Health Training for Correctional Officers

E-11 Nursing Assessment Protocols (important)

Nursing assessment protocols are appropriate to the level of skill and preparation of the nursing personnel who will carry them out, and comply with the relevant state practice acts. Standing orders may be used only for preventive medicine practices. — 2008 Standards for Health Services for jails and prisons

Correctional officers are a vital part of the process for delivering health care to incarcerated individuals. Not only do they facilitate the work flow, they also represent many eyes and ears throughout the facility to alert health staff to individuals with possible health issues. Because correctional personnel are often the first to respond to problems, they must be aware of the potential for emergencies that may arise, know the proper response to life-threatening situations, and understand their part in the early detection of illness and injury.

Standard C-04 focuses on a health training program for correctional officers. The intent of the standard is to promote the training of correctional officers to recognize when the need to refer someone to a qualified health care professional occurs and to provide emergency care until they arrive.

Training can be accomplished in a variety of ways, including classroom training, roll-call in-services, electronically or any combination of these methods. Health staff may have a role in the training or it could be conducted entirely by correctional staff who are qualified to instruct on such topics. Regardless of the method for training or who is responsible, the standard requires that correctional officers who work with the incarcerated receive health-related training at least every two years. The training program must be established or approved by the responsible health authority in cooperation with the facility administrator.

Components of a Training Program

This standard outlines required components of the training program. These are the minimum requirements and additional topics can and should be added when appropriate. Cardiopulmonary resuscitation (CPR) training should be provided by an approved body such as the American Red Cross or American Heart Association, or by an individual possessing a current instructor’s certificate from an approved body. Generally, courses provided by an approved body will cover another component required by the standard: administration of first aid. CPR training may be provided by any course that requires hands-on demonstration prior to certification.

It is not uncommon for patients who take medication or who have chronic illnesses to be housed in general population, away from health staff. Therefore, it is imperative that officers are able to recognize acute manifestations of certain chronic illnesses such as asthma, seizures and diabetes, as well as adverse reactions to medications. Officers must also be able to recognize and alert health staff to individuals with symptoms of intoxication and withdrawal for early intervention and treatment.

Instruction in precautions and procedures with respect to infectious and communicable diseases ensures that officers are knowledgeable in preventing the spread of these diseases to other incarcerated individuals, staff and visitors. In addition to understanding the proper procedure for handling infectious wastes, officers who work in facilities that have negative air pressure rooms should know how to protect themselves and others when respiratory isolation is indicated.

Another required component of a health training program is the administration of first aid. Courses are available through the previously mentioned approved bodies and may vary in their content. A good first aid component may be tailored to include topics that are common to your facility. For example, facilities with a high number of diabetic patients may want to include first aid response for diabetic emergencies. It is a requirement of the juvenile standards that child care workers assigned to outside programs such as forestry camps or routine outdoor recreation are current not only in CPR and first-aid training, but also in the prevention of heat-related illnesses.

Individuals with mental illnesses are common in correctional facilities and officers should be educated on recognizing the signs and symptoms of mental illness and procedures for suicide prevention. It is recommended that mental health staff review the training curriculum regarding these topics and offer communication skills for managing individuals with mental disorders.

Correctional staff must receive trianing on dental emergencies. It is good practice to incorporate the topics falling under dental emergency training based on events seen in your facility (i.e. dental abscess, infection, procedures in the event of a tooth being knocked out or broken, etc.)

Another required component of the training program is instruction in the procedures for appropriate referral of individuals with health complaints to health staff. This topic may be taught separately or can be referenced throughout the program with the other required components.

The final training component pertains to the importance of maintaining patient confidentiality.

Other Requirements

Once the health training program is in place, an outline of the course content, including the length of the course, should be kept on file (compliance indicator 2).

A certificate or other evidence of attendance must be kept on-site for each employee.

Lastly, it is important to note that although it is expected that 100% of correctional staff or child care workers who work with the incarcerated are trained in all of these areas, compliance with the standard requires that at least 75% of the staff present on each shift in jails and prisons and 85% in juvenile facilities are current in their health-related training.

Correctional staff should receive additional training on these special health-related topics if relevant to the services provided in the facility:

a. Health needs of adolescents, if applicable
b. Use of naloxone in the event of an opioid overdose
c. Pregnancy and labor considerations, if applicable
d. Additional mental health training, including de-escalation techniques, for officers
assigned to mental health units
e. Health effects of segregation

Having a well-developed health training program provides correctional officers with the knowledge to assist health staff in preventing, and responding when necessary, to adverse events within the facility.