A healthcare provider who is a serial killer may go undetected for some time. A number of findings should alert someone that this may be occurring.


Patient-related factors:

(1) unexpected death or illness in one or more patients

(2) patients who die with an atypical terminal course

(3) patients who respond poorly to standard resuscitation attempts

(4) pattern of incidents matches the provider's schedule (absent during vacation, occur only when present)

(5) pattern of incidents match times when fewer co-workers may be present (shift change, meals, etc), serving as windows of opportunity


Provider-related factors:

(1) background check shows serious problems or concerns at previous institutions

(2) bizarre behavior

(3) complaints by patients, families and/or staff members

(4) observed doing things that are not documented in the chart

(5) observed doing things that are inappropriate

(6) insists on being the person who completes the reports following unexplained incidents

(7) medications go missing when working

(8) someone who is always present when an unexpected code occurs


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