JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT 89
The benefits ofTaser CEWs in a
healthcare setting
Jeff Puttkammer, MaEd, CPP, and Richard D. Beougher II,
CHPA,CPP
In this article, the authors
maintain that ifproperly used
by trained security officers
Taser CEWs result in significant
reductions in i-11;juries and
reduction in costs by type of
injury. HSS s security officers
have carried Taser CEWs in
hospitalsfor more than 10
years in 40facilities across the
country producing no negative
CMSfinding or excessive use
offorce claims, they report.
(JeffPuttkammer, MaEd, CPP is currently the
regional Vice President ofHealthcare Security
for HSS Inc. He has more than 20 years ofsecurity
experience, 13 ofwhich in law enforcement,
combined with more than 20 years as
military officer focused on domestic and international
security issues. He is a current
IAHSS member and served as a past Treasurer
for the Colorado chapter ofIAHSS.)
(Richard D. Beougher II, CHPA, CPP is the
Associate Vice President for the Southwest
Region ofthe Healthcare Security Division of
HSS Inc. He supports healthcare security programs
in Georgia, Mississippi, Texas and Vir-
ginia.)
Clinical staff and healthcare
security staff face a difficult
challenge: their fundamental role
of providing for the care and
safety of patients has not
changed; however, the healthcare
environment in which they operate
has changed dramatically.
INCREASING VIOLENCE
IN HEALTHCARE
Violence in the healthcare industry
is on the rise. Staffare routinely
exposed to violent and
combative patients and visitors
under the influence ofdrugs and
alcohol or suffering from psychological
disorders. In many instances
hospital staff, including
securityofficers, are insufficiently
educated about how to work
effectively with combative and
aggressive patients in the care
setting. Frequently, securityteams ,
aren't equipped with the defensive
tools and technology needed
to suitably and effectively manage
these same patients.
90 JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT
Hospital administrators and risk
managers seek a deeper understanding
of the various use of
force tools and technology that
can help keep staff and patients
safe while reducing overall risk
and liability exposure.
Anumber offactors may influence
these decisions, such as the
acuity and demographics of the
patientpopulation; the analysis of
historical events of past aggressive
incidents; local crime rate;
and, the demographics associated
with the location, type, size and
trauma level designation of the
healthcare organization. The degree
of potential force of a
weapon is also an important factor.
For many healthcare administrators,
Conducted Energy
Weapons, orTaserCEW's, are an
acceptable option.
EFFECTIVENESS OF
TASER CEW IN A
HEALTHCARE SETTING
A Taser CEW is a conducted
electrical weapon used to deliver
electrical current that disrupts
muscle control, orneuromuscular
incapacitationandpainful stimuli.
Manufactured by Taser International,
Inc. ofScottsdale,Arizona,
Taser CEW's are classified as
non-lethal weapons defined by
\
the US Department of Defense.
These non-lethal weapons are
usedby over 15,000 law enforcement
agencies and securityteams,
andare deployed, onaverage, 904
times every day. Taser CEW's
are, we believe, a safe alternative
to de-escalate a threatening individual
withoutcausingpennanent
damage.
Similar to a fireann, a Taser
CEW's offers apsychological deterrence
factor; however, unlike a
fireann, a Taser CEW can be deployed
during aggressive situations
of violence where deadly
force is not warranted or needed.
In HSS's experience, incidents in
which the threat ofdeadly force is
warranted are extremely rare. In
fact, in many situations, officers
have simply infonned combative
individuals that they carried a
Taser CEW resulting in immediate
de-escalation. In some cases,
the mere presence of a Taser
CEW on a security officer's duty
belthas improvedthe behavior of
aggressive patients. These circumstances
illustrate the effectiveness
of Taser CEWs as
psychological deterrents of vio-
lence.
Numerous studies indicate that
the introduction ofTaser CEW's
JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT 91
into a healthcare setting helps to
avert and control situations that
otherwise might have resulted in
further injury to subjects, patients
and staff. (The Journal of
Emergency Medicine. Violence:
Recognition, Management and
Prevention).
Forexample, areport funded by
the International Healthcare Security
and Safety Foundation
(IHSSF) and investigated by
Duke University Medical Center
found a 41% lower risk ofphysical
assault among hospitals with
Taser CEW's available for security
personnel to carry and use
compared to those without Taser
CEW. When Taser CEW's are
deployed to manage combative
and violent patients, the data
shows a number ofpositive outcomes,
such as a significant reduction
in excessive force claims
(up to a 95% reduction resulting
in a reduction ofmore than $6M
in costs over a 5-year period in a
recent MMRMA study).
HSS's data supports this finding.
Nationally, we have more
than 40 healthcare facilities that
employ Taser CEW devices and
we have found that, when compared
against our other 140+
healthcare facilities withoutTaser
CEW's there is a significant correlation
in both reductions in injuries
and reduction in costs by
type ofinjury. Sixty-two percent
ofthose sites show a significant
reduction in the number of staff
injuries and 54% of those sites
showed a significant reduction in
the costs ofinjury type.
Taser CEW's offer additional
benefits when contrasted with
other forms ofphysical de-escalation
intervention such as chemical
irritant sprays like OC and
Pepper Spray. The deploymentof
a chemical agent within the confines
of a healthcare facility can
cause significant operational impacts
and delays due to the need
to decontaminate the treatment
area.
When contrasted with impact
weapons, such as expandable batons,
Taser CEW offers advantages
as well. Batons tend to
cause significant injuries, even
when utilized correctly, whereas
the Taser CEW allows for almost
immediate recovery with limited,
to no, lasting effects.
