Jayne King Head of Security & Site Services Guy’s & St Thomas’ NHS Foundation Trust Chair National Association for Healthcare Security (NAHS)
Security in Healthcare • Context • Role of NAHS • In house V’s Contracted out • Are SIA licences applicable?
Who are our people • 2nd career for managers and Security Officers? or • Make it a 1st career choice, addressing career pathways and/or apprenticeships • Is the pool drying up?
Training • Sector specific? • Acute • Community units • Mental Health • Ambulance
Training Conflict Need Resolution for Managers Skills Course Gap Day Ward Control & 2 Manager Restraint Security Training Officer Course Senior Senior Training Staff Staff Conflict Nurse Nurse Resolution Training Conflict Course Resolution Junior Conflict Refresher Resolution Course Day Skills Fade Training 1 Course 3 Year Refresher Year 1 Year 2 Year 3 Yearly Refresher
Do no Risk Assessment harm & Management Early Human Behaviour / Intervention Attitude Training ining Ethos & Ethos & Positive Syl Sylla labu bus Interactions Physical Intervention a last resort De-escalation Skills Inclusive Problem Practical Safety Solving Techniques
The Contract • Procurement of Security services in the NHS • Understanding the market/adjust? • Working with stakeholders (internal & external)
What do we do - Specialist role • Violence - 1100 incidents per year - approx 170 incidents of physical violence however approx 135 of those are patients whose clinical condition may be a factor. • Teach conflict resolution to frontline staff - definition front line (NHS Protect) any staff that may contact with patient or visitor • Theft - every hospital has this issue. • Safeguarding issues - vulnerable persons, elderly, dementia, mental health, children • VIPs ( anyone who may be subject to press intrusion, high risk prominent prisoners) • Location attracts a wealth of high profile visitors, PM’s/Ministers, Royal family • Major Incident. • Site Issues (facilities role) • Crime prevention adviser (CPDA) New builds (Evelina, CTC) ongoing project works • Domestic violence issues work closely with DV team
Defining violence, abuse or challenging behaviour • Violence is defined as the intentional application of force to a person of another, without lawful justification, resulting in physical injury or personnel discomfort • Abuse is defined as the inappropriate use of words or behaviour causing distress, alarm and or constituting harassment • Challenging behaviour is defined as any non-verbal, verbal or physical behaviour which makes it difficult to deliver good care safely The majority of the incidents we see are related to Challenging behaviour
7 days of Violence and Aggression Patient threatening to kill in ED nurses family and follow her home after work Patient punched Dr then put his hands round Drs neck Patient with self-harm punched security Patient deliberately pulled out guard in the face, pushed over the cannula spraying blood nurse and consultant everywhere Patient very verbally aggressive to Patient became very aggressive and nurse calling her ‘fucking bitch’ and shouting to nurse that she was 'a cunt' threatening to slap her and a 'motherfucker' Aggressive patient who had Patient shouted ‘fuck you’ then Very unwell aggressive patient self-harm cut his wrists hit nurse and security guard broke IV pole in half attempting to leave dept Patient stated ‘wait till Monday Patient was throwing punches, punched the comes and you find out what doctor once then punched the nurse in the happens to you' chest. Patient in waiting area been Confused elderly man lashing discharged but refusing to High risk mental health patient out hitting security with his leave trying to leave -restrained walking stick Patient started shouting aggressively because waiting Aggressive alcoholic patient Patient left department and time was too long sleeping in ED entrance then jumped 13 feet off a wall refused to leave
Examples of medical causes for patients becoming violent or aggressive • Head injury • Hypoxia (low oxygen levels) • Hypoglycaemia (low blood sugar) • Shock (sepsis, hypovolaemia, anaphylactic, cardiac) • Stroke • Neurological disorders • Seizures • Intracranial infections (infection in the brain) • Encephalitis (swelling of the brain) • Hyponatraemia (low sodium levels) • Drugs and alcohol • Mental health problems • Many other medical problems
It’s not just about our staff... The scene from an incident on one of our wards recently at 3am
Why do we have a problem • Increase in drug & alcohol abuse • Increase in the number of mental health patients in crisis • Staff hesitant to take action, giving the patient or family a second chance • Delay in identifying a problem, leading to crisis • Staff accepting its part of the job • Difficulty in trying to identify cause - ? Clinical • Not always agreement or support amongst the MDT • Staff don’t always stick to the plan • Lack of confidence & courage, staff hesitant to report and press charges • Our behaviours
How do we support our staff? Our aim is to ensure staff feel they can do their job without the fear of violence and aggression towards themselves and their patients. Staff respond with confidence and Give staff the skills are supported by & confidence to their managers identify a potential and the Trust or actual deteriorating Instil a culture that situation accepts it is not part of the job
Networks • Private and public sector partnerships (SBBW, LB Security Forum, Security Commonwealth, etc) • The Security Industry - common goals and links. • Best Practice – what can we learn from each other • Is there/should there be a strategy?
Ambulances Injury in the night-time economy requires: Scene Management to: – Ensure there is room for crews to work – Direct people away from scene, inside or outside – Protect the safety of ambulance crews
Looking ahead • Going forward • fit for the future • long term strategy
CQC Inspection 2016 Emergency Areas of outstanding practice- Department ‘The role of the security team in the Emergency Department was embedded into the day to day working of the department. The team was multi-lingual and trained in effective de-escalation techniques and demonstrated outstanding empathy to patients.’
Q&A
Recommend
More recommend
