Page 68 - 2021_American Jails NovDec

notes from the fieldhealth
inside correctional

NCCHC Jail Commander Conversations:
Jail Staffing Challenges Jail
Medical Surveillance for Inmate Standards
Staffing Challenges
This standard provides facili- they were employees working nothing beyond that. A routine
ties with a structured approach to outside the jail setting. spreadsheet lists totals of type
ensure that the health and safety • Inmate illness or injury poten- and number of inmate injuries
of inmate workers are evaluated, tially related to occupational for CQI monitoring, but it is
monitored, and protected through- exposure is tracked and generic and not clear what types
out their work assignment. trended over time and shared of injuries and hazards have
with the quality improvement occurred.
Why Is This Important? committee. • Neither a medical surveillance
When inmates are utilized It is important to note that program nor institutional com-
to provide help at the facility medical surveillance for occupa- mittee has been established at
(whether it be washing dishes or tional and environmental hazard this facility. All inmate work-
maintaining the building, grounds, is a broad topic area and that the ers receive an initial screening
or equipment), it is important to standards only begin to scratch the before enrollment in a work
identify and mitigate occupational surface by laying out a framework program. Inmate illness or
hazards. As we can see from the to develop a basic medical surveil- injury potentially related to
example of the dirty cell filled with lance plan. occupational exposure or with
human waste, the medical sur- occupational implications is
veillance program reduces work- identified but not reviewed
related risks and is developed and NCCHC Sample Survey at the quality improvement
conducted for inmate populations Observations from Surveyors committee.
at risk for occupational injury or
exposures. Observations Potential Contributing Factors
• This facility has not established • Facility staff did not understand
a medical surveillance program
Standards and Indicators of for inmate workers even though all the components involved
Compliance they use inmates to work as with developing and imple-
Inmate workers are exposed to menting a medical surveillance
many health hazards while per- trustees in various areas. program for inmate workers.
forming their duties, which may • There is no committee that • A facility committee was not
include mechanical (machinery), oversees the inmate worker implemented to oversee the
chemical (solvents/detergents/ program. Screenings are not medical surveillance program.
fertilizer), environmental (heat), based on risk factors for specific
or infectious (soiled linen/expo- jobs, nor are injuries/illnesses • Facility did not understand that
sure to blood-borne pathogens) tracked and reported to the CQI inmates are to be medically
hazards. committee. screened prior to enrollment in
the worker program and prior
For a facility to implement an • Screening for inmate workers is to starting work.
organized medical surveillance based on age and risk factors,
program, NCCHC has identified but it is not job specific. There • Facility had not implemented
several areas on which to focus: is no annual review, nor is there an ongoing medical screening
of inmates in work programs to
• The development and imple- any tracking of injured and/or ensure early detection of occu-
illnesses that are work related.
mentation of a medical surveil- pational hazards or exposures.
lance program is overseen by a • Inmates are screened by nurses
facility committee. (RNs) prior to reporting for • Policies and procedures are not
in alignment with all NCCHC
• Inmate workers undergo an ini- job assignments in the kitchen, compliance indicators in the
laundry or cleaning. If they are
tial medical screening prior to injured, they come to the clinic; standards.
enrollment in the inmate worker however, there is no struc-
program. The medical screening tured process nor program that • There is a lack of a standardized
can evaluate for health issues monitors workers after initial way to collect, manage, and
that may prohibit the inmate screening. store inmate injuries and ill-
from participating based on the nesses for trending and analysis
job risk factors and the inmates’ • There is no formal program or purposes.
health and physical condition. policy that describes an inmate • Inmate illnesses and injuries are
• Medical screening of all inmate surveillance program. All not reported to the quality com-
inmate workers are screened
workers enrolled and working by medical personnel prior mittee for review.
in the program is equivalent to job placement, but there is
to the same protections as if

66 | NOVEMBER | DECEMBER 2021 AMERICANJails