Hospitals address questions about safety measures

KANSAS CITY, Mo. - NBC Action News contacted nine different KC area hospitals to ask about their workplace violence prevention measures and reporting policies. The unedited responses of eight from whom we have received a reply are below.

READ THE FULL REPORT | Violence inside KC area hospitals: Nurses attacked by patients

The following are unedited statements provided by hospitals in the Kansas City Metro.

CENTER FOR BEHAVIORAL MEDICINE

CENTERPOINT MEDICAL CENTER

NORTH KANSAS CITY HOSPITAL

OLATHE MEDICAL CENTER

RESEARCH MEDICAL CENTER

ST. LUKE'S HOSPITAL

TRUMAN MEDICAL CENTER

UNIVERSITY OF KANSAS HOSPITAL
 


CENTER FOR BEHAVIORAL MEDICINE

Do you have armed police officers or security guards staffed in the hospital 24 hours per day?

Non-armed security officers are on duty 24 hours a day. These officers are trained in the same behavior management principles as are taught to clinical staff.
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

All visitors enter the facility through a metal detector and sign in at the front lobby.  Personal belongings arenot permitted in patient areas but secured in lockers.  Patients are examined at time of admission and their personal property screened, with any potentially dangerous items removed.
 

Are rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

The process used at CBM is that a central control station has a view of each wing on the unit.  If staff determine that a situation requires additional assistance, telephones are used to activate overhead codes which inform all personnel of the nature and location of assistance needed.
 

What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members?

All clinical staff receive a comprehensive training in behavior management and crisis response upon hire, and receive a review session each year thereafter. 
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally?

Incident reports are completed, reviewed for any additional follow-up action that might be required, and entered into an internal tracking system for ongoing monitoring.  All nurses are aware of their right to pursue legal action if they desire, and we respect individual decisions.
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?

All clinical staff are trained in behavior management and de-escalation, and the hospital conforms to national standards for physical environment and safety.  Patients are continually assessed and treatment is adjusted when needed to address aggressive behavior.  We are continuously looking for ways to improve safety for staff and patients.
 

Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient?

There are circumstances when a nurse would not be alone with a patient, depending on individual patient history and current behavior.  Nurses utilize their professional judgment when delivering patient care.  If they do not feel safe, they are assisted by other staff.
 

Does the hospital track the number of workplace assaults? If so, how many have been reported this year?

The hospital tracks all workplace injuries.  Since July 1st of this year there have been five patient assaults on staff requiring medical intervention beyond first aid.
 

The University of Kansas Hospital started using a Behavioral Response Team in 2010—a two-person team comprised of nursing manager and another nurse with a psychiatric background—to respond 24/7 to situations and attempt to diffuse potentially aggressive, violent patients. Is this something your hospital is considering?  If no, why not (staffing, cost, etc)?

CBM is a nationally accredited psychiatric hospital where all nurses and clinical support staff are trained in the skills utilized by a Behavioral Response Team.

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CENTERPOINT MEDICAL CENTER

Do you have armed police officers or security guards staffed in the ER 24 hours per day? 

Yes, Centerpoint Medical Center has highly-trained, professional security officers on duty 24/7/365. Our policy implements specific internal procedures that work in tandem with the local Police and Fire Departments in the case of emergencies and workplace violence.  We do have security officers in the Emergency Department at all times.
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

Yes, our security officers use security wands to check patients and visitors if the officers suspect the individuals have weapons on them.
 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

Yes, Centerpoint Medical Center does have panic buttons that staff can use if they feel threatened by a patient.  In addition, we also have an in-house emergency number that staff can use to call for immediate assistance from a security officer. 
 

What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members? 

Safety and Security Officers at Centerpoint Medical Center go through Nonviolent Crisis Intervention.   Hospital staff members are taking a de-escalation training – this training began this fall and will be offered annually to staff. 
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally? 

Centerpoint Medical Center does have procedures in place to report any incidents and we encourage all staff to report any incidents. 
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures? 

