be followed by the Safety Department when a patient is reported missing:

1. After receiving a missing patient report, the desk officer will dispatch a foot patrol officer to conduct a search of the grounds, and surrounding area.

a. Safety will notify the ward of the results of the search.

2. The Desk Officer will fill out appropriate information on Missing Patient Report #242ADM.

a. Patient's full name

b. Patient's legal status

c. Date of birth

d. Patient's complete physical description

e. Name of person making notification

f. Patient's ward

g. Desk Officer dispatches units for search

3. If the patient is found by a Safety Officer, he/she will bring the patient back to the ward.

a. In the event the patient is violent, the Safety Office will apply emergency restraint, and contact the Desk Officer to send both Clinical and Safety back up.

4. The Safety Officer finding the patient will complete the Missing Patient Report, and file it appropriately.

5. If patient is not found

a. Desk Officer will call ward and obtain additional information needed for report.

b. Desk Officer will call 34th Pct. #927-9711 if patient's status is one of the following:

(1) Court remanded (C.P.L.) (See Escape of C.P.L. Patient Policy Page 72)

(2) 2 P.C. who is dangerous to self or others

(3) Volunteer who is dangerous to self or others

(4) Homicidal

(5) Suicidal

(6) Any patient who was formerly a court remanded case.

*NOTE: Officers must use discretion giving out information that pertains to patients that have been reported missing by the Safety Department to the N.Y.P.D. The aided case number, shield and name of the detective assigned to the case must be recorded in the log and reference made to the original complainant (blotter entry) number.

c. The #242 ADM is held in the Safety and Security Office.

d. Until the patient is found.

6. When a patient is returned or reported by ward to have returned, Desk Officer retrieves missing Patient Report form from the office, fills in appropriate information, and submits report to Chief Safety Officer.

a. If patient had been reported to 34th Precinct, Desk Officer informs 33rd Precinct of patient return.

7. The staff member who reported the patient missing is to immediately complete an Incident Report.

a. Upon completion of this form, Safety is to be called and the information on the report is to be given to the Safety Officer over the telephone.

b. The completed form is to be kept in a folder in the file cabinet in the nursing station.

c. At the point the patient is returned to the ward, the lower portion of the form is to be completed and Safety is to be notified.

d. Where indicated Safety will notify the Deputy Director of the return of a patient. If the patient returns during the evening, night, weekend or holiday, the Deputy Director will be notified at the beginning of the next normal day of business.





ESCAPE OF CPL PATIENTS

I. Introduction

A. In the event that a patient admitted to the Psychiatric Institute leaves the grounds of the facility without authorization or fails to return from furlough at a scheduled time, the ward staff is to notify Safety, and Safety will follow the present procedures.


II. Procedure

A. Safety will:

1. Call local police

a. Be sure to inform local police of patients intents to assault or harm persons in the area.

2. Call ward for update on situation.

3. Upon patient return, the Safety Department will notify the local precinct of returned status.

PATIENT DEATH

I. Policy

A. It is the policy of the New York State Psychiatric Institute after the pronouncement of a patient death to:

1. notify next of kin,

2. notify the medical examiner,

3. arrange for the appropriate disposition,

4. meet all other administrative obligations related to patient death in accordance with the Board of Health and/or the New York City Medical Examiner.

II. After Pronouncement of Patient Death by a Physician

A. The physician pronouncing death will contact the Nurse Administrator or the Nurse on Call (NOC).

B. The physician and the Nurse will concomitantly participate in notifying the following:

1. Safety and Security Department via the emergency number 5555,

2. attending physician or Doctor on Call (DOC),

3. Chief of Service.

4. Primary Therapist when appropriate

*NOTE: The above parties will discuss who should notify the appropriate next of kin.

5. Deputy Director,

6. Director of Nursing,

7.

8. Director of Quality Assurance,

9. Next of Kin,

10. Medical Examiners Office,

11. appropriate Chaplain, when requested by the family.

C. When the next of kin is notified, permission to obtain an autopsy must be gained. Permission must be gained in writing.

1. Autopsy will be done in the event that the case is not accepted by the Medical Examiner.

D. An incident report will be completed by the appropriate staff person, and forwarded to the Director for Quality Assurance.

1. All patient deaths will be discussed at the Incident Review Committee.

E. In the following cases, the Safety Department will notify the 33rd Precinct:

1. suicide,

2. sudden, unusual, unanticipated death,

3. suspected homicide,

4. death within twenty-four (24) hours of admission.

5. In the above cases, the Safety Department will secure the area, and maintain a twenty-four hour watch over the body. The watch will continue until a full investigation has been conducted by the 33rd Precinct, and police authorizing for release is given.

III. Contacting the Medical Examiners Office

A. In all cases of inpatient death, the Medical Examiners office must be notified (212) 340-0100/0112.

B. After the people in 2.B are notified, the physician and the NOC will notify the following:

Commission on Quality of Care

99 Washington Avenue - Suite 1002

Albany, New York 12210

Telephone: 518-473-7537

C. The case will be given an number, an examiner's name, and will either be accepted or rejected for exam.

1. The case number, examiner's name and acceptance status of the case will be noted in the patient chart.

D. If the case is accepted by the Medical Examiner, one (1) signed death certificate will accompany the body, and one (1) signed certificate will be placed in the patient chart.

E. If the case is rejected by the Medical Examiner, one (1) signed death certificate will accompany the body to the morgue and/or undertaker and one (1) signed certificate will be placed in the patient chart.



IV. Sending Patients to the Presbyterian Hospital Morgue

A. The Psychiatric Institute uses the Presbyterian Hospital Morgue in the event of a patient death which is not accepted by the Medical Examiners Office.

B. The physician or the NOC, in conjunction with the Chief Safety Officer, will notify the Administrator on duty at Presbyterian Hospital 305-2232 that body will be transported to the morgue.

1. During off-hours, the Presbyterian Hospital Operator will answer this number, and will be asked to page the Administrator on Call for assistance.

C. The Presbyterian Hospital will be paged #2273, and asked to meet the stretcher by the #25 elevator car in the tunnel.

D. The physician and NOC will designate a unit staff member to properly tag the body with full identification.

E. The Safety Officer on Desk duty will open the MIlstein Bridge, and unit staff will accompany the body to meet Presbyterian Hospital staff and assist in the transport to the morgue.

F. The physician and the NOC will notify Dr. Andrew Dwork (ext. 2495 or 2496) that the body has been transported to the morgue.

1. Dr. Dwork will follow up with the Pathologist of the Medical Examiner to ensure that PI receives the report of the autopsy.

2. Presbyterian Hospital will make the necessary arrangements with the Department of Pathology for the autopsy.

G. The physician and the NOC will notify the family that the body has been removed to Presbyterian Hospital.

1. If the family objects to the autopsy, they will be referred to the Deputy Director's Office for assistance.



V. Unclaimed Decedents

A. In the event that the deceased patient has no relative, and a city burial is necessary, the Deputy Director will arrange for proper burial.

B. A burial permit must be obtained from the New York City Health and Hospitals Corporation burial desk located at:

1826 Arthur Avenue, Room 302B

Third Floor

Telephone: 583-5500

C. The Deputy Director will request the permit in writing.

D. The Chief Safety Officer will designate a Safety staff member to personally deliver the signed death certificate and the burial permit request to the above address, and receive the burial permit.

DRUGS IN THE WORKPLACE

I. Policy

A. The New York State Psychiatric Institute is responsible for providing a safe and healthy environment for patients, staff and visitors.

B. Employees regardless of funding source, shall not possess or consume any of the following:

1. alcoholic beverage

2. illicit drug or unprescribed depressant

3. stimulant

4. narcotic

5. hallucinogen

6. other intoxicating substance in any of the Institute's buildings or facilities, on Institute property, in an Institute vehicle or while on duty.

C. No employee shall report to work unfit for duty as a result of substances mentioned above prior to work.

D. Employees who appear unfit for work will be required to undergo a medical evaluation and may not be allowed to work or to continue working.

E. Employees or supervisors who violate this policy may be subject to discipline, up to and including termination.

II. Procedure

A. An employee's supervisor and/or Department Head has the responsibility of determining when an employee appears unfit for duty, and when reasonable grounds exist for implementing this policy.

1. Reasonable grounds include but are not limited to the following:

a. striking or assaulting an employee, patient or visitor, other than in self defense.

b. involvement in any accident at the Institute or in Institute property while on duty, in which there are reasonable grounds to believe the illegal use of drugs, the use of alcohol, or the use of controlled substances was involved.

c. excessive absenteeism or tardiness or patterns of abuse of accruals (absences around weekends, pass days, pay days or holidays).

d. declining productivity or other unsatisfactory work performance, or other behavior which may be reasonably attributable to use of alcohol or drugs.

e. observations which the supervisor or department head can articulate concerning appearance, behavior, speech or body odor, such as unsteady gait, odor of alcohol on breath, thick or slurred speech, abusive language, disorientation or lethargy.


B. On determining that an employee appears unfit for work, the employee's supervisor will contact the employee's Department Head and will page the P.I. Chief Resident on weekdays 8:00 a.m. - 5:00 p.m. On evenings, nights, and weekends, the employee's supervisor should call the doctor-on-call who will take charge of the situation. They will meet with the employee, who may request a union representative be present. This request will be honored if the representative can attend expeditiously (i.e. within 15 minutes). The representative cannot be present during the medical examination itself.

C. The employee's supervisor and/or Department Head should inform the employee that refusal to submit to the examination or to the testing procedures in whole or part constitutes insubordination and may result in later disciplinary action.

D. The physician should pick up the Employee Examination Kit, including form IIE-1, from the Emergency Medical Equipment. The physician will then check the employee's vital signs, and the physician's examination will consist of at least a review of: speech, gait, coordination, orientation, breath odor and general conduct. At nights or on weekends, the doctor-on-call should consult the P.I. Chief Resident by telephone for review of the situation.

E. A breath alcohol examination will be performed by the physician. If deemed appropriate a serum and/or urine toxicology may also be done.

F. Further medical steps which may be taken include: referring the employee to the Presbyterian Hospital Medical Emergency Room for further evaluation (e.g., labs) or treatment (e.g., for acute intoxication, withdrawal, or other medical problems); contacting family; arranging transportation home; or recommendations for follow-up treatment. The physician should contact the safety officer for assistance if necessary.

G. If the physician judges the employee to be incapable of functioning responsibility in the hospital, the physician and the employee's supervisor will place the employee on sick or other leave and arrange further immediate treatment or send the employee home.

H. The Department Head will prepare a brief summary for the Personnel Office on the next available workday and will recommend to the employee that he contact the Employee Assistance Program. The employee may not be allowed to resume duty without clearance by a physician approved by the Personnel Office.

I. The Chief Resident will inform the Deputy Director the following morning, or when needed, at the time the incident arises.

J. The Department Head, in consultation with the Personnel Office will determine appropriate administrative action to take against employee.

K. The results of all drug or alcohol tests will be kept confidential and will be disclosed only to the extent necessary to implement this policy.

L. All questions regarding the implementation of this policy should be referred to the Personnel Office at 543-5601.

CONTROLLED SUBSTANCE DISCREPANCIES

I. Introduction

A. Controlled substances are kept both on the units and in the pharmacy, and are dispensed to patients only under a doctor's order.

B. Controlled substances are always kept under double lock.

C. It is the policy of the Psychiatric Institute to keep strict count of the controlled substance inventory.

D. In the event of an inventory discrepancy, the Safety Department will initiate an investigation.

II. Procedure

A. If clinical staff discover a discrepancy in the inventory of a controlled substance, the Nurse Administrator will be notified immediately.

B. The Nurse Administrator will:

1. complete an incident report.

2. contact the following:

a. Safety Department

b. Unit Chief

c. Director of Nursing

d. Senior Pharmacist

C. The Loss Report and the 207 Med (Record of Controlled Substance Administered) is to be sent to the Pharmacy to be adjusted.

D. The Senior Pharmacist in consultation with the Director of Nursing will determine if a formal investigation is warranted.

