Positive Vibes Only
PBIS stands for this.
What is Positive Behavioral Interventions and Supports?
These three letters identify the Massachusetts agency that regulates inpatient psychiatric facilities.
What is DMH?
Shoelaces, drawstrings, and long cords all fall into this safety-risk category.
Shoelaces, drawstrings, and long cords all fall into this safety-risk category.
This type of search should occur as part of the admission process to identify items that could pose a safety risk.
What is a minimum contact body search and belongings search?
This term describes the therapeutic environment created through structure, relationships, activities, expectations, and safety.
What is the milieu?
Instead of saying, “Stop running in the hallway,” a PBIS-based response might sound like this.
What is “We walk in the hallway” or another positively stated expectation?
A patient disagrees with their treatment, voices concerns about their rights, and wants assistance outside of the immediate treatment team. Staff should ensure the patient has access to this resource.
What is Human Rights Officer?
You find a pair of sweatpants with an intact waist drawstring during an environmental sweep. This should happen next.
What is remove the string or secure the item?
A family member brings clothing and toiletries for a patient. Before the items are given to the patient, staff must do this.
What is search the belongings?
Consistency across staff is important because it helps patients experience these two things on the unit.
What are predictability and safety?
Name the units' 5 behavioral expectations.
Safe
Patient
Accepting
Communicating
Engaging
A physician must complete an in-person examination within this amount of time after restraint or seclusion begins.
What is 1 hour?
This common hygiene-product feature can contain a small metal spring and should be considered during environmental safety checks.
What is a pump dispenser?
During a search, a staff member finds an item that isn't specifically listed on the prohibited-items guide but appears potentially unsafe. This should guide the next step.
What is clinical judgement and escalation/clarification?
A patient begins pacing, speaking loudly, and becoming increasingly frustrated. Name two early interventions staff could use before the behavior escalates further.
Examples: calm engagement, validation, offering choices, reducing stimulation, sensory strategies, coping skills, space, identifying the unmet need, or offering staff support.
Before a potentially challenging situation, a staff member uses a precorrective conversation to proactively set the patient up for success. This four-letter acronym guides the components of that conversation.
What is DEEP?
This principle means using the intervention that safely places the fewest limitations on a patient’s freedom.
What is the least restrictive intervention?
A patient newly reports thoughts of self-harm involving strangulation. In addition to notifying the RN and clinical team, staff should immediately reassess this.
What is the patient's environment and access to potential ligature materials/points?
What is required when/if a patient refuses to participate in the admission minimum contact body search?
What is be placed on a 1:1 observation, remain out of the milieu and notify physician?
Name three staff behaviors that contribute to a safe and therapeutic milieu.
Examples: active engagement, situational awareness, consistent expectations, therapeutic communication, appropriate boundaries, teamwork, structured programming, and early intervention.
Individualization, increased intensity, and function-based intervention distinguish this level of support from universal and targeted PBIS strategies.
What is Tier 3?
Following a restraint or seclusion event, this process provides an opportunity to review what happened and identify strategies that may help prevent future events.
What is debriefing?
A staff member assigned to a patient on 1:1 observation needs to take a break. Before leaving, this must occur.
What is a direct handoff to another staff member who assumes the 1:1?
This routine safety practice involves systematically checking patient-accessible areas for prohibited items, hazards, or other environmental safety concerns.
What is an environmental sweep?
Consistent group programming helps reduce unstructured downtime while supporting coping skills, engagement, and this important feature of a therapeutic milieu.
What is structure/predictability?