Page 61 - 254988_AJA_JF22_NEW-1

NCCHC Jail Commander Conversations:

Utilization of Inmate Workers

This standard defines when and recommended best practices workers in clinical areas. During
how an inmate worker can provide to follow: the survey, it was observed the
assistance in the health services area. • The policy must stipulate when, inmate was providing direct
It clearly stipulates that inmate works where, and in what the inmate patient care, which is beyond what
cannot be substitutes for qualified worker can participate. In the is allowable in the standard.
health staff even in times when the policy, remind staff that inmates • The facility has inmates participate
correctional facility is understaffed. are not substitutes for health staff in medication passes, which is not
and that they cannot provide supported by the standard due to
Why Is This Important? direct patient care. patient safety issues.
Understaffed correctional facilities • Other than those in a reentry • There is no formal program or
may be tempted to use inmates training program, inmates are not policy that describes what inmates
in health care delivery to perform permitted to: enrolled in the reentry program
services for which civilian health — Distribute or collect sick calls. are allowed and not allowed to do.
staff are not available. Studies have • The policy and procedure for
shown that when inmate workers are — Schedule appointments. inmate workers enrolled in the
used as adjunct health staff, there is — Transport or view medical reentry program did not describe
an increased risk to both the patient records. a patient’s right to refuse care
and the facility. Their assignment — Handle or administer delivered by inmates in the health
to health services for direct patient medications. care training program (dental
care frequently and unknowingly assistant, nursing assistant).
violates state laws, invites litigation, — Handle surgical instruments
discredits the health staff’s expertise, and sharps. Potential Contributing Factors
breaches patient confidentiality, and • For inmates in a peer health- • Facility staff did not understand
gives inmates unwarranted power related/health care training all the components involved with
over their peers who may be in a or reentry program, they are developing and implementing an
vulnerable state. permitted to: inmate worker program.
Now, in some circumstances, — Assist in activities of daily • Facility did not understand all
inmates may be appropriately living. the components involved in
assigned to help the health staff with — Participate in a buddy system developing a reentry health care
routine tasks. For example, provided for non-acutely suicidal training program.
there is sufficient supervision, inmates after documented • Policies and procedures were
inmates may be employed to clean training. not complete and lacked clear
the health services unit, assemble — Participate in hospice programs documentation on what an inmate
charts, assemble health record after documented training (see worker who is not enrolled in the
forms, work in a laboratory that F-07 standards for Care for health care training program can
makes prosthetic devices, or handle Terminally Ill). perform.
biohazardous waste (only after • Facility did not have a process
proper training). that supports an inmate’s right to
Because there is a growing need NCCHC Sample Survey refuse care delivered by inmates
to develop job skills in the inmate Observations from Surveyors in the reentry health care training
population, properly established Not in Compliance program (e.g., dental assistant,
reentry health care training programs Observations nursing assistant).
can be a useful endeavor. If the • Inmate workers not enrolled in • Policies and procedures are not
facility has such training programs, the health care training program in alignment with all NCCHC
special care should be given to are working with minimal to no compliance indicators in the
maintain patient’s privacy and access supervision in medical areas. standards.
to care. • Inmates were assigned to collect
sick-call slips, which is not • Facility expanded the scope of
inmate workers to include direct
Standards and Indicators of supported by the standards. patient care without consulting
Compliance • Inmates are utilized for constant the standards or understanding
Inmate workers assigned to the observation for acutely suicidal state laws and regulations that
health services area cannot provide inmates with no other constant frequently prohibit the use of
direct patient care, unless they are observation process in place. This inmates in care delivery processes.
enrolled in a health care training is not acceptable or supported by
program. To assist with developing the standards. Checklist for self-assessment
and implementing an inmate worker • The facility has not developed
program or a reentry health training a comprehensive policy and on next page.
program, the following are the procedure for the use of inmate

AMERICANJails JANUARY | FEBRUARY 2022 | 59