Correctional health: Personal protection of correctional health staff

PERSONAL PROTECTION OF CORRECTIONAL HEALTH STAFF
DEFINITION OF RISK (NON-EPIDEMIOLOGY DEFINITION OF RISK; SAFETY DEFINITION)

Risk is the probability (likelihood) that a hazard will occur. It is classified as
– Certain (more than a 90% chance)
– Likely (between 50% to 90% chance)
– Moderate (between a 10% and 50% chance)
– Unlikely (between a 3% and 10% chance)
– Rare (less than 3% chance)

DEFINITION OF HAZARD
Hazard is the potential adverse effect

It is classifed as
– Insignificant (e.g letters of complaints to the ombudsman, professional councils, Department of Correctional Services, prison inspectors; this can be more serious if there was wrong-doing)
– Minor (individual verbal clashes between staff and inmates, bouts of inmate insubordination)
– Moderate (Heightened disatisfaction of inmates with the health service, heightened level of gang activity in the prison, proof of staff insubordination)
– Major (Rioting in the prison, escapes or attempted escape of inmates, disease epidemics in prison, mass hunger strikes in prison)
– Catastrophic (serious damage to the facility by means of fire; injury, death and hostage-taking of correctional staff; death and serious injury of inmates; suicides or serious self-mutulation)

RISK VALUE
Multiplication of risk and hazard leads to risk value
– Low risk value (prisons never have a green risk value. Prisons always start at a risk value of orange)
– Moderate risk value
– High risk value (red)
– Extreme risk value (prison has to be shut down and all processes need to be totally controlled)

DETERMINANTS OF HEIGHTENED
ENVIRONMENTAL RISK FACTORS
As can be seen from the hazard classification there are many environmental factors that raise risk such as heightened gang activity or surveillance information of planned escapes

INDIVIDUAL FACTORS THAT CAN HEIGHTEN THE CORRECTIONAL HEALTH CARE WORKER’S RISK
– Acute psychotic events of an inmate
– Gangster affiliation
– Medical and psychiatric afflictions such as dementia, hypoglyceamia, hypomania, psycho-affective disorders with acute mental decompensation
– Personality disorders with acute bouts of paranoia or manipulation
– Grudges against correctional health staff such as perceptions of discrimination in terms of health care access or medication access, personality clashes
– Emotional outbursts and increased frustration of inmates due to limitation of access to library books, kitchen duties, sport activities or isolation
– Pure antisocial behaviour
– Access and use of drugs
– Religious, ideological or political beliefs inducing the inmate in a state of “constant war against authority”
– Known history of violence and rape

BODY LANGUAGE OF THE POSSIBLY VIOLENT INMATE
– Clenching of fists
– Pursing of lips
– Glaring or fixation of eyes of victim
– Scanning environment in search of possible weapon
– Scanning environment for the presence or absence of security staff