Don't Tip The Scales

NE FAITES PAS PENCHER LA BALANCE!

LE SOINS DE PATIENTS IMPLIQU?‰S DANS UNE ENQU??TE POLICI??RE

De temp ?  autre le infirmi??res de salle d'op?©ration jouent un r??le complexe : celui de responsable de preuve m?©dico-l?©gales et de d?©fenseur du droit ?  la vie priv?©e du patient. La gestion appropri?©e de preuve peut ??tre facteur d?©terminant dans le r?©sultat d'une enqu??te criminelle. Pour mieux comprendre remark pr?©venir la destruction involontaire de preuve lors d'une intervention chirurgicale, il faut premi??rement comprendre l'importance de celles-ci.

DON'T TIP THE SCALES!

CARE FOR PATIENTS INVOLVED IN A POLICE INVESTIGATION

Author: Joan Porteous, RN BN CPN(C) is the Clinical Educator, General Hospital OR Department, at the Health Sciences midst in Winnipeg, MB.

ABSTRACT

Occasionally perioperative nurtures are involved in the mixed role of caring for medical-legal evidence while also advocating for the patient's right for privacy. Appropriate management of evidence may be the deciding factor in the issue of a criminal investigation. Understanding the importance of evidence is the first pace in learning how to obviate its unintentional destruction during the surgical procedure

Our first consideration with each patient is to provide safe and efficient care. In the OR, cooperation with the police is balanced with the patient's right to privacy and confidentiality of their health care information. This is not always an easy task. Perioperative supply with nourishments have a responsibility to their patients as well as to investigators to do what is appropriate, since our actions can have direct issues on the outcomes of criminal investigations. Understanding the importance of evidence is the first pace in learning how to hold fast evidence from being destroyed. Hospital documentation is ofttimes accepted in a court of law without challenge1.

Immediate Preoperative Considerations:

When a police officer accompanies a patient to the preoperative holding area, his or her name and badge number should be documented upon the patient record2. If the patient wishes to speak about the occurrence being investigated, ask the patient if the police officer can be near This may help to make secure accurate recording of the testimony and possibly avoid a court appearance for the supply with nourishment Document that the patient discussed the circumstance with the officer. The police officer may be petitioned to delay questioning if it interferes with necessary surgical care. Generally police officers do not approach into the theatre.

If, however, the patient is beneath arrest, the powers and duties of the police officer expand and he or she may ne to accompany the patient into the theatre and remain there until the patient is anaesthetized.3 one time the patient is asleep, the officer should leave the theatre. If the officer's vicinity seriously interferes with safe, efficient care, he or she may be asked to relocate as appropriate.

The perioperative nourish should assess the patient preoperatively for risk of violent behavior. If there is risk for violence the nourish may ask a police officer to accompany the patient into the theatre and remain until the patient is asleep. This would be done to help assure the safety of the surgical team. If the officer advances into the theatre with the patient, document the officer's name and badge number upon the patient record.

The preoperative assessment should also include a written account of the patient's physical appearance and behaviour2 and a record of any unusual odours of that kind as chemicals, gasoline or alcohol.4

Intraoperative Considerations:

If the patient is beneath arrest, or if the officer has a warrant, then the officer has the right to take any characteristic that is believed to be combineed with the offence.3 Occasionally the patient will arrive in the OR for life-threatening emergent processs without having had their clothes remov All evidence, including clothes, should be handled with glov hands.2'5 Be cautious of needle or other sharp realitys in pockets. If at all possible wound along seams and do not make an incision in through holes or punctures as apertures may provide police with evidence of bullet or stab entries.

In situations where each minute is critical, lay a clean sheet in the corner upon the floor and put the clothes upon the sheet, to be bagged separately later. Handle clothes as little as possible to avoid particles falling off

As presently as is practical, all clothing should be packaged individually into paper bags. The use of paper bags debars the decomposition of evidence that can appear if left in a plastic bag.5 If the clothes are wet with vital fluid or other fluids, they should be placed into moisture-proof bags for safe transport until they can be dried later by means of police. All footwear should be placed into paper bags. Any other physical evidence like as pills or other items ground in clothing should be documented. The transfer sheet from the preoperative stretcher should also be bagged separately, since evidence may have fallen from the clothes onto the sheet.6 Each item bagged should be numbered and labeled with the patient name single in order to ensure health care confidentiality. The satisfieds should also be identified upon the label. The same information should also be documented in the patient record.