6530 6000 2B
User Manual: 6530
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DEPARTMENT OF THE NAVY COMMANDER, NAVAL SURFACE FORCE UNITED STATES PACIFIC FLEET 2841 RENDOVA ROAD SAN DIEGO, CALIFORNIA 92155-5490 COMMANDER NAVAL SURFACE FORCE ATLANTIC 1430 MITSCHER AVE NORFOLK, VA 23551-2494 IN REPLY REFER TO COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B N01M/N02M 8 Oct 10 COMNAVSURFPAC/COMNAVSURFLANT INSTRUCTION 6000.2B From: Commander, Naval Surface Force U.S. Pacific Fleet Commander, Naval Surface Force Atlantic Subj: MEDICAL READINESS INSPECTION PROGRAM Ref: (a) (b) (c) (d) (e) Encl: (1) Medical Readiness Inspection Checklist OPNAVINST 6530.4B NAVMED P-117 (MANMED) COMNAVSURFORINST 6000.1 COMFLTFORCOMINST 6600.1 HA POLICY 06-001, Policy on Oral Health and Readiness 1. Purpose. To establish a Medical Readiness Inspection (MRI) program for afloat Medical Departments per references (a) through (c). Dental readiness standards for ships without an assigned Dental Officer is contained in references (d) and (e). 2. Background. The mission of the ship’s Medical Department is two-fold: to maintain the health and readiness of the ship’s crew and to maintain the readiness of the Medical Department. To ensure a continuous state of readiness, the Medical Department must provide for and promote the health and wellness of their crew, prevent and treat illness or injury and maintain complete documentation in medical and administrative records on individuals and medical programs. 3. Cancellation. COMNAVSURFORINST 6000.2A 4. Intent. To provide the Commanding Officer (CO) of a ship, the Immediate Superior in Command (ISIC) and the Type Commander (TYCOM), a timely pre-deployment assessment on the readiness of the ship’s Medical Department and its ability to accomplish its mission, functions and tasks. The MRI is used by the TYCOM to COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 certify the ship as medically ready for deployment. This certification is valid for a period of 18 months. No medical readiness certification shall exceed the 18 month periodicity without a TYCOM waiver. Platforms exceeding 18 months without a waiver will lose certification. 5. Action a. The Regional Medical Representative (RMR) will conduct a formal MRI no greater than D-120 and less than D-90 days prior to the departure date for any deployment which will be greater than 90 days. The RMR will conduct the MRI using the checklists contained in enclosure (1) of this instruction. The RMR will ensure that all chapters and sections of the inspection checklist are completed. Due to the wide variety of ship classes within the Surface Fleet, not all sections of the checklist will be applicable to all ships. Those sections not applicable to the ships being inspected will be marked “NA” for not applicable. Requests to modify the checklist to conform to class specific requirements must receive formal approval from the TYCOM prior to use of a modified checklist. Each section and sub-section will receive a grade of SAT, UNSAT or NA. A comment is required for all UNSAT grades. When an UNSAT grade is noted for an sub-section that is marked “Critical”, the entire section is deemed UNSAT. The RMR will review and verify the percentages and dates to be provided in the MRI. b. Chapter grading is based on the percentage of satisfactory sections within a chapter. Divide the number of satisfactory sections by the number of applicable sections then multiply the resulting product number by 100 to determine the percentage. The Overall Summary Grade is determined by averaging the percentages of Chapters 1 thru 6: (1) C-1 Fully Ready >= 90% (2) C-2 Substantially Ready>= 80% (3) C-3 Marginally Ready >= 70% (4) C-4 Not Ready <= 69% c. The Regional Medical