Reactive Response to Event

Patient to Staff Violence Tools/Example Policies
Security response
  • De-escalation attempted
  • Behavioral Control
  • Termination of care relationship
  • Law Enforcement Notification
    • Sharing minimum necessary PHI
    • If taken into police custody, ensure ongoing medical needs are communicated to law enforcement medical clinic/MD
    • Process for discharge/transfer to law enforcement
    • Restraining order
Prevention Policy

Policy and Procedure

Law enforcement investigation
  • Witness interviews
  • Security video footage preserved


Public Relations/Media Notified of potential media exposure re: arrest  
Ensure Victim support  
Ensure safe transfer of patient care  
Suggested Policy review:
  • Patient Search/Seizure of contraband/illicit substance/Patient Belongings
  • Surrendered weapons: storage safety and process for return to patient
  • Surrendered illicit substances or contraband: Disposal v. Law enforcement release
  • Criteria for report to law enforcement/responsible person
  • Criteria for restraint/seclusion application/responsible person
  • Competency/Capacity/Surrogate-decision-maker/mental-health hold/involuntary confiment
  • When is forced medication admin/restraint acceptable?
  • Security use of force: handcuffs, pepper spray, etc…
  • Security video archive process/timeframe/expectations
  • Release of information to law enforcement/release of video to law enforcement
  • Law enforcement brining weapons on-campus/ no weapon zone in psychiatry
  • Show of force/Code Strong/Code Grey response processes
  • Administrator-on-Call/RN Supervisor Responsibilities
  • Chain of Command
  • Professional discipline/Peer Review
  • Resolution of Patient Complaints and Grievances
  • Adverse Event Incident Reporting System
  • Guidelines for Environmental Protections in care of Known registered sex offender/patient in law enforcement custody
  • HIM restrictions/Patient Directory restrictions: Confidential/No-Publication/No Show/”Break the Glass”/ Pt Directory
  • Patient Alert/Care Plan/Electronic mechanism to notify all staff/all locations of increased risk of violence
  • Patient Term/Termination of Care relationship
  • Narcotic Care Agreement
  • Refusal of Care Form/Process
  • Discharge AMA
  • Elopement
  • Administrative Discharge
  • Patients who will not peacefully leave campus after discharge/Security escort off campus
  • Chaperone guidelines
  • Patient/Family Request for change in caregiver


Download the entire toolkit (PDF)

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