Name of MTF
MILITARY POLICE INFORMATION SHEET
Nursing Unit/Dept: Phone______Charge Nurse/ Beeper______
1. The location of stairwells and fire extinguishers/alarms were shown to the Officer.
2. Emergency overhead pages:
a. Code Red is a fire alarm. The announcement will indicate the location. All the doors will be closed. If needed, the nursing staff will immediately provide instructions. When the "all clear" is announced overhead, all the doors may be opened.
b. Code Black is an overhead page and/or phone notice to alert hospital personnel of an actual threat of a bomb or suspicious package.
3. Administrative Restraints: When the legal authorities need to physically restrain a patient by a locking mechanism (handcuffs or leg shackles).
a. The officer will keep the patient in view at all times (except in surgery and procedural areas).
b. The nursing staff will be informed of the location of the key.
c. In the event of a medical emergency, metal restraints will be removed by the officer.
d. The officer will maintain in confidence all information regarding the patient, and will not have access to the patient's chart.
I have received and understand this information.
Signature of Officer______Date______
Signature of Officer______Date______
Signature of Officer______Date______
NURSING: You must notify the Security Officer, ext. 2058 or Staff Duty Officer at ext. 2222 when the patient arrives on unit with Officer. Send a copy of the information sheet to Security Office when completed. Maintain one copy in the patient’s room.
Security/Staff Duty notified at:
______
Date/Time
Reviewed 20 March 2015