Representative will provide a verbal out brief with unit leadership at the conclusion of the inspection and will forward a copy of the full MRI report, to the unit, the operational ISIC and the TYCOM. C-1/C-2 2 COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Inspection results will be reported in writing within 10 days of the inspection. Scores of C-3 or lower will be reported to the unit, operational ISIC and TYCOM via fastest available means not to exceed 48 hours. The senior inspector will submit the final written report along with a Plan of Action and Milestones (POA&M) within 14 days after the date of the inspection. d. The RMR can conduct a Technical Assist Visit (TAV) at any time when requested by the unit leadership, when questionable circumstances exist within the ship’s Medical Department, prior to the SMDR turnover and/or prior to a formal MRI. The TAV is considered an informal review of the Medical Department and the results of the visit are for use by the inspected command and the ISIC to provide guidance to the SMDR and their chain of command. 6. Review Responsibility. COMNAVSURFPAC and COMNAVSURFLANT Medical Officers are responsible for the annual review of this instruction. R. A. ROGERS Chief of Staff J. P. GELINNE Chief of Staff Distribution: Electronic only, via COMNAVSURFOR Directives Web site, https://www.surfor.navy.mil/directives0/pages/default.aspx 3 COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 UNIT: NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION MRI/TAV DATE: Commanding Officer: DEPLOYMENT DATE: Executive Officer: SMDR: Senior Inspector: CHAPTER Percentage C-STATUS HEALTH MAINTENANCE PERCENT 1. Administration and Training 0% 0 Tetanus 0% 2. Supplies and Equipment 0% 0 Influenza, Seasonal 0% 3. Emergency Medical Preparedness 0% 0 Hepatitis A 0% 4. Ancillary Services 0% 0 Hepatitis B 0% 5. Environmental Health Programs 0% 0 MMR/Titer 0% 6. Occupational Health Programs 0% 0 OPV/IPV 0% AMAL Status (%): 0.00% Tuberculosis Surveillance 0% Current IMR % 0.00% HIV 0% Blood Bank Certification Date: 0-Jan-00 Periodic Health Assessments 0% Ship's Sanitation Control Certification Expiration Date: 0-Jan-00 Women's Health Examinations 0% DNA 0% Audiograms 0% Dental Readiness (IDC Ships) 0% OVERALL SUMMARY GRADE 0.0% Comments: GRADING CRITERIA: Chapter C-Status: Chapter grading is based on the percentage of satisfactory sections. Any UNSAT in a critical sub-section will make the entire section UNSAT Divide the number of satisfactory sections by the number of applicable sections. Multiply this amount by 100 to determine percentage. (Number of Satisfactory Sections / Number of Applicable Sections X 100) = % Overall Summary Grade: Overall Summary Grade is determined by averaging the percentages of chapters 1 through 6. C-1 C-1 >= 90% C-2 FULLY READY SUBSTANTIALLY READY C-2 >= 80% C-3 MARGINALLY READY C-3 >= 70% C-4 NOT READY C-4 <= 69% Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 CHAPTER 1 - ADMINISTRATION AND TRAINING 1. EXTERNAL REPORTS NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION EXECUTIVE SUMMARY SAT UNSAT a. DNBI (report submitted weekly) b. IMR % (90% or above) Comments Date Last Submitted: 0.00% Date Last Upload: c. DEERS (report submitted weekly) Date Last Submitted: SAT 2. MEDICAL DEPARTMENT DAILY STATUS REPORTS SAT UNSAT UNSAT Comments a. Report of Sick and Injured (Submitted Daily) b. Medical 8 o'clock Report (Submitted Daily) c. Reviewed and signed by ship's CO/XO. Submitted in a way as to ensure patient privacy. 3. SICK CALL LOG MAINTAINED IN SAMS/TMIP SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT Comments a. All sickcall visits entered. 4. PROFESSIONAL BOOKS AND MATERIALS SAT UNSAT Comments a. Current STATREF version onboard b. Required Books, Publications and Instructions per BUMEDINST 6820 and CFFC/PACFLT 6820. 