02.

Security Department Operations

02. Security Officer Training
04. De-Escalation Training

STATEMENT:

Healthcare Facilities (HCFs) should provide initial and ongoing training and education to staff on
the recognition and mitigation of disruptive behaviors. De-escalation skills should be emphasized to
mitigate these issues as a method of prevention and to assist in the creation of a safer patient care
environment.

INTENT:
a. De-escalation education, awareness and training should provide skills to recognize,
intervene and resolve verbal and nonverbal behaviors of concern in order to mitigate the
potential risk in a nonphysical manner.

b. De-escalation training should be provided to security staff. HCFs should also identify clinical
and other staff whose role may put them into situations in which disruptive behaviors are most
prevalent and provide them with de-escalation techniques training. Areas should be identified
through a Security Vulnerability Assessment and may include:
1) Public-facing front desk / reception areas
2) Cash handling / pharmacy dispensing areas
3) Human Resources and administrative departments
4) Emergency departments / urgent care areas / Intensive Care Units
5) Behavioral / mental health departments or areas caring for the same
6) Substance abuse / treatment units or areas caring for the same
7) Areas in which forensic patients are frequently provided treatment
8) Areas in which custody or child protective service interventions may be an issue.
c. De-escalation training should be provided to those working in the area as well as those
responding to security- or safety-related events. Preferably this training should be jointly
conducted and include exercises to facilitate coordinated responses and resolutions.

d. HCF Security departments should include de-escalation techniques and training at the onset of
employment and on a regular basis thereafter. De-escalation training should be provided as a
prerequisite to Use of Force training with the programs linked together.

e. De-escalation training may include the following elements:

1) A definition of workplace violence, that includes, but is not limited to the following:
a) Identification of behaviors of concern—verbal and nonverbal
b) The use of physical force against a healthcare employee by a patient or a
person accompanying a patient that results in, or has a high likelihood of injury,
psychological trauma or stress
2) An incident involving the use of a firearm or other dangerous weapon
3) How to recognize the potential for violence and applying principles centered around a calm,
concerted effort to control the situation
4) When and how to seek assistance to prevent or respond to violence, to include transitioning
to physical intervention and disengaging at appropriate time
5) How to report and document violent events or close calls
6) Any resources available to employees for coping with incidents of violence, including, but
not limited to, critical incident stress debriefing or employee assistance programs.

Copyright © 2018 by International Association for Healthcare Security and Safety (IAHSS)
8420 W. Bryn Mawr Avenue, Suite 1020 • Chicago IL 60631 • 888/353-0990 http://www.iahss.org
 02. Security Department Operations
02. Security Officer Training
04. De-Escalation Training

SEE ALSO:

IAHSS Healthcare Security Industry Guideline 01.09, Violence in Healthcare

IAHSS Healthcare Security Industry Guideline 02.02.05, Use of Force

California Health and Safety Code, Section 1250, requirement for a workplace violence prevention plan
National Institute of Occupational Safety and Health. Violence in the Healthcare and Social Work Settings

Medicare and Medicaid Programs (CMS); Hospital Conditions of Participation: Patients Rights (42 CFR
Part 482)

Approved: April 2016

Last Revised: June 2019

Copyright © 2018 by International Association for Healthcare Security and Safety (IAHSS)
8420 W. Bryn Mawr Avenue, Suite 1020 • Chicago IL 60631 • 888/353-0990 http://www.iahss.org