All Entries Tagged With: "security"
Can’t get no protection…
I’m not sure if you folks follow my HCPro colleague David LaHoda’s OSHA Healthcare Advisor e-newsletter and blog, but there’s an item this week that I think bears bringing to your attention in case you didn’t see it.
Now I think we can all agree that there is a great deal of attention being paid (and rightly so) to issues of workplace violence and how can we be assured that we are doing all we can to protect the front line folks from assaults, etc. And I think many, if not most, of us recognize that acts of violence by patients are definitely not diminishing over time. The variables are wide-ranging—the economy, the reduction of behavioral health resources, etc.—and endlessly complex. We must manage these variables in as proactive a manner as possible.
So, how are you folks out in the safety community addressing these types of concerns? What education are you providing and to what staff demographic groups are you targeting with that education? Are you mandating education in certain areas, or are you letting folks participate as they feel necessary? Who has a program that’s working well, and what monitoring and measures have you put in place to ensure that the program you have is getting the desired results? I think this is a dialogue that’s going to be with us for a while, so please weigh in on what you’re doing/facing/dreading.
As a final thought, back in the day before we had “standard precautions,” there was the term “universal precautions” based on the concept that you can’t tell whether a person is an infection risk just by looking at them, so you have to manage everyone as if they had the potential. Is it time for a truly “universal” approach to the potential for violence when it comes to patient management? What do you think?
Panic in Detroit – Panic at the Disco – Panic at the Surgery Center…Fire in the Hole!
I’m presuming (and please don’t attempt to disabuse me of this notion) that you are all dutifully conducting security risk assessments on a regular basis. As you conduct them, I’m sure you find risks of some events that are greater than some other areas. So, I to ask: When you’ve completed your security risk assessment, do you identify specific strategies, including the use of technology, for minimizing those risks to the extent possible? If you’re not including that facet in the risk assessment process, you might want to consider doing so.
Recently, I was looking at a survey report in which an ambulatory surgery center was cited during a TJC survey because they had not installed a panic alarm “at the registrar’s desk in order to obtain immediate assistance in an emergent or hostile situation.” Now, as with so many things that have been popping up during surveys, I don’t disagree with the concept of having panic alarms at those customer service/interaction points where unhappy folks (or folks of any ilk) can experience the need to vent their frustrations, etc. But in that disagreement, I think I’d first be looking at what tools have been provided to staff to actively manage, if not de-escalate, these negative encounters. I would much prefer to avoid having to use a panic alarm by appropriately managing the encounter, much like I would just as soon not “need” to have an emergency eyewash station.
I’m a great believer in the proactive management of risk, but I’m also a great believer in implementing risk management and response strategies that make operational sense. So, the question to the studio audience is: Where have you installed panic alarms and where have you not installed panic alarms, and why? There’s always the risk that some surveyor will disagree with your strategy, but if that strategy was derived through thoughtful analysis of the involved risks, does that not meet the intent of all this?
I like the concept of best practice as much as anyone, but I also recognize that there is a tremendous amount of variability in the safety landscape. Just because something works in one place does not necessarily mean that it will work in all cases—that’s the mystical, magical, and ultimately mythical power of the panacea. One size doesn’t fit all—never has, never will. But if we’re going to be held to that type of an expectation, how does that help anyone? Ok, jumping down from soapbox for now, but rest assured, you’ll see me back up here before too long.
I can’t drive – 5?
I recently fielded a question regarding vehicle speed limits on a hospital campus.
I think we can agree that we don’t want 
folks tearing around our grounds, running into or over people and things, but are there specifics involved? (I think I’m smelling a risk assessment here…)
The situation presented to me revolved around a current practice of posting 5 miles per hour as the campus speed limit, which, as I’m sure you can imagine, can be tough to enforce, regardless of whether you live in NASCAR country. So, the question became: Can the campus speed limit be raised to 10, or even 15, miles per hour?
To my fairly certain knowledge, there is no definitive nationwide regulatory source that would come into play; but, as you can well imagine, there are a number of Authorities Having Jurisdiction who might be willing to offer some assistance in this regard. My immediate thought (and probably the most useful) would be to check with municipal law enforcement to see what they might recommend/require in this regard, and move forward accordingly. I’m thinking that there would be only minor, if any, objection to a raise of the limit to 10 miles per hour, and maybe even 15 miles per hour. But checking with the law enforcement folks is a very fine place to start.
So, how fast can you go?
California hospitals will be required to tighten security if new bill passes
Preliminary approval was given by a California legislative committee for a bill to move forward that will increase security in hospitals and require workers to report acts of violence to the state.
Assemblywoman Mary Hayashi (D) and the California Nurses Association sponsored the bill and brought it to the Assembly Committee on Health, arguing that nurses are increasingly exposed to violence in the workplace, reports the Los Angeles Times. The bill comes after the death of a nurse who was bludgeoned in the medical facility she worked at in Northern California.
The California Hospital Association (CHA) opposes the proposed bill, saying it would put an increased burden on hospitals. The CHA says hospitals already have to report incidents of violence to the police, state Department of Public Health, and the Division of Occupational Safety and Health (OSHA).