E. If investigation is warranted, controlled substances losses will be investigated promptly by a committee, comprised of representatives of the following:

1. Nursing Department

2. Safety Department

3. Pharmacy Department

4. Administration

5. This group works under the aegis of the Chairperson of the Pharmacy and Therapeutics Committee.

F. The Investigating Committee will submit a written report to the Investigation Review Committee which is comprised of the following members:

1. Director of Nursing

2. Senior Pharmacist

3. Director of Personnel

4. 2 (two) members of the Investigating Committee

G. Upon review of the Investigating Committee's findings, the Investigation Review Committee shall make recommendations, for further action.



WEAPONS ON THE GROUNDS OF PSYCHIATRIC INSTITUTE

I. Introduction

A. To provide the maximum degree of safety for all persons in the facility.

B. The procedure is based on Official Compilation of Codes, Rules, Regulations of the State of New York (14A NYCRR PART 45), Sections 45.1 and 45.2 which deal with firearms.

C. Weapons include:

1. firearms of any type,

2. knifes and switchblades,

3. pepper spray or mace,

4. ammunition,

5. blasting caps,

6. explosives,

7. fireworks

8. Or other objects deemed dangerous and unrelated to the worksheet.

II. Policy

A. No person shall bring into or possess a firearm or other type of weapon on the grounds of the New York State Psychiatric Institute.

B. The Director may grant an exception to the prohibition in the following cases providing that the owner of the weapon is in the performance of official duties:

1. Police Officers of organized police departments,

2. Corrections Officers employed by the Department of Correctional Services.

C. The Director will set aside a place, under the control of the Safety Department where unauthorized weapons will be deposited and held until the weapon's owner leaves the Psychiatric Institute grounds.



III. Procedures - Safety and Security Officers

A. Maintains constant alert to detect presence of weapons on Psychiatric Institute grounds.

B. Responds to areas of the facility where weapons are reported to be unlawfully present.

1. Secures areas until such weapons may be seized with least possible risk to others or self.

C. Reports violations of policy to Chief Safety Officer.

D. Turn over seized weapons to local police authorities for proper disposal.

E. Informs armed law enforcement officers entering the facility of facility policy.

1. Assists in securing weapons at designated location before law enforcement officers proceed beyond the lobby.

F. Submits complete report of violations to Chief Safety Officer on the OMH 250 ADM form.

IV. Procedures - Chief Safety Officer

A. Immediately consigns seized weapons to local law enforcement officials.

1. Documents consignment on the OMH 250 ADM form.

B. Reports violations as follows:

1. Employees: report to Director and/or Deputy Director for Administration for appropriate disciplinary action.

2. Patients: report to nurse administrator of ward/area involved.

3. Visitors: report to local law enforcement officials.

4. Outpatients and Ex-patients: report to local law enforcement officials.

C. Reviews incidents and makes recommendations to Director, Deputy Director for Administration, and Safety Committee.

D. Files original OMH 250 ADM form.

E. Distributes copies of OMH 250 ADM form to the Deputy Director for Administration, and the appropriate OMH officials.

VISITORS TO THE BUILDING

I. Policy

A. The New York State Psychiatric Institute allows access to its buildings to appropriate visitors.

B. Visitors are defined as persons without regular, on-going business in the building, and who do not have a current photo I.D. badge. This includes people who are not staff, students or volunteers.

II. Procedures

A. All visitors must identify themselves to the Safety Officers on duty (on either 1051 Riverside Drive or the Annex Lobby) and sign in the Visitors' Log, indicating their name, the time and their destination.

B. If visitor is visiting an inpatient, these additional rules apply:

1. Visiting hours are:

Monday - Friday 5:30 - 8:00 p.m.

Saturday/Sunday/Holiday 2:00 - 8:00 p.m.

2. There is a limit of two (2) visitors per patient.

3. All packages are to be inspected by Nursing Staff on the in-patient units prior to being presented to the patient.

a. Sharp and glass objects, as well as prescription drugs will be confiscated.

4. Safety will be called to confiscate weapons and illegal drugs.

5. Safety will be called to escort visitors who are causing a disturbance.

6. Certain persons may be prohibited from visiting by the inter-disciplinary treatment team.

a. The names of these people will be supplied to the Safety Department, and the desk officer will inform visitor of restriction and escort person out of the building if he/she tries to enter.

MEDIA CONTACTS

I. Introduction

A. The Psychiatric Institute has a Public Information Office which provides and disseminates information about the Institute to the public. This office is the clearinghouse for the media's entrance to the building.


II. Procedures

A. When a media crew is granted access to the building by the Public Information Office, the Safety and Security Department is contacted and given the following information:

1. the name of the Media crew and the persons who will be given access to the Institute,

2. the date and time of the crews visit to the Institute.

B. When the crew arrives at the Institute, the Desk Officer will contact the Public Information Officer and she (or a designee) will escort the crew to the interview destination.

C. In the event an unauthorized media crew attempts to enter the building, the crew will be detained by a Safety Officer until the Public Information Officer gives clearance.

1. If clearance is not given, the Safety Officer will escort the crew out of the building.

NON-ARREST DETENTION

I. Introduction

A. The Safety Department staff function as Peace Officers and are charged with the responsibility of protecting the patients, staff and visitors from dangerous situations where ever possible.

B. As such, the Safety Officers are trained to watch for dangerous situations and/or intruders, and to eliminate potential hazards as quickly as possible.

C. Safety Officers are to screen each individual entering the facility to ensure he/she has proper identification.

1. If a person entering the building does not have proper identification, he/she will be asked to sign in at the Safety Desk, in the Visitors Log Book.

II. Statutory Provision - "Stop and Frisk"

A. A Safety Officer may stop any person on the grounds of Psychiatric Institute whom he reasonably suspects is committing, has committed or is about to commit an unlawful act and may demand of his name, address and an explanation of his actions.

B. When a police officer has stopped a person for questioning pursuant to this section and reasonably suspects that he is in danger of life or limb, he may search such person for a dangerous weapon.

1. If the Safety Officer finds such a weapon or any other thing which may constitute a crime, he may take and keep the object until the completion of the questioning, at which time he shall either return it, if lawfully possessed, or arrest such person.

III. A "Stop" and a "Frisk"

A. The "Stop" is not an arrest and, therefore, does not require probable cause. The stop must be made in a public place.

B. When a suspicious person is "Stopped", the initial scope of questioning must be narrow: name, address and an explanation of the suspect's presence and activities.

C. After a "Stop" a Safety Officer may "Detain" a person although he does not have probable cause to make an arrest. Such detention must be:

1. very limited in its scope.

2. based on unusual conduct which reasonably leads the officer to believe criminal activity may be in progress and that his personal safety may be at stake.

D. The Safety Officer must identify himself as such and make reasonable inquiries before a detaining and/or frisking the person.

E. The "Frisk" must be confined to a careful limited search of the outer cling of the suspect in an attempt to discover weapons which might be used in an assault him.

 

 

ARREST PROCEDURE

I. Introduction

A. An arrest is when an individual or individuals are deprived of their liberty, and compelled to appear for arraignment in a court where upon an accusatory instrument has been filed at or before such appearance by a peace officer.

II. Arrest Guidelines at Psychiatric Institute

A. The Psychiatric Institute is bound by the N.Y.S. Criminal Procedure Law, and regulations governing the Agency of Jurisdiction, and uses the NYCPD Manual of rules and procedures for arrest guidelines.

B. Any violation of State, County, Municipal and Local laws on the facility grounds will justify the Summary Arrest.

C. In the instances of traffic violations and misdemeanor violations of the Administrative Law and The Public Health Law, a Safety Officer may issue a summons as opposed to arrest.

III. Arrest Procedure

A. The first step in effecting an arrest is to ascertain the nature of the offense or offenses.

1. Safety Officers should have workable knowledge of the Penal Law Plan for keeping officers updated.

B. By virtue of the N.Y.S. Criminal Procedure Law and the N.Y.S. Penal Law, a New York State Safety Officer may arrest when on duty for either an offense committed in his presence or for an offense reasonably believed to have been committed.

C. When off duty a New York State Safety Officer may arrest any person or persons committing a crime, misdemeanor or felony in his/her presence.

1. When off duty, a Safety Officer may not make an arrest for a crime or, misdemeanor or felony, not committed in his/her presence. However, suspect can be detained.

D. Chapter Three of the N.Y.C. Police Department states that under no circumstances shall an arresting officer, allow an official record of arrest show another member as having arrested a person or persons, when in fact the arrest was by himself.

E. After observing the actual crime or receiving an account from a complainant, the Safety Officer will place the suspect under arrest following an orderly apprehension and search.

1. be sure to advise the suspect of his/her constitutional rights (the Miranda Warning). Next, proceed to transport your prisoner to headquarters to begin the arrest process.

F. After identifying the suspect, advise the desk officer on the 10th Floor Center of the suspect's name, address, age, sex, race, height, and weight. Also give a brief description of events relative to the arrest.

1. Desk officers will assign a blotter number to the case.

2. A "250 A.D.M." will be filled out bearing the case number identical to the initial blotter number.

G. Obtain a warrant check by contacting the N.Y.P.D. Warrant Section. Telephone: 927-9711.

1. identify yourself by saying "This is officer "Smith", my command is New York State Institute Safety Officer.

2. Give the name, date of birth, race address, and sex of your prisoner.

a. This information will determine if your prisoner is wanted for additional crimes and will disclose any outstanding warrants.

H. Proceed to the 33rd Precinct. Be sure to have a clear and concise description of details, be absolutely sure of all the merits of your case.

1. The details of the case should all correspond.

I. Upon arriving at the Precinct, approach the desk with your suspect hand-cuffed behind the back. Identify yourself by saying "I am Officer "Smith", New York State Institution Safety Officer, assigned to New York State Psychiatric Institute", display your shield and card.

1. Your shield should always be affixed to the upper left breast side, of your outer most garment.

J. Describe to the Precinct officer the details of the arrest and state the offense and or charge.

1. If you know what forms are needed ask for them, if not simply explain that you are not familiar with the process and the Precinct officer will give you the forms and assistance if required. The necessary forms are:

a. Arrest Report P.D. 244-156

b. Complaint Report 313-152 also call a "61"

c. Criminal Court Warrant (Accusatory Instrument)

d. Aided Cards (2) for any injury, sickness, lost mentally ill, or deceased. P.D. 304-152

e. Vouchers for property, contraband, recovered weapons, stolen merchandise or any evidence seized by the arresting officer. Mis. 1318

f. Pre-arraignment form Misc. 333 Revised 12/70 (CB)

g. Rap Cards and court control number CRC301.1 (CB)

h. Drug addiction suspected or not suspected cards (CB)

i. Court availability scheduled misc. 478A (CB)

j. Notice for a witness to appear in court (CB)

k. After prescribed forms, temporarily lodge your suspect in the holding cell, hand-cuffed at all times, and proceed to fill out the forms in their entirety.


2. After completing your preliminary paperwork you will proceed with your suspect back to the Precinct officer for approval and sign the arrest book.

K. Proceed to Central Booking.


IV. Central Booking Procedures

A. Take all documents to Central Booking and surrender them to the officer at the picture desk. This Officer will photograph your suspect, attach the photo to the court warrant, and give you an arrest number and a complaint number.

B. The suspect will be finger-printed and interviewed by criminal justice services for legal aid.

C. If your suspect is charged with a misdemeanor, he will be issued a Desk Appearance Ticket (DAT) or a VERA summons.

D. You will then be interviewed by a county A.D.A., who will prepare your case for court and assign you a date to appear.

1. After this interview your accusatory or docket will be typed up. The suspect by this time will have been released.

E. If the suspect is charged with a felony, he will not be issued a D.A.T. or VERA summons. You must proceed to pre-arraignment where you will swear to the accusatory instrument under oath and penalty of perjury. Afterwards, you will proceed to felony screening to be interviewed by a county A.D.A., who prepares the case and assigns you a court date.

1. When this is done you will return to the precinct of arrest to lodge the suspect, to be picked up by the department of correction. This ends your responsibility for custody of the suspect.

V. Vera Screening at 33rd Precinct

A. If you arrest a felon, it is required that the arresting officer and the suspect be interviewed by members of the Precinct Investigative Unit (PIU). If the P.I.U. have concluded their hours for vera screening, you will proceed to central booking and after completing the necessary paperwork as previously described, return to the 33rd Precinct where you will lodge your prisoner and return the following morning to be interviewed.