Centerpoint Medical Center has several Safety and Security policies and procedures in place, as well as several Environment of Care policies and procedures to avoid violence in the workplace.  During new hire orientation we review and explain our Safety and Security program with each and every employee.  We also semi-annually review with all Management Staff the hospital's Healthy Work Environment and any changes to the program.  We use the Healthy Work Environment Zero Tolerance as our baseline to put guidelines in place to protect all patients, visitors, employees and physicians on hospital property.
 

Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient?

Yes, we have policies and procedures in place to protect the staff, as well as the patient from hurting themselves.
 

Does the hospital track the number of workplace assaults? If so, how many have been reported this year? 

Yes, we do track incidents and report incidents to Independence police.  The Independence Police Department would have those numbers for 2011.
 

The University of Kansas Hospital started using a Behavioral Response Team in 2010—a two-person team comprised of nursing manager and another nurse with a psychiatric background—to respond 24/7 to situations and attempt to diffuse potentially aggressive, violent patients. Is this something your hospital is considering? If no, why not (staffing, cost, etc)? 

Yes, we do have a policy to respond 24/7 to any incident.  Members of the Security Staff will respond along with the charge nurse and/or nurse manager for the specific unit.

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NORTH KANSAS CITY HOSPITAL

Do you have armed police officers or security guards staffed in the ER 24 hours per day?

Yes. North Kansas City Hospital's Emergency Department is a restricted-access area where proper identification is necessary to gain entrance. The Hospital employs off-duty officers from the North Kansas City Police Department, in conjunction with patrols from the Hospital's Security staff. Security personnel are trained in de-escalation techniques and pressure point control tactics. The Hospital works closely with local law enforcement agencies to develop, implement and monitor best safety practices in the healthcare environment.
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

Signage inside and on the exterior of the Hospital reinforces that weapons on premises are prohibited. However, one of the best deterrents to violence in any workplace is awareness of suspicious activity. Hospital staff are trained to recognize agitated patients and how to de-escalate threatening situations. This training begins during new employee orientation and is ongoing throughout the year.

Security wanding is available if suspicious activity indicates the need.
 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

Panic buttons are located in multiple locations throughout the ER, in other areas of the Hospital, and with additional buttons included in the design for the new Emergency Department currently under construction.
 

What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members?

CALM (Crisis Alleviations Lessons and Methods) is a program developed specifically to train staff on techniques to use in the healthcare environment. Another available resource is the clinical expertise of a full-time, psychiatric medical director who conducts debriefings with staff if issues arise and conducts additional training when indicated. 

Security personnel, in conjunction with local law enforcement, continually evaluate best practice models and train in de-escalation techniques, pressure point control tactics, restraint training and carry Tasers. Many of the Security personnel have extensive experience in law enforcement, and the Hospital employs a certified self-defense trainer to prepare Security staff.
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally?

Hospital staff are required to notify a supervisor if an incident occurs and notification is made to the Security Department. Security will notify local law enforcement if the staff member pursues criminal charges. All staff receive education throughout the year on preventing, recognizing and reporting potentially violent situations.
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?

The Hospital philosophy is a proactive approach to the issue of workplace violence. Valuable resources are used like the federal government's Occupational Safety and Health Administration's (OSHA) 3148 guide on workplace violence and a continuing partnership with local law enforcement. As a result, preventative measures are of the utmost importance. These measures include interior and exterior survellience equipment like closed circuit television cameras, limited after-hours access, ongoing education of new and current employees with nurses receiving more in-depth training, annual competency training for all Hospital staff, continuing risk assessments of the Hospital environment, review of Hospital policies and protocols and monitoring for other opportunities related to additional staff preparation.
 

Are there rules or circumstances that dictate when a nurse should not be alone with a patient?

