CODE PINK: INFANT ABDUCTION PROCEDURES TO BE FOLLOWED IN THE EVENT AN INFANT ABDUCTION OCCURS AT LOMA LINDA UNIVERSITY HEALTH RESPONSE Hospital wide response to “Code Pink”. Research documenting that CPOE systems used in the hospital setting can decrease adverse drug events has fostered the promise and potential for CPOE to make the hospital a safer place for our patients, particularly when enhanced with decision support. Such scenarios might include having people pose as lab personnel or pulling the fire alarm to create a diversion. This was the case of Nikenya Washington, who actually entered the room of the would-be victim’s mother early in the evening on the night of the crime. “I think pediatricians should be completely supportive of programs that provide a safety net,” says Dr. Broughton. Prevention is the best defense against infant abductions.Infant abduction seems to be distinct from other types of kidnapping in several ways. Mortality odds ratios were calculated, and observed mortality before CPOE implementation was consistently better than after CPOE implementation. Issues such as being unable to enter orders on a patient in preparation of their arrival because they were not yet enrolled in the electronic system hampered the availability of important medications at the time of arrival.
There are as many as 20,000 abductions by family members in the United States each year.Every day in our practice we make efforts to compensate for failures in our methods to prevent errors from impacting our patient’s care. More disturbingly, though, the incidence of out-of-hospital abductions and the use of violence in abductions seem on the rise. There are also sections on how to advise parents and how to assess level of preparedness.Over the past several years attention has been increasingly focused on the inadequacy of patient safety in our practices. The dichotomy may be omnipresent: Use the system to gain protections from errors and bypass the system when its design or function interferes with good patient practice. Testicular exam should be incorporated as part of every physical exam, especially if an abdominal complaint exists.Heliox is a 70%/30% helium/oxygen mixture. The first unique characteristic of infant abduction is the profile of the stereotypical perpetrator. The person in the hooded sweatshirt standing near the entrance looked suspicious to respiratory therapist Betty Collins as she entered the newborn nursery on the evening of Jan. 12, 2006, during her shift at Ouachita County Medical Center in Camden, Ark. Getting physicians to say, “this is important” is an essential first step.Though changes in the landscape of infant abduction are difficult to discern, a few trends are notable.
Australian hospitals and other buildings are covered by Australian Standard 4083 (1997) and many are in the process of changing to those standards. Among these about 29% have involved violence to the parents or family of the infant including eight cases of homicide.Obviously, preventing abductions outside the hospital presents its own challenges.
The review included 436 patients ranging from one to 25 years. Male subjects were hesitant to seek medical attention for conditions associated with the genitals. Thankfully, the healthy 8-pound, 1-once baby girl was safely returned to her mother. Many are overweight, and they may have a history of depression or lying, manipulative behavior.Additionally, the motives of these women are notably different than those of other kidnappers who are interested in sexual exploitation, money, or revenge. Some kidnappers have even bought baby items or furnished nurseries in anticipation of having a child. Similarly, the pharmacy reviewed and processed the order before the medication was available to the nurse for delivery to the patient.These checks and balances have the potential to prevent errors in medication ordering, but if inefficient, they may not be appropriate for an intensive care setting in every circumstance.
The implementation of CPOE for improved patient safety requires exploration given the exposed inadequacies of our current methods of practice.Like any best practice this exploration will be continuous and require evaluation and improvement. Many offenders visit the hospitals or other facilities they later target on several occasions prior to an attempted abduction. After all factors (race, insurance status, income, region, and hospital location) were evaluated, increased age at presentation was the only statistically significant factor associated orchiectomy.
Further delays were evident due to the fact that a nurse had to activate orders placed by the physician, bypassing some of the efficiency of an electronic system.
Collins and the other nurse in the unit bravely wrestled with the would-be abductor. As the director of the Child Abuse Program at the Mayo Clinic in Rochester, Minn., and co-author of the American Academy of Pediatrics’ Clinical Report on the pediatrician’s role in the prevention of missing children, he is an expert on the subject.There are an estimated 1-2 million runaways and as many as 200,000 abductions by family members in the United States each year. Code Red. “These shouldn’t include any specifically identifying information,” she states, such as full names of parents or a home address.Second, parents must understand the potential danger of posting signs or balloons outside the home after a birth, as these might alert a potential abductor to the presence of an infant. Something didn’t seem quite right. In response, hospitals, insurers, and practices have examined many potential changes to current systems in an effort to improve safety.The Institute of Medicine (IOM) and the Leapfrog Group have championed computerized physician order entry (CPOE) as necessary for improving patient safety, citing the inadequacy of paper and pen for the ordering process. Currently in its eighth edition by John Rabun of the NCEMC, the book discusses the problem of infant abduction and defines its scope.