5. OTHER ADMINISTRATION a. Current TMIP/SAMS version onboard: SAT UNSAT Comments Critical (1) Daily back-ups being accomplished on separate media? (2) Password on file with CMS/Security Manager? (3) All Medical Department personnel proficient with TMIP/SAMS? (4) TMIP/SAMS has network connectivity? Critical (5) Providers have access to CHCS/AHLTA? b. Health records management (1) Record security maintained? (2) TMIP/SAMS data matches health record data? (Compare 1% of random crew records) c. Medical admin files maintained per SECNAVINST 5210.2 series? 2 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 d. Injury reports completed and routed through the COC? e. Emergency relief procedures for HMs standing nonmedical watches on file in OOD Binder/log? 6. CURRENT, FUNCTIONAL TICKLER SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT Comments a. Follow-up appointments tracked b. Consultation Log 7. TRAINING SAT UNSAT Comments a. Inservice Training for Medical Personnel conducted? (1) PQS/JQR used for Jr. HMs (a) Completed w/in six months of reporting (2) BCLS Certification (a) All Medical Department personnel (3) ACLS Certification (As applicable) (4) Medical inservice training conducted and documented semi-weekly at a minimum b. Medical Training for Stretcher-Bearers conducted and documented bi-weekly c. Medical Training Team (MTT) identified d. Medical conducts training with "I" Division e. Crew training per Long Range Training Plan and documented in Med ADP and ships training database 8. DENTAL (SHIPS WITHOUT DENTAL DEPARTMENTS) SAT UNSAT Comments a. Shipboard dental procedures manual onboard b. Dental kit instruments packed/sterilized c. Dental readiness <95% CAT I & II=UNSAT I 00% II 00% III 00% IV 00% Overall: 00% 0.00% TOTAL SECTIONS: 8 SAT SECTIONS: 0 APPLICABLE SECTIONS: 8 PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = % CHAPTER C-STATUS C-1 C-2 C-3 C-4 >= 90% >= 80% >= 70% <= 69% 3 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Chapter 2: SUPPLIES AND EQUIPMENT 1. AMAL DOCUMENTS a. Sams used for supply tracking b. Current AMAL update being used NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION APPLICABILITY SAT UNSAT Critical Comments Date: c. Supply/Medical Department has Prime Vendor Account 2. AMAL STATUS <90%=UNSAT a. Total Combined AMAL percentage: 0.00% (1) General Medicine Percentage 0.00% (2) Minor Surgery AMAL Percentage 0.00% (3) Preventive Medicine AMAL Percentage 0.00% (4) Pharmacy AMAL Percentage 0.00% SAT UNSAT b. Current bulkhead-to-bulkhead inventory (Annual) 3. EQUIPMENT, MAINTENANCE & REPAIR a. Equipment AMAL Percentage: UNSAT SAT UNSAT Comments DATE: <90%=UNSAT SAT UNSAT COMMENTS 0.00% b. Biomedical repair checks accomplished per PMS: c. All equipment included in 3M system (OHMSNG/SNAP) d. NAVMED 6700/3 current and maintained for each piece of medical equipment e. Reefer temp maintained at 36 - 46 degrees Fahrenheit? Reefer log maintained per 6000.1: f. Reefer alarm functional and audible (audible outside of Medical if not manned 24/7): SAT DATE: Critical Critical Critical g. SERP list for ship current and aligned with AMAL: h. CASREP submitted for non-functioning Medical equipment: i. ACLS equipment available and functional: Critical j. Medical oxygen cylinder hydrostatic testing up-todate? (Review min 10% onboard) k. Sterilizer(s) functional test: l. Medical WBGT functional test: TOTAL SECTIONS: 3 SAT SECTIONS: 0 APPLICABLE SECTIONS: 3 PERCENT SAT: 0% SAT UNSAT C-3 C-4 (# SAT DIVIDED BY # APPLICABLE X 100) = % CHAPTER C-STATUS C-1 C-2 >= 90% >= 80% >= 70% <= 69% 4 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Chapter 3: EMERGENCY MEDICAL PREPAREDNESS NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION Stocked Per AMAL = 100% ONBOARD 1. EMERGENCY RESPONSE KIT SAT UNSAT COMMENTS a. Emergency Response Kit (MORK/IDC) (1) Stocked per 53/56 AMAL Critical __________% (2) Inventoried semi-annually and documented. Last Inventory: b. Jr. HM Emergency Response Kit (1 kit per 2 Jr HMs on MO ship/1 per Jr HM on IDC ship) (1) Stocked per 55 AMAL Critical __________% (2) Inventoried semi-annually and documented. Last Inventory: 2. CRASH CART a. Stocked per 54 AMAL SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS Critical __________% Critical Last Inventory: b. Anti-pilferage device used c. Inventoried monthly and documented d. ACLS algorithm current and posted 3. MINOR SURGICAL PACKS (open one and verify) SAT UNSAT COMMENTS a. Appropriate number of packs for ship class (Per CNSL/CNSP 6000.1) b. Instruments properly cleaned, packed & sealed c. Packs labeled with applicable expiration dates d. Sutures / knife blades attached to outside of pack 4. OXYGEN SAT UNSAT COMMENTS a. PMS accomplished on all Oxygen cylinders: b. "Grade B shock mounting" installed & in use Critical c. Valve covers on "stowed" cylinders d. Non-sparking wrenches available e. At least 1 "in-service" cylinder ready for use. (minimum 75% full): f. Oxygen handling and stowage precautions posted (Appendix of CNSP 6000.1) 5 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 5. FIRST-AID BOX (FAB) a. Stocked per 50 AMAL SAT UNSAT COMMENTS Critical __________% Critical Last Inventory: b. Required locations adequate c. Properly marked d. Contents divided in thirds; stored in plastic e. Anti-pilferage device used f. Inventoried semi-annually and documented 6. FIRST-AID KIT, GUN CREW (GUN BAG) a. Stocked per 57 AMAL SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS Critical __________% Critical Last Inventory: b. One per two First Responders (Stretcher Bearers) c. Anti-pilferage device used d. Stored in plastic bags inside Gun Bag e. Stored in BDS f. Inventoried semi-annually and documented 7. BATTLE DRESSING STATIONS (BDS) a. Stocked per 52 AMAL SAT UNSAT COMMENTS Critical __________% Critical Last Inventory: b. Routes to BDS marked (interior/exterior) c. Access signs on BDS doors d. Surgical light & emergency lighting operable e. Potable water tank with diagram and valve labeling f. Surgical sink operable g. Operating table functionable with straps and pads h. Inventoried semi-annually and documented 8. MASS CASUALTY BOX (MCB) a. Stocked per 51 AMAL SAT UNSAT COMMENTS Critical __________% Critical Last inventory: b. Required number onboard c. Located & mounted properly d. Contents contained in plastic bags e. Anti-pilferage device used f. Inventoried semi-annually and documented 6 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 9. FIRST-AID KIT, GENERAL PURPOSE (BOAT BOX) SAT a. Stocked per 58 AMAL UNSAT COMMENTS Critical __________% Critical Last inventory: b. One per each Rhib, MWB, and Gig, c. Contents sealed in plastic bag d. Anti-pilferage device used e. Inventoried semi-annually and documented 10. FORCE HEALTH PROTECTION SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS a. Stocked per 05 AMAL (1) CBR Medication (2) Pandemic Medication (<100% = UNSAT) Critical __________% (<90% = UNSAT) __________% b. Quarterly SLEP update completed: c. Inventoried annually and documented: Critical Last inventory: d. Contents stored in locked or secure area: 11. STRETCHER/LITTERS # Reqd a. Stokes Stretchers 2 b. Sea-Air Rescue (SAR) Litters 1 (1) Wire Rope Assembly 1 (2) Sling Rescue, Helicopter with valid weight test available Critical CONDITION SAT/ UNSAT Properly located Patient straps (LHA/LHD ONLY) 100 d. Reeves Sleeve Critical Comments Authorized to carry extra. No pt straps on flt deck or