Awareness continues to be one of the most effective ways for staff to help ensure a safe work environment. Through ongoing training, they receive the knowledge to recognize potential situations and be proactive to call for assistance should that help be needed. Also, ambulance personnel can give emergency department staff advance notice if they are transporting a difficult patient so staff can proactively prepare for that arrival.
 

Do we have plans to consider a behavior response type-team like KU?

Security personnel continue to evaluate other opportunities to provide a secure and safe working environment for all Hospital employees. The CALM program previously mentioned is an effective and comprehensive way to train and prepare staff at North Kansas City Hospital. Another option is the STAT team which has received additional training, in coordination with the Security Department, to respond quickly and de-escalate volatile situations.
 

Does the hospital track the number of workplace assaults? If so, how many  have been reported this year?

Security personnel evaluate the safety of the workplace environment for all healthcare workers and monitoring is part of that process. We work closely with the North Kansas City Police Department and support reporting to law enforcement. North Kansas City Hospital Security staff confirms that four reports have been made to the police in the evaluated timeframe.

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OLATHE MEDICAL CENTER

Do you have armed police officers or security guards staffed in the ER 24 hours per day?

The security office is located at the ER entrance. We have security officers on the premise 24 hours a day, seven days a week, but they are not armed.

 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

Olathe Medical Center has signs posted on its doors stating that weapons are not allowed on the hospital premise. Security cameras are located at each entrance and throughout the hospital. The hospital also has a firearm policy. If someone is observed on the premise with a firearm, OMC security officers request that the firearm be taken off the premises.  If the person refuses the Olathe Police Department is called.

 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

The Olathe Medical Center ER has panic buttons in several locations throughout the department. We also have a security code that staff members can have announced if they feel threatened by a patient.


What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members?

We provide targeted information to our staff members at their request or the request of department supervisors regarding conflict/resolution in the workplace. This includes such topics as how to deescalate a situation and appropriate interpersonal communication.

During orientation, every employee learns about the hospitals policies and procedures regarding workplace violence. This information is reviewed annually with each employee during mandatory Annual Validation training.   


I f a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally?

The procedure for reporting an incident is below. The items are from the OMC Emergency Response Reference Guide. OMC security officers inform staff members that they have the right to report the incident to the police department.

Reporting procedures during incident:

  • Any situation that cannot be corrected by the employee in a safe manner should be reported to the nursing supervisor, unit director, supervisor, director or unit coordinator.
     
  • Employees, patients, and visitors are encouraged to promptly report any issues they feel require the attention of the Security Department.
     
  • In the event that the Security Officer or supervisor determines that hospital property or personnel are in immediate jeopardy, they shall contact the Olathe Police Department for back-up (call 911).
     
  • Situations posing imminent danger to persons or property should be reported immediately to the safety officer.


Reporting procedures following event:

  • Any event that occurs related to the safety of patients, visitors, staff, physicians or property should be reported to Risk Management using the Event Report process.
  • Employee injuries are reported to the Employee Health Nurse.


What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?

Olathe Medical Center has a variety of measures in place to avoid violence, including its safety policies and procedures outlined above.

The Olathe Medical Center Environment of Care committee meets regularly to determine and maintain a safe environment for all employees, patients, and visitors. They call upon various departments to assist in presenting a review of safe practices and procedures and to schedule OHSI safety in-services. The committees review all employee and patient/visitor incident reports and provide recommendations to resolve any unsafe practices, equipment problems or safety hazards.

At Olathe Medical Center, we track and monitor security issues very carefully. If the need arises for additional preventative measures, we would consider the necessary steps to implement them.


Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient?

A nurse always has the option to ask another nurse or the nursing supervisor to accompany them to a patient's room, if they feel it is necessary.


Does the hospital track the number of workplace assaults? If so, how many have been reported this year?

Yes. No assaults have been reported this year.


The University of Kansas Hospital started using a Behavioral Response Team in 2010-a two-person team comprised of nursing manager and another nurse with a psychiatric background-to respond 24/7 to situations and attempt to diffuse potentially aggressive, violent patients. Is this something your hospital is considering? If no, why not (staffing, cost, etc)?

