Jayne King Head of Security & Site Services Guys & St - - PowerPoint PPT Presentation

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?

• r
• 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

Conflict Resolution Training Course Training Need Skills Gap Conflict Resolution for Managers Course 3 Year Refresher Year 1 Year 2 Year 3 Conflict Resolution Junior Refresher Course Skills Fade Senior Staff Nurse Ward Manager Senior Staff Nurse Control & Restraint Training Course Conflict Resolution Training Course Day 1 Day 2

Security Officer Training

Yearly Refresher

Training ining Ethos Ethos & & Syl Sylla labu bus

Do no harm Early Intervention Physical Intervention a last resort Inclusive Problem Solving Risk Assessment & Management Human Behaviour / Attitude Positive Interactions De-escalation Skills Practical Safety 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

Very unwell aggressive patient broke IV pole in half

7 days of Violence and Aggression in ED

Aggressive alcoholic patient sleeping in ED entrance refused to leave Patient very verbally aggressive to nurse calling her ‘fucking bitch’ and threatening to slap her Patient in waiting area been discharged but refusing to leave Patient left department and then jumped 13 feet off a wall Patient with self-harm punched security guard in the face, pushed over the nurse and consultant Patient started shouting aggressively because waiting time was too long High risk mental health patient trying to leave -restrained Patient was throwing punches, punched the doctor once then punched the nurse in the chest. Confused elderly man lashing

• ut hitting security with his

walking stick Aggressive patient who had self-harm cut his wrists attempting to leave dept Patient punched Dr then put his hands round Drs neck Patient shouted ‘fuck you’ then hit nurse and security guard Patient threatening to kill nurses family and follow her home after work Patient became very aggressive and shouting to nurse that she was 'a cunt' and a 'motherfucker' Patient deliberately pulled out cannula spraying blood everywhere Patient stated ‘wait till Monday comes and you find out what happens to you'

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

• ne 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?

Instil a culture that accepts it is not part of the job Give staff the skills & confidence to identify a potential

• r actual

deteriorating situation Staff respond with confidence and are supported by their managers and the Trust

Our aim is to ensure staff feel they can do their job without the fear of violence and aggression towards themselves and their patients.

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 Department

Areas of outstanding practice-

‘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

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