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An annual self-assessment tool is created to assist each facility with the identification of potential risk and the development of defensive measures for future threats.

Infant Security - Threat Analysis   >

The Threat Analysis helps identify potential risk to your maternal-child and pediatric units and assist in the development of an assessment tool for your facility. Specific threats are identified and analyzed so that security measures can be implemented to eliminate or reduce as much as possible imminent threats as well as potential threats to your maternal-child and pediatric units. Every hospital needs to conduct an initial Threat Analysis followed by an annual Self-Assessment to meet JCAHO Standards as well as industry norms. To meet JCAHO and industry standards, it is important for hospitals to develop an on-going assessment program with well defined, security protocols, policies, and procedures, reinforced with education and training.

Security Assessments International will be glad to evaluate your existing security practices and offer our recommendations to assist you in the protection of your mother/baby and pediatric units in a mutually acceptable time frame and at a reasonable cost.


Hospital Infant Security Risk Factors

YES

NO

1. Sensitive areas not equipped with controlled access or appropriate locking mechanism and maintained in the lock position at all times. 

   

 

 

2.  Open visitation with no visitor control.

 

 

 

3.      Access codes that are not changed periodically or upon termination or resignation of employees.

 

 

 

4.      Emergency Exits / Egresses not equipped with time delay locks and alarms. (Must meet NFPA Requirements)

 

 

 

5.      No video surveillance cameras installed in the nursery and pediatric units which monitor access into and out of  these sensitive areas.

 

 

 

6.      Closed Circuit Television Cameras without record and archive capability as well as cameras not positioned to capture appropriate images.

       

 

 

7.      Electronic Infant Protection Systems not equipped to alarm if a band is cut, falls off, or removed by an unauthorized individual and a system  not UL 294 Listed or with an equivalent listing.

 

 

 

8.      Facilities that have not had a comprehensive security assessment by a qualified healthcare security professional within the past 3 years?

 

 

 

9.    Hospitals that do not have appropriately written protocols, policies, and procedures, re-enforced with education and training, approved by the safety committee, and documented.

 

 

 

10.  Employees and Staff that do not wear a facility photo I.D. badge facing forward, at chest level that displays the hospital logo, individual's name, department, and professional credentials.

 

 

 

11.  Any education and training conducted that is not documented  in the employee’s education and training records.

 

 

 

12.  Maternal-Child Care Units that do not provide a second form of identification for care-givers authorized to handle babies.

 

 

 

13.  Facilities that do not place I.D. bands, infant security tags, and parent identification on the baby and mother in the Delivery Room.

 

 

 

14.  Facilities that do not check the information on the infant’s band for accuracy before the baby leaves the Delivery Room and during any transfer or movement up to and including discharge.

 

 

 

15.  Facilities that do not require fathers and significant others authorized to handle and transport babies to be banded.

 

 

 

16.  Employees and staff not trained on the National Center For Missing & Exploited Children’s “Typical Profile” of the infant abductor, maternity safeguards, visitor policy, physical security, admission/discharge procedures, I.D. Systems, Infant Alarm Systems, and Critical Incident Response.

 

 

 

17.  Facilities that do not have a Critical Incident Emergency Response Plan which includes the establishment of a “Hotline” and Event Control Log.

 

 

 

18.  Facilities that have a Critical Incident emergency Response Plan , but do not exercise their plan on a regular basis.

 

 

 

19.  Personal information about the parents /mothers / infants (i.e. names, address, delivery information, etc.) conspicuously displayed in the nursery or postpartum units.

 

 

 

20.  Hospitals that do not have a written agreement, signed by the mother and placed in her medical record showing that the mother has read applicable material and understands her responsibility for assisting in the protection of her child, not only while in the hospital, but also after discharge.

 

 

 

21.  Hospitals that place “birth announcements” in the newspaper without a signed consent from the parents and do not warn parents of the risk of placing “birth announcements” in the newspaper as well as warning parents of the danger of placing complete names and addresses in the “birth announcements” of a newspaper.

.

 

 

22.  Hospital maternal-child care units that do not have appropriately written protocols re-enforced with education and training addressing mother/baby matching and infant switching.

 

 

 

 


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