Transcript Pandemic Influenza: Hospital Impact

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Patient Care and Prisoners
Florida Society for Healthcare Security,
Safety, and Emergency Management
Professionals
Welcome
Welcome to the e-learning module prepared by the
Florida Society for Healthcare Security, Safety, and
Emergency Management Professionals (an affiliate of
the Florida Hospital Association).
The purpose of this module is to help assist hospitals
in meeting their accreditation requirements relating to
prisoners or in-custody arrestees that become patients
and to educate you, the officer, about your
responsibilities related to patient care while in the
hospital.
Joint Commission & Hospitals
 The Joint Commission evaluates and accredits nearly
15,000 health care organizations and programs in the
United States.
 An independent, not-for-profit organization, The Joint
Commission is the nation’s predominant standardssetting and accrediting body in health care since 1951.
 Hospitals are accredited approximately every three
years.
 Joint Commission accreditation supports accepting
Medicare patients - in most cases 50% or more of a
hospitals patients and revenue!
Joint Commission Standard
 Joint Commission developed a standard relating to
patient-prisoners referred to as “forensic patients.”
 The reason for this standard, according to the Joint
Commission - “in forensic services, staff members
with no clinical training or experience (for example,
correctional officers or guards) may become involved
in activities that could support or hinder therapeutic
goals for the patients.” (JCAHO HAS 2003 HR.4.1 )
Joint Commission Standard (cont’d.)
 The specific elements of the standard are as follows:
“The hospital trains these staff members in the
following areas:
1. How to interact with patients
2. Procedures for responding to unusual clinical
events and incidents.
3. The hospital’s channels of clinical, security, and
administrative communication; and
4. The distinctions between administrative and
clinical seclusion and restraint.”
Why?
 Fatal shooting death of law enforcement officer and
hospital Security Officer in Montgomery County, VA 2006
 Escape of patient-prisoner from Wuesthoff Medical
Center - Rockledge, FL
 Shooting at Tallahassee Memorial Hospital
 and other examples in your jurisdictions...
What are the hospital’s expectations?
 Keep the prisoner or in-custody arrestee under
constant superversion (in line of sight) while you are
inside the room.
 If the prisoner or in-custody arrestee is in airborne
isolation, you will be required to be posted in the
anteroom.
 You are to accompany the prisoner or in-custody
arrestee when transported to areas outside their room.
Hospital expectations (cont’d.)
 You will not be asked to participate in any patient care
activities and you will notify the nursing staff when
your prisoner or in-custody arrestee requires attention.
 Visitation is prohibited except as approved by the
Chief of Police, Jail Administrator (or designees) and
the Chief of Hospital Security (or designee).
Hospital expectations (cont’d.)
 Your prisoner or in-custody arrestee shall be
administratively restrained (using handcuffs or leg
shackle[s]) unless medically contraindicated. In such
cases, other arrangements must be made for security.
 If transporting the prisoner or in-custody arrestee, the
restrained patient will be covered with a blanket to
conceal handcuffs and/or shackles to limit attention.
Hospital expectations (cont’d.)
 You may use your communication devices
however; if medical equipment is present and in
use, please stand at least three (3) feet away
from this equipment when using your cell
phone, blackberry or two-way radio.
 If a hospital radio has been provided to you,
please use this for priority communication to the
hospital's security department.
How to interact with patient-prisoners
 Patients have a fundamental right to considerate care
that safeguards their personal dignity and respects
their cultural, psychosocial, and spiritual values.
 If you have questions concerning how to appropriately
interact with the prisoner or in-custody arrestee,
consult with the nurse assigned to care for this patient.
 Lastly, participate in the orientation and sign an
acknowledgment form indicating that an orientation
has been conducted.
Channels of Communication
 Clinical Communication - any questions concerning
the clinical aspects of the prisoner’s or in-custody
arrestee’s care should be directed to the nurse who is
caring for the patient or in his/her absence - the charge
nurse.
 Security Communication - questions regarding
security should be directed to the hospital’s security
department. The nursing staff can contact security for
you or you may refer to the orientation information
provided to you.
Channels of Communication (cont’d.)
 Administrative Communication - questions regarding
administrative issues should also be directed to the
hospital’s security department.
Distinction between Administrative
and Clinical Restraint
 Clinical Restraint - Any manual method, physical or
mechanical device, material or equipment that
immobilizes or reduces the ability of a patient to move
his or her arms, legs, body, or head freely. This
includes the use of a drug or medication when it is
used as a restriction to manage the patient’s behavior
or restrict the patient’s freedom of movement and is
not a standard treatment or dosage for the patient’s
condition. Examples include, leather restraints, a
posey vest, and soft restraints and mitts.
Administrative and Clinical Restraint
(cont’d.)
 Administrative Restraint - are handcuffs and leg
shackles or other means of restraint applied by law
enforcement officers.
 Clinical Seclusion - the involuntary confinement of a
patient alone in a room or area from which the patient
is physically prevented from leaving.
Responding to unusual clinical
events and incidents
 If the prisoner or in-custody arrestee exhibits some
unusual clinical episode (for example, pulls out an
intravenous line, vomits, is bleeding, or is
unresponsive) you should immediately summon the
closest hospital employee or activate the nurse call
system for assistance.
Emergency Codes
The next slide provides a list of hospital emergency
codes used by most of the hospitals throughout the
State of Florida (there may be variations). Please
check with the hospital’s Security Department to
obtain these codes.
If you should hear an overhead page with one of the
codes, please follow the instructions of hospital
employees to ensure your safety.
Emergency Codes (cont’d.)
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Code Blue - cardiac or respiratory arrest
Code Pink - infant or pediatric abduction
Code Black - bomb or bomb threat
Code Orange - hazmat or bioterrorism event
Code Gray - violence or security alert
Code White - hostage
Code Yellow - lockdown of the hospital
Code Green - mass casualty event/disaster
Code Brown or Purple - severe weather
Code Red - fire or smoke
Test Questions… Answers appear every 10 seconds
1.
2.
Patients have a fundamental right to
considerate care that safeguards their
personal dignity and respects their
cultural, psychosocial, and spiritual
values. T or F
Clinical Communication should be
addressed through:
a. Hospital Security
b. Nursing
c. Hospital Chaplain
d. Both a and c
True
B
Test (cont.) Answers appear every 10 seconds
3.
4.
Security Communication should be
addressed through
a. The hospital’s security department
and officers
b. The nurse assigned to your patient
c. The hospital's Chaplain
d. Both b and c
Clinical restraints are restraints (both
physical and drugs) that are administered
by the hospital.
T or F
A
True
Test (cont.) Answers appear every 10 seconds
5.
6.
Administrative restraints are devices that
are used by law enforcement officers.
T or F
Administrative communication should go
through the hospital’s security
department.
T or F
True
True
This is the end of the course.
Thank you for your time and attention.
Click here to receive a completion certificate.