Emergency Department Ambulatory Access

[Rickbos]

I was wondering how many hospitals allow ambulatory patients & visitors to access the ER directly through the ambulance bay? I work in a hospital that for 35 years, has allowed the ambulance bay to be an open access point to the ER & the rest of the hospital. We are moving into a new facility and we want that practice eliminated in order to secure the work site for patient/staff safety and provide higher patient confidentiality. Does anyone know if there are any regulations that define or address this issue? I would appreciate any & all input.

[rjflyn, ASN, RN]

Very Few.

Ours is a secure entrance, anyone passing through the ambulance entrance needs a hospital issued badge coded for that door i.e. ED staff or know the code and punch it in to the key pad.

The last several, 4-5 ED's I worked were that way, one went so far as to change the code monthly, though it changed on a pattern so medics didnt need to be notified each month what it was.

Believe me it only take one time for someone to get a gun in your ED and it will be locked down tighter than you know what.

[Larry77, RN]

We've had 2 guns brought into our dept...both SI patients and both brought in through the front door...point is they will come no matter how secure your back door is. We have a card reader and key pad...local EMS know the code others have to be met at the door.

[OldnurseRN]

We have a camera and when someone comes to the door we buzz them in via the overhead door. We are a critical access hospital and only have 3 staff total in our facility at night. We assume the person there is coming to the ED. No, it isn't safe but, we really have no alternative.

[Lunah, MSN, RN]

Our back door (ambulance entrance) requires a code. The front door from the waiting room has a code for employees, and visitors can be buzzed through the door by the secretary (or whoever answers their call) -- there's a phone by the triage window that rings directly to the secretary's phone at our nurses station for entrance requests.

My (continuing) complaint is that the ambulance entrance door opens when you walk near it. I think it should have a button to activate it, rather than motion sensing. What if someone is at the back door with a gun, and we walk too close to the door? You also have to get right up to the door to turn the key to lock it down, so ... not so safe, in my opinion.

[Virgo_RN, BSN, RN]

Our ambulance entrance has a keypad, requiring a code to be punched in to open it. The door from the lobby has a card reader and only unlocks with an employee badge.

[LilgirlRN, ADN, RN]

Our ER ambulance entrance is as others have described. Our problem is that when the weather is bad the walking wounded don't want to come through the front door because they'll get wet. They go to the ambulance bay and bang on the door. Our facility is just a few years old. When we saw that this would be a problem we asked for an awning. 10,000 bucks they said. No awning.