2015 ANNUAL UI/MUI TRAINING
What is anUnusual Incident (UI)?
An Unusual Incident (UI) is an event or occurrence involving an individual that is not consistent with routine operations, policies and procedures, or the individual's care or individual service plan, but is not a major unusual incident. Unusual incident includes, but is not limited to, dental injuries; falls; an injury that is not a significant injury; medication errors without a likely risk to health and welfare; overnight relocation of an individual due to a fire, natural disaster, or mechanical failure; an incident involving two individuals served that is not a peer-to-peer act major unusual incident; and rights code violations or unapproved behavior supports without a likely risk to health and welfare.
What is a Major Unusual Incident (MUI)?
A Major Unusual Incident (MUI) is the alleged, suspected, or actual occurrence of an incident when there is reason to believe the health or welfare of an individual may be adversely affected or an individual may be placed at a likely risk of harm, if such individual is receiving services through the developmental disabilities service delivery system or will be receiving such services as a result of the incident. There are three categories of major unusual incidents,
Category A: Accidental or suspicious death, Exploitation, Failure to Report, Misappropriation,
Neglect, Peer-to-peer act, Physical Abuse, Prohibited Sexual Relations, Rights Code Violations,
Sexual Abuse, Verbal Abuse
Category B: Attempted suicide, Death (other than accidental/suspicious), Medical Emergency,
Missing Individual, Significant Injury (known or unknown)
Category C: Law enforcement, Unapproved Behavior Support, Unscheduled hospitalization
All staff must call-in possible UIs and MUIs to the AOC immediately, as soon as the individual is safe, and within four hours. If it is a life-threatening situation, then you need to call EMS before calling the AOC
AOC Number: (330) 807-1645
What are some reasons for reporting UI/MUI?
Identifying cause of incidents
Developing prevention plans
Detecting trends to address larger issues
Examples of MUIs:
Someone goes to the hospital and is admitted with dehydration or pneumonia.
A staff witnesses what they believe is abuse, but waits until the next day to say anything.
A small sum of money is missing from someone’s personal funds.
A staff denies an individual a meal.
An individual falls and breaks a bone.
An individual is choking and staff successfully perform abdominal thrusts to clear blockage.
Notable changes:
Verbal abuse now includes any communicative means, encompassing social media and texting.
Known and Unknown Injuries were combined into ‘Significant Injury’.
New staff must be MUI trained before having contact with any individuals.
MUI DEFINITIONS BY CATEGORY
Category A MUI Definitions:
Accidental or Suspicious Death
If anyone dies.
If you find someone who has died.
It doesn’t matter the cause, you should always contact the AOC immediately.
Exploitation
The unlawful or improper act of using an individual or their resources for monetary or personal benefit, profit or gain.
If you find strange items on someone’s bank statement, if an individual has mentioned “signing for a loan” or anything that makes you wonder, contact the AOC immediately.
Failure to Report
If someone believes something has happened, but doesn’t say anything, they are involved in a separate MUI.
We MUST report our suspicions immediately. Usually by calling the AOC.
Misappropriation
Depriving, defrauding or otherwise obtaining the real or personal property of an individual.
Misappropriation
Typically we see this as stealing, but it could also be ‘tricking’ someone into giving up their possessions, or into paying for something that isn’t their responsibility.
If we think it may have happened, call the AOC.
Neglect
If there is a duty to provide a treatment, care, goods, supervision or services, and they are not provided.
It is a wide category, and includes; supervision, assistance with personal care items, and help with activities of daily living. If we are supposed to provide the service (it is part of their ISP), and that service isn’t given, contact the AOC.
Peer to Peer Acts
One of the following incidents involving two individuals served:
- Exploitation of another individual.
- Theft of anything worth at least 20 dollars.
- Physical act where an individual is targeting, or firmly fixed on another individual; that involves the head or neck or results in treatment by a physician or nurse practitioner.
- Sexual acts without consent.
- Verbal assaults if there is an opportunity to act.
Physical Abuse
Physical force that could result in harm.
You know hitting is wrong, or pushing someone, or throwing objects at someone, or doing anything that could reasonably be expected to hurt someone, we should contact the AOC immediately.
Category A MUI Definitions continued…
Prohibited Sexual Relations
An employee engaging in a consensual sexual relationship with an individual for whom they are providing services.
Non-consensual would be sexual abuse, but consent does not make this relationship acceptable, it should be reported to the AOC immediately.
