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Around the Hospital AROUND THE HOSPITALJoint Consultative Staffs CommitteeEnforcement of fire precautions now clarifiedInformation on the enforcement of fire precautions in the hospital has now been produced following a series of Officers' Meetings. The subject was originally raised at last January's Consultative Staffs Committee meeting, when the staff side, prompted by the release of the report of the Committee of Inquiry into the fire at Coldharbour Hospital, submitted a list of ten questions to the Committee. Following this, a Working Party was set up to discuss the staff side's document and to formulate replies, and consisted of the Head of Nursing Services, Medical Superintendent, Hospital Secretary, Group and Hospital Engineers, Night Superintendent, Fire Safety Officer, and the chairman and secretary of the staff side. After two meetings the conclusions of the Working Party were submitted to the May meeting of the J.C.S.C., but the staff side proposed that further discussion should take place on certain of the recommendations. The revised recommendations were received at the July meeting of the J.C.S.C., and - apart from one sentence - subsequently approved by the Hospital Management Committee. Hospital Officers on the Working Party have continued to meet in order to produce a comprehensive policy for the prevention of fire and the action to be taken by staff in event of fire. It is understood that this is shortly to be circulated to staff. In order to emphasise the importance of clear understanding of the responsibilities of staff in fire prevention, we publish below the ten questions originally submitted by the staff side, together with the answers arrived at by the multi-disciplinary Working Party:- (1a) What is the present policy regarding smoking in the hospital by Patients? Smoking by staff and patients is prohibited in dormitories, single rooms, store rooms, cleaners rooms, kitchen and CSSD/Clinic rooms by day or night, and in any other area where this is indicated. Where a patient is confined to bed, smoking may be permitted during the daytime at the discretion of the nurse in charge of that area and under nursing supervision. During the night, smoking is permitted only at the discretion of the nurse in charge of that area and under nursing supervision, in an area designated by that nurse. Contravention of these smoking regulations by patients should be recorded in the Ward Report Book and brought to the immediate attention of the Medical Officer. (lb) What is the present policy regarding smoking in the hospital by staff? The policy of the DOHSS as stated in HM 71/53 is recommended as follows:- 'The example of staff is particularly important and hospital authorities should, therefore, seek their co-operation not only in the guidance of patients but also in their own actions. Doctors and nurses do not smoke in treatment areas and would no doubt agree to refrain from smoking in any part of the hospital which is open to the patients or the public. Smoking is forbidden in kitchens and food preparation rooms and staff are asked to refrain from smoking in waiting rooms, lifts, corridors and the administrative areas of the hospital. Some staff will find it easier to comply with these rules and to encourage the public to comply if there, is a place where they can smoke when off duty. Staff must restrict their smoking to the designated area of their ward or department. (2) If patients insist on smoking in unauthorised areas, what is the immediate procedure to be adopted by staff? Staff should direct patients to go to an authorised area to smoke. Again, any contravention of smoking regulations should be entered in the Ward Report Book and reported to the Ward Medical Officer. (3) If a fire occurs due to patient smoking in an unauthorised area, will the person in charge of that immediate area be held responsible for the fire? The person in charge of that area will be held responsible for carrying out the HMC's instructions. regarding fire prevention. (4) Which patients may carry lighters or matches? If some may not, how should staff enforce this? It is virtually impossible to stop patients carrying matches, and in many eases undesirable to do so. Although the official policy has always been that patients should not be allowed to do this we recommend that the policy be brought up to date. The Hospital Management Committee recognise that patients may carry matches. Where a patiient is considered to be unsafe to have matches, cigarettes, etc, he/she should be asked by the nurse in charge to surrender these. Any refusal should be noted in the Ward Report Book and reported to the Ward Medical Officer. Patients considered by the Medical Officer to be fire risks should be designated as such in their case notes and deprived of matches, etc. All Ward staff should be aware of any such patients on their ward and should supervise them closely at all times. (15) If a dormitory is left unstaffed at night and a fire occurs, who will be held responsible? It would be the responsibility of the agent of the Management Committee who was responsible for the staffing of the wards providing this agent has been provided with adequate resources to fill the establishment. If staff had left their post without permission they too would be guilty of a breach of regulatlons. (6) Is it in order for a nurse to leave a dormitory unattended at the end of a shift if no nurse is allocated to the ward to supervise that dormitory? A nurse should not leave the ward unattended without the permission of the Duty Nursing Officer. (7) As most wards have some locked exit doors, can the policy regarding the locking of ward doors be clearly defined on a ward to ward basis? The ward policy for locking fire exit doors should be reviewed, ward by ward, by each individual Consultant and Nursing Officer, as soon as possible. (8) Should a fire occur in a ward where staff have not been supplied with pass keys, and evacuation is thereby impeded, who will be held responsible for any injuries or deaths caused? Any member of ward staff without a pass key should inform his/her charge nurse or domestic supervisor who, in turn, should inform the Unit Officer or Domestic Superintendent. Thus, officers should be aware of the number of staff on a ward or department who are without keys, and take steps to remedy this, either by a re-distribution of keys or by requisitioning additional keys fron their senior officer. As a long-term measure and following on the reviewing of the policy of locking exit doors, many wards should have the standard locks removed from all doors and panic bolts fitted to exit doors. This would release locks and keys for those wards which still require their use. It is suggested that an immediate safeguard could be obtained by all staff handing over their ward keys to the staff relieving them on a change of shift and thus preventing the keys being taken off the premises as happens at the moment. The withdrawal of a personal issue of keys would necessitate the Management Committee absolving the staff from financial responsibility of a personal key issue. (9) If evacuation is impeded by faulty locks, who will bear responsibility for any injuries or deaths caused? Where any lock is found to be faulty, the person concerned should report this to the nurse in charge of the ward or department, who would telephone the Engineer's Department requesting urgent repair. (10) Can clear instructions be given as to the maximum period a nurse on night duty may leave a dormitory unattended? A nurse on night duty should not leave the dormitory unattended for more than 5 to 6 minutes. If it is necessary to leave the dormitory for a greater length of time, then a relief night nurse must be requested.LostPowder Blue Diary.
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