Prevent Infant Abductions In Your Hospital

An article from CNN "Missing 5-Day-Old Girl Found in				"We only allow people to view the baby with
Texas" demonstrates the reality of infant abduction.				permission from the parents," said Kim Harmon,
"On June 5, 2006 an ailing 5-day-old girl, snatched from				director of women's services at Timpanogos Regional
her mother by a woman who had posed as a hospital				Hospital in Utah.o Only allow visitors up to five minutes
worker, has been found and is being evaluated at				of observation time per visit to the neonatal nursery.
University Medical Center," hospital spokesman Greg				Staff Related Factors
Bruce said according to the article.				Poor preparation and training create inconsistency and
The article states, "It appears that she established				confusion, which abductors can use as an opportune
something of a relationship -- went in the hospital,				time for a potential abduction. Ensure the following:o
presented herself as a nurse, checked on the status				Abduction prevention measures should be reviewed
of the baby and that kind of stuff," said Lt. Roy Basset,				regularly and there should be adequate ongoing,
a Lubbock Police Department spokesman.				in-service training. Infant-abduction drills should be
According to everyone involved in this particular				preformed on a regular basis. Many hospitals are
abduction, no one suspected the woman to be a fraud.				aware of the risk of infant abduction and several of
She even wore scrubs and had a fake ID. Still, it was				these hospitals do routine "baby abduction drills" in the
clear that this incident was something the woman had				mother/baby units. Hospital staff doesn't always know
been planning over a period of several days.				if the code called is a drill or the real thing; and they all
From 1983 to 1998, 177 infants were abducted				have to make sure their patients are accounted for.
according to the national Center for Missing and				Timpanogos Regional Hospital's marketing and public
Exploited Children. Of that total, 100 babies were taken				relations director, Jacque Brown, said at one of the
from the hospital (57 from the mother's hospital room)				drills they used a test patient, where a baby was
and 94 were recovered. According to JCAHO, infant				registered with an identification badge, and then taken
abductions are usually premeditated acts; however, in				out of the hospital by a family member. The mother
most cases the particular infant abducted is taken out				played along as though her baby was actually missing.
of impulse or opportunity.				"I think the scariest thing we've ever done is actually
According to Child Find ( there is a general profile for				one of these drills. We knew what was going on, but
potential abductors and the infants abducted. These				the staff did not," Brown said. As it is done with all of
behaviors/characteristics should be known by hospital				the drills, the hospital went into lockdown, but this time
staff and mothers.				there was a real baby missing.o Hospital personnel
Profile of the Abductoro Usually female and on				should be alert to any unusual behavior they encounter
average 30-years-old.o Normally overweighto				from individuals such as:o Repeated visiting "just to
Generally no prior criminal record.o Appearing normal,				see" or "hold" the infantso Questioning about hospital
but emotionally immature or compulsive.o Has low				procedures and floor layout such as "When is
self-esteemo Wants to replace a lost infant or one				feeding?" or "Where are the stairs located?"o Taking
unable to conceive.o Announces "phantom" pregnancy				uniforms or other means of hospital identification.o
and prepares for an awaiting birth as an expectant				Physically carrying an infant in the hospital instead of
mother would.o Will make themselves known and				using a crib or isoletteo Anyone carrying large
become familiar with the hospital personnel and even				packages, totes or duffel bags off the nursing unit
the infant's parents.o Usually visits the nursery prior to				should have their belongings examined.
the abduction asking detailed questions about hospital				Such behavior should be reported immediately to the
procedures and unit layout.o May visit more than one				unit supervisor.o Be aware of the possibility of
hospital to assess security measures and explore				diversionary tactics being used as a part of the
infant populationso Might not target a particular infant,				abduction. An abductor could create a disturbance in
but take the most available.o Unlikely to leave the				another area of the hospital to create an opportune
community from which the infant was taken.				distraction.o Be conscious of targeted rooms like those
Profile of the Infanto Usually seven days old or				out of view of the nurses' station, close to stairwells,
younger.o Perceived by the abductor as their				fire exits or elevators.o Nursery doors should remain
newborn.o Same race as the abductor or abductor's				locked and never left unattended.
companion.				Policies and Procedureso All infant abduction protocols
Prevention Tips				and response plans should be in writing and known to
Safety and security are key areas that should be				all hospital staff.o Ensure that either the mother or the
involved in systems designed to prevent infant				nursing staff always supervises infants. The infant
abduction. Multiple vendors have products, alarms, and				should always remain in the direct line of sight of either
other measures for protection. Hospitals should				the hospital staff or mother/father/caregiver. Infants
evaluate the various product options to ensure				should never be left unsupervised.o Provide the
selections meet their needs.				parent(s) with educational material and handouts
Additionally, hospitals should establish specific guidelines				explaining hospital policies in place to protect the safety
for staff to follow in the event of an infant abduction.				of infants. Also, teach the parents/family the
Families should also be instructed concerning abduction				importance of abduction precautions.o Instruct the
prevention.				patient/family to notify the nursing staff immediately if
The following are information and ideas to aid in				they have any questions or concerns.o Do not post
creating guidelines and precautions for infant abduction				the mother or infant's name, address, or telephone
prevention.				number where it is visible to visitors.o Only give out
From ankle bracelets to private entrance codes,				information about the infant to the mother/father
hospitals go to great lengths to provide a secure				caregiver and always verify the infant ID number on
environment for mothers and their newborns.				the wristbands before releasing the information.o
Safe Environment				Infants should be taken to mothers one at a time.o
The hospital environment should be assessed for				Require visual proof of the identification and matching
potential security measures. Make sure your hospital is				wristband for a person taking an infant from the
equipped with the following:o Security cameras in				hospital.o At the time of discharge, the mother
strategic locations like the nursery, stairwells, doorways,				dischargee must bring the mother's ID band and photo
elevators, and hallways to monitor the incoming and				ID.
