Safety

Will it go ’round in circles? More managing the physical environment relative to suicide risk

Hospital Safety Insider, June 28, 2018

Want to receive articles like this one in your inbox? Subscribe to Hospital Safety Insider!

Editor's note: This was originally published on Steve MacArthur's blog, Mac's Safety Space.

Hopefully you have already gotten a chance to look through the July issue of Perspectives for the latest reveals on how at least one accrediting body is working through the issues relating to ensuring each organization has a safe environment for the management of behavioral health patients.

There is a fair amount of content. This comes to us in the form of FAQs -- presumably these will find their way to the official FAQ page, if they have not yet done so -- and splits up into three general categories: inpatient pysch units, emergency departments, and miscellaneous. (I’m going to guess that the FAQs relative to managing at-risk patients in acute care settings is going to merit their own FAQ edition, so I guess we’ll have to stay tuned.)

I don’t know that I would term anything to be particularly surprising (lots of emphasis on the various and sundry risk assessment processes that comprise an integrated approach to such things). However, they do make some efforts to describe/define, going so far as to indicate that only patients with “serious” suicidal ideation (those with a plan and intent) need to be placed under “demonstrably reliable monitoring” (aka 1-on-1 monitoring), with the further caveat that the monitoring be linked to immediate intervention, which means something in terms of competency, education, experience, etc.

Clearly -- and I completely agree with this -- there is an expectation relative to who does the monitoring that probably doesn’t include a rookie security officer or other newbie. I personally have advocated for a very long time the use of folks who are specifically prepared for these types of activities, so maybe that idea is going to approach something of a standard. We shall wait and see.

Another interesting item is the indication that if you -- and, yes, I mean you! -- designate a room in your ED as a “safe room," then the expectation, at least for TJC, is that the room or rooms would be ligature resistant. Makes sense, but I think it does represent something of a caution for those of you looking at designating safe rooms in your EDs (and perhaps extending to the inpatient side of things – probably in the next installment).

I guess the other interesting thing (and this probably doesn’t apply to all) relates to freestanding EDs – the recommendations for EDs would apply (you can check out the November 2017 issue of Perspectives for the particulars if you’ve not yet done so). I understand that this is rather a big deal in general and is very close to endlessly complex in the practical application of the management of risks. I think this is one ball we’re going to be keeping an eye on for the next little while.

To end this week in the truth is stranger than almost anything category, I was looking through an email devoted to all things culinary and I noted a headline, “We’re All Using Clorox Wipes Wrong, Apparently." And I said to myself, "Dwell times have entered the vernacular of the American household (I’m not saying it’s anything more than a toehold, but still) and darned if I wasn’t pretty much spot on." The other “revelation” is the absence of bleach in some of the kitchen wipe products identified in the article (I think I knew that, but I can’t really say when I might have acquired said knowledge). There’s also some information on what surfaces should be cleaned with certain kitchen wipes, etc. At any rate, I thought it worth sharing, at least as an example of how our work can span all demographics.

Happy Independence Day to all!



Want to receive articles like this one in your inbox? Subscribe to Hospital Safety Insider!

    Hospital Safety Center
  • Hospital Safety Center

    Improve compliance with hospital safety standards from The Joint Commission, OSHA, and other regulators with this...

  • Healthcare Life Safety Compliance

    Created exclusively for healthcare facility managers, plant operations professionals, and directors of engineering, this...

  • Hospital Safety Insider

    Stay on top of hospital safety requirements and best practices with our free, fast-paced weekly update.

  • Basic OSHA Compliance Manual Kit

    Total compliance has never been easier. This one convenient package contains everything you need to ensure your outpatient...

  • Basic Dental OSHA Compliance Manual Kit

    Total compliance has never been easier. This one convenient package contains everything you need to ensure your dental...

Most Popular