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Mr. / Mrs. strong

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Purpose

To provide a procedure that can be implemented to summon assistance tomanage potentially assailant persons.

Definitions

(Mr. or Mrs. strong) is the code used to summon assistance when it is or may benecessary to manage a potentially assailant person

OVR: Occurrence Variance Report

EOD: Executive on Duty

responsibility It is the responsibility of each department to ensure that all of his/her staff

awareness of this policy

Policy

During a code to manage a potentially assailant person, staff shall be aware ofpersonal items and clothing worn on duty, which may be used to cause harm toanyone in the area. Items such as stethoscopes, eyeglasses, watches, scissors,

pens, lighters and matches shall be removed and secured in a safe place prior toapproaching the problem person. Name pins, badges, earrings, necklaces andchains shall be out of sight or secured so that they cannot be used as weapons.Clothing shall have no loose ties, collars or edges that could be pulled by theproblem person.

Note: If the problem person is female, male staff may assist in her management,but there must be at least one female staff member present.

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Procedure:The decision to make a MR STRONG announcement shall be made by

the charge nurse /person on duty in the area. In the EMS, the charge

nurse or primary EMS physician shall make this decision.

Dial #4444 and inform security to announce CODE MR STRONG and

specify the location clearly repeating it three (3) times.Security command center operator shall contact via Bravo group#

the Mr. strong 1st respond team which includes:

The on duty Safety & Security Officer. Bravo # 36

The master key security patrol. Bravo # 88

Female security Bravo # 90

Social worker Bravo #Note: If assistance is required to manage a female patient, staff should

announce

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MRS STRONG plus the location three times.

The charge nurse/person in the area will direct the activities andwill be the team leader of the 1st Mr. Strong response groupunless he or she is directly involved with the Assailant person.Actions taken by the group leader shall include the following:

Talking with the problem person.

Clear the area of people and equipment.

Try to take the assailant in another room which is equipmentand sharp/harmful items free

Assign someone to stay with other patients, visitors, etc. inthe area.

Assign an authorized person to prepare and administratemedications if ordered.

Advice the social worker on arrival on the case to properlyapproach the problem person.

How and when the team will approach the problem person.

Advice security to be visible but not to directly to havecontact with the person unless necessary

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If the case is not solved, to advice the Safety& Security officer to contact the secondresponse group thru the operator whichincludes: Executive on Duty (EOD), ER

physician, 2 nurses preferred to be Arabicspeaking and same sex of assailant personand more security back up.

Noting times of responses to activitiesduring the code.

Ensure the documentation of activitiesbefore, during and after the Code.

Conduct and attend the Code debriefingsessions.

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Mr. Strong 1st response team shall respond to thearea announced immediately when notified.

All responding staff shall be directed by the charge

nurse/person in charge of the code area and are not

to approach the problem person alone or withoutspecific instructions by the initiating staff.

All documentation of the event including the case

summary and findings in addition to the case OVR

shall be forwarded to concerned departments

including TQM, patient affairs and the Social worker.

Mr. Strong team shall meet every two months to

discuss all incidents and OVR during the period.

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Advice the social worker on arrival on the case to properlyapproach the problem person.

How and when the team will approach the problem person.

Advice security to be visible but not to directly to havecontact with the person unless necessary

If the case is not solved to advice the Safety & Securityofficer to contact the second response group thru theoperator which includes: Executive on Duty (EOD), ERphysician, 2 nurses preferred to be Arabic speaking andsame sex of Assailant person and more security back up.

Noting times of responses to activities during the code.

Ensure the documentation of activities before, during andafter the Code.

Conduct and attend the Code debriefing sessions.

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VIOLENT INCIDENT REPORT FORM

A reportable violent incident is defined as any threatening remark or overt act of physical violence againstperson (s) or property, whether reported or observed.

Date: Day of Week: Time:Assailant Male Female

Specific Location of Incident:

Violence Directed Toward: Patient Staff Visitor Other:

Assailant: Patient Staff Visitor Other:

Assailants Name if Known:Name of Victims:Predisposing Factors: Intoxicated Dissatisfied with Care/Waiting Grief Reaction Prior History of

Violence Other:

Description of Incident: Physical Abuse Verbal Abuse

Injuries: Yes No Extent of Injuries:

Detailed Description of Incident:

Did any person leave the area due to the incident? Yes No Unable to determine

Present at time of incident: Police Name of Department:

Necessary to Call: Police Name of Department:Hospital Security Officer

Resolution of Incident: Diffused Police Notified Arrested

Disposition of Assailant: Stayed on Premises Escorted Off Premises Left on Own AccordOther:

Were restraints utilized? Yes No Type:

Witnesses (list)

Completed By: Date/Time: Supervisor Notified: Date/Time:

Security Management Program Revision Date: 06/2006 ATTACHMENT H

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Ms / Mrs. Strong

(Code gray)Preparation:

If you are informed that there is Mr. /Mrs. Strongsituation, prepare yourself to handle a violent client.

Dont hesitate, leave everything and go a headquickly to the place you have been informed to go to.

Take a deep breath when you are on your way to goto the client.

Control yourself.

Believe that the client is always right.

Believe that the patient and his/her family aresuffering and always need support and help.

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How to Approach to Mr./Mrs. Strong Approach the client with mild trust steps ( if you arein a hurry, the client could feel that you will attackhim/her )

Approach with a smile.

Stop any arguments between the client andemployee.

Remove the client to another quiet closed place.

Gives the client the feeling that he/she is the most

important client in the hospital. Calm the client down with support words.

Ex: We are all here for you we will take care ofeverything...etc

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Serve the client water or juice in a paper cup. Begin to discuss with the client the reason of the

problem and begin with supporting wordsdepending on the problem.

Ex: We will solve your problem- it's just a simple

misunderstanding.... etc Gives the client the chance to explain the problem

in his/her way.

Control your voice and your eye contact during thediscussion with the client.

In case the client continues saying bad wordscontrol yourself and support him/her by sayingcomforting words Ex : It's ok- just tell us what'shappened we're here for solving your problem.

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If you feel that you will lose your temper

give yourself a second.

Concentrate on controlling yourself takea deep breath and then return back to

the client.

If you feel that you will lose control

excuse yourself and leave the client, call

someone else to handle the situation.