FIRE SAFETY OVERVIEW

1. Introduction

A. Fire Safety in the facility is of the utmost importance. The protection of Psychiatric Institute patients against loss of life or injury by fire or smoke is as much the facilities responsibility as providing the best attention available.

2. Psychiatric Institute Lay-out

A. Psychiatric Institute consists of four (4) buildings:

1. The Main Building,

2. The Kolb Annex,

* NOTE: The Only building to house patients is the Main Building.

B. Only one type of fire extinguisher is used: ABC Extinguishers.

3. Fire Hazards

A. The layout and design of the Psychiatric Institute presents several special fire hazards such as:

1. The patient kitchens located on each patient unit,

2. The patient laundry rooms located on each patient unit,

3. The boiler room located in the basement,

4. The main kitchen located on the first floor,

5. The linen storage rooms located throughout the facility,

6. The maintenance shops located on the first floor,

B. Some of our patients are unable to cope with danger, Psychiatric Institute Staff must be constantly watchful to prevent fires, and should fires start, be prepared to take whatever immediate action is necessary to extinguish the fire and safeguard the patients.

4. Fire Causes

A. Ordinary conditions, if left unattended can be the potential source of fires. Fires can be ignited by careless smoking, faulty wiring, faulty electrical equipment, cooking (either attended or unattended), and spontaneous combustion.

B. Employees, visitors, and patients can reduce the incident of fires by being cautious and abiding the following guidelines:

1. Smoking is not allowed in the Institute.

2. Faulty electrical equipment or cooking equipment will be reported to the Engineering Department for inspection and repair,

3. Flammable materials will be properly stored,

4. Cleaning materials will be properly stored. In the event cleaning materials come into contact with petroleum products, (oil, grease, paints, or other flammable liquid) they will immediately be disposed of or stored in tightly covered metal containers.

5. Any combustible items which are essential to the operation of the facility or a research project should be properly stored, and kept only in the quantity necessary for one or two days use.

6. Each person in the Institute should be familiar with all fire fighting equipment, (extinguishers, etc.). When a person is in doubt regarding the safety procedures, he/she should contact the Safety Department for training.

5. Special Fire Precautions

A. Any person seeing frayed wires or over-heated appliances will notify the Safety Department and the Engineering Department immediately.

B. Avoid using extension cords unless approved by Engineering.

C. The Housekeeping Department will remove rubbish and waste materials from stairways.

D. Close doors to stairways after each use. Report doors that do not close properly to Engineering.

E. Doors to the utility rooms will be closed.

F. Avoid obstructing hallways with furniture, file cabinets, or rubbish.

G. Fire doors will be inspected on a regular basis, and will be kept in good working condition at all times.

H. Smoke barrier doors will be kept closed at all times. Do not prop doors open for ventilation.



When conducting new employees' orientation on mandatory yearly refresher orientation, we hope to achieve the following objectives upon completion the participants will be able to:

A. State the purpose of the Fire Safety Program.

B. Identify three components of fire combustion

C. State the four deadly by-products of combustion.

D. Define and outline procedure for implementation of R.A.C.E.

E. Match combustible materials with the proper Fire extinguishers.

F. Identity fire alarm code and evaluation Plan for own work unit.

G. Be aware of the building deficiencies.

FIRE SAFETY PLAN

I. General Instruction to Be Followed when FIRE or SMOKE is Discovered, R A C E:

A. REMOVE: remove from immediate area where smoke or fire is spotted any patients, staff or visitors to a safe location near an exit.

B. ALARM: activate an alarm by pulling the fire alarm box located at nearest exit .

1. Use the emergency number 5555 to alert and report the exact location of the fire to the Safety Department.

2. Turn off oxygen or flammable cylinders that are in operation in area threatened by fire.

C. CONFINE: confine the fire by:

1. Closing the door the room which is on fire,

2. Closing all doors and windows in the area of the fire.

D. EXTINGUISH or EVACUATE: if possible, take steps to extinguish the fire. If this is not possible, evacuate the area using the closest fire exit.

1. If evacuation from a patient care area is required, the Deputy Director will notify the affected unit of the safest site to transfer patients and staff.

E. The floor captain is responsible for implementing this plan until he/she is replaced by appropriate supervisory personnel. The Fire Department will assume operational responsibility upon arrival.

II. Fire Fighting Tools B E E T:

A. BOX: Open an alarm box and pull the lever all the way down.

1. Do not pull the lever if the alarm is already sounding, as this disrupts the signal.

2. On the 4th floor, Children's Services, the box is encase to avoid false alarms being sent in the children. Open the Encasement to pull alarm.

B. EXTINGUISHER: Psychiatric Institute only uses ABC extinguishers which are appropriate for any type of fire.

C. EXITS: All patients and staff should be familiar with the exit routes as detailed on page Of the manual.

1. Diagrams of fire evacuation routes are provided on all floors.

D. TELEPHONE: To report a fire in the event of an alarm box malfunction, or in the event that an alarm box is not accessible, Call the Psychiatric Institute Emergency Number 5555 on any facility telephone.

1. Give the location of the fire,

2. Give any relevant details,

3. Give your name and extension number.

4. A Safety Officer will immediately go to the location and assess the situation.

III Fire Classifications

A Class "A" Fire: any fire that can be extinguished by cooling and quenching with water, soda-acid, or wet blankets. Sources of combustion include:

1. wood,

2. textiles,

3. paper,

4. trash,

5. window drapes,

6. etc.



B. Class "B" Fire: any fire that requires dry powder, carbon dioxide (CO2), or foam in order to be extinguished. Water should not be used on these types of fires, as it spreads the flames. Sources of combustion include:

1. oil,

2. grease,

3. paint,

4. other chemicals.



C. Class "C" Fire: any fire that is caused by an electrical or mechanical malfunction and requires dry powder or CO2 in order to be extinguished. If possible, the source of power should be turned off before attempting to fight this type of fire. Sources of combustion include:

1. fire caused from a motor,

2. fire caused from faulty electrical wiring,

3. fire caused from electrical appliances.

IV Extinguishers

A. Psychiatric Institute only uses "ABC" extinguishers which are appropriate for any of the above fire situations.



V Extinguishing Fires not Immediately Involving Patients

A. Quickly appraise the situation.

B Dial 5555 on any facility phone and give the following information to the Safety Officer and the Switchboard Operator:

1. Your name,

2. The location of the fire,

3. Your assessment of the condition.

C. Alert patients, staff and visitors in the immediate area of the situation.

D. Attempt to extinguish the fire with an ABC Extinguisher, but remain close to an exit in case there is the need to escape.

E. Close all doors and windows in the immediate area to prevent smoke and flames from traveling.

F. Wait for Safety Officers to arrive.

VI Fire Drills for Patients

A. The Safety Department holds fire drills once a month on all shifts under varied conditions to familiarize the patients with evacuation procedures. Written reports are kept in the Safety and Security Office.

1. Fire drills for patients are conducted on all three shifts.

2. Documentation drills are reported to on a monthly basis to the EOC Committee.

3. Drills will be held more frequently if deemed necessary by the Chief Safety Officer or the Director.

B. Members of the Safety and Security Department and the Patient Care staff agree on a time to conduct the fire drill.

C. Patient Care Staff will explain fire exiting procedures to all patients when they are admitted to the unit.

D. The Safety Officer will initiate the drill, the patient care staff practice procedures as outline on page . Patient Care Staff will line up all patients by the fire exit doors, and wait for the arrival of a Safety Officer.

VII. Fire Inspections

A. Safety staff inspect all buildings for fire safety as specified in # 101 of the Life Safety Code of the National Fire Protection Association (NFPA).

B. Inspections assure compliance with State and local fire codes.

C. In the event that the fire detection and alarm system is not functioning, Safety staff will conduct hourly fire watch inspections of the entire building.

1. Reports are kept in the Safety and Security Office.

VIII. Fire Safety Training

A. All employees receive a course on fire safety conducted by the Safety and the Education & Training Departments during the orientation to the facility.

B. Employees also receive a mandatory refresher course in fire safety annually.

IX. Extinguishing Flames on a Person

A. In the event that a patient, staff member, or visitor becomes engulfed in flames, immediately take the following actions:

1. Take the largest piece of flexible material at hand ie. Blanket, sheet, bed spread, window drape, coat, sweater, etc.,

2. Hold material in front of yourself below eye level,

3. Lay material on persons throat and wrap the material around the patient in an attempt to direct all flames, heat, and smoke away from the persons face,

4. Push person to the floor and roll back and forth to smother the flames.



X. Extinguishing Fires Involving Oxygen - Bottle oxygen Only

A. Smoking and open flames are prohibited in the vicinity of oxygen area where O2 is in used.

1. All areas where O2 is used must have a Carbon Dioxide ( C O2 ) extinguisher.

B. Call for help from people in the immediate vicinity , and have them contact the Safety Department using the emergency number 5555.

XI Fire Hazards

A. The various functions of the Psychiatric Institute present several special fire hazards such as:

1. patient kitchens located on each patient unit,

2. patient laundry rooms located on each patient unit,

3. boiler room located in the basement,

4. main kitchen located on the first floor,

5. linen storage rooms located throughout the facility,

6. maintenance shops located on the service floor,


XII Fire Causes

A. Ordinary conditions, if left unattended can be the potential source of fires. Fires can be ignited by careless smoking, faulty wiring, faulty electrical equipment, cooking (either attended or unattended), and spontaneous combustion.

B. Employees, visitors, and patients can reduce the incident of fires by being cautious and abiding by the following guidelines:

1. Smoking is not allowed in the Institute, unless special permission is granted by the EOC Committee,

2. Faulty electrical equipment or cooking equipment will be reported to the Engineering Department for inspection and repair,

3. Flammable materials will be properly stored,

. Any combustible items which are essential to the operation of the facility or a research project should be properly stored, and kept only in the minimum quantity necessary.

5. Each person in the Institute should be familiar with all fire fighting equipment, (extinguishers, fire houses, etc.).

6. When a person is in doubt regarding safety procedures, he/she should contact the Safety Department for additional training.



XII Interim Life Safety measures

A. Fire watches are conducted on patient floors every hour 7 pm to 6 am

B. Fire watches are conducted on all other floors every two (2) hours 7 pm to 7 am

C. Testing of exit doors for obstruction positive latching, exit and stairwell lights are conducted two (2) times a week. Tuesdays and Thursdays. Forms are sent to Maintenance the next day for repairs.

D. Fire Drills are conducted once per month on all shifts more than the allotted one per quarter.


 

 

NEVER TAKE ELEVATOR IN CASE OF FIRE!

In case of any emergency, always listen for instructions over the Public Address System

Once you are outside, move away from the building.

RESPONSIBILITIES IN THE EVENT OF A LOCALIZED FIRE

I Local Staff On-site

A. Any employee discovering a fire will pull the fire alarm closest to the fire, and call the emergency number 5555 to alert the Safety Department.

1. The fire alarm system is connected to the Holmes Protection Agency which immediately alerts the New York City Fire Department.

2. If an employee is not in the vicinity of a pull station, he/she will do the following:

a. yell "Code F" in the patient care areas to alert staff of the fire situation,

b. yell "FIRE" in the non-patient care areas to alert staff of the fire situation.

3. Fire boxes are located on all wards in the nursing station, and outside the front doors to wards by all fire exit doors.

B. Employees will remove patients from close proximity of fire or smoke.

1. Horizontal Evacuation - moving all people on the ward beyond the smoke barrier doors on the same floor - will be used before evacuation out of the building.

C. Employees will close all windows and doors in an attempt to contain the fire.

D. When safe and appropriate, employees will assist in fighting the fire.



II Switchboard Operator

A. Upon receipt of the fire call:

Relay fire information to the Fire Department by calling (911) or 999-2222.