The bill is waiting to go to the Assembly appropriations committee before going to the full Assembly.
Do you think this bill should pass? What does your facility require in terms of reporting violence? Let us know in our comment section.
Do you feel safe in your healthcare facility?
The September shooting at Johns Hopkins Hospital in Baltimore left some healthcare workers pondering the same question: Are healthcare facilities a safe place to work?
Recently, the Wall Street Journal (WSJ) ran a blog post about which healthcare workers are most likely to be assaulted. The Journal of the American Medical Association published a study and after looking at government statistics, found that the rate of assaults in healthcare facilities is fairly high. Nursing home staff, ICUs, emergency departments, and psych units are amongst the higher risk of assault, the WSJ reported.
Why is the assault rate so high? The study found a few different factors. Physicians are not respected as much, the healthcare industry is more seen as a business, and patients are not always happy with the healthcare system, reported the WSJ.
Is this a trend you are noticing and planning for, or do you think the study focuses too much on big cities? Do you feel safe in your facility? We’d love to hear your thoughts on this.
Efforts underway to improve security in California hospitals
The death of two healthcare workers has prompted hospitals to increase safety and security in California hospitals.
An East Bay, CA, assembly-woman, Mary Hayashi, D-Hayward introduced a bill last week, saying it would improve the safety in hospitals, mental health institutions, and correctional medical facilities, reported The Napa Valley Register.
In addition, Napa State Hospital unions have requested safety improvements such as increased police officers and staff having just their first names on ID badges.
The bill, titled Assembly Bill 30, would require hospitals to do the following:
- adopt a violence prevention plan
- report attacks on personnel to law enforcement within 24 hours instead of the current 72 hours
- detail to the state legislature information on acts of violence at the facilities
- require annual safety training sessions for all hospital employees assigned to a psychiatric unit
The bill is expected to come in front of a committee early next year.
On October 23, a psychiatric technician at Napa State Hospital was found dead by a patient. A nurse was attacked on October 25at The Martinez Facility in Contra Costa County, CA, by an inmate who hit her with a lamp. She died three days later Both incidents led to staff and unions coming forward to improve security.
How do you think the proposed security procedures would improve the safety of the staff? Let us know in our comment section.
Mac’s Safety Space: Humidity in the operating room
Q. I have a question regarding OR humidity. If OR humidity drops below the required range, can a portable reservoir type humidifier be used to bring the humidity back up within range? If not, what should the facility do? Should the facility stop surgeries?
I have been researching the World Wide Web to find additional information. What I have found is that reservoir type humidifiers should not be placed in duct work. Any additional help would be greatly appreciated.
A. The humidity levels are very much in the way of guidelines as opposed to strict regulations. Recently, ASHRAE (the American Society of Heating, Refrigeration and Air-Conditioning Engineers) dropped the lower control limit for humidity to 20%, basically because electrical systems and OR environments in general are much better designed and can safely tolerate a “drier” environment.
At the end of the day, it all comes down to the comfort of occupants, and as long as the OR rooms aren’t dripping condensation, the infection control risks are minimal. However, if you are dealing with humidity levels below 20%, I would contact your HVAC vendor and see what type of humidification is available.
You are correct in that reservoir-type humidifiers should not be placed in duct work, but there is humidification equipment that can be installed for those really dry days.
Don’t shoot the care provider; make hospitals safer for workers
Following a wealth of discussion on the John Hopkins Hospital shooting that took place a few weeks ago, The Baltimore Sun reports that according to a federal lab report, healthcare workers are four times as likely as the average American worker to encounter violence on the job. The risk is higher for those working in psychiatric or emergency units.
The article suggests that patient safety is directly linked to staff safety, and that workplace violence in hospitals is an “epidemic” that needs to be recognized by the public and remedied. The Baltimore Sun informs that healthcare workers are not only threatened by guns being brought into the facility (much of the discussion surrounding the shooting was focused on the need for metal detectors), but that a majority of staff assault is by patients who push, punch, scratch or choke.
A balancing act – no nets, no problem!
I’m sure you’ve all been discussing the shooting that happened last week at Johns Hopkins, as I have. I don’t know that this changes the landscape all that much – we know this threat exists, and we know that there is only so much preventative medicine that we can employ without turning our facilities into armed camps.
At this point, I am not familiar with a lot of specific detail – sometimes a person’s parent can be the focus of a lot of ill feelings, and sometimes those feelings will prompt an action far in excess of normal behavior. That being said, I trust that you are all establishing a means of continuously identifying workplace violence risks, and establishing response plans with municipal law enforcement.
Implementing workplace violence policies
Howdy, safety profs!
I’ve received a number of inquiries lately looking for workplace violence policies. I figured if a few might have questions, then that’s enough indication to me that there may be some other folks as well looking for these elusive policies.
With all that said, to be honest, I don’t know that I would advise pursuing policy development. It’s more than likely that any policies you would need to support the management of risks associated with workplace violence are already in existence. The key to compliance is to follow the risk assessment recommendations in the SEA and, for all intents and purposes, conduct a gap analysis based on the elements identified in the SEA.
