1. Here are some tips for navigating this learning module: Runs like a movie. All slides are approximately :30 in length. Click on the ‘screen’ in the bottom left corner to allow a full screen view. This will also start the presentation. At the end, press the ESC button to exit.

2. Patient Care and Prisoners Florida Society for Healthcare Security, Safety, and Emergency Management Professionals

3. 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.

4. 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 standards- setting 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!

5. 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 )

6. 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.”

7. 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...

8. 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.

9. 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).

10. 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.

11.  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. Hospital expectations (cont’d.)

12. 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.

13. 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.

14. Channels of Communication (cont’d.)  Administrative Communication - questions regarding administrative issues should also be directed to the hospital’s security department.

15. 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.

16. 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.

17. 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.

18. 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.

19. Emergency Codes (cont’d.)  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

20. Test Questions… Test Questions… Answers appear every 10 seconds 1.Patients have a fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values. T or F 2.Clinical Communication should be addressed through: a. Hospital Security b. Nursing c. Hospital Chaplain d. Both a and c True B

21. Test (cont.) Test (cont.) Answers appear every 10 seconds 3.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 4.Clinical restraints are restraints (both physical and drugs) that are administered by the hospital. T or F T or F A True

22. 5.Administrative restraints are devices that are used by law enforcement officers. T or F T or F 6.Administrative communication should go through the hospital’s security department. T or F T or F Test (cont.) Test (cont.) Answers appear every 10 seconds True True

23. This is the end of the course. Thank you for your time and attention. Click here to receive a completion certificate. here