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Infant and Child Abduction Prevention

According to the National Center for Missing and Exploited Children (NCMEC), a study of cases from 1983 to 2014 indicates that 45% of infant abductions occur from healthcare facilities with the remainder occurring from homes (40%) and other places (15%). Children are also at risk for abduction from hospitals; however, the most common location for a child abduction is the home or an area nearby. Unlike infants, children are usually abducted by family members.

The keys to reducing the risk of infant/child abduction in the healthcare setting are:

  • Proactive planning
  • Security
  • Staff Training

Planning

  • Develop an incident response plan with associated written policies and procedures. Resources to assist with developing, revising or assessing your plan: [For Healthcare Professionals: Guidelines on Prevention of and Response to Infant Abductions]
  • Partner with local law enforcement and emergency response personnel and conduct a mock infant/child abduction drill at least annually. Include an incident debrief to evaluate the effectiveness of the response. Revise your plan as needed and provide staff education.
  • Include parents in the safety of their child.
    • Educate all parents regarding unit security procedures (bracelets, tag alarms, special staff identification).
    • Provide parents-to-be with written safety guidelines during prenatal education classes, or provide written safety guidelines to parents-to-be who are not planning to attend prenatal education classes thru physician practices.
    • Instruct parents to keep infant in direct line of sight at all times and to be deliberately watchful.
    • Instruct parents not to release their infant to anyone without proper identification.
    • Educate parents about safe guarding infants at home.
      • Require proper identification before letting anyone enter their home.
      • Advise parents of the risk of using outdoor decorations, banners, balloons, etc., to celebrate their baby's birth.
      • Discuss the risks associated with published birth announcements (home address should not be included in a birth announcement).

Security

Units with neonates, infants and children:

  • Conduct a comprehensive risk assessment.
  • Restrict the public entry to one entrance to the unit.
  • Monitor all entrances and exits including elevators and stairwells.
  • Restrict unrelated traffic.
  • Implement an infant and pediatric security system i.e., ID tags that activate access control mechanisms.
  • Develop and implement other surveillance and access control systems as appropriate (continuous video monitoring, key pad door locks at entries).
  • Verify volume for all sound alarms is adequate for staff to hear in all areas of the unit.
  • Monitor all entrances and exits if the locks on the unit disengage when a fire alarm is activated. A fire alarm pull could potentially be utilized by an abductor to disengage the lock-out systems allowing them to slip out of an exit with an infant or child.
  • Position the nurses' station so exits are visible.
  • Transport all infants in a wheeled isolette/bassinet.

Identification of employees, infants, children and parents/guardians:

  • All employees (including temporary staff) should wear up-to-date, color photo ID badges. Employees in direct contact with infants should have another form of ID, such as a special pin that is known only to the staff and parents.
  • Inventory and control scrubs.
  • Require ID bands for both mother and infant. Place identically numbered ID bands on the infant and mother immediately after delivery.
  • If fathers/significant others are allowed to retrieve infants from unit, provide them with the same identically numbered ID band as the mother and infant.
  • Complete additional infant ID forms before removing the infant from the delivery room or upon admission if the infant is born elsewhere. Information should include:
    • Footprints of the infant at birth.
    • A full face photograph of the infant.
    • Infant/mother ID band number.
    • A written description of the infant, i.e., length, weight, hair, eye color, race, identifying marks.
  • Provide ID bands to the parents of admitted children as well. Do not permit anyone other than parents/guardians or staff to remove a child from the unit.
  • Do not discharge an infant or child to anyone who does not have an ID band that matches the child's band.

Staff Education and Training

Educate all employees about their role in preventing and responding to an infant abduction. Conduct training upon initial employment and at least annually. Address the following areas:

  • What to do if a visitor asks about the location of uniforms, layout of the floor and methods of entry/exit.
  • How to address and report incidents of suspicious behavior such as persons wanting to see or hold the infants, anyone carrying a newborn infant in their arms, or persons asking specific questions about the unit routines, layout and where scrubs are kept.
  • ID bands should always be checked when releasing an infant or child.
  • Policies and procedures related to protecting infant security.
  • The incident response plan including employee responsibility for manning exits, etc. Current information on characteristics of the typical abductor (from the National Center for Missing and Exploited Children):
    • Female of "childbearing" age (range now 12 to 53), often overweight.
    • Most likely compulsive; most often relies on manipulation, lying, and deception.
    • Frequently indicates she has lost a baby or is incapable of having one.
    • Often married or cohabitating; companion's desire for a child or the abductor's desire to provide her companion with "his" child may be the motivation for the abduction.
    • Usually lives in the community where the abduction takes place.
    • Frequently initially visits nursery and maternity units at more than one healthcare facility prior to the abduction; asks detailed questions about procedures and the maternity floor layout; frequently uses a fire-exit stairwell for her escape; and may also try to abduct from the home setting.
    • Usually plans the abduction, but does not necessarily target a specific infant; frequently seizes any opportunity present.
    • Frequently impersonates a nurse or other allied healthcare personnel.
    • Often becomes familiar with healthcare staff members, staff members work routines, and victim parents.
    • Demonstrates a capability to provide "good" care to the baby once the abduction occurs.
  • In addition, an abductor who abducts from the home setting:
    • Is more likely to be single while claiming to have a partner.
    • Often targets a mother whom she may find by visiting healthcare facilities and tries to meet the target family.
    • Often both plans the abduction and brings a weapon, although the weapon may not be used.
    • Often impersonates a healthcare or social-services professional when visiting the home.
  • There is no guarantee an infant abductor will fit this description.

Resources:

National Center for Missing and Exploited Children. www.ncmec.org

Association of Women's Health, Obstetric and Neonatal Nurses. www.awhonn.org

Hospital Incident Command System, California Emergency Medical Services

The Joint Commission, Sentinel Event Alerts Issue 9: Infant Abductions: Preventing Future Occurrences