Resident and Fellow Policy ManualAppendix 1 - Patient Prisoner Population:
Policy:
Prisoner patients who are on medical leave of absence (LOA) may not require a security plan. However, the forensic agency must communicate the patient prisoner’s medical LOA status to the hospital along with any special considerations. Prisoner disappearances must be reported immediately to UR Security Services (x13). General Description: Administrative Issues: 1. In order to plan for special needs, the hospital and its staff must be notified of a patient’s status as a prisoner. This status must be communicated to the hospital by the forensic agency. 2. The Emergency Department is responsible for notifying Security Services when they are treating a prisoner. If the prisoner is admitted, ED must also notify Admitting. 3. The Admitting Office is responsible for notifying Security Services of the admission of prisoners. 4. Prisoners in ED may not have visitors. Exception may be considered only under special circumstances and after collaboration and agreement among the healthcare team, the forensic agency and Security Services. 5. Prisoners will not be placed in a semiprivate room with a private citizen. Two prisoners may share a semi private room. The responsible forensic agency must evaluate the appropriateness of such an arrangement. (For example, sentenced and nonsentenced prisoners or state and county prisoners cannot share a room. Similarly, a prisoner may not share a room with another prisoner on their enemy list.) 6. Prisoners may require restrictions regarding information, mail, visitors, meals, etc. The restrictions are part of the security plan and should be discussed and agreed upon by the forensic agency and the clinical team. The forensic staff is responsible for enforcing the restrictions, however hospital staff should notify those hospital departments that must support the security plan or prisoner’s care. For example, the Communications Center may be asked to implement a no visitor designation; Food & Nutrition Services may be asked to provide plastic tableware. 7. Prisoners must follow the hospital smoking policy. In most instances, security reasons preclude prisoner’s use of designated smoking areas. This is the forensic agency’s decision. 8. Telephone service is not permitted for prisoners unless they are on medical LOA status. The telephone will be removed from the room by nursing staff upon admission of a prisoner. However, for prisoners on medical LOA status, payment for services must be made at the time of activation.
9. Payment for television service only is the prisoner’s responsibility and must be made at the time of service activation. 10. Deaths of prisoners must be reported to the Medical Examiner’s Office and the forensic agency. (See also, SMH policies 5.4 Medical Examiner’s Cases and 5.5 Release/Disposal of Body). The forensic agency is responsible for required procedures that might apply, such as photographing and fingerprinting the deceased. If these require hospital support (i.e., need to hold release of the body until fingerprint technician arrives), the forensic staff must communicate the need to hospital staff. Additionally, some forensic agencies require that the SMH form 878, “Patient Prisoner Death Notification/Body Receipt”, be completed by hospital personnel and the forensic staff. Access to the DOC holding area may be obtained by contacting Security at x5-3333. 11. To minimize exposure to other hospital patients, all outpatient prisoners should be escorted directly to a private exam room or waiting area. Inpatient prisoners should not be taken to any hospital area until that area is ready to take the patient directly into an exam or treatment room. 12. Contact Financial Services to answer specific questions regarding insurance precertification requirements. Security: 1. For security reasons, prisoners should NOT be informed of future follow-up appointment dates, times, days of the week, or other scheduling information. 2. Securements (shackles, handcuffs) for security purposes are to be determined, instituted, and maintained by the forensic staff or agency. At no time should metal restraints be attached to bed frames. 3. Revisions to the security plan should be agreed upon by the forensic agency and the clinical team. SMH staff are responsible for communicating such changes to appropriate departments, such as Security Services, Admitting, Food & Nutrition Services, and the Communications Center. 4. If the patient is no longer considered a prisoner or if the forensic agency removes the forensic staff prior to the prisoner’s discharge, the forensic agency must notify nursing, the Communications Center and Security Services. If Security Services and the administrator-on-call believe this poses a possible risk to patients, visitors, or staff, the forensic agency will be contacted to remove the patient from the hospital. 5. Nonmedical security-related questions regarding patient prisoners should be referred to Security Services. Clinical 1. Use of restraint or seclusion (i.e., patient confused and pulling out IV line) are to be determined, instituted, and maintained by the clinical staff in concert with SMH Policy 10.2. 2. As with all patients, prisoners will be discharged when medically stable and with a safe discharge plan. 3. A behavioral management plan of care and disciplinary restrictions will be mutually determined by the clinical team and the forensic staff, as necessary. Other: Specific department guidelines or polices may also apply, for example Ambulatory Care policy, 8.0 Management of Patients from Correctional Facilities, Operating Room policy 1.12, etc. 9.10 History 7/83 Policy number changed from 9.7. 4/86 Reviewed by Patient Registration and Accounting Services, Emergency Department, Security Division, Nursing, and Legal Affairs and Risk Management with small addition reviewed by Policy Development Group. 3/89 Reviewed by Patient Registration and Accounting Services, Emergency Department, and Security and Traffic Division; small changes made. 5/89 Reviewed by Policy Development Group. 5/91 Reviewed by Patient Care Policy Committee. 6/98 Revised by Patient Prisoner Work Group. 7/98 Sent to Clinical Council for approval. 10/98 Approved by Clinical Council 9/01 Reviewed and updated by Security 10/01 Reviewed and approved by Policy Management Team 7/03 Revised by Administrator Security, Security and Traffic Division 8/03 Reviewed and approved by Policy Management Team 10/03 Reviewed and approved by Manager, Patient Access Services, Continuity of Care and Case Management 5/05 Revised by Manager, Patient Access Services, Continuity of Care and Case Management and Security Services 7/05 Approved by Policy Management Team
©2005, University of Rochester
|
 |
