Better Safe than Sorry
FIRST action you should take if you see an unsafe item on the unit or in the patients' bedroom?
What is take it out
PBIS focuses on reinforcing this type of behavior
What is positive/appropriate behavior
This is the primary goal of maintaining a therapeutic milieu
What is maintaining safety and structure
How do you ensure that contraband is not brought into the environment?
What is Searches (belongings, johnny, room, items brought)
This type of question encourages patients to elaborate rather than answer yes or no.
What is open-ended question
Maintaining this physical distance can help prevent an escalation or a boundary crossing
What is Personal Space
These 2 items are used to provide a visual of positive reinforcement to patients.
What is a passport and a stamper
This allows for the patients to maintain structure throughout the day
What is activity schedule/group offerings
You observe a patient in their bedroom using supplies brought in by a family member. You notice there is a pencil sharpener with the supplies that the patient appears to have attempted to hide. What is your intervention?
What is take the item and receive a doctor's order to complete a room search.
This communication style often escalates situations: arguing, lecturing or proving a patient wrong.
What is a power struggle
This level of supervision requires constant visual observation of the individual.
What is 1:1
These are the 5 behavioral expectations on the IPS
What is Safe, Patient, Accepting, Communicating and Engaging
Allowing one patient to break a rule "just this once" can weaken the essential component of milieu stability
What is consistency
If a patient becomes defensive during a search, the best communication strategy is this.
What is calmly explaining the safety policy and maintaining professionalism
A patient attempts to staff split by saying "the other nurse lets me do it." The response should involve this.
What is reinforcing consistent boundaries/expectations
When should the safety checks person be in the hallway
What is ALWAYS
This acronym is used in precorrection of behaviors with a patient.
What is DEEP
Describe situation
Explain the concern
Elicit feedback from patient
Pick a solution to try
Staff clustering at the nurses' station while patients argue in the village weakens this key component of milieu management.
What is active presence and supervision
During a belongings search, you find a questionable item not clearly listed in policy. What is the best next step?
What is secure the item and consult leadership before deciding
A patient begins a self-deprecating spiral about her body image and appearance during mealtime in the kitchen. How will you respond?
What is prompt to change the conversation topic to something that is neutral
This document outlines procedures for individually preventing and responding to escalations.
What is a Safety Scale (or Safety Plan)
These are the 3 Tier 1 interventions used with all patients
What is praise, prompting, and precorrection
A group of patients are refusing to attend group and instead are sitting in the hallway talking to one another. What is an appropriate intervention?
What is prompt using expectations and maintain supervision of the patients without secondary reinforcement.
A patient refuses to complete a required johnny search on admission. What is the best next step?
What is initiate a 1:1 observation and notify the psychiatrist.
A patient is in a physical restraint and attempting to engage inappropriately with those in the room. What is an appropriate response?
What is ignore the inappropriate comments, maintain professional focus and restate the behavioral expectation clearly and calmly.