Ask the expert: Security risks in the ICU
Q: Where do ICU security breakdowns most commonly occur in high-stress moments? Are there specific triggers or scenarios where incidents tend to escalate?
Blake Garcia, executive director of Covey Security: Many times, patients are in the ICU with life-threatening conditions, which can lead to heightened emotions and stress. These heightened levels can lead to adverse reactions where security may be called to help mitigate the situation.
People don’t always know how to handle news and emotions they weren’t prepared for. In unfortunate circumstances, if family members or loved ones begin to blame medical staff for their particular predicament, security may be involved to de-escalate a situation.
Q: How should hospitals balance open access for families with controlled access for safety in the ICU? What principles should guide decisions around badges, escorts, visiting limits, or lockdowns without harming care or compassion?
Garcia: The inside of an ICU must remain restricted for the well-being of the patient. This is much more of a medical issue than one of security.
However, vigilance should be maintained for visitors who might be dealing with a highly stressful situation. This is more about staff being proactive in calling security if they witness behavior that could lead to escalation. ICU visitors should be limited only to immediate family or known significant others. The less people, the less risk. While this might cause discomfort, we need to be mindful of the medical staff who work in these environments; their safety is paramount.
Q: What role should security play during emotionally charged ICU situations, and where should the line be drawn? How do you define the difference between “supporting care” and “over-policing” in sensitive clinical environments?
Garcia: Security is there to help the medical staff feel like they are protected so they can properly administer the care they need to provide to patients in the ICU. Security may overstep their boundaries if they are too forceful with loved ones or mistake proper grieving as potential escalation. Training is important in these circumstances, as is properly communicating with the medical staff.
Editor’s note: This Q&A was excerpted from our Healthcare Safety Leader newsletter.