FireNet Community
PRIVATE INDUSTRY => HealthCare => Topic started by: Shaun Doyle on November 16, 2003, 11:13:11 PM
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Just something for openers (for a small debate). Do readers think that fire training carried out by only CD rom / computer is suitable for the only fire training in a hospital?
If so, what extra training do staff involved in progressive horizontal evacuation procedures need to undertake?
I have put this up as a general question to stimulate debate, which may be of interest to people. Welcome any views.
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Shaun,
What a debate to start on! :lol:
The age old question of how much training, at what frequency and by what method will always invoke debate.
As you know the current guidance given in Firecode is for every member of staff to be trained in fire safety for 1 hour each year. At best this isn't the best use of time for some, whilst for others it may not be sufficient.
The guidance being drafted that will detail requirements for staff training will seek to amend the requirements for training on the basis of an assessment of the training needs in order to perform specific duties in respect of preventing fire and/or responding to fire.
The issue of evacuation training is a particularly thorny one since some organisations do not consider the risks involved in manual handling 'evacuation subjects' acceptable when there isn't an emergency.
That should liven up the debate!!! ;)
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There are pros and cons to consider with all methods of training delivery. If a ‘self-learning’ package on CD or video is more convenient and therefore reaches a greater audience than lecture based training, then this innovative approach should be considered. However, there needs to be necessary checks in place to ensure that the training takes place and that it is effective. With the increasing levels of turnover of personnel in large hospitals (including secondments/agency nurses, etc) the battle to ensure that everyone receives their annual fire training is getting more difficult for hospital Fire Safety Advisers. One of the most important times to train personnel is when they first start work in a healthcare environment, so, I would suggest induction training is paramount. But, I don’t see why annual refresher training cannot be delivered by CD or video. In fact, I have seen a very good video produced by a leading Trust for this very purpose, and it has even managed to reach those people who usually use any excuse to miss fire lectures (I think you know who I mean).
Let the debate continue.
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CBT certainly has it's place in staff fire safety training, but, it cannot replace hands on, face to face training sessions. CD training by nature of it's delivery is general, fire risks aren't. Staff in cardiology will need a more indepth training session than those involved in out patients for example. What about the ugly sisters of the NHS (the service not the staff), staff involved in healthcare of the elderly, LD and mental health, these guys have major problems which maternity units have never even thought of. I use CBT to reach staff who cannot attend an organised training session, but it is understood that they must attend next year. CBT is an aid to training, not unlike a video or indeed the instructor, it is not a substitute. Incidentaly, if we continue to insist on calling fire safety training sessions "lectures" how on earth are we supposed to generate interest in staff who see lectures as something they must attend rather than a learning experience?
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The trust runs a two day induction in a large lecture theatre and we have an hour allocated, for this we use a lap top presentation. however, we then carry out our annual training in the area in which people work. A three month period is given to all departments and they have as many sessions as they consider they need to cover all staff. we then do a practical demonstration, one day on each site giving six sessions in a day using a gas simulator; this is advertised and people come at a time to suit the department. This is in addition to the mandatory session. Walk through evacuation drills using ski sheets are done every other year. We do use videos occasionally, but only as part of the session. We have not used a CD due to the restrictions on how many people could be involved. There is no easy answer to training, but if it's interesting, they will not try so hard to get out of it next time.
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Colin Newman mentions above the firecode requirement for one hour fire training per year.
I cannot see how a quality training session can be delivered, covering all areas of healthcare fire awareness, in one hour.
Can anyone shed any light on how this arbitory figure arrived at? Is there a national curriculum and does this include extinguisher training?
Messyshaw
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Messy,
HTM 83 defines the understanding staff should have regarding fire safety in hospitals. Don't go under the misaprehension that nursing staff are trained to become fire fighters in the obligatory 1 hour training session because as you say quality training, covering all areas of fire safety awareness, cannot be achieved in a single annual training session.
Like any other major organisation, the NHS has grunts and leaders, the grunts do what they can under the leadership of others. Fire fighting is not that difficult in modern hospitals, fire engineering solutions have seen to that (?), fire prevention, fire safety awareness and risk assessment are the keys to creating safe environments, despite the best efforts of the general public. NHS staff as an industrial group are far more fire safety aware than any other comparable group, the fire safety figures for the NHS will back that up.
Fire safety training changes as the role and responsibility of the individual changes, that knowledge and experience is cascaded to the staff as and when necessary, not unlike the fire service, otherwise there would be no need for a rank structure.