IMPORTANCE OF USE OF
FORCE PROGRAMS AND
POLICIES
The appropriate use of Taser
CEW's by trained, competent
92 JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT
POPULAR TASER CEW MYTHS
Taser CEWs Are Lethal Weapons
Numerous reputable studies conducted on Taser CEW use indicate they are safe. In
2007, researchers from Wake Forest University examined 1,000 instances ofTaser
CEW use and found that in 997 of these instances there were no injuries, or mild
injuries that did not require hospitalization. Ofthe three odd instances that required
hospitalization, two were from the fall resulting from the Taser CEW use, and the
third person was admitted with a condition unrelated to Taser CEW (httt>://www.
wakehealth.edu/NewsReleases/2007/Nationwide Independent TASER CEW
CEW% C2%AE Stud;x Results Suggest Devices are Safe.htm).
Doesn't a Taser CEWElectrocute?
No. A Taser CEW delivers 1,200 volts ofelectricity to the body, at an amperage
that is 1/10 that ofa strong electric shock. For perspective, consider that a standard
wall outlet produces 16 amps, a holiday tree bulb produces 1 amp, while the Taser
CEW produces 0.0036 amps (Marveggio report).
Taser CEW CEWs Are Easy to Misuse
Ifa situation is escalating or use-of-force becomes necessary, there will be some
risk involved regardless of the method used. There are some compelling safety options
available with Taser CEW CEWs to ensure accountability and to keep an accurate
record ofuse, unlike alternative types ofuse-of-force. For example, a Taser
CEW can be outfitted with a device called Taser CEW Cam, which is an accessory
used to automatically record both audio and video ofTaser CEW deployments.
Taser CEW Cam helps to produce an accurate record each time a Taser CEW is
used.
The Use ofTASER CEW CEW's Inside Healthcare Facilities Does Not Comply
with CMS Guidelines
Under CMS' interpretive guidelines to section 482.13(e) of the State Operations
Manual, the use ofa weapon is considered a law enforcement action, not a healthcare
intervention. CMS does not support the use of weapons by hospital staffas a
means of subduing a patient in order to place that patient in restraint or seclusion.
The interpretive guidelines state that "ifa weapon is used by security or law enforcement
on a person in a hospital to protect people or hospital property from
harm, we would expect the situation to be handled as a criminal activity..."
It is incredibly important that hospital staff, especially security staffwho may carry
a Taser CEW device understand the CMS requirements. For example, Taser CEW
should not be used to coerce a patient back into bed simply because they are not
compiling with verbal commands. It is our beliefthat Taser CEW CEWs should only
be used when there is an imminent risk ofbodily injmy and the incident rises to a level
ofcriminal activity.
JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT 93
staff, together with the healthcare
facility's policies, and applicable
law reduces the risk of injury to
patients and staff. In addition to
having an articulate use of force
policy in place and following
the recommended manufacturer
training by Taser International,
healthcare facilities should also
develop a Taser CEW policy and
procedure, including the relevant
policy guidelines as well as
Taser CEW training and usage
procedures. The policy should
also include information on force
continuum considerations, CMS
guidelines on the use of Taser
CEW's within healthcare facilities,
and other factors for determining
the reasonable level of
force to use.
CONCLUSION AND
RECOMMENDATIONS
We believethere is sufficientevidence
to support the use ofTaser
CEW's in hospitals in situations
that represent an imminentrisk of
bodily injury and that rise to the
level of criminal activity. HSS's
security officers have carried
Taser CEW's in hospitals for
more than 10 years in facilities
across the country producing no
negative CMS finding or excessive
use of force claims. This
track record is based on a combination
ofsound policies, training
andunderstanding ofthe capabilities
ofthe TaserCEWdevice. U1timately,
Taser CEW's have not
only helped reduce injuries associated
with aggressive behavior,
but have also helped to improve
hospital staffperceptions ofsafety
on campus.
Vesting officers with the authority
to use reasonable force while
protecting the welfare and safety
ofpatients, staff, and visitors requires
a careful balancing ofpatient
care and staffsafety.
Whether healthcare administrators
decide to equip their security
team with firearms, or less-thanlethal
tools, such as chemical
agents, impact weapons, or Taser
CEW's, the primary aggression
management technique should always
includeverbal de-escalation
first, but when verbal de-escalation
techniques have failed, and
staffis facing injury due to physical
assault, the Taser CEW is an
effective means ofcontrollingthe
situation and stopping the aggressive
action. This is true when ac-
tuallydeployedorsimplythrough
the psychological deterrent value
ofthe device. In our experience,
Taser CEW's are a non-lethal
94 JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT
weapon optionthathospital leaders
should strongly consider.
References
Ho, J. D., MD, Clinton, J. E., MD,
Lappe, M. A., BS, Heegaard, W. G.,
MD, Williams, M. F., MD, & Miner, J.
R., MD. (2009). Violence: Recognition,
Management and Prevention. Introduction
of the conducted electrical weapon
into a hospital setting. The Journal of
Emergency Medicine, XX(XX), x, 1-8.
Aveni, T. J., MSFP. (n.d.). The MMRMA
Deadly Force Project. A critical analysis
of police shooting under ambiguous
circumstances [Scholarly project].
Retrieved April 23, 2016, from
http://www.theppsc.org/Research/V3.M
MRMA_Deadly_Force_Project.pdf
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