Maintenance helping with medical procedures.

[Nurse-C]

I work in a 65 bed hospital, on occasion when a male pt. becomes combative maintenance is called into assist with security & including helping contain pt's for medical procedures, like drawing lab, changing a foley, once a spinal tap,injections anyway these men have been no telling where doing their job in dirty areas, besides they are untrained non medical people what if they hurt a pt. during a struggle or get hurt themself. Is this a violation? I don't see why the men from x-ray, lab, resp, and other male nurses can't be called instead. Once I thought one of the maintenance men was going to pass out himself and one even commented that he personally felt traumatized himself .Thanks

[RN1989]

I've seen this at several small hospitals and I think it is ridiculous. They are also used as security officers because the hospital declines to pay for real ones. I think this type of thing is inappropriate and dangerous but getting it to stop is unlikely.

[TiggerBelly]

If a Code 99 is called (missing adult patient) then maintenance will help man doors and look in stairwells for the missing patient. Other than that, thats the extent of their duties are far as helping the medical team goes. They have enough on their plate with fixing TV's, patching holes in the walls, fixing that leaky sink than to have to be in the room when a medical procedure is taking place.

Unless it stated on their job duties when they were hired that they would be called into patient's rooms for assistance, then IMO they should not have to go through that.

[OldPhatMC]

I work in a 65 bed hospital, on occasion when a male pt. becomes combative maintenance is called into assist with security & including helping contain pt's for medical procedures, like drawing lab, changing a foley, once a spinal tap,injections anyway these men have been no telling where doing their job in dirty areas, besides they are untrained non medical people what if they hurt a pt. during a struggle or get hurt themself. Is this a violation? I don't see why the men from x-ray, lab, resp, and other male nurses can't be called instead. Once I thought one of the maintenance men was going to pass out himself and one even commented that he personally felt traumatized himself .Thanks

:nono:I'd also think this was a big stinky HIPAA violation. I'd be guessing that the maintenance guy is not trained in HIPAA and would present an immediate violation.

[nuangel1, BSN, RN]

its not a surpriseto me that this occurs.i work at a community hospital ed we only have full time security officers on days .on eves /nocs there is one person.when we call a code grey ie combative agitated pt ,may or maynot be drunk drugged or a 1:1 psych pt maintenance men aides our drs and pa's help in restraining pt .sometimes in extreme cases we call the local cops .they come.

[cjmjmom]

I have not worked in a hospital with less than 150 patients however, unless it was an EXTREME

[PoppaD]

:nono:I'd also think this was a big stinky HIPAA violation. I'd be guessing that the maintenance guy is not trained in HIPAA and would present an immediate violation.

All hospital staff and volunteers have to comply with HIPPA...

[OldPhatMC]

All hospital staff and volunteers have to comply with HIPPA...

No argument that all staff should be HIPAA trained, but is the maintenance guy trained? If the hospital takes someone like a maintenance worker to do security work, it is up to the hospital to make sure that appropriate personal safety and HIPAA training are provided. In a small hospital environment, wouldn't it be more likely that maintenance would be skipped over than the direct care staff?

My yellow flag in this case is that it's implied that the maintenance guy is not trained as a security officer. Just being a male that can lift heavy stuff does not automatically endow one with knowledge of safe patient handling techniques. And OSHA is big on personal safety, so is this employee trained in protecting him/herself?

Sorry about the initial post. I need to remember to only post when I

am awake and oriented. :zzzzz

[PoppaD]

No argument that all staff should be HIPAA trained, but is the maintenance guy trained? If the hospital takes someone like a maintenance worker to do security work, it is up to the hospital to make sure that appropriate personal safety and HIPAA training are provided. In a small hospital environment, wouldn't it be more likely that maintenance would be skipped over than the direct care staff?

Every hospital that receives federal reimbursement must comply with CMA regulations. The privavcy provisions per HIPPA are are prime concern to CMA. If you recall your own hospital orientation...there were people there from not only clinical services, but also your security officers, maintenance guys, kitchen folks, etc.

The fact that the hospital is dual hatting it's maintenance staff to serve in "extended roles" does not mean that the facility is not complying with HIPAA.

[Nurse-C]

I hadn't even thought about OSHA.

[OldPhatMC]

Every hospital that receives federal reimbursement must comply with CMA regulations. The privacy provisions per HIPPA are are prime concern to CMA. If you recall your own hospital orientation...there were people there from not only clinical services, but also your security officers, maintenance guys, kitchen folks, etc.

The fact that the hospital is dual hatting it's maintenance staff to serve in "extended roles" does not mean that the facility is not complying with HIPAA.

I fully agree with you that there are many mandates that even a small hospital would need to meet for each and every employee. I'm in agreement with your analysis and approach.

However, since I've had some time in the compliance business, my take on this is that some people get missed; some training programs are great for documentation and poor at causing affective changes; and small hospitals have limited resources for training and monitoring.

In that neither of us are on the ground with the employee in question and don't know the full story, we both reflected back to the OP viewpoints which are worth considering. Ultimately it's the patient who gains or loses based on how compliant the employee is with HIPAA, OSHA, and the raft of other requirements.

Personally, I think that loose talk and breaching confidentiality is a harmful thing, but not as harmful as an employee who is not trained in security causing an escalation of tension, harming a patient, or getting trapped in a situation. Nothing at all wrong with dual-hatting workers: we do it with fire and EMS, but we expect a fire medic to be trained in both roles. I would hope that a custodial worker was very aware of what PHI looked like and how to safeguard it.

It does no harm to verify compliance has occurred. The answer might be surprising, but we can hope otherwise. Be we shouldn't assume otherwise.

[TiredMD]

If the maintenance person isn't HIPAA trained, then the institution is violating the law every time he walks through a patient care area, so this aspect is kind of moot point.

Last I checked, there was no special certification that made someone "trained" to be a security guard in a hospital. I have worked in hospitals where security was specially-assigned officers trained at the State Police Academy. I have also worked in hospitals where security jobs were farmed out to private companies that paid minimum wage.

Neither does assisting in a bedside procedure require any special training or certification. I have used security guards and hospital volunteers to help position patients, especially when they are drunk or immobile. Once in a while when I can't get help, I'll have parents pin their kids down while I work on them. The only person liable in situations like this is the physician, whose license is on the line for any complications resulting from their assistance.

It may not be the greatest idea in the world, but there is nothing illegal about it.