This document is a summarised version of OP-RS5 – Search of Patient or Visitor. The summary has been created to be Emergency Department specific, and was endorsed by the ED Leadership Team and Security Leadership. Staff should review the full document if they require further information.
Overview
This QRG provides an overview of procedures for ensuring patient (or visitor) searches are part of an organisational wide coordinated clinician and security response. Staff members may only perform a search of a patient (or visitor) after obtaining consent; or if authorised by law (e.g. Mental Health Act; MHA 2014)
Applicability
This QRG is applicable to all staff working in Western Health (WH) Emergency Departments (EDs).
Responsibility
The ED Nurse Unit Manager/s, and Directors are responsible for ensuring that all relevant staff are appropriately trained and orientated. All WH ED staff are to ensure this guideline is always adhered to.
Guideline Details
When to Conduct a Search
A search may be undertaken when clinical staff have undertaken a risk assessment and – based on clinical judgement – believe there to be reasonable suspicion that the patient has items in their possession that may be used to cause significant harm to self or others.
All patient searches must be clinically led with assistance from WH security staff whenever required.
Before conducting a search, clinical staff should ask the patient – “Do you have any items on your person which may be considered dangerous or inappropriate? Would you hand over these items?” If the patient hands over the items, a search may not be required.
Consent
A patient’s consent must be obtained before a search is undertaken. All patients must be presumed to have capacity to give informed consent unless it can be demonstrated that the person lacks capacity at the time the decision needs to be made.
The patient being searched is informed that the search is voluntary, and that consent can be withdrawn at any time. Refer to P-CM3 Patient Consent for further guidance.
The exception to this is when police have transported the patient to the ED and are available to search the patient on arrival.
If consent is refused or withdrawn:
- Consider review of the patient by the home team and if they are required to stay in hospital (only applicable to patients not being held in hospital under MHA or Medical Duty of Care).
- Alternatively, a Code Black may need to be called; involving Police assistance (and powers) to search the patient. Refer to OP-RS5 Emergency Procedures Manual for further guidance.
- Discharging a patient because of their refusal to consent to a search should be considered as a last resort.
Process for Conducting a Search of Patient’s Person and Property/Belongings
- Always maintain the patient privacy and be cognisant of dignity and patient experience during a search. Staff should consider, gender, culture, and previous history of trauma.
- If a language barrier exists use an interpreter.
- Staff should use appropriate PPE.
- Non-contact screening activities should be sufficient for a search:
- Requesting the person to empty their pockets.
- Pat down consisting of the patting of persons pockets, side of torso, outside of legs and around ankles. This must be conducted over the patient’s clothing.
- Metal detection scanning including use of electronic wands (by security staff only).
- Always complete a search in the presence of another WH staff member.
- Search must be conducted by WH staff of the same gender as the patient identifies, if the patient doesn’t identify as either gender then they may select the gender they are most comfortable with to complete the search.
Mental Health Act (2014) Considerations
Clinical staff should always seek the patient’s consent for a search. When a patient refuses, are unable or lack the capacity to consent – and discharge from hospital or refusal of service is unreasonable – a search may be consented to by the Authorized Psychiatrist or delegate.
Where consent of an Involuntary Patient has not been forthcoming; and based on a clinical risk assessment there is still cause for concern, a Code Black response should be initiated.
Non-Invasive Wand Search of all section 351 Patient Presentations – Sunshine and Footscray Emergency Departments (Figure 1):
- On presentation of police with a s351 patient to Sunshine or Footscray ED, the ED admitting staff member will call the security phone and request a ‘planned code grey – 351’ for a non-invasive search (this will allow accurate documentation to track numbers per month)
- Footscray (0417 037 873) / Sunshine (0432 758 929)
- The Supervisor mobile can be called if this number is not contactable.
- The ED roving security officer (only) will retrieve the metal detector wand device from the extraction pad cupboard (SH) or the fire panel room (FH) and attend as soon as possible.
- The ED roving security officer will conduct search as requested with the clinical lead present at the BOC/BAR (SH) or BAR (FH) room, in the presence of police.
- The search is to be conducted in line with training provided and Western Health procedure OP-SE5 – Search of Patient or Visitor.
- If the metal detection device detects any suspicious items on the s351 patient, police are to be requested to conduct a more thorough search.
- The security team leader is to be contacted for any assistance or advice by the ED roving officer where required.
- If more than one 351 patient presents at a time a triage system is will be used.
- Where the ED roving officer is attending a code response in ED, the ED rover will either be released from the code by approval from the security team leader, if safe to do so, or attend the s351 search request as soon as available to do so.
- Note: The ED roving security officer assigned to ED is required to always carry the No 3 security phone at each site.
Figure 1: Non-Invasive Wand Search of all section 351 Patient Presentations – Sunshine and Footscray Emergency Departments
Searching of Visitors
All searches of visitor’s property must be undertaken by security or police, however, searches of a visitor’s person can only be undertaken by police. If staff believe there is a reason to search a visitor it must be referred to a security team member.
Documentation
Once a search has been completed the following information must be documented in the EMR, clinical file and Riskman:
- The reason for the search / the risk that was assessed.
- If consent was obtained / or not (why not).
- Full name of all staff involved in the search.
- Actions taken (description of the search).
- The outcome of the search.
- Arrangements for storing or disposing of any objects or substances found.
Supporting Documentation:
Document Governance:
| Title: |
Search of a Patient or Visitor |
| Version: |
2.0 |
| Date Published: |
May, 2022 |
| Date of scheduled review: |
01/02/2023 |
| Author: |
Approver: |
| ED Leadership Team |
ED Leadership Team |