3. Notify the Safety Department of the fire if the call did not come in on 5555.

B. Immediately relay information about the fire to the following:

1. Director, (Physician on Call during off-hours)

2. Clinical Director

3. Deputy Director, (Nurse on Call during off-hours)

4. Deputy Director for Administration,

5. Director of Nursing,

6. Director for Quality Assurance

7. Business Officer/Chairman of the EOC Committee.

III Safety Officer

A. Safety Officer picking up the 5555 emergency call shall obtain all necessary information and alert other Officers either by two-way radio.

B. Upon receiving notification of a fire, all Safety Officers except the Desk Officer will proceed immediately to the scene of the fire and assist with fire containment until the Fire Department arrives.

C. The Officers going to the fire will confirm location with the Desk Officer.

D. Fire boxes are located by every exit door on all

E. The Desk Officer will ensure that the Switchboard Operator has transmitted the fire call to the Fire.

F. Officers on foot patrol will go to the Safety Department equipment room to pick up fire fighting tools (Scot-Pack and Halligan Tool), and proceed to the scene.

G. An Officer will wait outside the facility to meet the NYC Fire Department, and direct fire fighters to the scene.

H. Safety Officers at the fire scene will assess if the horizontal evacuation is safe. If dangers are still present, the officer will instruct the people to evacuate the building using the stairways.

I. Safety Officers at the fire scene will organize available staff and attempt to extinguish the fire until the Fire Department arrives.

J. The Chief Safety Officer or the Senior Safety Officer will be in charge at the fire scene. He will coordinate to the fullest extent with the supervisor in whose area the fire occurred.

IV Clinical Director (Doctor-on-Call during off hours)

A. Check on the status of the fire and the functioning of staff at the fire scene.

B. Convene Command Post if necessary to decide if partial or full building evacuation is necessary.

V Deputy Director or Nurse-On-Call

A. Convene with the Director, and the Deputy Director for Administration to decide if partial or full building evacuation is necessary.

B. Report to the internal evacuation scene to supervise patient care if ward(s) is involved.

VI Director of Nursing or Nurse Administrator

A. will assess the staffing needs for the designated site which provides temporary housing for transferred patients.

1. Additional staff will be assigned as needed.

VII Plant Superintendent and Business Officer/Chairman of the EOC Committee

A. Proceed to the location of the fire to assess situation, and aid in extinguishing the fire.

B. Maintenance and Engineering Staff should be on alert status for further directions from the Chief Safety Officer or Sergeant in charge.

 

 

 

EVACUATING PATIENTS IN THE EVENT OF A LOCALIZED FIRE



I Procedures

A. In patient care areas, supervisors must thoroughly understand the evacuation plan and ensure that every employee is familiar with fire alarm boxes, fire extinguishers, and exit passageways.

1. Every staff member should have a defined role in the evacuation plan.

B. Every attempt should be made to evacuate horizontally from a patient care area in the event of a localized fire.

1. Moving patients from a dangerous to a safe area on the same floor can be done by moving beyond smoke barrier doors in the hallways.

C. Ambulatory patients can be directed to the safe location leaving sufficient staff members available to move semi-ambulatory patients.

D. The nurse in charge of each floor will be responsible for assigning a staff member to the unit telephone. This person will:

1. generate a patient roster,

2. notify the Command Post of the removal of patients,

3. be the last to leave the floor and will give final notification to the Command Post that the floor has been evacuated.

E. The most senior physician, the charge nurse and other staff person will search all rooms, restrooms, lounges, and work areas to ensure a complete evacuation before joining the unit beyond the smoke barrier doors.

BOMB THREAT

Bomb Threat Procedures and Checklist

 

1 Safety Department Procedures

A. Upon receiving notification that there has been a bomb threat, the Chief Safety Officer will designate someone to contact the following agencies:

1. New York City Police Department: Phone 911

2. 33rd Police Precinct: Phone 927-3200

3. Bomb Squad of the NYPD: Phone 220-5311

4. Fire Department (if necessary): Phone 665-2200

2 Person Receiving Bomb Threat

A. It is usually the telephone operator, sometimes the Safety Officer, who receives the bomb threat.

B. In areas where there is direct in-dialing, any employee can receive the threat.

3 Procedures

A. Remain calm.

B. Use Bomb Threat Checklist form (page 49, 52), if available.

C. NOTE THE TIME.

1. This is most important since most bombs are activated by some type of watch or clock which restricts the "bomber" to a 12-hour period or less.

D. If caller specifies a time, ask him to repeat the exact time.

1. Note whether or not caller used the 24 hour time system.

E. Ask all the questions that could be helpful in locating the bomb or that would be helpful in case it is a hoax.

F. Ask for location of bomb saying, "Did you say the bomb is in the basement?"

G. Ask for time of possible detonation.

H. Inform caller that building is a hospital and a bomb could result in death or injury to innocent persons.

I. Note background noises such as motors running, music and other sounds which may give a clue as to where the call is being made form.

J. As soon as caller hangs up, report the above to the Facility Safety Department Emergency Number - X5555.

AFTER REPORTING TO SAFETY OFFICER AT FACILITY EMERGENCY

NUMBER, DO NOT DISCUSS THIS INFORMATION.


4 Role of the Engineering Department

A. After receiving the report of a Bomb Threat, the Safety and Security Department will contact the Plant Superintendent.

B. The Plant Superintendent will evaluate the information provided and prepare Engineering staff for possible action.

C. If bomb actually explodes, the Plant Superintendent and the Plant Utilities Engineer III will respond to the site of explosion.

1. See page 8 for the Emergency Disaster Plan.

2. After reporting to safety officer at facility emergency number, do not discuss this information.

5 Search Procedures

A. The Command Post will convene at the 10 Center Safety Desk.

B. the Director (or Designee) in consultation with Safety will:

1. make all necessary decisions,

2. evaluate the bomb threat as received,

3. issue orders and prepare for the arrival of assistance.

C. The Director (or Designee) will have the final authority to call for the evacuation of the building.

D. Upon arrival of the NYC Police Department Bomb Squad will take over all responsibility for the search procedures.

1. The Chief Safety Officer will assist in the search operations, as the Police will not be familiar with the physical lay-out of the facility.

2. Each Safety Officer assigned to a search team will be issued a two way radio so communications can be established.

E. Staff involved in the search proceedings will remain calm and alert so as not to alarm any patients, staff or visitors to the facility.

1. The Director will designate additional staff to aid in the search effort if the Bomb Squad does not have sufficient staff to conduct the search. People who can be named:

a. Engineering Supervisors,

b. Nursing Supervisors,

c. Housekeeping Supervisors,

d. Safety Officers.

2. Staff assigned to the search will be given floor plans by the Plant Superintendent.

F. Security Staff will be posted at the entrances to the Facility and keep anyone from entering the building.

G. If a suspicious object is found, Do Not Touch.

1. Clear the area of all patients, staff and visitors.

2. Notify the other search teams via two way radio.

3. Open all doors and windows in the area to reduce blast and secondary fragmentation damage.

4. Only the trained Bomb Squad will touch or attempt to move or disable the bomb.

H. The Bomb Squad will notify the Command Post when the area is safe to reenter.



6 Final Report

A. Each person involved in the search will report to the Command Post immediately after a thorough search of the building and report the results.

B. A written report will be prepared by the Chief of Security outlining any difficulties encountered during the incident, and recommendations for updating and revising the procedures.

1. Report will be given to:

a. Director,

b. Deputy Director,

c. Deputy Director for Administration,

d. Director of Nursing,

e. Director for Quality Assurance,

f. Plant Superintendent,

g. Business Officer/Chairman of the Safety Committee.

Safety and Security Department

BOMB THREAT CHECK LIST


INSTRUCTIONS: Be calm and courteous. Listen, do not interrupt caller. If possible, notify the Safety Department while caller is on line.

DATE: ________________________

TIME OF CALL:_______________ 24 hr. system YES____ NO____

CALL RECEIVED BY________________________________________________________

RECORD THE EXACT LANGUAGE OF THE THREAT

________________________________________________________

KEEP THE CALLER TALKING - ASK QUESTIONS

1. When will it go off?_____________________________________________________

2. Where is it?______________________________________________________

3. What kind of bomb?__________________________________________________

4. Why are you doing this?____________________________________________________

5. Did caller appear familiar with plant or building by description of the bomb threat?

YES_____ NO_____

Explain__________________________________________________

If building is occupied, inform caller that detonation could cause serious injury or death.

VOICE OF CALLER:

___ Man

___Woman

___Child

___Intoxicated

___Speech Impediment

___Accent

___Angry

___Incoherent

___Other_____________________________________________

BACKGROUND NOISES:

___Airplane

___Voices

___Animals

___Traffic

___Children

___Typing

___Machinery

___Music

___Other______________________________________________

NOTIFY SAFETY DEPARTMENT AT ONCE

FLOOR CAPTAINS

1. Policy

A. Floor captains are individuals on each floor of the Main Building and the Kolb Annex who ensure that all persons have followed the procedures detailed in the Emergency Preparedness Manual. The floor captains are chosen by the Safety Committee and the Quality Assurance Director, and periodically updated as to the status of emergency drills.

B. Floor captains should report any troubles they experienced during emergency drills on the Floor Captains Report Form, and should make suggestions as to how they feel the drill process could be improved.

2. Training

A. Floor captains should participate in a training session at least one (1) time per year. The training should be used to update captains of any changes in the Emergency Preparedness Manual, and/or any changes in their role during an emergency.

3. Drill Reports

A. Floor captains will be supplied with emergency procedures reporting forms. These forms will be filled out and returned to the Director for Quality Assurance after any emergency drill is conducted.

B. This form is to contain the following information:

1. The building,

2. The floor number

3. The time during the drill which all persons were off of the floor,

4. Names of any person who refused to leave the building,

5. Any relevant comments.

EMERGENCY RESPONSE

PSYCHIATRIC EMERGENCY



1. Upon receiving a call to a psychiatric emergency all available Officers except the Desk Officer will respond.

2. If an Officer is occupying a post the Sergeant or Senior Officer on the scene will access the situation and if the post Officer is not needed he will return to his/her post.a)

3. When Safety Officers reach the scene of the psychiatric emergency they will stand by and wait for instruction for the clinician.

4. If a patient is hostile and appears to be a danger to him/her self or to the staff, the Safety officer will use minimal force to subdue the patient.

A. The clinical staff will first attempt to restrain the patient, and if these efforts are unsuccessful, may enlist the aid of a Safety Officer.

5. If a patient gets hurt while being subdued the Safety Officer will conduct a full investigation and report back to the Chief Safety Officer who will report it to the Safety Committee.

6. All psychiatric emergencies must be recorded in the blotter and safety officer report must be completed.

MEDICAL EMERGENCY - NOT CARDIAC ARREST

1. Upon receiving a call or hearing an announcement of a medical emergency all available Officers except the desk officer will respond immediately to the announced area.

2. One Safety Officer will obtain stretcher if needed and take it to the scene of the emergency and the crash cart located on the 10th floor.

3. If transportation is needed, Sergeant on scene or senior officer will summon a safety officer to bring the elevator to floor and hold it there.

A. A second safety officer will open the 8th floor door and all tunnel doors while one safety officer assists clinical staff with transport.

4. Safety Officer will document incident on Safety Department standard form and desk officer will also log it in the blotter.





MEDICAL EMERGENCY - CARDIAC ARREST

1. Upon receiving a call of a cardiac arrest a Safety Officer will:

A. common-gear the south elevator, take it to the 10th floor, and obtain the crash cart located on the 10th floor in the emergency equipment room,

B. take crash cart to the scene of the emergency.

2. A second Safety Officer will await the cardiac arrest team on the 10th floor and escort them via hi-rise elevator to the location of the emergency.

3. The first Safety Officer will then:

A. hold the south elevator on the involved floor,

B. transport patient and staff to the 8th floor and open all tunnel doors and assist nursing staff to the emergency room,

C. return to the scene and assist nursing staff in returning emergency equipment to the 7th floor.

4. In case of patient death, the first Safety Officer will remain with body and assist with transport.

5. The first responding Safety Officer will document incident on Safety Department standard form (250 form).

D. the Desk Officer will log precise time, who called in the emergency, and who responded.

EMERGENCY MEDICAL SERVICES

1. Introduction

A. The Psychiatric Institute will provide appropriate emergency medical services. In the event of a medical emergency. Initial assessment and management will be provided by Psychiatric Institute staff. The need for transfer the injured person to an outside facility for further treatment will be determined by the physician in attendance.

