Accreditation

Know how to handle high-security and prisoner patients

Accreditation Connection, April 12, 2004

When creating a policy to handle high-security and prisoner pa there's more than meets the eye.

"Up-front it sounds like a simple thing, but you need to do it and do it well," says Earl Williams, HSP, safety coordinator for BroMenn Healthcare in Bloomington, IL. "In reality, if you're going to do a good job, it's complex."

To create a well-detailed and thorough policy, Williams says the hospital needs to involve security personnel, nursing staff, and even local law enforcement. They also need to consider different high-security patient scenarios.

Handling high-security patients

Chances are, your hospital deals with high-security and prisoner patients regularly.

"A lot of hospitals have to deal with this if not on a daily then on a weekly basis," says consultant Cameron Bruce, PE, CSP, president of Cameron Bruce Associates, a health care safety consulting firm in Orinda, CA. Adding that the number of high-security patients varies deon the location and type of hospital.

Bruce says high-security patients can fall into the following two categories:

  • Nonprisoner patients, who aren't in law enforcement custody, but require greater protection than regular patients. For example, this type of patient may be a prominent political figure, gang member, or even a battered spouse. "A private patient can be anyone who fears for his or her welfare and, hopefully, the patient will communicate that to the hospital staff," Bruce says.
  • A prisoner patient is obviously someone who is under law enforcement custody.

Working on your policy

Before you create policies, evaluate the type of security that already exists at the facility. For example, do you already have security officers in the hospital? Do you have armed or unarmed security guards? What kind of training has the present security team undergone?

Although it is up to the hospital to create the policy, Bruce recommends developing a broad, general policy for the entire hospital staff, followed by two specific policies for nurses and security personnel. Hospital-wide policies are usually written for the general reader; staff must stay away from or be put off by complex writing.

Working together

Whether the hospital writes several policies or one comprehensive policy for the entire facility, Bruce says nursing, security, and local law enforcement should work together to ensure these policies don't contradict each other.

"You need to talk together and work out procedures," Bruce says. "Nurses are the frontline staff dealing with a patient every hour. If a nurse works in a high-security department, he or she should receive training on managing aggressive and assaultive behavior."

However, it's important to set a strict line between nursing and security. "Security should only assist with a combative patient and should never be asked to handle patient care," Bruce says.

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