Evaluation of Hospital Disaster Drills: Main Spreadsheet (continued)

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Evaluation of Hospital Disaster Drills: A Module-Based Approach

Main Spreadsheet (continued)

Hospital	#	Question		Incident Command Center	Decontamination	Triage	Treatment
Section	#	Question		Incident Command Center	Decontamination	Triage	Treatment
Zone Operations	C23	Location of zone determined	Prior to drill
	C23	Location of zone determined	During drill
	C24	Disaster plan available?	Y / N / U
	C25	Format of plan	a. Complete manual
			b. Flow diagram
			c. Job action sheets
			d. NA
			e. Other (specify)
	C26	How was plan accessed?	a. Computer/Internet
			b. Paper
			c. Personal data assistant (PDA)
			d. NA
			e. Other (specify)
	C27	Biological incident component to disaster plan?	Y / N / U
	C28	Radiation incident component to disaster plan?	Y / N / U
	C29	Space for zone adequate?	Y / N / U
	C30	Zone activity overflow	a. Adequate space allotted
			b. Conference room
			c. Hallways
			d. Outside hospital
			e. Treatment/victim care areas
			f. Waiting rooms
			g. No overflow
			h. NA
			i. Other (specify)
	C31	Zone used for same function during non-drill operations?	Y / N / U
	C32	Usual use for zone	a. Ambulance ramp
			b. Conference room
			c. Hallway
			d. Lobby
			e. Treatment, emergency
			f. Treatment, non-emergency
			g. Triage
			h. Unused
			i. Waiting room
			j. Other (specify)
	C33	Clinical staff interact directly with victims' families?	Y / N / U / NA
	C34	Victims' families referred to specially designated staff?	Y / N / U / NA
	C35	Victim privacy ensured?	a. Curtains
			b. Individual areas
			c. Privacy screens
			d. Not ensured
			e. Other (specify)
	IC26	ICC configuration	One room
			Two or more contiguous rooms
			Two or more non-contiguous rooms
			Other (specify)
	IC27	Approximate number of people in ICC	<5
			6-10
			11-20
			>20
	IC28	Did noise level interfere with effective communications?	Y/ N/U
	IC29	Steps taken to correct noise problem	Y / N / U
	DE4	Decon zone set up prior to arrival of 1st victim	Y / N / U
	DE5	All victims sent immediately through decon on arrival (explain in comment section)?	Y / N / U
		Victims able to undergo decon simultaneously?
	DE6	Ambulatory	#
	DE7	Non-ambulatory	#
	DE8	Method to decon non-ambulatory victims	a. Victims and means of transport put through decon
			b. Victims transferred to another means of transport , then put through decon
			c. No non-ambulatory victims
			d. Other (specify)
	DE9	Non-ambulatory victims re-positioned to ensure decon?	Y / N / U / NA
	DE10	Separate male/female decon provisions?	Y / N / U / NA
DE11	Victims' clothing and belongings removed for decon?	Y / N / U
DE12	Handling of clothing	a. Chain of custody initiated
		b. Contained
		c. Discarded
		d. Held for later retrieval
		e. Identified
		f. Marked as HAZMAT
		g. Returned after decon
		h. Secured in storage
		i. Unclear
		j. NA
		k. Other (specify)
	Handling of personal belongings	l. Chain of custody initiated
		m. Contained
		n. Discarded
		o. Held for later retrieval
		p. Identified
		q. Marked as HAZMAT
		r. Returned after decon
		s. Secured in storage
		t. Unclear
		u. NA
		v. Other (specify)
DE13	Materials used to contain clothing and personal items	a. Aluminum foil wrapping
		b. Cotton hampers
		c. Paper bags
		d. Plastic bags
		e. NA
		f. Other (specify)
DE14	Measures taken to improve victims' comfort	a. Heaters
		b. Partitions
		c. Shelters
		d. Towels
		e. None
		f. NA
		g. Other (specify)
DE15	Additional steps taken in handling materials or equipment potentially contaminated?	Y / N / U / NA
DE16	Covering provided to victims after decon?	Y / N / U / NA
DE17	Barriers between decon and next zone	a. Doors
		b. Elevators
		c. No barriers
		d. Stairs
		e. Other (specify)
DE18	Did EMS provide any resources to assist decon	a. Decon tents
		b. Fire trucks with hoses
		c. PPE
		d. Personnel
		e. Water containment systems
		f. No services provided
		g. Other (specify)
DE19	Mechanism of decon	a. EMS or fire department vehicles with hoses
		b. Permanent overhead showers/sprinklers
		c.Temporary decon tent(s)
		d. Other (specify)
DE20	Contaminated water run-off contained?	Yes, and adequate collection capacity
		Yes, but inadequate collection capacity
		No, but runoff directed into drainage system
		No runoff control
		Unclear
DE21	Decon affect normal flow of EMS traffic?	Y / N / U / NA
DE22	Established plan in place for re-routing EMS traffic?	Y / N / U / NA
DE23	EMS notified of traffic flow change?	Y / N / U / NA
DE24	How notified? (specify)
TG5	Proportion of victims screened for biological or chemical or radiation exposure prior to entry to triage	None
		Less than half
		At least half (but not all)
		All
		Unclear
TG6	How screened	a. Personal interview
		b. Physical examination
		c. Screening device
		d. Not screened
		e. NA
		f. Other (specify)
TG7	Proportion of victims in triage received care beyond basic airway maneuvers and control of active bleeding	None
		Less than half
		At least half (but not all)
		All
		Unclear
	Comments:

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