1. Unless otherwise designated, patients, staff, and visitors in need of additional outside care will be brought to the Presbyterian Emergency room.

B. Facility staff available and authorized to provide emergency evaluations, and to arrange for patients to be referred or transferred to another facility when necessary include the following:

1. medical staff.

2. nursing staff.

C. Outside facilities to which patients are referred or transferred are provided with the following, both by phone (in the case of emergency transfers) and in writing via the consultation request or transfer form:

1. present complaint

2. significant past history

3. medication history and current regimen

4. known allergies

D. Patients temporarily transferred to a non-psychiatric facility will receive further evaluation and/or treatment of psychiatric condition in accord with the provisions of the agreement between that facility and Psychiatric Institute.

E. It is the responsibility of Psychiatric Institute to provide transportation of patients from the facility providing emergency services back to Psychiatric Institute.

F. Following emergency treatment at an outside facility, those patients who are not admitted for further care will be returned to the Psychiatric Institute.

2. Procedures

A. The first staff member on the scene will administer first aid or life-saving measures. Announce over the Public Address System that there is a Medical Emergency.

B. The nearest available staff will notify the switchboard, giving location of emergency.

C. The switchboard will:

1. Alert the following:

a. physician on emergency call

b. nurse administrator on duty

c. safety department

2. Announce over the Public Address system that there is a medical emergency.

D. The physician and nurse administrator will proceed to the site of the emergency.

1. In the event the emergency occurs on a patient floor, ward staff will assure that the emergency treatment team have immediate access, i.e. bit key doors will be unlocked, obstructions removed and the area cleared of other patients.

E. The nurse administrator shall instruct the appropriate nursing staff to proceed to and secure the crash cart closest to the emergency.

F. The physician in attendance will decide if:

1. Emergency Assistance is needed from outside the Institute

2. Transfer to Presbyterian hospital is needed.

G. If outside EMS are called a Safety Officer will wait at the 10th Floor entrance and accompany EMS personnel to the site of the emergency.

H. If injured person is to be transferred to a Presbyterian Hospital emergency room, the physician in attendance will notify the emergency room by telephone as soon as practicable, providing all relevant medical information.

1. In case of transfer of a patient, the physician in attendance will complete the transfer form.

a. The 1st and 2nd copies of that form will accompany the patient to the emergency room, and the third copy will be put into the patient's PI chart.

b. A staff member will accompany the patient to the ER and remain with the patient until a disposition is reached.

c. If the patient is to be admitted, the escort will inform the nurse administrator on duty.

d. If the patient is to be discharged following emergency treatment, the nurse administrator on duty will be informed; transportation back to P.I. from the ER will be arranged by the Nurse Administrator.

I. The staff member who first identified the medical emergency will complete his/her section(s) of the Incident Report (Form 147).

AFTER HOURS ACCESS TO THE PHARMACY



I. Introduction

A. The following policy provides guidelines for securing medications from the pharmacy during hours when the Pharmacy is closed.

1. The pharmacy is open daily, except Saturdays, Sundays, and holidays, 8:30 a.m. - 12:30 p.m. and 1:00 p.m. - 5:00 p.m.

B. The pharmacy may be opened to obtain emergency medications by the Nurse Administrator or nurse-on-call, a Safety Officer, and the Doctor-on-call going to the pharmacy together.



II. Procedure

A. The charge nurse on duty will call and give the Nurse Administrator or Nurse-on-call the written prescription for the medication.

B. The prescription shall be in sufficient amounts for immediate therapeutic needs and shall be signed by the Doctor-on-call.

C. Two keys are required to enter the pharmacy. One key is kept in the Nursing Administrator's Report Book and the other in the Safety Department.

D. The identified designated personnel will enter the pharmacy to obtain the emergency medication.

E. An entry shall be made in the Emergency Entrance Log. This log is located next to the telephone on the pharmacist's desk. The entry is to include the date and time of entry into the pharmacy, name, strength and amount of medication removed and the signatures of the individuals who entered the pharmacy.

F. The medication and prescription will be taken by the Nurse Administrator or Nurse-on-call to the unit where the unit nurse will sign and date the reverse side of the prescription.

G. The Nurse Administrator or Nurse-on-call shall return the signed prescription to the Pharmacy within 24 hours.

H. The Head Pharmacist will be called to obtain location of key for the controlled substance cabinet if the emergency request is for a controlled substance.



EMERGENCY TRANSPORTATION OF PATIENTS

I. Introduction

A. Emergency transportation of patients shall be the responsibility of the Nursing Department.

B. The Safety and Security Department will provide an escort.



II. Procedures

A. The Safety Officer will open all doors leaving the Building, including the Bridge to Milstein Hospital, and assist with the stretcher until the patient reaches his/her destination.

B. The Safety Officer will return to the facility leaving the Nursing staff with the patient.

C. If the patient is admitted, the Nursing Department will obtain written documentation regarding the admission to be kept with the patients chart.

D. If the patient is not admitted, the Nursing staff will return with the patient back to P.I.

1. The nursing staff member may call the Safety Department should assistant be necessary.



ELEVATOR USE

I. Policy

A. The elevators at the Psychiatric Institute are available for the convenience of all patients, staff and visitors to the building.

B. Elevators use is prioritized as follows:

1. emergency transport of patients or staff needing medical care,

2. emergency transport of medical staff to the site of an emergency,

3. transport of patient meals,

4. general building transport.


 

ELEVATOR FAILURE

I. Policy

A. In the event of an elevator failure the Engineering and Safety Departments will work jointly to correct the problem as quickly as possible.

1. The first priority is to ensure that no one is trapped in the elevator.



II. Procedure

A. If elevator service is interrupted due to a mechanical or electrical problems, or, while riding any elevator in the building, an employee becomes aware that the elevator is not operating properly the following should occur:

B. If a person(s) is trapped in the elevator:

1. ring the alarm,

2. pick up the emergency telephone which rings directly to the Safety Desk.

3. A Safety Officer will remain on the line to keep the trapped person(s) calm.

4. The Safety Department will contact the Engineering Department for help in removing the trapped person(s).

5. The trapped person(s) will be instructed to remain inside the elevator until the problem is identified.

6. If service cannot be restored to the elevator by Engineering staff, the maintenance contractor must be called for an emergency visit.

7. If the contractor cannot restore service, the Engineering and Safety Departments will rescue the trapped person(s).

C. If the elevator does not operate properly:

1. call the Engineering Dept. Ext. 5778 Monday - Friday 7:30am to 4:00pm or during off hours call the Boiler Room Ext.#5550.

a. Report the problem to the Stationary Engineer in charge.

2. Call the Safety Desk either in the Main Building or the Annex and report that the elevator is not working, and that Engineering has been notified.



III. If Service Cannot Be Restored

A. Safety Officers and Engineering Personnel will evacuate people from elevator.

1. Safety Officers and Plant Facility Personnel have been trained and have the proper keys to evacuate the elevator.

2. Emergency elevator keys are located in the Power Plant.

3. Before any elevator evacuation procedure is attempted, the power to elevator car must be turned off.

B. If Plant personnel cannot restore elevator service, the following should be done:

1. place signs in front of the elevator on every floor that state that the elevator is temporarily "Out of Service",

2. Senior Stationary Engineer

a. notify the switchboard operator that elevator is out of service. Switchboard operator will notify the following:

(1) Nutrition Services Department,

(2) Nurse Supervisor or the Nurse on Call,

(3) Safety and Security Department.

b. arrange to keep the services and operation of the building on-going.

3. Plant Personnel

a. report all details and steps already taken to the Engineer in charge of the Power Plant (Ext. #5550).

b. Advise the Engineer of the elevator problems and request they call the elevator service contractor.

4. Plant Superintendent

a. will make all necessary arrangements to maintain the operations and function of the building.

IV. Elevator Service Contractor

 

V. General Information Relating to the Elevators

B. No smoking is allowed in the elevators at any time. No smoking signs are posted inside the cars.







VI. Building #4, The Kolb Annex

A. The freight Elevator, (car 1) will operate in power failure, from the power of Generator # 3 located on the roof of the annex.

VII. Hospital Personnel

A. An elevator failure is an inconvenience to all parties involved. All departments must work together; communicate and cooperate.

DEPARTMENT SAFETY

I. Policy

A. It is Psychiatric Institute policy to provide a safe environment for all patients staff and visitors. The varied nature of the work we perform requires that all staff are familiar with potential hazards that are unique to their tasks.

A. Awareness allows individuals to take preventative measures so that unsafe or unhealthy acts or conditions do not occur, or to know what to do if an unsafe condition develops.

B. Safety precautions are the responsibility of every employee.

C. The Institute welcomes and promptly evaluates and implements safety suggestions from all employees.

D. The precautions outlined in this manual are intended to promote safety by providing methods and procedures designed to overcome conditions which present the possibility of accidents.



II. Safety Policy

A. Management Responsibilities:

1. establish Safety policies and procedures,

2. institute periodic safety inspections within the facility and ensure that unsafe conditions and practices are corrected,

3. develop and implement Safety Training Programs,

4. undertake programs to promote favorable attitudes toward safety and to assure enforcement of safety rules and regulations,

5. ensure that appropriate documentation of safety programs and results are maintained,

6. The Chief Safety Officer will be in charge of the compliance program. He will provide for prompt and thorough investigation of accidents to determine causes.

B. Supervisors' Responsibilities

1. instruct each employee concerning job specific hazards,

2. conduct periodic safety appraisal of his section, and ensure that safety equipment or protective devices are provided for each job,

3. verbally advise each employee that willful violation of safety rules will not be tolerated,

4. ensure that prompt corrective action is taken when unsafe conditions or unsafe acts are noted,

5. ensure that all injuries are promptly treated and reported, using the Accident Report Form which is obtained from the Safety and Security Department.

6. instill safety awareness in each employee through personal, periodic safety contacts and to support all safety activities and all safety procedures.

C. Employee's Responsibilities

1. follow safety procedures and take an active part in protecting the patients, themselves, their fellow-workers, and visitors,

2. report any hazardous conditions, practices, and behavior in their work area to their supervisors

3. make suggestions for the correction of hazardous situations.

4. follow safety rules, use all safety guards and safety equipment provided, and make safety a part of the job.

5. report all accidents promptly to immediate supervisor, and obtain first aid or medical help without delay, complete the Accident Report Form as soon as possible.

6. learn the duties for which the employee is responsible in the event of fire, evacuation, accident or other emergency,

7. cooperate in every respect with the safety program.

SAFETY MATRIX - SAFETY AND SECURITY DEPARTMENT

Potential

Safety Hazards

Fires









Weapons







Apprehensions













Patient Restraint

Potential

Hazardous Outcome

Burns, Destruction of Property, Death







Injury or Death to Self or Others





Injury to Self or Others













Injury to Self or Others



Safety Precautions

* Stay alert during fire watch inspections.

* Correct and report all fire hazards.

* Extinguish fires if capable.

* Evacuate persons in area of fire if not extinguishable.

* Follow fire safety plans as outlines in this manual.

* Watch all people entering the building for weapons.

* Confiscate any unauthorized weapons.

* Follow precautions as outlined in the Weapons Section of this manual.

* Be aware of surroundings during foot patrol.

* Try to convince suspicious persons to be willingly apprehended.

* Use extreme caution when physically restraining suspicious persons.

* Follow Apprehension Guidelines detailed in this manual.

* Assist patient care staff only when necessary.

* Try to restrain patient from behind.

