How to prevent infant abductions, aid recovery

A program to diminish the risk of infant abductions must include an array of solutions, from the high-tech to the human approach of simply asking questions when you feel something isn't quite right.

The following words of advice are from the National Center for Missing and Exploited Children (NCMEC), risk managers, and hospital security experts:

· Install a video surveillance system. The video surveillance system should be clearly visible to visitors in the obstetrics and pediatrics areas, serving as a deterrent that makes the potential abductor fear being caught. The system also will aid in the recovery of a child by providing a description of the abductor.

· Consider the other electronic deterrents. There are a number of security systems specifically designed to deter infant abductions. Most of them involve a device placed on the infant's arm or hidden in the diaper, setting off an alarm if the infant is carried past sensors placed at all the exits leading from the area. While too costly for some health care facilities, the systems can serve as a last chance to thwart an abductor headed out the door with a child.

· Urge all staff to look out for abductors. Remind all staff, and particularly those working in obstetrics and pediatrics, to be alert for anyone who seems out of place, asks unusual questions about babies or hospital procedures, or otherwise raises suspicions. Emphasize that this is a responsibility for all staff, not just security officers.

Don't overlook nonclinical staff when urging people to report suspicions or confront strangers who seem out of place. The housekeeping staff, for instance, spend a great deal of time in patient care areas and have great opportunity to observe people acting suspiciously.

The NCMEC suggests that staff respond to suspicious behavior by asking a simple question like "May I help you?" while noting the person's physical description. Simply asking a friendly question will slow the abductor down. The person then should be reported to a nursing supervisor and/or hospital security.

· Carefully band the baby, mother, and father. Wrist and ankle bands should be placed on the baby immediately after birth, with matching identification bands placed on the wrists of the mother and father or significant other. If the fourth band is not used for the father, it should be cut and stapled to the chart or cut and discarded in a sharps box.

· Record the baby's identification immediately after birth. Within two hours of the birth, you should record the baby's footprint, take a color photograph of the baby, and record a full physical assessment. That information, along with documentation of the identification band placed on the baby and family, should be placed in the chart. When making the baby's footprint, apply ink sparingly to the entire foot and make a complete impression using light pressure. Be sure the impression captures the ridge detail on the ball of the foot.

· Store a sample of the umbilical cord blood. A sample of the cord blood should be stored until the day after the infant is discharged from the hospital, to be used in future typing if the baby is abducted.

· Take photos of all infants up to 6 months old at admissions. The photos will help identify the babies if a problem occurs. Make sure the photos are clear, high-quality close-ups of the face.

· Require all health care facility personnel to wear identification badges. The badges should be conspicuous, with color photos. Staff allowed direct contact with infants, including physicians, should wear unique badges, and parents should be taught which badges allow contact. The badges must be worn above the waist and not obscured in any way. Some facilities change the color of the badges for infant-contact personnel every week to discourage impersonation.

· Tightly control the way babies are handled. Several rules should be written in stone: Only an authorized employee is allowed to move a baby from one location to another. A baby is never left in a hallway or even a mother's room without direct supervision - not even while the mother goes to the bathroom. Babies are taken to their mothers one at a time; they are never grouped for movement. An infant is always moved in a bassinet, never carried in the arms.

· Limit information available to the public. Abductors often will use identifying information to help trick people into giving up the baby. Never post the mother's or baby's full name anywhere it can be seen by the public, including bassinet cards, room nameplates, or department status boards. If the public relations staff release birth announcements to the local media, they should include no home address or other information that could aid an abductor after the baby leaves the hospital. Abductions have taken place after discharge, with abductors going directly to the parents' homes.

· Incorporate shift changes into the response plan. Abductors may study the hospital's daily routine and commit the crime at a shift change, when there are more distractions and possibly more confusion about who is responsible for responding to an incident. The response plan must include a provision for holding the prior shift until someone in authority authorizes the release.

· Use special caution when custody is in dispute. Infants involved in custody disputes between the parents, or those who are being taken from the parents because of alleged abuse or neglect, are at special risk. Staff should be notified of the infant's status and security personnel should be put on alert.