hanger bay 2 c. Decon Litters and Stands Date: 1 per BDS (1) Handling Lines for litters with Locking Gate TOTAL SECTIONS: SAT SECTIONS: APPLICABLE SECTIONS: PERCENT SAT: # On Board 2 11 0 11 0% SAT UNSAT C-3 >= 70% C-4 <=69% # SAT DIVIDED BY # APPLICABLE X 100 = % CHAPTER C-STATUS C-1 >= 90% C-2 >= 80% 7 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Chapter 4: ANCILLARY SERVICES NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION 1. LABORATORY APPLICABILITY a. Stocked per 32 AMAL <90%=UNSAT SAT UNSAT COMMENTS __________% b. Laboratory Procedures Manual current and available c. Laboratory Log maintained d. Equipment function test Critical SAT 2. BLOOD BANK (CRTS ONLY) a. Stocked per 33 AMAL SAT UNSAT <90%=UNSAT UNSAT COMMENTS __________% b. Blood Bank Procedures Manual current and available c. Blood Bank Assessment Current DATE: d. Required Blood Products Onboard (PRBC) e. Blood Bank Training Current (annual) (HM-8506) f. Blood Bank Pack-up Kit (PUK) complete and within periodicity: g. Emergency Backup system for blood bank available and functional: (CO2 bottles 100% filled): (On applicable CRTS. Maintained by Supply Dept) 3. X-RAY a. Stocked per 31 AMAL SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS <90% = UNSAT __________% Critical DATE: b. X-Ray Procedures Manual current and available c. X-Ray Log maintained d. Films Forwarded For Radiologist's Reading e. Performance Test current f. Dosimetry Program current g. External Audit current h. Equipment function test DATE: Critical 8 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 4. PHARMACY a. Stocked per 34 AMAL SAT UNSAT COMMENTS <90=UNSAT b. Prescriptions per MANMED Chap 21 c. Designated pharmacy space can be locked d. Controllled Substances (1) AMAL quantity onboard and maintained in Bulk Stock (2) Custodians and inventory board members assigned in writing (3) Proper administrative procedures followed (4) Controlled Substances Inventory conducted as required Critical 5. ICU/WARD (As applicable) a. Stocked per 23 AMAL <90=UNSAT SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS b. ICU and Ward SOP current and available c. Nursing procedures current and available d. Linen provisions adequate e. Dietary provisions adequate f. Infection Control (1) Universal Precautions posted (2) Isolation Plan current and available (3) Mattresses meet Blood-Borne Pathogen Standards g. Required number of patient beds onboard and functional h. Oxygen, suction unit, patient vital signs monitor and intravenous pump available at each ICU bed and functional: (100% function check) i. Mechanical ventilators available, calibrated and functional j. Electrocardiogram machine available and functional 6. PATIENT ADMINISTRATION Critical Critical (LHA/LHD - 10; LPD-17 - 6) Critical (As applicable) SAT UNSAT Comments a. Admission criteria current and available b. Mechanism for Patient Identification In Use c. Patient Tracking Plan/Status Board d. MO orders written for each patient e. Proper forms utilized for documenting care f. Restraint policy current and available g. Thrombolytic Therapy Protocol and Supplies h. Inpatient Records Maintained & Retired properly SAT 9 Enclosure (1) UNSAT COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 7. OPERATING ROOM (CRTS ONLY) SAT a. Stocked per 21 AMAL (<90% = UNSAT) b. Stocked per 20 AMAL (<90% = UNSAT) UNSAT COMMENTS (1) AMAL requirement of Dantrolene onboard. c. Sterility of Supplies (1) Utilizing Event Related Sterilization (2) Cold Disinfectant Documented (3) Weekly biological testing conducted and documented. (For all non-table top sterillizers) d. Patient Administration/Identification (1) Proper Form for Documentation of Care (and maintained for two years) (2) Pathological Specimen Procedures current and