[MCOH-EH] combative patients

Hodgson, Michael - OSHA Hodgson.Michael at dol.gov
Thu Aug 28 10:22:02 PDT 2014


There is a body of literature on this, "flagging", starting with David Drummond's' 1989 paper in JAMA, most recently descrined in our 2013 AJIM paper (Hodgson et al).  In between the VHA flagging process was a semifinalist in the Harvard Innovations in American Government award, relies on a nationally visible electronic flag in vHA's'electronic record, and is regulated by national directives concurred by VA's' Legal Counsel.  Lynn Van Male, PhD, runs a miniresidency at the Portland VAMC to train the commitee chairs of the Disruptive Behavior Committees, which exist at each facility under the direct authority of the Chief of Staff.  I'm on vacation but can explain more when im back if people need more pointers

Michael Hodgson, MD, MPH - formerly Chief Consultant for Occupational Health at VHA, where this was one of the programs i had the honor to lead
________________________________________
From: MCOH-EH <mcoh-eh-bounces at mylist.net> on behalf of Gordon, PA-C, Lisa <lgordon at emhs.org>
Sent: Thursday, August 28, 2014 10:19:58 AM
To: 'mcoh-eh at mylist.net'
Subject: [MCOH-EH] combative patients

I sit on the Workplace Violence Prevention committee for our hospital.  We have discussed a way to "flag" a combative or aggressive patients as well but wondered about any legal concerns.  Has anyone consulted their legal department about symbols on the door or any other way to give a "heads up".  Also, any information/resources/advise that anyone could share regarding workplace violence prevention would be much appreciated.  Thanks!!!

Thank you,

Lisa Gordon PA-C
Employee Health and Occupational Medicine-
Eastern Maine Medical Center
489 State St. Bangor, Me 04401    &
885 Union St. EMMC Healthcare Mall Suite 215 Bangor, Me 04401
Phone:  973-7335 or x38520
State St. Fax:  973-7081
Union St. Fax: 973-7238
lgordon at emhs.org


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Sent: Thursday, August 28, 2014 9:48 AM
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Subject: MCOH-EH Digest, Vol 245, Issue 51

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Today's Topics:

   1.  Combative patients (Senior, Cathy (DRMC))
   2.  N95 Fit Test competency form (Brenda Kantner)
   3. Re:  Combative patients (Viereck, Maryann)


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Message: 1
Date: Thu, 28 Aug 2014 08:37:49 -0400
From: "Senior, Cathy (DRMC)" <CESenior at phhealthcare.org>
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Combative patients
Message-ID: <222DF8583BBC7C4CB20DD7562B9DDD5E0F17294A4D at ex07>
Content-Type: text/plain; charset="us-ascii"





I am attempting to develop a system to warn ancillary departments of combative patients. Ex patient admitted to med surg floor and is extremely combative.  This patient is chronically combative so the floor staff is familiar and do take precautions when approaching the patient. The problem is when lab comes in the morning at 6 am to draw labs and has no idea of the danger and approaches the patient to gently wake him and he kicks them in the face injuring their jaw.  I wanted to have some sort of symbol placed on the door  however there are already so many symbols representing fall precautions, turn every two hours etc. Does anyone use a symbol to represent if a patient is combative that the meaning would be only for the staff's understanding of what the symbol meant? Any suggestions would be appreciated to decrease risk of injuries in our ancillary departments.

Cathy Senior RN BSN CDE
Employee Health Director
Penn Highlands DuBois
100 Hospital Avenue
P.O. Box 447
DuBois Pa 15801
Phone 814-375-3392
Fax 814-372-2610
cesenior at phhealthcare.org
www.phhealthcare.org


This email and any attached files are confidential and intended solely for the intended recipient(s). If you are not the named recipient you should not read, distribute, copy or alter this email. Any views or opinions expressed in this email are those of the author and do not represent those of Penn Highlands Healthcare or its affiliates.. Warning: Although precautions have been taken to make sure no viruses are present in this email, the company cannot accept responsibility for any loss or damage that arise from the use of this email or attachments.

