Safety

Tip of the Week: How to handle psych and forensic patients

Hospital Safety Insider, December 2, 2010

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Hospital security is especially important when handling inmates who could pose a threat. Safety consultant Steve MacArthur of The Greeley Company touches on the issue of handling psychiatric and forensic patients from December’s Briefings on Hospital Safety.

Q. What should be considered from a security standpoint when treating an inmate?

A. MacArthur: Minimally, you have to manage the education process as outlined in The Joint Commission standard HR.01.04.01, element of performance 7, which requires the hospital to orient external law enforcement and security personnel on the following:

• How to interact with patients
• Procedures for responding to unusual clinical events and incidents
• The hospital’s channels of clinical, security, and administrative communications
• Distinctions between administrative and clinical seclusion and restraint

Additionally, you want to cover some of the other niceties—parking, infection control, fire response plans, etc. The distinction between administrative and clinical seclusion and restraint is very important as the Centers for Medicare & Medicaid Services has gone on record as wanting there to be a clear distinction between the two. Most of the time, any forensic patient will be in administrative (forensic) restraint, but there may be times—for example, if the prisoner is going to have surgery—where shackles are not an appropriate device, so there has to be an understanding of the clinical roles, the need for safety, etc. This can really only be done through the education process, which means that you need to have a good working relationship with all your jurisdictional law enforcement types.



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