The role of the fire safety trainer in the NHS (as I see it), is not to produce hoards of fire extinguisher wielding nurses, but to educate staff at all levels with regard to their roles and responsibilities. Most observers and particularly operational fire fighters do not see beyond staff using fire extinguishers, putting fires out and evacuating the place before the brigade show up, in reality staff have much more to think about, moving their patients to a place of safety for example, progressive horizontal evacuation is the technical term, the eighty odd seconds it takes to totally discharge a 9 litre water extinguisher is best spent moving people away from the source of danger. Who was it said get out and get the fire brigade out? The chance of surviving a fire in hospital (in the UK), is better than average and certainly better than the same situation at home.
So, the training requirement is a minimum of 1 hour annually, believe me they all get much more and topics discussed are relevant to the situation at hand, mental health and learning difficulty units have vastly different problems to general hospitals, who in turn have greater problems than community hospitals who have loads of problems too, it's not cut and dried believe me.
In answer to your question, it isn't, it takes much longer and relies on experience, knowledge and the odd fire resisting compartment or two.
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Thanks Colin, I couldn't have put it much better myself!.
Messy, the reality is that like most things in the world of fire safety 'arbitrary' and 'nominal' measurements abound. I'm not sure where the 1 hour period of training came from, I only know it's not intended to last for much longer.
I've always thought it quite perverse to give 1 hour training every year to an admin clerk working in a hospital whose expected response to an alarm is to get out and stand at the assembly point, and give the same period of training each year to nursing staff that are required to evacuate patients whilst continuing their care.
In my opinion there is a need for some members of staff to receive less than 1 hour training each year and for many other members of staff to receive considerably more than 1 hour of training each year.
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you are quite correct Colin. Fire Safety Advisors have been saying that for years. So the question is not what training but when will it change.
Some Trusts are under an unecessary burdon at present. As CM says it shouled be related to the risk. IE Mental health against nhs beds in the community or as you say an office premises.
It is not rocket science.
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This Trust runs two day Fire Team Members course (0.5 day spent with F&RS at their training facility. Results over the past six years have been brilliant. Subject to continual review/improvement. Willing to share all lecture plans, drawings, exercises etc. issued on CD powerpoint and word formats. 3D ward plans available. Want to stop reinventing the wheel. Interested in exchange of info? Contact at Kettering General Hospital NHS Trust. Roy Grogan
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I have recently spent quite a bit of time considering the merits of CBT for hospital staff which has included attending an E-learning facilitators course and looking at some of the packages on offer including the NHSU's effort. They all varied in content, ease of use and quality of graphics the ones that had been put together for a specific organisation being the better ones from an instructional and informative point of view, although what stuck out in all of them was that they seemed to be obsessed in going into great detail about the different classes of fire and the use of extinguishers rather than the emphasis being on causes of fire, simple precautionary measures and emergency procedures.
Having said that I do think that there is a place for these packages as part of a tailored training programme based on the outcome of an assessment mentioned by Colin Newman, although I do remain sceptical about the generic packages for the reasons given above, site or organisation specific are much better
Also when attending the facilitators course I became concerned that one trust was looking to meet its fire safety training obligation by using these packages which were going to be facilitated by staff in the training department without any fire safety experience. A very dangerous road to go down where there is a need to convert knowledge gained in to good practice on the ground.
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BS 5588 Part 12 Managing Fire Safety appears to rule out CBT alone as there is the old base requirement for the Training to be given by a competent person.
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This Trust runs two day Fire Team Members course (0.5 day spent with F&RS at their training facility. Results over the past six years have been brilliant. Subject to continual review/improvement. Willing to share all lecture plans, drawings, exercises etc. issued on CD powerpoint and word formats. 3D ward plans available. Want to stop reinventing the wheel. Interested in exchange of info? Contact at Kettering General Hospital NHS Trust. Roy Grogan
Roy
I am very interested in how you do things over your way. I now work with Chubb Training after 26 years with the Australian Capital Territory Fire Brigade.
I spent much in Fire Safety and finished as Manager for training in the Emergency Services Bureau.
Hope to see more and exchange our appraoch.
Regards
Marc
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Interesting debate but when is someone in the Department of Health going to bite the bullet and write to Trusts rescinding the absurd and onerous requirements of Firecode Policy and Principles. We have been told for almost a year now that there is change in the pipeline. It might be in the pipeline but there is nothing coming out of the end. All it takes is a letter to Chief Execs. There are plenty of documents on which to base this advice.
