HospitalInspections.org

10686


Based on document review and staff interview, the facility failed to (a) provide training in hospital policies to the New Paid Detail Officers contracted to provide services at the facility, and (b) develop a plan to evaluate this contracted service.

Findings include:

Review of the New York Police Department (NYPD) Paid Detail Agreement with the Facility, dated May 15, 2018 documented, "Police Officers assigned to the Paid Detail Program are bound by the rules and procedures (i.e., Patrol Guide) of NYPD as well as laws of the United States, State of New York, and the City of New York."

During interview on 5/31/18 at 11:58 AM, Staff E, Director of Security, stated that the contract with NYPD for Paid Detail services started about a month ago, in May 2018. The NYPD Precinct provides the facility one (1) Paid Detail NYPD Officer every shift. The Paid Detail Officer carries a gun, handcuffs, and a taser in accordance with the NYPD regulations. Staff E stated the Hospital Security staff are trained to call the NYPD Paid Detail Officers on-site to respond for assistance when there is a crime or assault within the hospital premises; they are also called to assist in the management of aggressive/emotionally disturbed patients in the Emergency Department and in the in-patient units.

During interview on 5/31/18 at 1:54 PM, Staff F, Vice President and Chief of Staff, when asked about the paid detail officers responding to security's call, stated that the role of the NYPD Paid Detail Officer is to patrol the facility perimeter and surrounding area of the hospital.
Staff F acknowledged that the facility has not provided any orientation and training to the NYPD Paid Detail Officers working in the facility.

During interview with Staff E and F on 5/31/18 at approximately 1:54 PM, they acknowledged that the facility has not developed a plan to evaluate the services provided by the NYPD Paid Detail Officers.

10686


Based on document review and staff interview, the facility did not ensure that the contract with the New York Police Department (NYPD) Paid Detail officers, included a delineation of the duties and responsibilities of the NYPD Paid Detail Officers.

Findings include:

Review of the Agreement between the facility and the New York Police Department (NYPD) Paid Detail Officers, dated May 15, 2018 documented, "Police Officers assigned to the Paid Detail Program are bound by the rules and procedures (i.e., Patrol Guide) of the Department as well as laws of the United States, State of New York, and City of New York.

The Agreement did not delineate the duties and responsibilities of the NYPD Paid Detail Officers assigned to the facility.

On 5/31/18 at 1:54 PM, during interview with Staff F, Vice President and Chief of Staff, she explained that the roles of the NYPD Officers are to patrol the facility perimeter and surrounding area of the hospital; to serve as a deterrent to hostile individuals; and armed response in the event of active shooter or terror in the hospital.

Staff F, and Staff E, Director of Security, who was present at interview, acknowledged that the facility does not have written delineation of duties and responsibilities for the NYPD Paid Detail Officers.

Based on medical record review, document review and interview, in two (2) of Two (2) medical records reviewed, the facility did not afford the rights of parents (patients) to co-nurse/breastfeed their newborn with a person of their choice. (Patient #s 1 and 2)

Findings include:

During review of the hospital's complaint and incident logs for January 2018 through June 1, 2018, the surveyors identified two (2) complaint intakes involving breastfeeding issues.

Patient #1: Review of the Complaint Log documented a complaint intake dated 3/29/18. The complaint intake stated, "Referral by Primary Nurse as same sex couple, the patient's partner had been latching baby, and providing mature milk for syringe feed."
Documentation indicated staff RN advised the patient on the recommendations of, "The Academy of Breastfeeding Medicine position statement from 2018 which states that milk sharing should be discouraged in the hospital setting as the staff will not have access to her partner's health records, and we need to know that there are no medical or medicinal contraindications to breastfeeding with all our patients..."

Review of the facility's response letter to the complainant dated April 27, 1018, documented the facility has no current policy regarding co-nursing.

During interview with Staff A, Lactation Consultant on 5/31/18 at 10:00 AM, she stated that she informed the birth mother (Patient #1) regarding the "Academy of Breastfeeding' recommendations which indicates that the partner needs to be tested medically and medicinally before milk-sharing. She instructed the patient and her partner not to continue milk-sharing."
Staff A was unable to provide the written recommendation of the Academy of Breastfeeding .


Patient #2: Review of the facility's Safety Events Minutes (Incident Log) dated 4/23/18, documented an event reported on 4/14/18. The Registered Nurse asked the mother (Patient #2) how she fed the baby that evening. The mother explained that her friend, who is currently nursing her own newborn, breastfeed the patient's baby. The Registered Nurse explained to the mother the practice of milk sharing was against hospital policy because it is potentially dangerous for the baby.

There was no documentation in the MR that the patient was afforded the right to co-nurse/breastfeed her newborn with breast milk from a friend, the patient's person of choice.


During interview on 5/31/18 at approximately 10:30 AM, Staff B, Mother/Baby Lactation Consultant, and Staff Q, RN Maternal and Child, both stated that the facility does not support the practice of co-nursing/milk-sharing, and have no written policy and procedure on co-nursing/milk-sharing.

On 5/31/18 at 1:00 PM, during interview with Staff C, Nursing Director of Maternal and Child, and Staff D, Nurse Manager Maternal and Child, both staff acknowledged that there were no written policies and procedures regarding co-nursing/milk sharing.