* Follow restraint guidelines presented in Safety Officer Orientation,

PSYCHIATRIC INSTITUTE


OLD BUILDING 1
WATER TANK
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18  
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13 Epidemiology  
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11 Columbia University School of Public Health  
10 Gymnasium HIV Center
9    
8 Auditorium  
7    
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5    
4    
3 Research Assessment Training Unit Medical Education
2 Deaf Unit, Employees Cafeteria,
1    
B Boiler Room Engineering, Generator


 

PSYCHIATRIC INSTITUTE

KOLB ANNEX BUILDING 4


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9 Animal Care Facility Labs
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4 Biological Psychiatry-Brain Imaging
3 Cell Genetics Lab - Developmental Behavioral Study Medical Genetics
2 Child Psychiatry Clinical Psychology
1 Behavioral Endocrinology, Genetic Epidemiology Pediatric Neurology
-1   Neuroscience
-2 Communication Science, Epidemiology - Brain Disorders

Copy Center

Director of Research

-3 Medical Illustration Photography Water Pumps, and Acid Wastes Tank
AIR
EXCAV



APPENDIX B





THE DEPARTMENT OF EDUCATION & TRAINING

& SAFETY DEPARTMENT


FIRE & SAFETY ANNUAL

REFRESHER


NEW YORK STATE PSYCHIATRIC INSTITUTE

PREFACE




This self instruction module is one part of a comprehensive annual mandated training curriculum for all staff.

A self-instruction program teaches with minimal direction from the instructor. This differs from traditional teaching methods which simply presents material to be studied. The program actually teaches.

DIRECTIONS


Before You Begin

You will find that this booklet is divided into shorter units called "frames." Most frames present some information and then ask you to do something - write a word or phrase, select an answer from two or more choices, or check an appropriate box. When you have done what a frame asks you to do, you can compare what you have written with the correct answer.

This program asks questions, but it is not a test, since answers are always given. As soon as you answer a question, you can check yourself. You will find that you will be right nearly all of the time. The purpose of the program is to teach, not test or trick you.



HOW TO USE THE PROGRAM




Read carefully. A program cannot be scanned for its contents. You will find that each frame has a specific purpose. To skip a frame may mean missing some essential information. Each content frame is separated from the next frame by a double line.

Write down every answer. Some of the frames are so easy that you will be tempted simply to think your answer. Please don't. By the time you complete the last question in the frame, you will have forgotten what your first answer was.

Cover the answers until you have completed everything in the frame. Use a card or sheet of paper as a mask. Lay the mask at the top of the page and begin sliding it down until you come to the "Question" section of the frame. Answer all of the questions in the frame, and then slide the mask down to check your answers. (Answers are separated from questions by a line of asterisks). Continue sliding the mask down the page until you come to the next content area.

Check your answers. If you make a mistake, please make sure you understand why your answer is wrong before you go on to the next frame down the page.

Take your time. The program is designed so that you can move at the speed which is most comfortable for you.

OBJECTIVES




Upon completion, participants will be able to:

1. State the purpose of the Fire Safety Program.

2. Identify three components of fire combustion.

3. State the four deadly by-products of fire combustion.

4. Define and outline procedure for implementation of R-A-C-E.

5. Match combustible materials with the proper fire extinguisher.

6. Identify fire alarm code and evacuation plan for own work unit.

7. State the alarm codes for internal disaster and total building evacuation.



FIRE STATISTICS




The National Fire Protection Association (NFPA) estimates that an average of 6,633 people die each year from fires in the United States. However at least 30,000 individuals are injured each year with about two-thirds of these injuries occurring in house fires. The causes of fire have been traced to four categories; SMOKING MATERIALS followed by:



I. Incendiary and suspicious ignition such as arson

II. Hearing equipment

III. Cooking equipment





QUESTIONS



1. The number one cause of fires: ____________________________________.







ANSWERS: Smoking materials



The purpose of this program is to provide fire prevention and preparation information that is essential for safety of all staff and patients.

Problems associated with fires are well known; we hear about them on the television news and read about them in the news papers. Despite these reminders. thousands of people die every year from fire related circumstances. Many of these deaths occur because people do not understand fire behaviors and risks, or they panic or simply do not know what to do.

You can reduce the risks associated with fire by planning for a fire. Planning involves employing fire prevention and preparation measures:



1 Prevention

Measures and actions that prevent fire from starting or spreading include:

a. installation of fire stops & sprinkler systems

b. automatic door closures, fire doors

c. regular inspections of heat and electrical sources

d. proper storage of flammable substances

Fire prevention also requires that individuals practice good fire safety principals, such as assessing the environment. High-risk environments are those areas that contain a likely ignition and/or combustion source for fire. Understanding the risks associated with such environments can direct you to further prevention action.



2. Preparation

Fire preparation measures are those actions that prepare individuals to respond effectively in the event of a fire. Preparation includes all the prevention aspects plus education and fire drills. Fire drills are conducted as rehearsal for the "real thing". Primary and secondary escape routes are identified and escape time is calculated according to the route.

Comprehensive preparation is particularly important where so many lives are at stake and many people are not able to respond on their own. For example, our patient floors have locked doors which may delay evacuating the unit. These floors may be considered high-risk environments. Therefore, it is essential that staff is educated and well rehearsed to evacuate themselves and patients in the event of a fire.



QUESTIONS

1. The purpose of this fire safety program is to reduce the risks with fire by employing _____________________________and _________________________________ measures.







ANSWERS: Fire prevention and Fire protection



FIRE DEFINITIONS




Fire is a chemical reaction that occurs when three critical elements are present fuel (combustible material) heat and oxygen.

Fuel

HeatOxygen





This chemical reaction takes place in every fire. To stop a fire, you must remove one or more of the critical elements.

QUESTIONS



Complete the following sentence:

1. Fire will burn when _______________ __________________ and _________________________ are present.





ANSWERS: Oxygen, Heat and Fuel







BY-PRODUCTS OF FIRE


In any chemical reaction, by-products result; there are four characteristic by-products of fire combustion:



Heat, Smoke, Gases, Flames



HEAT/FLAMES




Anyone who has ever used a barbecue or stood by a campfire knows that fire can be hot. However, if heat is contained in an enclosed structure, it is much more intense. The heat from a large fire can cause clothes to instantly ignite and melt into the skin. Sometimes on the six o'clock news, we see charred fire victims being removed from rooms that seemingly have little burn damage. It is the heat that caused the damage.

SMOKE/GASES


Most often it is neither the heat or flames that kill individuals. It is the smoke and toxic gas effects that cause most deaths.

Inside a burning structure the gases and by-products of combustion accumulate, making rooms instant gas chambers. Also, light smoke (early stage) produces carbon dioxide which acts as an anesthetic. If individuals are already asleep the smoke acts as a sedative and deepens their sleep, making it more difficult to awaken them.

Smoke moves freely and quickly. It comes up between the walls and escapes from every seam where the baseboards, ceilings and door frames connect. It will leak through the floorboards follow small pipes and wires, and eventually leak through outlets reaching people trapped in a structure fire.

Smoke carries the toxic effects of an ammonia gas cloud. Fire fighters have described smoke inhalation as if they have "taken a teaspoon of ammonia and put it in each eye and inhaled the rest of the container". THIS IS NOT THE SAME SMOKE FROM THE CAMP FIRE OR GRILL. This is toxic smoke from synthetic materials and burning rubber, mixed with all the chemicals you may have in your house, or work unit. Smoke also carries a black soot that can block out light from light sources within the fire. Even emergency lighting may be completely coated and ineffective.

The heat from the fire also impacts on smoke. Heat allows smoke to travel and rise 200 times faster than cyanide poison in a gas chamber.

It is difficult, if not impossible, to outrun smoke. It is estimated in some fires as large as the MGM Grand Hotel (Las Vegas, Nevada several years ago] that a room the size of a football field was completely enveloped in deadly smoke in less than 191 seconds. A college athlete running his best hundred yard dash would have difficulty maneuvering through the obstructions and outrunning the smoke to the nearest fire exit.

In this type of situation the need for early alarm might now be appreciated as the time one needs to get a head start on the race out of the gas chamber.

REMEMBER


* Smoke always rises and seeks out the path of least resistance.

* Smoke tends to fill the upper sections of a room and back downward as its volume increases.

* Positive pressure created by smoke displaces cool air and it rises causing voids in the corners of rooms.

* The line between the area of smoke overhead and clear air below is called the thermal barrier and is 12 - 18 inches above the floor.



QUESTIONS



Complete the following sentence:

1. Four characteristic by-products of fire combustion are _______________________, __________________________, ________________________ and___________________.



ANSWERS: Heat, Smoke, Gases and Flames





FIRE SPREAD




Heated smoke and hot air move up in a fast and unobstructed manner. Smoke and gases rise quickly between walls. Fire stops (seals around openings between floors) are used to prevent the smoke and gases from rising between the walls. However, large structural openings like stairwells can fill very fast.

Smoke, fire and heat can be stopped by solid walls. Many times the flame is actually intertwined within the smoke which presents a blow-torch-type effect allowing the flame and heat to travel through the building, by contact or heat conduction. For example, if you put a pipe through a wall and took a blowtorch and heated the pipe on one side of the wall until it was red-hot, the heat would be conducted through the pipe and could cause fuel on other end (on the other side of the wall) to ignite. This is similar to what happens within building structures. Pipes, electrical conduit, metal beams, and other structural components move the heat to other areas.

The following scenario illustrates the high temperature and speed of fire in an average size house. If a couch is on fire in an 8 x 30 foot room, the temperature will reach 200 degrees within one minute and 500 degrees within three minutes. If there is fuel and oxygen allowing the fire to continue for a few more minutes, the temperature could exceed 700 degrees.

Normally, it takes a smoke detector one to two minutes to detect a fire in a distant part of the house. The residents may take 10 to 30 seconds to wake up (if they have not suffered any smoke inhalation); it may take another 30 seconds to put on a robe or slippers before going to the bedroom door. By this time, the fire in the original room has reached 500 degrees, and if the resident were to walk upright into the room, he/she would be instantly burned and killed from heat and smoke.

Many people waste their final two minutes of life getting dressed, getting valuables and making phone calls. The only use of this time should be to alert others and to escape. There is no time to do anything else.

Smoke in a fire moves very rapidly and is extremely thick, engulfing every empty space with a large, smothering, black billow. It fills all areas from the ceiling down to about 12 to 18 inches off the floor. This is why it is so important that you CRAWL through a burning or smoke-filled building. However, many of the heavier toxic gases in smoke sink to the floor. These gases will hover within 6 inches of the floor, and they can kill

if inhaled. Again, in escaping from a burning or smoke-filled building, YOU MUST BREATHE THE AIR THAT IS BETWEEN 12 TO 18 INCHES ABOVE THE FLOOR (the thermal barrier).

QUESTIONS





Complete The following sentence:

1. When evacuating from a smoke filled building you should crawl and breathe the air that is ______________________ above the floor







ANSWERS: 12 - 18 inches

The New York State Psychiatric Institute Safety Manual mandates the use of the R-A-C-E formula when responding to a fire. This is based on National Fire Protection Agency (NFPA) guidelines.

R - RESCUE - All individuals in close proximity to a fire should

be immediately removed from the hazardous area. Evacuation should be accomplished in an orderly manner.

A - ALARM - The individuals who discovered the fire immediately sounds the nearest fire alarm.

C - CONFINE - All doors should be closed to contain the fire.

E - EXTINGUISH - Use appropriate extinguishing material for the fire.



QUESTIONS

Complete the following sentence:

1. The NFPA R-A-C-E formula stands for__________________, ______________________, __________________________and__________________________.





ANSWERS: Rescue, Alarm, Confine, and Extinguish



At PI we have automatic and manually operated fire alarms. They transmit both audible and visual alarms to the Safety Department.

The alarm can be activated by the smoke detectors, the sprinkler system, or manually at strategically placed fire alarm pull boxes throughout the facility.

The alarm system also activates an alarm bell in the affected areas. The alarm bell rings in a series of tones which indicates the location of a fire; count the number of tones. The code for each location is posted in each work unit near the fire alarm pull box. Be sure to know the alarm Code of your work area.

Fire alarm pull boxes are located by fire exit doors. Be sure of the location of the pull boxes in your area by checking their exact location. To operate a pull box, simply pull the handle down and release. The alarm should sound in five seconds.

All patient bedrooms are equipped with automatic smoke detectors. This smoke detector system is electrically monitored by the alarm system that indicates the fire area.



QUESTIONS

At PI fire alarms and detection include (Circle all that apply):

A. Manually operated fire alarm boxes

B. Smoke detectors

C. Sprinkler system

D. All of the above



ANSWERS: D

EVACUATING FROM A FIRE


All fire exits are identified by exit signs. Exits can be found throughout the building. On patient units, exits are located in the center area and each end of the hall. Be sure to know where they are for your location.

