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Demand for ‘supervision services’ for violent patients

More than 125,000 hours of close supervision of violent and/or aggressive patients were required at University Hospital Galway (UHG) last year, new data has revealed.

Close supervision by security personnel is required when a patient is considered by staff to be a danger to themselves, other patients or staff by being “aggressive or violent”.

An average of 43 security officers per day were allocated to close supervision services in UHG alone in 2018.

The huge demand for close supervision services at the hospital reflects the immense challenges faced by hospital staff and others in dealing with difficult patients.

According to documents released by Saolta University Health Care Group seeking new security services, including close supervision, for UHG, Merlin Park University Hospital and Roscommon University Hospital: “Where a patient is a danger to himself, other patients or staff through being aggressive or violent, and it is beyond the capacity of nursing staff to manage the case, then the nursing manager can request the consultant/registrar to consider placing close supervision with the patient to support the staff caring/responsible for the patient to observe and prevent any harm to themselves or others and minimise the risks.

“Where the consultant/registrar deem it appropriate to do so, this must be documented in the patient’s medical notes and on the patient close supervision documentation daily. The requirement for close supervision is expected to decrease substantially from the current position following the award of the contract.”

Close supervision may include, in an emergency to deal with a crisis situation, “a longer-term intervention for a situation to assist clinical staff undertake clinical interventions and/or for the protection of other patients/visitors, for the prevention and detection of anti-social behaviour and for the protection and wellbeing of the patient”.

The security officer on close supervision is charged with ensuring that a patient does not abscond and should be constantly aware of the patient’s precise whereabouts through visual observation or hearing, according to the hospital.

Security officers may also be required to assist in instances where a patient is seeking to leave the emergency department without being formally discharged.

In other instances, “patients who are very ill may become confused or disorientated and may seek to engage in activity that causes disruption in the unit and interferes with other patients. In any instance of this type, security personnel will respond and assist the clinical team.”

Recently, the Medical Independent revealed that 566 violent incidents took place in University of Limerick (UL) Hospitals Group between 2016 and 2018.

The IMO has also brought up the issue of violence against health professionals at its AGM.

See feature, p14et the same standards as those who have trained in the UK will make this process much easier.”

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