At Olathe Medical Center, we track and monitor our security incidents very carefully. If the need arises for this type of service, we would consider it.

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RESEARCH MEDICAL CENTER

Do you have armed police officers or security guards staffed in the ER 24 hours per day?

Research Medical Center has armed security officers, commissioned by the Kansas City, MO Police Department, assigned to the Emergency Department 24/7/365.
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

Yes, our security officers use security wands to check patients and visitors if the officers suspect the individual may have a weapon.
 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

Yes, Research Medical Center has panic buttons located within the facility and every nurse carries a portable phone that may be used to contact our rapid response team. Security dispatch is located in the emergency department and is easily accessible to respond immediately. 
 

What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members?

Staff are provided with Crisis Prevention Intervention (CPI) training. 
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally? 

Research Medical Center has procedures in place for staff to report any incident to security and we encourage all staff to report any incident.  Staff are also given the option of notifying the Kansas City Police Department.   
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?

Research Medical Center has comprehensive  Safety and Security policies and procedures in place, as well as Environment of Care policies and procedures to avoid violence in the workplace.  During new hire orientation we review and explain our Safety and Security program with each employee. The campus provides extensive lighting, closed circuit television monitors, controlled card access and multiple call boxes. After visitation hours, entry to the facility is controlled through the emergency department. The hospital has a safety committee comprised of staff and department leaders, with each unit having a representative Department Employee Safety Officer (DESO) to communicate and promote safety in our facility. 
 

Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient?

We have policies and procedures in place to protect the staff, as well as the patient from hurting themselves.
 

Does the hospital track the number of workplace assaults? If so, how many have been reported this year? 

Research Medical Center has robust safety & security policies and procedures with a highly-trained staff of security officers. The safety and health of our patients and employees are our top priority. Research Medical Center internally tracks incidents related to workplace safetyand we encourage the individual to report the incident to the KCPD. Research reports any incident that is against the hospital, such as theft and property damage, to the police department. You should be able to get all of the reported incidents from the KCPD.
 

The University of Kansas Hospital started using a Behavioral Response Team in 2010—a two-person team comprised of nursing manager and another nurse with a psychiatric background—to respond 24/7 to situations and attempt to diffuse potentially aggressive, violent patients. Is this something your hospital is considering? If no, why not (staffing, cost, etc)? 

Yes, we have a 24/7 rapid response team available to respond to any incident.  A multidisciplinary team is trained with regards to safety procedures and responding to various risks and challenges.

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ST. LUKE'S HOSPITAL

Do you have armed police officers or security guards staffed in the ER 24 hours per day? 

Saint Luke's takes the safety of its staff and patients very seriously and proactively works to ensure a secure environment to support the delivery of patient care. The emergency room is staffed with police officers from 6 p.m. to 6 a.m. Security staff is in close proximity to the emergency room and frequently patrols the area.
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?  

Like most hospitals, weapons and firearms are prohibited. We do not utilize walk-through metal detectors, but hand-held wands are used on an as-needed basis. 
 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient? 

Yes, panic buttons are present in every room as well as the nurse's station 
 

What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members? 

We provide non-violent crisis intervention training from the Crisis Prevention Institute. Training is mandatory for staff in the emergency department. 
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally? 

We encourage all staff to report incidents of violence and assault to the police department.
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?  

A task force with representatives from Security and the emergency department continually assesses and addresses incidents involving violence. Recent enhancements include additional surveillance cameras and panic buttons and increased Security rounding. Security staff also meets patients brought in by ambulance who have the potential for behavioral issues.
 

Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient? 

Anytime the nurse fears for his/her safety, or when the patient is acting out aggressively. 
 

Does the hospital track the number of workplace assaults? If so, how many have been reported this year? 

Assaults are tracked internally and range from verbal threats to physical assaults toward staff. We encourage all staff to report incidents of violence and assault to the police department.
 

