Every unit that cares for newborns strives to maintain stringent security measures to protect their smallest patients. The abduction of even one infant is too many, resulting in anguish for parents and staff members as well as repercussions including lawsuits and negative consumer opinion.

A popular recent practice has become the installation of complex, high-tech security alarms, called electronic asset surveillance (EAS) systems. Once one facility in a community installs such a system, other area facilities feel a need to follow suit in order to remain competitive. However, this type of response is neither evidence based nor cost effective.

EAS systems are not perfect. Their sizeable monitors consume limited space in nurses stations; large and clunky transponders placed on infants cause some parents to worry about the comfort of their newborns; bracelets loosen and fall off; some complain that these items make it seem that the infant is a piece of merchandise, like an expensive designer outfit in a department store. In addition, these systems consume an inordinate amount of valuable nursing time with the effort of placing, inputting, and recording each transponder; replacement of loose and lost bands; response to frequent false alarms; and the removal, cleaning, and proper storage of each transponder.

Clearly, obstetric and pediatric units must have comprehensive security protocols, policies, and procedures in place to meet the requirements of the JCAHO as well as the expectations of the community. These procedures do not need to include electronic security systems to be effective. Many alternative proactive measures can and should be instituted to meet these needs. A comprehensive listing of recommended strategies can be found on the Web site of the National Center for Missing and Exploited Children (NCMEC) (Rabun, 2003). Among the recommendations are the use of unique badges and uniforms as identifiers, four bracelet identification systems for the infant and parents, and lock, swipe, and video surveillance technologies.

Education of staff and patients is also highly important. Education of the patient and their family should begin prior to admission, in childbirth classes, clinics and doctor's offices, and should inform parents of the unit's security policies and procedures. Such information could include instructions that no one will pick up their baby and attempt to carry the infant out of the room in their arms (a behavior that might be expected of an abductor). Once the infant is born, the patient needs reinforcement of this information as well as instructions regarding safety measures related to rooming-in with their infant. Closing the door of the room and leaving the bathroom door open is essential to maintain line-of-sight contact with the infant, for Joint Commission guidelines do not require EAS systems. In its Infant Security Sentinel Event Alert (1999), JCAHO identified certain issues that led to abductions. The first item on the list was that security equipment had not been "available, operational or used as intended" due to system failures and/or user error.

In my opinion, EAS systems may be providing a false sense of security to staff and to parents. Parents have been known to react to this system as if it will protect their infants and, therefore, believe they needn't be vigilant about their infant's safety. Staff might also feel that they can be secure in the safety of infants, believing that the alarms from the EAS will always function in the case of an attempted abduction. This, of course, is not true, for even with the best security alarm system, all of the other security protocols must be followed for the infant to remain safe from abduction. Not one of our current security procedures can be replaced by the use of these expensive and cumbersome technologies.

I believe that we are relying far too much on complex technologies and not enough on the resources already available to us. In these financially challenging times, healthcare funds that are currently being used to purchase and maintain EAS systems might be better utilized for the purpose of recruiting and retaining staff that can use their own eyes, ears, and intuition to protect our precious newborns from harm.

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