Precautions
SIB stands for what
Self-Injurious Behavior
The difference between CVO and CVO-R
CVO- is at all times including groups and school
CVO-R while in room only
A pen is found in a patients room during room checks
NO-This does NOT require an incident report. The item should be removed from the room and noted on the Safety Checklist
Code CI
Crisis Intervention.
Your nurse ran upstairs to grab a med, and a patient needs to go to the bathroom, you can leave the other patients in the dayroom to open their door, as long as it's less than 30 seconds.
NO!- patients should never be left alone in any setting
Amount of time patients on Bathroom precautions have to wait after eating to use the bathroom
1 hour
Patients on 1:1 status can be left alone to visit with their guardian
False- the 1:1 continues through the visit and staff should remain within 3 arms lengths of a patient
Two patients start arguing in Process and verbally threaten to physically assault each other.
YES- file an incident report under "threatening behavior" or "verbal altercation"
Code silver
Hostage, terrorist, or active shooter.
You have a patient on sexual behavior level 2, it is fine to go outside with their track if outside time is on the schedule and there are extra staff available.
NO! Patients on Sxl Beh Lvl 2 can only go outside during STRUCTURED groups, such as rec therapy or specific BHS/Nursing Groups with a clear objective and structured activity. An extra staff must also accompany this pt as a 1:1 during this time. You may also choose to bring this patient outside one on one when there are no other patients outside for 10-15 minutes, with or without a structured activity.
Patients on elopement/AWOL precautions are allowed to wear their personal cloths
False - they need to wear scrubs
Staff can do 15 minute checks via the security camera when patient are awake in their room
False - live checks MUST be done during awake hours and at the hand off
You get hurt during a Crisis Intervention
YES - anytime you staff get hurt an incident report should be filled out under "Employee accident/injury/issue"
Code Blue
Cardiac or respiratory arrest
Two patients have been at P.C. for 4 weeks and one is finally leaving. After spending so much time together they ask you if it's okay to give each other a hug
NO! Patients are prohibited from hugging or touching.
Patients with Sexual Vulnerability precautions must have solo showers
False- patients on Sexual Behaviors must have solo showers
A Rec Therapy group leader can give you a verbal acknowledgement that a patient is in the room with them for a 15 minute check
False - A BHS or RN must visually confirm all patients for themselves
Scissors were found in the dayroom after a group, but were not used unsafely by patients
YES - this is a "near miss"
Code Pink
Missing or abducted child
A patient who is not enrolled in school, but has SI,SIB precautions ask to go to their room to sleep.
Yes! A patient who is not enrolled in school can go to their room to sleep during school, but 15-minute checks should still be done in person.
Adolescent patients on elopement/AWOL precautions can go to the off-unit library in the cafeteria.
Patients on elopement generally still have off-unit privileges, provided they are wearing scrubs and hospital socks. They are not allowed to go outside, however, and they may have off-unit privileges limited by other orders from their PMD.
How should we monitor a patient when on a pass?
Patient should be monitored CVO at all times when outside of the building on a medical pass.
Patients are play fighting in the dayroom and one playfully kicks the other patient in the buttock
YES - incident report should be created under "inappropriate sexual contact or behavior"
Code Purple
Staff talking about patients in front of other patients
Staff are having conversations about another patient while another patient is around. Because this is not about them, it is okay for the staff to continue to talk about this patient.
No! If there are other patients around, staff should go to a private room to have conversations regarding another patient's treatment.