Emergency Preparedness News and Announcements

Missing Resident

CODE: PLAIN SPEECH/TEXT

Defined

Elopement is defined by the National Institute for Elopement Prevention as “When a … resident who is cognitively, physically, mentally, emotionally and/or chemically impaired wanders away, walks away, runs away, escapes or otherwise leaves a caregiving facility or environment unsupervised, unnoticed and/or prior to their scheduled discharge.”

Immediate Action

  1. Announce or communicate to staff within the resident’s unit.
  2. Note the time that the resident was discovered to be missing.
  3. Staff members assigned to the resident’s unit report to nursing station to verify that resident is not signed out.

Common Staff Assignments

  1. Share any personal knowledge that you may have with the Administrator or Director of Nursing that may help to locate the resident.
  2. Remain calm to not upset the residents.

Specific Staff Assignments

  1. Contact Administrator and Director of Nursing (facility to fill in appropriate titles/positions) if not on the premises.
  2. Activate the Incident Command System (ICS) to manage the incident, if necessary. The most qualified staff member (in regard to the Incident Command System) on duty at the time will assume the Incident Commander position. If severity of incident warrants, then appoint other positions of ICS structure.
  3. Facility management staff should report to the Incident Command Post for instruction.
  4. The Administrator/Incident Commander will assign each staff member a section when searching to minimize overlapping or overlooking of an area.
    • Systemically search facility, grounds, and neighboring streets.
    • When conducting a search, look under beds and furniture, in walk-in refrigerators/freezers, in closets, under desks, behind doors, as well as in storage rooms, behind boxes, in boxes, and on shelves. A resident who has eloped may be frightened and may be hiding.
    • Thoroughness is extremely important.
    • When finished searching a section, staff members report back to the Administrator/Incident Commander.
  5. If the resident has not been found after a period of minutes of the search, the Administrator/Incident Commander will call the police to report the resident missing.
  6. When the police arrive the Administrator/Incident Commander will provide a picture and pertinent information such as:
    • What the resident was wearing.
    • How the resident was ambulating, i.e., with a cane, walker, etc.
    • The resident’s cognitive status, i.e., confused, alert.
    • Information as to where the resident may be going, if known.
    • Resident’s previous address and family’s address.
  7. Notify the resident’s family/representative and attending physician if the resident is not found in the facility or grounds.
  8. Report the incident to Division of Health Service Regulation.

Specific Staff Assignments When the Resident Has Been Located

  1. The Administrator/Incident Commander should notify all staff members that the resident has been found.
  2. Examine the resident for injuries.
  3. Notify the attending physician concerning resident’s status.
  4. Contact family/responsible person and inform her/him of resident’s status (ensure all the above steps are documented in the nursing notes).
  5. Notify the police.
  6. Update the care plan.
    • Consider implementing additional measures such as the addition of a wander bracelet if not in current use.
    • 15-minute safety checks
    • Document in resident record.
  7. Complete an incident report and follow the facility’s incident reporting process.
  8. Ensure the incident and events are documented objectively in the resident record, including:
    • Circumstances and precipitating factors
    • Interventions utilized to return the resident to the unit
    • Resident’s response to the interventions
    • Results of reassessment upon the resident’s return and the condition of the resident
    • Care rendered
    • Notification of police, family, and physician
    • Physician orders following notification
    • Additional prevention strategies implemented
  9. Administrator should report the incident to the KY Office of the Inspector General, and the local Ombudsman’s Office
  10. Contact the local law enforcement office for a Golden Alert.
  11. Contact KY CHFS Adult Protective Services Branch.
  12. Report elopement in Quality Assurance/Risk/Safety Committee.

Preparing Ahead/Training

  1. Obtain information during pre-admission/admission conferences with family regarding history of, or potential for, wandering.
  2. Make a list of all residents known to be at risk of wandering; update list as necessary based on resident care plan.
  3. Include resident name, picture, and physical description in wander book located at nurses’ station.
  4. Ensure that staff know all residents on the list and are able to intervene as necessary.
  5. Include missing resident policy in new employee orientation.
  6. Routinely check door alarms.

See Also

Medical Emergencies