outgoing activity.o Fire doors equipped with special				After analysis of several recently reported infant
alarms. Install alarms with time-delay locks on stairwells				abductions, JCAHO found problems in the procedures
and exit doors.o Consider installing an electronic				and systems of hospitals.
surveillance detection system.o Use baby identification				Common Problemso Security equipment not available,
bands and check the band number with the mother				operational or used as intendedo Problems in
father/caregiver's number before giving the infant to				visualization of key areaso Inadequate patient
either parent. Also, staff should know to check the				educationo Staff related problemso Information related
same bands for corresponding numbers before the				problemso Cultural factors inhibiting confronting
infant is released from the hospital.o Electronic				unidentified visitors
key-card system in newborn areas for staff.o				Ways to Minimize Error
Nurseries and maternity wards are located away from				1. Reduce reliance on memory. Nurses, doctors, and
lobbies with street access with doors always locked.				other hospital staff have an overwhelming amount to
Patient Information				remember daily. Use checklists for assessments and
Measures for infant identification include a variety of				procedures.
standard methods plus new devices:o Foot printso				2. Simplify. Keep policies and procedures simple to
Hand/finger printso Head shotso Written description of				guarantee staff compliance, but complete to ensure
the infant, medical records, and special identifying				patient safety. Reducing the number of steps makes it
markso Infant Protection Systems with baby				easier for staff to remember, fulfill and perform policies
identification bracelets and alarms ( Such systems				and procedures.
have special ID devices that will set off alarms if the				3. Regulate. All policies, procedures and forms should
bracelet is cut or if an infant is taken from the unit				be clearly documented and standardized. Staff must
facility without permission.o Numbered umbilical cord				be oriented, trained and demonstrate competence in
clamps with matching identification wrist bands. These				these policies. All nurses should be instructed during an
bands should be secured on the infant's ankle and				initial orientation and each quarter in abduction
wrist and the matching two should be placed on both				prevention procedures, precautions, and guidelines.
the mother and father/caregiver's wrists.o Mark infant				4. Use restrictions. If a divergence/discrepancy occurs
gowns at the neckline with the hospital name and logo				in procedure, create a "stop" process so that proper
so the infant is able to be quickly identified as a patient				action must be ensured before proceeding. If any
of the hospital.o Infant blankets should be marked on all				difference occurs in patient identification or transport to
four corners so the infant is readily identified as a				mother, create "stops" so the baby is identified and
patient of the hospital.				secured.
Staff Identification				5. Inform. Actively involve mothers in the care of their
Proper identification of hospital personnel is critical as				newborn. Inform the parent(s) about policies and
an abductor may pose as a nurse, doctor, or other				procedures that are designed for infant safety and
staff member.o All hospital personnel must wear photo				security.
identification badges with the hospital logo. Each ID				6. Reduce handoffs. Reducing the number of steps,
badge must be worn on the outside of their clothing				persons involved and handoffs will reduce the risk of
with the photograph facing outward.				errors.
"I look for the pink badges," said Amey Walters, a new				"If mom wants to give the baby to grandma, that's
mother at Intermountain Healthcare Hospital in Utah.				mom's choice, but the hospital staff [is] only going to
She said she appreciates the hospital's security				give the baby to mom," said Brown.
measures. The hospital workers wear special pink				Have the same personnel provide care as much as
bars on their name tags to identify them as nurses				possible to reduce inconsistency and risk of unfamiliar
who are allowed to handle the newborns.o Anyone				personnel. Multiple caregivers or handoffs to other
transporting the infant outside of the mother's room				departments increase the chance that the mother
must wear an identification wristband and can only				may not know who is with her baby.
transport a newborn by use of a crib or isolette.				7. Keep a safe environment. Make sure the hospital
Nursing staff, physicians, mother/father/caregiver with				work environment focuses on safety and prevention.
valid corresponding wristband are the only people to				Ensure that there is good visibility of infants and entry
transport the infant.				exits, restricted access to unauthorized personnel and
Nurse Janet Frank, public relations director for Orem				the ability to "lock down" quickly.
Community, American Fork, and Utah Valley Regional				8. Team training. An effective team will make fewer
Medical hospitals in Utah, said baby transporters have				errors so training can enhance teamwork. Develop
a special method of carrying the infant. "If a baby isn't				mechanisms to train new and current staff on policies
being transported that way, we know there is a				procedures, safety measures, new equipment and
problem," she said.o Staff should identify themselves to				ensure proficiency. Also, encourage feedback
the mother, instruct the mother of procedures their				because this will correct behaviors leading to problems
infant will be taken for, and expect the mother to				and will minimize error.
question anyone not properly identified.				A good idea is to establish a review mechanism for
Visitor Identification				identifying system errors to reduce errors rather than
Consider ways to provide visiting times for families and				focusing blame on individuals.
friends while ensuring proper precautions are in place.o				Infant abductions are generally infrequent, yet
All visitors must immediately sign-in at the nurses'				devastating for anyone involved. It is important for
station upon arrival. Ask the visitor which mother they				hospital staff, nurses, and the mother and father
want to see, and each visitor must be signed out				caregiver to be aware of the potential threat and to
when leaving.o Distinctive stickers with the date of the				keep security measures in mind. Preventative methods
visit should be obtained at the check-in area and given				and guidelines are the first step to creating a safe
to visitors to wear while in the hospital.o No person				environment for a newborn. The second is continuing
should be allowed in without proper identification.o				to follow through with the precautions. This is
Mothers should be asked to designate a limited				something that can be prevented.
number of visitors who can come to the nursery.

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Prevent Infant Abductions In Your Hospital