Patient's jewelry stolen as she rests in the ED

Thief in scrubs apparently walks freely through ED

A 96-year-old woman was brought to the ED at Rhode Island Hospital in Providence on the afternoon of Oct. 10, 2007. Later that night, a wedding band and a ring with two white diamonds were stolen while she lay in her bed. According to published reports, a man in blue scrubs used a lubricant to slip the rings off her fingers, while assuring her they were being put away for safekeeping. However, he then left behind a note saying, "Your daughter took your rings with her so they wouldn't get lost."

Nancy Cawley, a hospital spokeswoman, told The Providence Journal that the hospital was cooperating with the police investigation.1 When subsequently contacted by ED Management, she indicated that the facility was reviewing its procedures, but she would not provide additional comment until the review was completed.

How did this individual get into the ED in the first place? "Since he had scrubs on, he could have come in with them on," notes Jeff Snyder, MD, FACEP, emergency medical director of Alegent Health in Omaha, NE.

Alegent Health switched to color-coded scrubs in July. The switch at Alegent started in January for all new hires, says Snyder, noting that patient safety, as well as security, was one of the reasons for the switch. "We put placards up in all departments indicating what colors were for which department," he explains. For example, lab staff wears teal, respiratory wear black, surgery is green, and ED nurses are dressed in burgundy. Physicians can wear a variety of colors, but in the ED they wear forest green or gray, Snyder notes. "If [this individual in Rhode Island] had bought scrubs on the outside, he would have had to match it with the proper color," he offers.

It would have been virtually impossible to obtain the scrubs in one of his system's EDs, says Snyder. "No scrubs are available in closets here except for surgery," he says. "In the ED, you have to go through one outside door, two inside doors, and into the locker to access them."

Regardless of whether someone is wearing scrubs,
all staff should have ID badges, Snyder says. "Even our 'travelers' have ID badges," he notes. Thus, even if the thief had worn scrubs of the proper color, "the first person who saw him should have checked his ID."

If ED staff members see a strangely dressed person or someone who looks lost or like he or she doesn't fit in, staff are supposed to question the person as to his or her identity, Snyder says. "You can always go to security if you do not want to confront the individual," he advises.

Apparently, the Rhode Island hospital did have some protocols for the handling of jewelry, but they don't appear to have been thorough enough in following them. For example, while a phlebotomist had urged the patient to surrender her necklace, bracelet, and watch because they could not stay on during an X-ray, no mention was made of the rings.

"We have different protocols for jewelry," notes Snyder. "One is trauma; there can be different acuities, but if you use the trauma protocol, you must remove the jewelry and give it to security." Once the jewelry is given to security staff members, they log it in, put it in an envelope with the patient's ID sticker in it, and put it in a safe. They also have an orthopedic protocol, Snyder says. "If there are broken bones but it is not a ['traumatic'] trauma, we still do exactly the same thing," he says.

While there is no formal written policy, the staff does the same thing if someone is unconscious or critically ill, Snyder says. "If they are coding, we do not fool around [with jewelry removal], but we remove necklaces and so forth for chest X-rays," he says.

If family members are present in the ED, they are asked if they want to be responsible for the jewelry, Snyder adds. "If they say, 'Yes,' we document that it was given to the family, and write down their name and their relationship to with patient," he says.

In an event such as the one in Rhode Island, even if the jewelry is stolen, ED managers who have security cameras in their departments can be of great assistance to law enforcement efforts, Snyder adds. "For example, while we don't have cameras positioned in patients' rooms, we do have them in common areas, so even if the theft is not witnessed, you can go and play back the tape," he notes. "So, for example, you could see if there was a guy in scrubs that did not match any of our colors, if they went into the nurses' lounge, and so forth." You also can attempt to obtain a description of the thief for police, he adds.

Reference

www.projo.com/ri/cranston/content/Missing_Jewelry_10-13-07_407FJSO.314a8c0.html.

Source

For more information on protocols to ensure the protection of patients' valuables, contact:

  • Jeff Snyder, MD, FACEP, Emergency Medical Director, Alegent Health, Omaha, NE. Phone: (712) 328-5230.