In my opinion the best defense against infant abduction is a vigilant staff, educated parents, and a well-choreographed response to the perceived or real threat of infant abduction. Electronic security systems play a key technological role in supporting a hospital's infant security program through monitoring, surveillance, and response time.

Technology-based infant security systems generally fall within three categories: closed-circuit television with back-up recordings, access control to secure areas, and infant bracelet or umbilical cord tag alarms (Cesario, 2003). These systems are constantly vigilant and unaffected by distractions, rest/lunch breaks, and shift changes (Rabun, 2003). The choice of an infant security system (whether alone or in combination) should be based on a hospital's needs assessment of its physical plant, review of unit and security policies, interviews with staff and families, and an extensive study of hospital and unit traffic patterns. Furthermore, the Joint Commission on Accreditation of Healthcare Organizations considers infant abduction to be a "sentinel event," designates particular areas in healthcare facilities to be security sensitive, and stipulates that these areas require a specific access control plan (JCAHO, 1999). Maternity and pediatric units meet these criteria. In addition, the National Center for Missing & Exploited Children (Rabun, 2003) considers essential the installation of security-camera systems, alarms, locks, and self-closing hardware on all stairwell and exit doors leading to, from, or in proximity to maternity, nursery, neonatal-intensive-care, and pediatric units for prevention and documentation.

Electronic infant security systems provide constant monitoring, with video of everyone entering or leaving the unit, thus providing a photographic record of an abduction and subsequent identification. They can also continuously monitor entry points and areas that may be out of the clear line of sight of nursing stations. Controlled access to units can be maintained through magnetic swipe cards, key-pad access, and electronic release locks. Umbilical cord or bracelet transponders send signals to sensors strategically located around the perimeter of the established secure area. Some sensors can actually track the constant movement of an infant. Thus, response can occur within seconds rather than the minutes it could take for members of the hospital security team to achieve the same results.

It is imperative for every healthcare facility to have a written proactive infant abduction prevention policy and response plan that extends beyond security and the maternity and pediatric units. The policy should include other hospital departments such as facilities management, public relations, communication and information systems, and local law enforcement. Mock abduction drills should be conducted unannounced once or twice each year involving all personnel to critique and evaluate the identification of an infant abduction and the facility and local law enforcement response.

The cost of electronic infant security systems may seem prohibitive; however, in the event of an infant abduction the financial cost due to liability will likely exceed the initial investment. Abduction of one infant could precipitate dramatic decreases in hospital census and significant losses in patient volume and revenue. An institution's reputation for safety is key to its survival in the current healthcare environment. Thus, purchase of an electronic system is part of an overall strategy to secure the environment. Successful implementation of a system may be key to an organization's financial health.

The devastating impact of an attempted or successful infant abduction includes the physical, psychological, and financial costs it takes on the infant's parents and family, maternity and hospital staff, and the surrounding community. Few hospitals truly recover from the stigma of such an event. Therefore, in my opinion hospitals should take every measure, including the installation of electronic security systems, to ensure the safety of its most vulnerable patients: infants and children.

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