How can a Fire Advisor write new Policy when there is no clear directive from the Centre?
Please Colin Newman answer this one.
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O.K I'll answer.
The guidance was written over 12 months ago. A limited consultation took place. A reveiw of the guidance and the implications of BS 5588 Part 12 was undertaken, and the document now sits with NHS Estates Policy team.
I'm as frustrated as the rest that this damned document has been over 3 years in preparation.
It appears to have been held up at every turn, partly because some of the management structures are deemed too contrioversial (i.e. Fire Safety Coordinators), and partly because of the worderful Gateway process.
Thankfully I haven't had direct dealings with Gateway, but some of my colleagues regularly run the gauntlet of trying to get information and guidance out to the NHS.
For those that don't know, Gateway is the process by which those nasty people in the centre are prevented from dictating to the NHS and thereby drowning the Chief Execs in paperwork. Now whenever the centre wants to just send a letter to the Chief Execs they have to persuade those kind people at Gateway that the letter is necesary, desired, places no undue burden upon the organisation its being sent to, is a valid use of resources, cannot be communicated in any other way, is written by someone wearing pink underpants etc. etc. ok maybe not the pink underapnts, but you get the picture.
My advice would be to produce a rationale for the provision of appropriate training showing increases and decreases in traning activity as appropriate. Get the Chief Exec to approve the approach and then append it to your annual fire safety certificate.
If your Chief Exec. is not prepared to readily approve the rationale, seek the buy in of your local fire authority, Strategic Health Authorty and even NHS Estates (but be quick 'cos they won't exist much longer!).
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Hi,
I was at a conference recently and this subject was mentioned and my personal interpretation from the NHS Estate speaker was...... the new policy(when issued) will make provisions for additional training aids like Video and E learning on a risk assessment approach with times and occurences. However they can't be used as a stand alone training solution but are avaliable as a part solution of a Trust fire safety training package/policy.
Regards
Jason
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I have been reading this thread with interest as I am currently working on a Uni assignment around the adequacy of fire safety training generally. I like the idea of e-learning, but agree with some of the comments about it not replacing hands-on direct teaching and learning from experts.
Whilst one hour is surely not enough for some of the staff (I work in a small (ish) 300 staff - part of the NHS - a rehabilitation centre) - we have to drag staff kicking and screaming as it 'interrupts' their clinical workload and some perceive it as uneccessary!?
This worries me as at any one time we can have quite a few patients sitting in our waiting area legless literally whilst their limbs are being fixed in the workshops.... and I wonder whether an hour a year is enough to prepare us for if we had to evacuate en masse?
Is there any evidence out there regading the effectiveness of this training?
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One might argue that the proof of the pudding is in the eating. There have been very few deaths from fire in general acute hospitals since free health care was introduced, and yet look at the potential problems. People who are very difficult to move in the event of fire, low staff numbers in some patient care areas, operations in progress and, historically at least, building stock that left a lot to be desired even though the use of small sub-compartments does form an important and valuable part of the fire strategy. So something must be done well, and I have always felt it was the staff reaction, based on the level of training they receive, which is a lot more than in other sectors. As part of your research, you might like to look at the %age of fires that spread beyond the item and also the room of origin. While that has got a lot to do with the level of AFD and the level of compartmentation, it must be an indirect reflection on staff response (or so I have always believed). Many years ago, I did an exercise to look at these %ages for hospitals, hotels, dwellings and (I think) some other occupancies, and I was impressed by the very low %age of fires that spread beyond the item of origin and the room of origin. It convinced me that the NHS is poor at patient medical care but really good on fire safety.
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mr todd, i would dispute your point with reference to the nhs not providing a good level (poor - in your words?) of patient care. are you making a specific reference to the organisation or the staff?
dave bev
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Davey, An organization is a collection of staff, so one cannot divorce the two. Last time, I was in an NHS Hospital (pending a private ambulance coming to collect me after a few days to go to the first available bed in the local private hospital), the sister dropped in to ask if I was taking my temperature regularly. Bearing in mind that I was there as a result of a fever, I thought that this was possibly the job of nursing staff, but evidently I was wrong.
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Colin: I know of at least one LFB IO who would willingly assist in taking your temperature (as long as he chose the method, orifice and size of thermometer!!!)
Makes my eyes water to think of it!
Hope you are now keeping well. Me? I've joined the chosen few and am now off the station (away from those dangerous fires and afd calls) and keeping you consultants on your toes. I am looking forward to checking one of your FRAs, as I understand they are often problematical.