Fire exits are designed to lead you out of the building. The use of fire doors at PI in the fire exits renders our stairwells smoke-free in the event of a fire. Remember never to use the elevators during evacuation.

A fire is burning on your work unit and you have to evacuate. Please obtain the Fire Safety reference material and fill in the following information:

My work location is ______________________________

The alarm code is __________________________________

Primary evacuation route is _________________________

Secondary evacuation route is ________________________



If you smell smoke or see a fire, get staff and patients out quickly.

Before opening a door in a burning building, feel the door quickly with the palm of your hand. If the door is hot, the room on the other side is probably on fire.

If the door is cool, kneel down and check the air coming under the door. If the air is cool, the room may be safe to enter.

REMEMBER: IT IS THE SMOKE THAT KILLS MOST PEOPLE. SMOKE MAY NOT MAKE THE DOOR HOT, SO YOU MUST ALSO SMELL FOR SMOKE. DON'T OPEN THE DOOR IF BLACK SMOKE IS SUSPECTED.

Kneel behind the door while you open it just a little with your face turned away from the opening. Listen and smell for fire and smoke. If the room behind the door is on fire, very hot air and gases may explode when the door is opened. If smoke and hot air rush into the room that you are in, shut the door fast.

If you cannot escape quickly, protect your hands, face, and breathing passages with wet cloths and wet clothing. If you are trapped in the building, open a window a little and hang something out of it - a shirt, sheet, towel, that will show your location and attract others.

If your clothes catch fire, immediately stop and roll on the floor or ground to put out the flame. If someone else's clothes are burning, make the person stop, drop to the floor, and roll. Smother the fire by wrapping the person in a heavy blanket or coat. DO NOT RUN.

Close all doors and windows behind you as you leave. Remember the thermal barrier and when leaving a smoke-filled area move quickly but crawl on your hands and knees with your head up. Hot air, carbon monoxide and many other poisonous gases are likely to rise,

while other gases may lie near the floor. For those reasons, the air will be fresher about one foot above the floor. Use a stairway instead of an elevator to escape from a burning building. The fire may damage the elevator and trap you inside.



QUESTIONS

When evacuating from a fire situation you would (Circle all that apply):

A) Close all doors to contain the fire as much as possible.

B) If your clothing catches fire you should "stop, drop and roll".

C) If smoke and gas is present, crawl on the floor with your head up towards your escape exit, breathing the air that is 12-l8 inches above the floor.

D) Feel a door for presence of heat prior to opening the door.

E) Open a door that is cool even if you smell smoke from coming from under the door.



ANSWERS: A, B, C and D







As in any fire situation, once evacuation is achieved all must be accounted for. This is true at home with your family as well as at work. A designated assembly point must be established for all to meet outside of the fire danger. A list of employees and patients should be readily available to account for all individuals. Some examples might be assignment sheets, medexes, cardexes, etc. When possible, the medical records cart with the patient records on it should be placed in the medication room and the door locked.



QUESTIONS

Circle all that apply:

In the event of an in-patient unit, staff should:

A) Designate an assembly point beyond the fire danger so that assurance can be made that all staff and patients have been safely evacuated.

B) Evacuate all of the medical records at the same time the staff and patients are being evacuated.

C) Bring a listing of all patients and staff so all can be accounted for after evacuation.





ANSWERS

A & C



EXTINGUISHING A FIRE


You will recall the fire triangle and the 3 elements necessary for fire combustion:



Fuel











HeatOxygen





Fire extinguishment is based on the removal of one or more of the three elements.

TYPES OF FIRES AND FIRE EXTINGUISHERS






Class A Fire

Type of Extinguisher

Ordinary combustibles such as paper, wood, cloth, etc.

Since this is a Research Facility we use only one type of extinguisher, the ABC. This type of extinguisher will extinguish all classes of fire.

Class B Fire

Flammable liquids such as gas, oil, grease

paint, etc.

Class C Fire

Electrical fire such as

live electrical appliances-toasters, radios, TV's, stoves,

outlets, etc

Class D Fire

Burning metal such as

magnesium, engine blocks,

etc. Highly flammable. This type of fire can occur in industrial settings.


D Class Extinguisher

Contains special dry powder as an extinguishing agent

not available at PI.



When attempting to extinguish a fire, use the appropriate extinguisher for the combustible material, use extreme care: a burning pile of papers may hide a live electrical appliance beneath it.

QUESTIONS

A small pile of clothing in a patient room is smoldering. One of the staff has called the Safety Office to report the fire. Another staff member is moving 15 patients from the dormitories. You decide to extinguish this small fire. You recognize that this is a class fire and the best extinguisher to use is one filled with .











ANSWERS: A - In all cases ABC



USE OF FIRE EXTINGUISHERS




1) Read the label; use appropriate extinguisher for type of fire.

2) Carry the extinguisher as close to the fire as possible but maintain a safe distance; radiant heat can ignite clothing. Rule of thumb is that when you can feel radiant heat on your face, you are close enough.

3) Pull the pin or activate according to manufacturer's recommendations.

4) Test squirt.

5) Aim the nozzle at the base of the fire compress the lever.

6) Extinguish the fire by applying the agent in a sweeping motion to the base of the fire.

7) After fire is out, do not return extinguisher back to the rack or cabinet from which it was taken. Instead, lay it on its side. This alerts the Safety Department or Fire Department that the extinguisher has been used.

8) If the Safety Department is not present, notify them later that the extinguisher has been used.

9) Safety Officers will replace the used extinguisher, no matter how little was used. This keeps you prepared for any future need of the extinguisher.









QUESTIONS

It took you only 5 seconds to extinguish the small clothing fire. Since so little of the chemical was used, you decide it is safe to return the extinguisher to the cabinet



Circle one: True or False



ANSWERS: False

LOCATION OF FIRE EXTINGUISHERS



Fire extinguishers should be placed away from areas of high fire hazard to ensure that they are accessible in fire emergency.

All areas are equipped with fire extinguishers of the type required for the class of fire normally anticipated in each particular area.

You will find fire extinguishers at various locations throughout the facility. For example in Nurses' stations, in rooms housing computers, the staff library, and near other selected machinery. CHECK FOR THE LOCATION OF THE FIRE EXTINGUISHER IN YOUR WORK AREA.

There is an automatic sprinkler system for all designated storage areas.

The facility is also equipped with hose stations and stand-pipe system. The hose boxes are located North Center and South on each Unit and on every floor.

REMEMBER: THE BEST MEANS OF FIGHTING FIRE IS PREVENTING FIRE





INTERNAL DISASTER/TOTAL BUILDING EVACUATION


The fire alarm code bells also can signal an internal disaster. An internal disaster alarm is initiated by a Safety Officer after assessment of the situation.

The bell consists of a continuous sound and constitutes the evacuation of the building. In the event you hear such a sound, round up all the patients and staff in your area, proceed to the fire stairs and await further instructions and evacuation.

If total evacuation is warranted, proceed according to instructions and in accordance with the PI Disaster Plan.





QUESTIONS

1. __________________________is the alarm code for total building evacuation.



2. Evacuation is done according to ____________________________ and _____________







ANSWERS: 1. A continuously sounding bell.

2. The PI Disaster Plan and instructions.



RESPONSIBILITIES OF ALL EMPLOYEES REGARDING FIRE/ACCIDENT PREVENTION





* Keep all areas neat and clean so they are safe from a fire or accident hazard. All electrical appliances must be inspected by the Engineering Department.

* Report all types of unusual activity or hazards in the working area.

* The person who first witnesses or discovers an incident must report it.

* Report all accidents to the Safety Department; Safety will then investigate.

* Always make out an accident report.

* All employees must comply with all fire and safety regulations.

* All employees must take part in fire drills.





FIRE AND SAFETY




ANNUAL REFRESHER




This is to acknowledge that Fire and Safety has been explained to me and any questions I may have had, have been answered.



The following objectives have been covered:

1. The purpose of the Fire and Safety Program.

2. The 3 components of fire combustion.

3. The 4 deadly by-products of fire combustion.

4. The R-A-C-E procedure.

5. Combustible materials and the proper fire extinguisher.

6. The fire alarm code and evacuation plan for my own work unit.

7. The alarm code for total building evacuation.



 

Print Name

 

Employee Signature

 

Social Security Number

 

Date







APPENDIX C - NEW EMPLOYEE ORIENTATION

New York State Psychiatric Institute


Employee Orientation


Fire Prevention Safety & Right-To-Know


Annual Fire Safety Refresher Course


Prepared By: Department of Safety and Security

 

OBJECTIVES




Upon completion, participants will be able to:

1. State the purpose of the Fire Safety program.

2. Identify three components of fire combustion.

3. Define and outline procedure for implementation of R-A-C-E.

4. Identify the four (4) classes of fire.

5. Identify Fire Alarm Code and Evacuation Plan for own work unit.

6. Identify routes for means of egress.

7. State the alarm code for internal disaster and total building evacuation.







The purpose of this program is to provide fire prevention and preparation information that is essential for safety of all staff and patients.

Problems associated with fires are well known; we hear about them on the television news and read about them in the news papers. Despite these reminders. thousands of people die every year from fire related circumstances. Many of these deaths occur because people do not understand fire behaviors and risks, or they panic or simply do not know what to do.

You can reduce the risks associated with fire by planning for a fire. Planning involves

employing fire prevention and preparation measures:



1 Prevention

Measures and actions that prevent fire from starting or spreading include:

a. installation of fire stops & sprinkler systems

b. automatic door closures, fire doors

c. regular inspections of heat and electrical sources

d. proper storage of flammable substances

Fire prevention also requires that individuals practice good fire safety principals, such as assessing the environment. High-risk environments are those areas that contain a likely ignition and/or combustion source for fire. Understanding the risks associated with such environments can direct you to further prevention action.



2. Preparation

Fire preparation measures are those actions that prepare individuals to respond effectively in the event of a fire. Preparation includes all the prevention aspects plus education and fire drills. Fire drills are conducted as rehearsal for the "real thing". Primary and secondary escape routes are identified and escape time is calculated according to the route.

Comprehensive preparation is particularly important where so many lives are at stake and many people are not able to respond on their own. For example, our patient floors have locked doors which may delay evacuating the unit. These floors may be considered high-risk environments. Therefore, it is essential that staff is educated and well rehearsed to evacuate themselves and patients in the event of a fire.

FIRE STATISTICS






The National Fire Protection Association (NFPA) estimates that an average of 6,633 people die each year from fires in the United States. However, at least 30,000 individuals are injured each year with about two-thirds of these injuries occurring in house fires. The causes of fire have been traced to four categories; SMOKING MATERIALS followed by:



A. Incendiary and suspicious ignition such as arson

B. Heating equipment

C. Cooking equipment



STANDARD INSTRUCTIONS


All employees should recognize the importance of fire prevention. However, in the event of a fire, they must be aware of safety procedures, in order to safeguard the lives of patients and personnel, and reduce the loss of property.

It is important that supervisors and staff know thoroughly the evacuation routes, the location of fire alarm boxes and extinguishers. Every employee should be assigned definite duties and be familiar with evacuation procedures.

Evacuating patients at Psychiatric Institute vertically by use of stair-wells, or elevators involves difficulties so that every effort should be made beforehand to plan for a horizontal escape.

The moving of patients from an imperiled area to a safer area on the same floor can be done by moving the patients from the fire area to safe zones on the other side of the smoke barrier doors in the corridors. In the meantime, keep the smoke barrier doors closed as much as possible to prevent the travel of smoke, heat and gases to other sections of the hospital.

Ambulatory patients should be led to a place of safety. Simple verbal directions may suffice for most patients, leaving hospital personnel free to work with less able patients.

Semi-ambulatory patients may be moved in wheelchairs, while critically ill patients may have to be moved in beds or be carried.

All life sustaining equipment, oxygen, respirators and the like should be moved with the patient if at all possible. The portable oxygen tanks should be in the closed position until the fire area is cleared. Before removing a patient who was on oxygen from a room, be sure to turn off the control valve on the oxygen being piped into the room.