available (3) Pathology Specimen Log maintained (4) IV Conscious Sedation Protocol current and available e. Structure and Equipment Functionality (1) Anesthesia Machines/RGM's certified, functional and calibrated (2) Required surgical scopes onboard (EGD, Colon, Bronch) and functional (3) Electrosurgical apparatus w/ necessary accessories functional (4) Operatin beds and transport gurneys with safety restraints (5) Suction and oxygen available in each OR room and functional (6) Hypo/Hyperthermia and Fluid Warming Equipment available and functional: Critical DATE: f. Required Number / Type of Surgical Sets Onboard g. Wrong Surgical Site Protocol current and available TOTAL SECTIONS: 7 SAT SECTIONS: 0 APPLICABLE SECTIONS: 7 PERCENT SAT: 0% SAT UNSAT (# SAT DIVIDED BY # APPLICABLE X 100) = % CHAPTER C-STATUS C-1 C-2 C-3 C-4 >= 90% >= 80% >=70% <=69% 10 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Chapter 5: ENVIRONMENTAL HEALTH PROGRAMS NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION 1. SANITATION SAT UNSAT Comments a. Food Safety Program (1) Formal Inspections in periodicity (a) Inspections forwarded to Supply Officer & Commanding Officer (b) Discrepancies corrected in a timely manner & verified on inspection form (2) Food Service Physical Examinations conducted as required & documented b. Quarterly Habitability Report: (Areas as applicable) (1) Berthing & Head Facilities (Officer and Enlisted) (2) Barber Shop(s) (3) Potable Water System and supplies (4) CHT/MSD Systems (a) Inspections Completed (b) NKO Course complete and current (5) Ship's Store and Vending areas (6) Laundry (7) Fitness/Exercise Facilities (8) Brig 2. MEDICAL WASTE a. Current Instruction available SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT Comments OPNAV P-45-113-3-99 b. Proper disposal procedures followed c. Waste properly stored onboard d. Medical waste log maintained 3. PEST CONTROL SURVEYS / TREATMENTS SAT UNSAT Comments a. HM Pest Control Certifications Current b. Personal Protective Equipment available c. Pest Control Program documented using SAMS Expiration Date: d. Ship's Sanitation Control Certification 11 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 4. POTABLE WATER SANITATION a. Halogen Residual Testing conducted and documented when necessary b. Bacteriological Testing conducted and documented weekly SAT UNSAT Comments c. Potable water log maintained using SAMS SAT 5. TUBERCULOSIS CONTROL PROGRAM a. Ensure annual evaluations are conducted for converters <100% UNSAT SAT Critical b. New reactors evaluated by an MO Critical c. INH therapy complete and documented Critical UNSAT UNSAT Comments SAT 6. HEALTH MAINTENANCE <90%=UNSAT SAT UNSAT PERCENT a. Tetanus 0% b. Influenza 0% c. Hepatitis A 0% d. Hepatitis B (for required personnel) <100%=UNSAT 0% e. MMR 0% f. OPV/IPV 0% g. Tuberculosis Surveillance/Screening (Annual) <100%=UNSAT Critical Comments 0% h. Periodic Health Assessment (Annual) 0% i. Pap Smears (if applicable) results recorded in Health Record 0% j. HIV (Projected through deployment) 0% k. DNA Verification <100%=UNSAT 0% l. Blood Type 0% m. G6PD 0% n. Sickle Cell 0% o. Baseline audiogram (DD 2215) 0% p. HCP Audiogram (DD 2216) (Annual) 0% SAT TOTAL SECTIONS: 6 SAT SECTIONS: 0 APPLICABLE SECTIONS: 6 PERCENT SAT: UNSAT 0% UNSAT (# SAT DIVIDED BY # APPLICABLE X 100) = % CHAPTER C-STATUS C-1 C-2 C-3 C-4 >= 90% >= 80% >= 70% <= 69% 12 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 Chapter 6: OCCUPATIONAL HEALTH PROGRAMS 1. INDUSTRIAL HYGIENE SURVEY a. Baseline Industrial Hygiene Survey on file NAVAL SURFACE FORCE MEDICAL READINESS INSPECTION SAT UNSAT Critical Comments Date: b. Follow up completed within 2 years Date: 2. ASBESTOS MANAGEMENT SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT Comments a. Command Asbestos Management Plan current and available b. Personnel assigned to AMSP have current screenings per OPNAVINST 5100.19 c. Roster of personnel assigned to AMSP current and available d. If Emergency Asbestos Rip-out Team (EART) established medical surveillance current? 