It's not true what you have said about a certain Met FB, I've met several competent IOs so far - well at least 3!!
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Colin: I know of at least one LFB IO who would willingly assist in taking your temperature (as long as he chose the method, orifice and size of thermometer!!!)
Makes my eyes water to think of it!
Hope you are now keeping well. Me? I've joined the chosen few and am now off the station (away from those dangerous fires and afd calls) and keeping you consultants on your toes. I am looking forward to checking one of your FRAs, as I understand they are often problematical.
It's not true what you have said about a certain Met FB, I've met several competent IOs so far - well at least 3!!
How many fire safety risk assessments do FRS check each year? Roughly? (dozens/hundreds/thousands/millions)
Most organisations still don't seem to have them.
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Messy, Give me a clue? Which particular I/O would that be. Give us a clue! Glad you have chosen the easy life of fire safety. No future in this firefighting business, unless Davey stops them from closing stations.
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i would say i was trying colin, although a few probably think (or know!) that already!
dave bev
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Colin: I have a plan. After a spell enjoying the 'easy life', I'll retire and intend to be the 1st ex certain-met-FB officer to be employed by CST.
I enjoy a challenge!!!!
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No, you would be the 2nd. There will not be a third. But best of luck with the new role anyway. And remember your pals here will always be happy to help you.
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Just to say a big thanks to those who responded to my request for help on my assignment - I passed with 84%. I am happy for anyone to see it - good old Saint Florian - that's all I can say. I think you all have the patience of saints trying to unravel the mysteries of the Firecode and NHS Estates and Health & Safety 'guidance'. Thought I'd let you see the conclusion anyway - hopefully the bulk of the assignment hasn't got anything as controversial as "Messy" posts on the site :-D Thanks again everyone - especially Colin Todd.
Hotstuff aka Kim
CONCLUSION
Whilst it is opportune that the new Regulatory Reform Order (ODPM, 2004) and the Firecode Policy ‘HTM 05 – Fire Safety in the NHS’ (NAHFO, 2005) are being published, it is problematic in that it coincides with a torrent of welcomed recent guidance published from the DH and NHS Estates concerning safety and standards.
Whilst the transformation and modernisation is necessary for both the Fire Service and the NHS, it generates much confusion amongst those professionals in both Services whose passion to “do the right thing” is what has fuelled the oft heated dialogue on the ‘Firenet Discussion Forum’ but has provided some constructive exchange of ideas.
There appears to be scant evidence to suggest that the current standard of fire training is ‘inadequate’, and indeed this may be difficult to determine whether the standard of training was solely ‘to blame’ following an incident? Indeed, if we are to apply the lessons learned from the DH’s 2000 OWAM report on ensuring that there is a blame free assessment, the report states that:
“Rather there is a complex interaction between a varied set of elements,
including human behaviour, technological aspects of the system,
sociocultural factors and a range of organisational and procedural
weaknesses.”
In conclusion, the author believes that the superfluity of NHS
and Fire Service guidance, policy and legislation around fire safety requires the wisdom and ‘patience of a Saint’ to explore, and distinguish relevant and consistent information.
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All that is required from the Director of Policy is a letter mandating Trusts to carry out their training according to a training needs analysis and to keep suitable and sufficient records. Will the powers that be do this oh no, that would be too simple. I recently sent a letter to a senior person in DOH requesting that this was done. (I will not name him because I know he does some excellent work and is at times also frustrated.
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This thread was started nearly nine years ago!!...so it's about time it was resurrected :)
HTM 05.03 (General Fire Safety) says that e-learning is not acceptable as a sole means of training staff. E-learning can only be used to support training delivered by a competent fire safety advisor
In extreme circumstances, where a member of staff cannot be made available -due for example to long term sickness- the use of e-learning may be used as a temporary alternative (Im not sure why they would need any fire training if they are off sick!) However no member of staff should go without training by a fire safety advisor for longer than 2 years. Therefore staff should not receive refresher training via e-learning more than once in a two year period.
Clarification on this was sought from the Department of Health.
A letter sent out to a number of relevant parties says
organisations will not be in breach of any statutory duty under the RRO if the following approach is taken
Training should not be reliant solely on e-learning but should include face to face training by a competent person
Staff in direct patient care will require training from a competent person
Then it gives a table showing examples
Direct patient care........competent person annually ....e-learning as an additional option
No patient contact .......e-learning annual...........competent person every 2 years as additional option
sounds a bit messed up to me