Search all rooms, restrooms, lounges and work areas to ensure complete evacuation.







These steps should be followed by any member discovering a fire in the hospital complex:

KEY WORD "R A C E":

R Remove from immediate danger anyone in close proximity to the fire or smoke.

A Turn in an alarm.

A. By using one of the manual fire alarm boxes located on each floor next to the stairwells.

1. Open the door of the alarm box.

2. Pull the internal lever down once and release. The alarm should sound within five seconds. If no bells sound, the staff member should use another alarm box in an adjacent area or utilize step B.

B. Dial the hospital's fire emergency telephone number 5555. The caller should give the operator the exact location of the fire.

When notifying other staff members in a patient area that there is a fire, the term "CODE F" should be used. Do not yell "FIRE." This would only create a panic situation among the patients and visitors.

C Confine the fire by:

1. Closing the door to the room which is on fire.

2. Closing the door to all other patient rooms in the area.

3. Ensuring that all stairwells, laundry chutes (all sealed now) and corridor smoke barrier doors are closed.

E If possible, steps should be taken to extinguish the fire by using the portable extinguishers located throughout the hospital. This step should not be attempted until the first three steps have been completed.



Once these steps are completed, the staff members shall take the steps to reassure the patients who are still in their rooms that the situation is under control. The staff members shall then await further instructions from the hospital administrator on the scene or the New York City Fire Department Officer in charge.





ANY QUESTIONS RELATED TO FIRE PREVENTION, THE HOSPITAL'S FIRE RESPONSE POLICY OR ANY SAFETY RELATED ISSUE SHOULD BE DIRECTED TO THE SAFETY AND SECURITY OFFICE AT EXTENSIONS 2210 OR 5555.



FIRE FIGHTING TOOLS AND HOW TO USE THEM - KEY WORD "B-E-E-T"

BOX Pull lever down once all the way. Do not pull lever if alarm is already ringing as this will disrupt the signal.

EXITS Know their location for the orderly evacuation of patients, visitors and employees.

EXTINGUISHERS The only type of extinguishers used at the Psychiatric Institute are the ABC type of extinguishers, which are used in any type of fire.

TELEPHONE To report a fire in the event of an alarm box malfunction or in the event that an alarm box is not accessible, DIAL 5555 on any hospital telephone. Give the location of the fire to the operator. The operator will then use the Public Address System to warn anyone in immediate danger, and the New York City Fire Department.



HOSPITAL FIRE RESPONSE POLICY

When either a manual fire alarm is pulled or a call is made to the fire emergency 5555 number, the call goes to the Fire Department automatically via Holmes Protection Agency. The operator then notifies the hospital's internal fire response team which is composed of personnel from the Engineering, Maintenance, Security and Environmental Services Departments. They will assist in any necessary evacuation and containment of the fire until the arrival of the New York City Fire Department.

FIRE ALARM BOXES AND CODES

Know the location and codes for the fire alarm boxes on your floor. There are at least three boxes on every floor of the hospital. The alarm boxes are usually located right next to the fire stairwells. These locations can be easily spotted by the illuminated exit signs over the doors leading to the stairwells. All staff are urged to immediately report malfunctioning "exit" indicator lights.

EVACUATING FROM A FIRE


All fire exits are identified by exit signs. Exits can be found throughout the building. On patient units, exits are located in the center area and each end of the hall. Be sure to know where they are for your location.

Fire exits are designed to lead you out of the building. The use of fire doors at PI in the fire exits renders our stairwells smoke-free in the event of a fire. Remember never to use the elevators during evacuation.

If you smell smoke or see a fire, get staff and patients out quickly.

Before opening a door in a burning building, feel the door quickly with the palm of your hand. If the door is hot, the room on the other side is probably on fire.

If the door is cool, kneel down and check the air coming under the door. If the air is cool, the room may be safe to enter.

REMEMBER: IT IS THE SMOKE THAT KILLS MOST PEOPLE. SMOKE MAY NOT MAKE THE DOOR HOT, SO YOU MUST ALSO SMELL FOR SMOKE. DON'T OPEN THE DOOR IF BLACK SMOKE IS SUSPECTED.

Kneel behind the door while you open it just a little with your face turned away from the opening. Listen and smell for fire and smoke. If the room behind the door is on fire, very hot air and gases may explode when the door is opened. If smoke and hot air rush into the room that you are in, shut the door fast.

If you cannot escape quickly, protect your hands, face, and breathing passages with wet cloths and wet clothing. If you are trapped in the building, open a window a little and hang something out of it - a shirt, sheet, towel, that will show your location and attract others.

EXTINGUISHING A FIRE




You will recall the fire triangle and the 3 elements necessary for fire combustion:



Fuel

Heat

Oxygen

Fire extinguishment is based on the removal of one or more of the three elements.



TYPES OF FIRES AND FIRE EXTINGUISHERS






Class A Fire

Type of Extinguisher

Ordinary combustibles such as paper, wood, cloth, etc.

Since this is a Research Facility we use only one type of extinguisher, the ABC. This type of extinguisher will extinguish all classes of fire.

Class B Fire

Flammable liquids such as gas, oil, grease,

paint, etc.

Class C Fire

Electrical fires such as those caused by

live electrical appliances (toasters, radios, TV's, stoves, outlets, etc)

Class D Fire

Burning metal such as

magnesium, engine blocks,

etc. Highly flammable. This type of fire can occur in industrial settings.


USE OF FIRE EXTINGUISHERS



1) Read the label; use appropriate extinguisher for type of fire.

2) Carry the extinguisher as close to the fire as possible but maintain a safe distance; radiant heat can ignite clothing. Rule of thumb is that when you can feel radiant heat on your face, you are close enough.

3) Pull the pin or activate according to manufacturer's recommendations.

4) Test squirt.

5) Aim the nozzle at the base of the fire, compress the lever.

6) Extinguish the fire by applying the agent in a sweeping motion to the base of the fire.

7) After fire is out, do not return extinguisher back to the rack or cabinet from which it was taken. Instead, lay it on its side. This alerts the Safety Department or Fire Department that the extinguisher has been used.

8) If the Safety Department is not present, notify them later that the extinguisher has been used.

9) Safety Officers will replace the used extinguisher, no matter how little was used. This keeps you prepared for any future need of the extinguisher.



LOCATION OF FIRE EXTINGUISHERS



Fire extinguishers should be placed away from areas of high fire hazard to ensure that they are accessible in fire emergency.

All areas are equipped with fire extinguishers of the type required for the class of fire normally anticipated in each particular area.

You will find fire extinguishers at various locations throughout the facility. For example in Nurses' stations, in rooms housing computers, the staff library, and near other selected machinery. CHECK FOR THE LOCATION OF THE FIRE EXTINGUISHER IN YOUR WORK AREA.

There is an automatic sprinkler system for all areas.

The facility is also equipped with hose stations and stand-pipe system. The hose boxes are located North, Center and South on each Unit and on every floor.

REMEMBER: THE BEST MEANS OF FIGHTING FIRE IS PREVENTING FIRE





RESPONSIBILITIES OF ALL EMPLOYEES REGARDING FIRE/ACCIDENT PREVENTION







Keep all areas neat and clean so they are safe from a fire or accident hazard. All electrical appliances must be inspected by the Engineering Department.

Report all types of unusual activity or hazards in the working area.

The person who first witnesses or discovers an incident must report it.



Report all accidents to the Safety Department; Safety will then investigate.



Always make out an accident report.



All employees must comply with all fire and safety regulations.



All employees must take part in fire drills.







Copy Emergency Evacuation Route

Appendix D - Right to Know Training

Appendix E - Recommended Abbreviations

acc. - accident

l.m.s.d. - lost, missing, stolen damaged

adm. - administration

loc. - location

amb. - ambulance

med. - medical

att. - attendant

not. - notify

b.e. - blotter entry

off. - office

bldg. - building

poss. - possible

c.b.e. - case book entry

prop. - property

comp. - completed

ptl. - patrolman

con't. - continued

rec. - received

d.e. - delayed entry

ref. - refer

disp. - dispatched

s.o. - safety officer

emer. - emergency

supv. - supervisor

ext. - extension

surg. - surgical

f.r. - fire report

trp. - trooper

hosp. - hospital

wd. - ward

intox. - intoxication

inv. - investigation

* NOTE * -- Standard codes can be used in the blotter but not in the making of reports or form.

Appendix F - NYS Safety Officers - Police Deptartment Signal Code

10-2 RETURN TO H.Q.

10-4 AFFIRMATIVE-MESSAGE RECEIVED

10-6 OPERATOR BUSY-STAND BY

10-7 OUT OF SERVICE

10-8 IN SERVICE-SUBJECT TO CALL

10-9 REPEAT TRANSMISSION-POOR RECEPTION

10-10 PATIENT ELOPEMENT

10-12 OFFICIAL VISITOR PRESENT

10-13 ASSIST PATROLMEN

10-17 URGENT BUSINESS

10-18 ANYTHING FOR US-YOU HAVE A LANDLINE

10-19 NOTHING FOR YOU, RETURN TO HQ.

10-20 WHAT IS YOUR LOCATION

10-21 CALL BY LANDLINE

10-23 STAND BY

10-32 INVESTIGATE OCCUPANTS OF AUTO, SUSPICIOUS PERSON

10-33 TROUBLE AT HQ. - NEED HELP

10-35 (LICENSE NO.) VERIFY WHETHER CAR IS REGISTERED

10-36 CAR IS REGISTERED

10-37 CAR IS NOT REGISTERED

10-38 AMBULANCE IS NEEDED AT ..... (GIVE LOCATION)

10-39 CONFIDENTIAL INFORMATION

10-40 UNFOUNDED CALL

10-41 ACCIDENT AT .... (GIVE LOCATION)

10-63 OUT OF SERVICE (MEAL)

10-92 SUMMONS GIVEN

10-99 NO SUMMONS, NO WARNINGS

CODE 3 FIRE AT..(GIVEN LOCATION)

Appendix G - Phonetics

A-----ADAM

B-----BAKER

C-----CHARLIE

D-----DAVID

E-----ERNEST

F-----FRANK

G-----GEORGE

H-----HENRY

I-----IDA

J-----JOHN

K-----KING

L-----LEWIS

M-----MARY

N-----NANCY

O-----OTTO

P-----PETER

Q-----QUEEN

R-----ROBERT

S-----SUSAN

T-----THOMAS

U-----UNION

V----VICTOR

W-----WILLIAM

X-----XRAY

Y-----YOUNG

Z-----ZEBRA

** Example in the Use of Phonetics **

1. UNIT 5 TO HQ. - PLATE CHECK

2. WILLIAM, BAKER, 2, PETER, OTTO, ZEBRA

3. (CAR PLATE NUMBER----------W B 2 P O Z)



Appendix H - The Miranda Law

  • You have the right to remain silent and refuse to answer questions DO YOU UNDERSTAND?


  • Anything you do say may be used against you in a court of law DO YOU UNDERSTAND?


  • You have the right to consult an attorney before speaking to the police and to have an attorney present during any questioning now or in the future. DO YOU UNDERSTAND?


  • If you cannot afford an attorney, one will be provided for you with out cost. DO YOU UNDERSTAND?


  • If you do not have an attorney available, you have the right to remain silent until you have had an opportunity to consult with one. DO YOU UNDERSTAND?


  • Now that I have advised you of your rights, are you willing to answer questions without an attorney present?






Appendix I - Ticket and Violation Codes

Plate Type Codes

Plate Type Code

Regular Passenger 16

Motorcycle 36

Rental Car 52

Taxi 54

Omnibus 56

Dealer 62

Transporter 66

Commercial Transporter 76

Tractor 81

Tractor Trailer 85

State Alpha Codes

Abbreviation State

CA California

CT Connecticut

DC Washington DC

FL Florida

MA Massachusetts

NJ New Jersey

NY New York

PA Pennsylvania

Parking Violation Codes

Violation Code

Alternate Side (note time) 1

Obstruct Driveway 2

Crosswalk 3

Bus Stop 4

Double Parked 5

Meter Violation (meter #) 6

Restricted Area (note violation) 7

Fires Hydrant 8

All Others 9








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