3. HEAT STRESS SAT UNSAT Comments a. Heat stress training conducted at "I" Division documented. b. Heat Stress Program Binder current and complete per CNSFINST 6000.1 c. Heat Stress Surveys signed by the CO 4. HAZARDOUS MATERIAL CONTROL AND MANAGEMENT (HMC & M) a. Medical Department assists Supply Department with Hazardous Material training. b. Medical Department maintains a complete copy of the MSDS File SAT Comments Critical 5. HEARING CONSERVATION PROGRAM a. Audiogram % for personnel assigned to HCP UNSAT SAT UNSAT <90% = Unsat COMMENTS __________% b. Hearing Conservation Program Binder current and complete per CNSFINST 6000.1 c. Roster of personnel assigned to HCP current and available. d. PPE provided for personnel assigned to HCP e. Hearing Conservation training conducted at "I" Division documented. f. Annual refresher training conducted for personnel in the HCP documented. 13 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 g. Work-related STS incidents are entered in WESS 6. SIGHT CONSERVATION PROGRAM SAT a. Eye examination % for personnel assigned to SCP (HT, MR) b. Sight Conservation Program Binder current and complete per CNSFINST 6000.1 c. Roster of personnel assigned to SCP current and available. d. Sight Conservation Signs posted as required by IH Survey UNSAT <90% = Unsat SAT UNSAT SAT UNSAT SAT UNSAT SAT UNSAT COMMENTS __________% e. PPE provided for personnel assigned to SCP f. Safety Officer maintains a current list of eye-wash stations onboard 7. RESPIRATORY PROTECTION PROGRAM SAT UNSAT COMMENTS a. Medical screening conducted for personnel to wear respirators 8. LEAD CONTROL PROGRAM (LCP) SAT UNSAT Comments a. Personnel exposed to lead informed of OSHA Lead Standard, 29 CFR 1910.1025 Appxs A & B b. Personnel assigned to LCP received initial / follow up exam with Occ. Health TOTAL SECTIONS: 8 SAT SECTIONS: 0 APPLICABLE SECTIONS: 8 PERCENT SAT: 0% (# SAT DIVIDED BY # APPLICABLE X 100) = % CHAPTER C-STATUS C-1 >= 90% C-2 >= 80% C-3 >= 70% C-4 <= 69% 14 Enclosure (1) COMNAVSURFPACINST 6000.2B/ COMNAVSURFLANTINST 6000.2B 8 Oct 10 SURFACE FORCE MEDICAL READINESS INSPECTION HEALTH RECORD REVIEW Unit: Requirement Date: Inspector: Records Reviewed 1 2 3 4 5 6 7 8 9 10 % Last 4 SSN Record jacket in good or better condition 0 0% Record jacket information complete (inside/outside) 0 0% Current Adult Prev & CC Flowsheet (DD Form 2766) 0 0% Hepatitis A (Completed series of 3) 0 0% Hepatitis B (Completed series of 2) 0 0% MMR (Completed series of 2) 0 0% OPV/IPV (Single dose) 0 0% Tetanus (Q 10 yrs) 0 0% Influenza (Annual) 0 0% Tuberculosis (TB) Surveillance/Screening (Annual) 0 0% DNA (Drawn and verified as being on file at AFIP Repository) 0 0% Blood Type (ABO/RH) 0 0% G6PD 0 0% Sickle Cell 0 0% HIV (Drawn Q 2 yrs) 0 0% Baseline Audiogram (DD 2215) 0 0% Annual Audiogram (DD 2216) As required for Hearing Conservation Pgm 0 0% Medical Surveillance Questionnaire (OPNAV 5100/15) 0 0% 0 0% Required Specialty Exams complete (CS, HT, MA, HM, etc.) 0 0% Well Woman Exam (Results in Record) - (Annual) 0 0% Total 0 0% PHA (SF-600) - (Annual) 1. Pull HR's randomly and include CHT, CS, TB reactor, SH (barber, laundry), HCP, and Women's Health. 2. Place in each box (an "X" if complete, a "0" if missing, and "N/A" if not applicable). 3. Overall Score = Number of items required - Number of items missing / Number of items required x 100 Comments: 15 Enclosure (1)
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