Safety in Non-Institutional Settings

In the last unit we learned of the organization's responsibility in establishing protective policies for staff working outside the hospital, such as in home care settings. You also have to be active in following a safety checklist:

• Review agency files to confirm that a background check was done on a patient regarding any history of violence or crime, drug and alcohol abuse, and mental health diagnoses. Also check to see if a patient's family member has a record of violence or arrest.
• If entering a situation already assessed by telephone as potentially dangerous, you should be accompanied by a team member who has training in de-escalation and crisis intervention (Hoff & Hoff, 2012). Years ago in early crisis outreach work the two-person team was established as a national standard, although this standard is often breached in the name of cost containment, and unfortunately, sometimes at great cost to healthcare workers in terms of safety.
• Travel with a cell phone.
• Make sure someone knows where you are. Have a code: call your office and use the code word to let them know you're in trouble, assuming you can't call the police.

You will see a home-health care scenario in Unit 11: Case Study 3.