Active shooter-it’s not a game of hide and seek
Nancy Robin, M.Ed, RN, CEN; Denise Brennan, MSN, RN, CNL; Robert Boss III, BSN, RN, CEN; Christopher Amore, BA, BSN, RN; Tara D'Elena, BSN, RN, CEN; James Corbett, ADN, BS, RN
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Session D presented Thursday, September 27, 2:30-3:30 pm
Purpose: Active shooter events have been on the increase in public areas including hospitals, schools and churches. Many hospitals have developed plans to address active shooter incidents but training in healthcare settings presents unique challenges. This project looked specifically at developing preparedness and training by emergency department (ED) staff for emergency department staff. In alignment with the corporate hospital plan, this unit’s specific plan was designed to meet the emergency department staff’s knowledge and preparedness needs.
Design: Staff development project. Setting: Teaching, urban 70,000 visit ED.
Participants/Subjects: ED RNs, Unit support staff, ED Leadership.
Methods: : Although there were many steps done to limit violence in the ED including limiting access points, zero tolerance policies and posters, and early identification of escalating behavior, this project was specific to active shooter preparedness and training drills. Emergency department nurses along with other hospital and local police participated in the filming of a hospital training video. This video was shown to all hospital staff who attended workplace violence and active shooter training but the ED wanted to incorporate preparedness distinctively geared toward their environment. The ED had developed a specific unit based plan which supported the three- step process (RUN-HIDE-FIGHT) that is used to prevent or decrease the loss of life in an active shooter event. Staff were taught to be aware of the closest exits and immediately run. If they couldn’t evacuate with a clear escape plan, staff were taught where they could hide. Prior planning identified areas where doors could be locked or blocked. These areas had an easily identifiable plaque symbol chosen by the ED leadership team and located on inconspicuously on the upper left-hand corner of the door. Blinds/shades were installed. Actively aggressively throwing objects and using improvised objects was the third option reviewed. Staff were brought to each of the care areas in the ED and asked to identify the exits, safe areas to hide and items that could be used to fight.
Results/Outcomes: Watching a video, discussing RUN-HIDE-FIGHT, and taking a tour of the unit, was the first step in preparedness training. All these concepts were again reinforced with a corporate on-line training. In the month of November, education was strengthened and followed by one on one drills designed to evaluate knowledge, skills and attitudes. To validate competency, very little remediation was necessary. Having 100% of the staff identify the nearest exit and the rooms that are the safe places to hide was the result that was reached.
Implications: The most unique part of this active shooter plan is the identification of safe areas within the emergency department. These areas are clearly identifiable by staff and should be used if running is not an option. If an event was to occur, the ability of ED staff to not hide under desks, but to seek their best safety option in an active shooter situation can only be done through reinforcement and drills.
Emergency Nursing 2018. Held at David L. Lawrence Convention Center, Pittsburgh, Pennsylvania, USA
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