The University of Kansas Hospital started using a Behavioral Response Team in 2010—a two-person team comprised of nursing manager and another nurse with a psychiatric background—to respond 24/7 to situations and attempt to diffuse potentially aggressive, violent patients. Is this something your hospital is considering? If no, why not (staffing, cost, etc)? 

Saint Luke's utilizes a Crisis Intervention Response Team to respond to patients who are acting out aggressively.

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TRUMAN MEDICAL CENTER

The following is a statement provided by the Truman Medical Center to NBC Action News:

"In addition to providing top quality healthcare, Truman Medical Centers' (TMC) paramount concern is for the safety of patients and staff. TMC utilizes a well trained 65-member armed security team that provides 24/7 protection across the entire organization. Our security team can utilize a multitude of methods and technology to ensure the continued physical safety of our 4,300 member workforce including, but not limited to, de-escalation training and extensive camera surveillance.

"TMC seeks to avoid and de-escalate patient or guest's aggression and violence through training and the use of multidisciplinary Staff Advocacy Response Teams (SAT). In these unusual situations where disruptive, inappropriate or aggressive behavior is exhibited, individuals responding to the situation include a behavioral health trained manager and our security teams . In addition, many of our frontline patient care staff also complete CPI training and/or Pro-ACT training. Both are highly regarded, best practices and behavior management training courses that stress the importance of prevention of crisis situations through innovative skills and methods.

"The safety and security of our entire organization is our chief concern. TMC works diligently to provide a safe working environment for staff and a secure healing environment for our patients and guests."

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UNIVERSITY OF KANSAS HOSPITAL

 

Do you have armed police officers or security guards staffed in the ER 24 hours per day?

Yes…The University of Kansas Hospital has its own police department
 

Is there any kind of security process to make sure patients and/or family members do not take weapons into the hospital (i.e. metal detectors or security wands)?

Yes…metal detectors are present in the Emergency Dept. and there is signage throughout the hospital campus alerting the public that weapons are not allowed.
 

Are ER rooms equipped with "panic buttons" that nurses, doctors or other staff members can utilize if they feel threatened by a patient?

Yes…there are buttons in every room and each staff member has a cell phone that rings our campus police in an emergency…and/or KCK police if needed.


What type of training is offered to staff for managing and identifying aggressive behavior by patients and family members?

Every employee annually takes an online, mandatory refresher course on identifying workplace violence.  Additionally, specific members that make up Behavior Response Teams, which include a psychiatric nurse and/or administrator, are trained to respond and de-escalate all types of behavior that might interfere with medical response for patients.
 

If a nurse is the victim of a physical or verbal assault, what is the procedure for reporting the incident? Are nurses encouraged to contact police to pursue prosecution or instructed to report assaults internally?

Every hospital employee is encouraged to report any type of workplace violence, aggression or threat. Workplace violence is part of the orientation process for all our employees.  All employees and supervisors are required to report any incident
 

What type of preventative measures does the hospital have in place to avoid violence? Are there any plans to implement additional preventative measures?

Part of the mandatory, annual online training addresses ways to avoid violence in the workplace.  The Behavior Response Teams have added specialized training to de-escalate situations.
 

Are there rules or circumstances that dictate when a nurse should not be alone in a room with a patient?

At The University of Kansas Hospital, any health care provider can request assistance if they feel threatened by anyone in the course of their duties.  The preferred response is to call the Behavioral Response Team if there is a feeling an unsafe situation is developing. Any threat to healthcare personnel is taking very seriously and no staff member will face an unsafe situation by themselves.
 

Does the hospital track the number of workplace assaults? If so, how many have been reported this year?

TOTAL 44 IN 2010

TOTAL 38 IN 2011 THRU SEPT 30

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Are you a healthcare worker and been a victim of violence in the workplace?  Tell your story in the comments below or e-mail Ryan Kath at kath@nbcactionnews.com.

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