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Message: 2
Date: Thu, 28 Aug 2014 09:45:12 -0400
From: "Brenda Kantner" <bkantner at schuylkillhealth.com>
To: "MCOH/EH" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] N95 Fit Test competency form
Message-ID:
        <B16D9119F683184583059E276640B03908A411EB at ahwexcpapot001.papot.ahealth.org>

Content-Type: text/plain; charset="us-ascii"

Good morning,



Has anyone developed a competency form to be used when training staff members to complete N95 fit testing for other healthcare workers?

Could you please share?



Thank you.

Brenda Kantner RN COHN-S/CM
Employee Health Coordinator
Schuylkill Medical Center
700 East Norwegian St
Pottsville, PA 17901
Phone 570-621-4351
Fax   570-621-4257
bkantner at schuylkillhealth.com






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Message: 3
Date: Thu, 28 Aug 2014 13:48:13 +0000
From: "Viereck, Maryann" <mviereck at caperegional.com>
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Combative patients
Message-ID:
        <7FCF8FE41638F943ACE320C939BC45D9E0C852EE at EXSRV2.BTHOSP.INT>
Content-Type: text/plain; charset="us-ascii"


[cid:image002.png at 01CFC2A5.2F1918C0]We Attempted to use a light house symbol to caution, but senior management did not approve.

Maryann Viereck RN,BS,CEN,COHN-S
Employee Health Coordinator
Cape Regional Medical Center
2 Stone Harbor Blvd
Cape May Court House, NJ 08210
phone 609-463-2512
fax 609-463-2910

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Senior, Cathy (DRMC)
Sent: Thursday, August 28, 2014 8:38 AM
To: 'MCOH/EH'
Subject: [MCOH-EH] Combative patients




I am attempting to develop a system to warn ancillary departments of combative patients. Ex patient admitted to med surg floor and is extremely combative.  This patient is chronically combative so the floor staff is familiar and do take precautions when approaching the patient. The problem is when lab comes in the morning at 6 am to draw labs and has no idea of the danger and approaches the patient to gently wake him and he kicks them in the face injuring their jaw.  I wanted to have some sort of symbol placed on the door  however there are already so many symbols representing fall precautions, turn every two hours etc. Does anyone use a symbol to represent if a patient is combative that the meaning would be only for the staff's understanding of what the symbol meant? Any suggestions would be appreciated to decrease risk of injuries in our ancillary departments.

Cathy Senior RN BSN CDE
Employee Health Director
Penn Highlands DuBois
100 Hospital Avenue
P.O. Box 447
DuBois Pa 15801
Phone 814-375-3392
Fax 814-372-2610
cesenior at phhealthcare.org<mailto:cesenior at phhealthcare.org>
www.phhealthcare.org<http://www.phhealthcare.org>


This email and any attached files are confidential and intended solely for the intended recipient(s). If you are not the named recipient you should not read, distribute, copy or alter this email. Any views or opinions expressed in this email are those of the author and do not represent those of Penn Highlands Healthcare or its affiliates.. Warning: Although precautions have been taken to make sure no viruses are present in this email, the company cannot accept responsibility for any loss or damage that arise from the use of this email or attachments.



Confidentiality Notice: This e-mail message, including any attachments, from Cape Regional Health System contains information which is CONFIDENTIAL AND/OR LEGALLY PRIVILEGED.The information is intended only for the use of the individual named above and may not be disseminated to any other party without Cape Regional Health System's written permission. If you are not the intended recipient, or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, disclosure, distribution, copying or taking of any action in reliance on the contents of this e-mailed information is strictly prohibited.  If you have received this e-mail in error, please notify us immediately by telephone at 609-463-2163 to arrange for the return of these documents to us without cost to you.
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