Mock Drill- Fire Emergency (Code Red)

Mock Drill- Fire Emergency

Code Red

S.N	Event	Yes/No	Actual time taken	Time in mins
1	Mock Drill start time
2	Code Red Announced at
3	Main switch turned off at
4	Generator switched off at
5	Code Red Team responded at- with/without extinguisher
6	Type of fire identified
7	Fire restricted
8	Identified risk areas cordoned off
9	Call for evacuation
10	Patient evacuation started
11	Material evacuated
12	Fire hydrant activated
13	Front office activated
14	Safe assembly area activated
15	HR manager checks rolls of employees
16	MS ensures all patients have been evacuated (checks census)

Detail of discrepancies observed -………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Sign of Observer:…………………….............

Date:………………..

Sign of Quality Manager:…………………….

Sign of Administrator:.....................................

Sign of MS:…………………….....................

Mock Drill- Child Abduction (Code Pink)

Mock Drill- Child Abduction (Code Pink)

S.N	Event	Yes/No	Actual time taken	Time in mins
1	Mock Drill start time
2	Code PINK reported by first res-ponder at
3	Code PINK announced by PA system at
4	Code PINK initiated at
5	Child identity notification
5	Time of arrival of security guard
6	Time of arrival of 2nd res-ponder/
7	Time of arrival of 3rd res-ponder
8	Security officer cordons off the area
9	Closing of gate time
10	Child identify time
11	Child with their guardian/place
12	Code PINK called off at

Detail of discrepancies observed -………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Sign of Observer:…………………….

Date:………………..

Sign of Quality Manager:…………………….

Sign of MS:…………………….

MOCK DRILL- SPILL (CODE ORANGE)

MOCK DRILL- SPILL

CODE ORANGE

S.N	Event	Yes/No	Actual time taken	Time in mins
1	Mock Drill start time
2	Time of drill initiated
3	Code orange  reported by first res-ponder at & name
4	Code orange announced by PA system time
4	Spill management initiated at
5	Time of arrival of spill kit
6	Time of arrival of 2nd res-ponder/ Code orange Team
7	Security guard cordons off the area time
8	Housekeeping arrival time
9	CAUTION SIGN available or not
10	Labeling of disposal bag yes/no
11	Spill kit removed from site time
12	Mopping yes/no

Detail of discrepancies observed -………………………………………………………………………………………………………………………………………………………………………………………………………………

Sign of Observer:…………………….

Date:………………..

Sign of ICN:…………………….

Sign of Quality manager ……………

Sign of MS ……………

Mock Drill- Code Yellow

Mock Drill- Code Yellow

S.N	Event	Yes/No	Actual  time of occurrence	Time in mins
1	Mock Drill start time
2	Call for emergency received at
3	Code Yellow Announced
4.	Code Yellow team activated
5	Equipped ambulance sent to the site of disaster.
6	Normal admissions are stopped immediately
7.	Command nucleus activated
8.	Team reported at command nucleus
9.	Disaster card distributed
10	Pre defined area for creation of disaster ward evacuated
11	Disaster ward created
12	Medicines & other consumables reaches the disaster ward.
13	Security controls the crowd
14	Reception desk positioned at the main entrance of the hospital
15	Patient identification by the designated team member done
16	First patient reported
17	Triaging Done
18	Patient shifted to ICU/OT
19	Patient shifted to disaster ward
20	Patient discharged by
21	Media handling done by spokes person
22	Blood bank in charge reported at the command station
23	Dietitian Reports at the command station
24	Store in charge reports at the command station
25	Pharmacy in charge reports at the command nucleus
25	Code Yellow called off at

Detail of discrepancies observed -………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Sign of Observer: …………………….

Date:………………..

Sign of Quality Manager:…………………….