Wednesday, 8 December 2010

Protecting our Nurses with mobile technology

The Corporate Manslaughter and Corporate Homicide Act 2007 introduced a new offence of corporate manslaughter which applies to corporate bodies in both the public and private sectors. It only applies in circumstances where an organisation owed a duty of care to the victim under the law of negligence. The offence can be punishable by an unlimited fine and orders for remedial action.

This law makes it easier for an organisation to be found guilty of manslaughter through the result of gross failings of senior management. The definition of ‘senior management’ is not limited to the board of directors and includes those who have a significant role in the management of the whole or part of an organisation.

The law does not affect the provisions of the Health and Safety at Work Act or its associated health and safety regulations in any way. All employers must still comply with their duties under existing health and safety legislation. The HSWA imposes a duty on employers to "ensure so far as is reasonably practicable, the health and safety and welfare at work of all its employees" and to ensure that persons not in their employment are "not exposed to risks to their health and safety so far as is reasonably practicable".

In addition, there are hundreds of health and safety regulations which set out more specific health and safety duties. For example, under the Management of Health and Safety at Work Regulations 1999, employers must carry out a 'suitable and sufficient' risk assessment of their activities.

As a result of this new law, duty of care and traceability must become a priority to senior managers in any organisation both in the public and private sector.

The problem

A recent report by Hallamshire University in 2007 highlighted that nurses are particularly at risk, the report concluded that Two-thirds of respondents (66.1%) stated that their employer did not know their whereabouts or only 'sometimes' knew their whereabouts when they were working. However, approximately three-quarters (78.8%) stated that their employer did have the details of their vehicle.

More alarmingly More than a third of respondents had been assaulted or harassed in the last two years and 6.2% stated that they had experienced a physical assault. Not all incidents were reported to managers; indeed only 44.6% of verbal assaults were reported to managers and only 86.5% of physical assaults. More than a quarter of physical assaults were regarded as racial in nature.

Another concerning statistic was that more than one-third of respondents (38.3%) stated that they rarely or never carried out a risk assessment ahead of a client/patient visit and 72.5% stated they 'never', 'rarely' or only 'sometimes' received all the information they needed about the risks associated with a visit.

Deployment of enterprise mobility solutions will assist in meeting with duty of care obligations: risk assessment and lone worker protection.

Risk assessment

Risk assessment has become a key process in the protection of the mobile workforce. A risk assessment is an important step in protecting the workforce as well as complying with the law.
A risk assessment is a careful examination of what could cause harm whilst undertaking job functions. This allows the decision to be made as to whether or not enough precautions are being taken or whether more should be taken. Workers and others have a right to be protected from harm caused by a failure to take reasonable control measures.

A correctly deployed enterprise mobility solution will provide any mobile workforce with an effective tool to undertake risk assessments at key stages of their daily duties whilst out of the office. Not only this, the enterprise mobility solution will provide a traceable record for each risk assessment undertaken for that all important proof of compliance.

So how does this work ?Enterprise mobility could be used say for district and mobile nurses; using PDAs to undertake a start of day vehicle risk assessment. This works by forcing the nurses, to enter vital risk assessment data at the start of day on the condition of the vehicle prior to the nurses receiving their days work on the PDA.

On arrival at the patients home the nurse is presented with a risk assessment which is specific to the patient which must be completed before any work is carried out.

In the case of mobile workforces undertaking anything from emergency medical asstance to social care, the use of enterprise mobility to provide job specific risk assessments is set to become the duty of care tool of choice.

The whole risk assessment process can easily be built into any enterprise mobility solution and will work for every known field worker discipline.

Lone worker protectionSenior managers face significant challenges in their responsibilities for lone workers. As a minimum they must;

Undertake appropriate health and safety risk assessments

Make provision for lone workers who may be faced with a risk of violence.

Put contact procedures in place for emergencies so that the alarm can be raised and prompt medical attention provided if there is an accident or an attack.

Ensure lone workers are medically fit and suitable for the lone-working role they have been assigned.

Enterprise mobility can assist in providing the solution. Using PDAs with built in GPS and software that can provide real time status updates, workflows can be built to provide a good level of protection for lone workers

Panic button and safety alert functionality

Using the GPS in the PDA we can accurately track the fieldworkers so at any time during the working day the exact location of all mobile staff is known.

A simple panic button function on the PDA can send a message for help to a central location giving the location of the fieldworker and also make a voice call to a call centre so that any abusive conversations can be recorded as evidence.

This feature can be further automated to protect the fieldworker who is undertaking work on site. When a nurse arrives at the home of a patient, they tap the screen on their PDA which will trigger a status message containing the date and time of their arrival, the GPS coordinates and the postal address of the location.

This information is sent from the PDA to a call centre. On activation of the on status message, the PDA software starts an inactivity timer which monitors the nurse’s usage of the PDA. For instance, if the PDA is used as expected to enter information whilst in the patient’s home, the PDA alarm mechanism remains inactive. However, after a predetermined period of inactivity a message will appear on the PDA screen asking if the field worker is OK. If the nurse answers no or fails to respond to the message, the PDA will raise an alarm back at the call centre. Under normal nurse activity, the PDA will not alarm and on completion of the visit the safety alert mechanism will turn off until the social worker arrives at the patient’s home.


The Corporate Manslaughter Act has increased the need for health based services to provide duty of care on their employees whether mobile or otherwise and makes it easier for local authorities in breach to be prosecuted.

Proof of compliance will ultimately become a necessity and it will be up to senior managers to prove duty of care policies and procedures are working and are being used by their employees. Paper systems are problematic as mistakes can be made and paper proof can easily be lost. use of enterprise mobility solutions in providing duty of care compliance and lone worker protection will therefore become more prevalent over the next 18 months.

If you have already deployed an enterprise mobility solution or if you are planning to do so, ensure that you build in duty of care into your mobility workflows.

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