Att 9 Inpatient Mental Health Unit Orientation Information - Non-clinical Staff.pdf

Inpatient Mental Health Unit Orientation Information

Veterans Health Administration

Mental Health Environment of Care

Patient Safety Challenges

• Patients on Inpatient Mental Health units pose unique safety challenges;

• Mixed ages 18-95;

• Mixed gender;

• Mixed diagnoses;

• Admission status: voluntary and involuntary;

• Some may be a flight risk;

• May have suicidal or homicidal tendencies;

• May have history of violence;

• Some may have poor impulse control;

• Some may have hurt themselves, and will keep trying;

• Boundary issues.

Patient Safety Challenges (Continued)

• Each patient is an individual with feelings. They are here to get well and return to the community of his or her choice;

• Some may hear voices or respond to other internal stimuli;

• Some may try to take things left unattended like a plastic bag on a housekeeping cart which become a suffocation device;

• Screws left behind by construction crews have been used to harm self or others;

• Over 45% of completed suicides are by hanging and something as simple as an extension cord could be used;

• If you turn your back on equipment for a minute, or even seconds, it could be taken.

Method of RCA reports of suicide attempts and completions on mental health units 2000-2015 (N=336, 30 completions)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Crushed

Removed Lines or Equipment

Jumping

Ingestion of Chemicals

Method Not Specified

Gun Shot

Setting Self on Fire

Stabbing Self

Other

Asphyxiation

Over Dose

Strangulation

Cutting with a sharp object

Hanging

Attempts

Completions

Anchor Points for RCA reports of hanging on mental health units through 2000-2015 (N = 139)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Ceiling

Bathroom Stall

Bedroom furniture

Window

Privacy Curtain

Toilet Seat

Not Specified

Sink or Sink Faucet

Grab Bars or Hand Rail

Ceiling Vent

Other

Wardrobe or Locker

Bed or Bed Rail

Shower

Door or door handle

Attempts

Completions

Cutting methods for RCA reports of cutting in mental health units 2000- 2015 (N=79)

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Light Bulb

Toilet Paper Holder Spring

Sewing Needles

Plastic Name Plate

Comb

Metal from spiral notebook

Scissors

Sharp Rock

Aluminum Can

Glass

Sharp Vent

Pencil

Knife

Toothbrush

Not Specified

Metal Piece

Plastic Knife

Razor Blade

Locked Doors

• All locked doors must remain closed and locked;

• Locked doors include exit doors, office doors, therapy room doors, and interview room doors. These doors cannot be propped open for any reason;

• Be mindful when coming in the front door of the unit. The door should be opened and closed quickly and not held open.

Open the Door?

• Notify nursing if someone wants you to open a locked door for them;

• Only clinical unit staff may allow people in or out of the unit.

Ladders

• Use of a ladder is a 2 person job;

• One person climbs up the ladder while the other keeps the climber safe;

• Never leave a ladder unattended.

Keys

• Keys must kept in staff’s possession at all times;

• Never lay keys down or leave them anywhere.

Equipment in Line of Sight

• Never leave equipment unattended. This is a danger to staff and patients;

• Equipment such as a plastic bag, extension cord, equipment cord, or screwdriver could be taken very quickly;

• Clean up nails, screws, washers, bolts and other remnants of your job before you leave.

Equipment List Sample

Count Equipment List

#3 bags 15 screws per bag

#1 Drill

#5 Screw drivers 3 Phillips, 2 flat heads

#2 Extension cords

#1 Ladder

#3 Saw horses

#5 2x4”s

Equipment in Line of Sight (Continued)

• Never leave cleaners, chemicals, or gloves where patients can take them.

No Exchanges Please

• Please do not exchange money, goods, or food with patients.

Breaks

• Breaks must be taken off of this unit.

Off Limits

• Do not engage patients in conversation. Refer them to the treatment team or staff members on the unit;

• All information is confidential, even the fact that someone is on a locked inpatient unit.

Everyone is Important

• It has been discovered that after an inpatient suicide or other adverse event, people noticed odd behavior and did not come forward because they did not think it was their responsibility;

• If you are in housekeeping, contracting, or engineering and you observe something that does not feel or look right, please inform a unit staff member, you could be saving a Veteran’s life.

Questions?

DEPARTMENT OF VETERANS AFFAIRS

Edward Hines VA Hospital

5000 S. Fifth Avenue Hines, IL 60141

Acknowledging Inpatient Mental Health Orientation Information Sign-In Sheet

Project # 578-26-702 EHRM Installation of DDPO2 - Hines, IL

NAME COMPANY Signature Date