Rights Code Violation
A violation of someone’s rights that creates a risk of harm.
Really, ANY violation of someone’s rights needs to be reported to the AOC immediately. People’s rights are incredibly important.
Sexual Abuse
Unlawful sexual conduct or contact.
Non-consensual actions that involve the commonly understood sexual areas of another. Actual contact is not required, window peeping is included in this rule.
If we suspect something has happened, we should contact the AOC immediately.
Verbal Abuse
Threatening, coercing, intimidating, harassing or humiliating an individual through ANY communicative means.
Not just talking, but this also includes gestures, text messages, posts on social media sites.
Any that feel uncomfortable should be reported to the AOC immediately.
Category B MUI Definitions:
Attempted Suicide
If someone tries to kill themselves, through any method. For example, taking too many pills (even if they’re not really enough) or cutting themselves (even if it’s not quite deep enough).
If someone is acting like they want to end their life, we should contact the AOC immediately.
Death
If it was accidental or suspicious, it falls into Category A.
Any other reason, dying of natural causes, falls into this category.
Medical Emergency
If someone has to provide ‘life sustaining’ treatment to an individual, like CPR, or abdominal thrusts, or a breathing tube.
It doesn’t matter who has to do the treatment, staff, EMT, physician, or a person on the street, we should contact the AOC immediately.
Missing Individual
If an individual’s whereabouts are unknown and there is a risk of harm.
If someone is gone from the level of supervision in their ISP, we should contact the AOC immediately.
Category B MUI Definitions continued…
Significant Injury
Any injury that results in harm should be reported to the AOC immediately
- Concussion
- Broken bone
- Dislocation
- 2nd or 3rd degree burns
- Immobilization or casting
- 5 or more stitches
Category C MUI Definitions:
Law Enforcement
If the police are involved with an individual, including arrest, charges or incarceration.
We should notify the AOC immediately when the police are involved.
Unscheduled Hospital Admission
If it is unplanned or unscheduled. Some admissions are not MUIs if the reason is explained in the ISP.
Regardless of reason, if someone is admitted to the hospital, we should notify the AOC immediately.
Unapproved Behavioral Support
If there is an attempt to change someone’s behavior by adding or subtracting something from their day or life, AND it hasn’t been approved. This includes restraints, loss/removal of item or right, and promises of reward or other coercions.
It should be reported to the AOC immediately.
What to do when something unusual happens:
1)PROTECT the health and safety of the individual.
2)REPORT your observations and experiences to the AOC immediately.
IMMEDIATELY means, as soon as they are safe from further harm.
How to report an UI/MUI:
- Protect the individual, make sure they are safe (provide First Aid if needed)
If life threatening, call EMS first
If you are unclear about an injury, call the NOC (330) 414-6024
- Call and notify the AOC as soon as individual is safe (330) 807-1645
- Complete an Incident Report
a)Log into AccelTrax, go to Consumer Information, and choose the Individual.
b)Double check that the incident has not already been reported.
c)Choose “Add New Report”.
d)Fill in date and time the incident occurred, then all staff on duty at the time (even if they were absent).
e)Fill in the ‘site resided’ with where they lived, and if the incident was witnessed or discovered.
f)Choose the location of the incident.
g)Choose body parts affected by the incident. If no injury, then ‘not applicable’.
h)Describe what was happening prior to incident.
Usually 20 minutes before this happened, what was going on? Include as many details as possible.
i)Describe the incident. Answer Yes/No to restraint, and if restrained enter the number of minutes.
Be detailed. Remember the person reading this wasn’t there. Give all the details.
Were there witnesses? What was unusual about the occurrence? Where were you at the time?
j)Fill in Initial Treatment section.
Always include the details of what the nurse told you to do, and anything else you did immediately.
k)Fill in section completed by (your name) and date.
l)Go to the bottom of the screen, fill in notifications.
AOC (name), time, date, and who called.
Nurse (name), time, date and who called.
m)Click “save report”.
What happens after you report an UI/MUI:
The AOC may tell you to take some action, maybe even removing someone from the shift.
We’ll start collecting witness statements.
An investigation will begin.
Remember, during an investigation it is VERY important that you NOT discuss the situation with anyone except your supervisor, the investigative agent or the AOC. This includes text messages, phone conversation, face to face meetings and social media posts.
Remember, if you are in doubt, it’s best to report to the AOC. The AOC is an excellent resource for you. (330) 807-1645