using maintainence for patient care

[capability]

i work in a longterm care/ rehab facility. We have no wanderguard system and have patients that have eloped. We now use maintainence workers on overtime to "sit" with our high elopement risk patients. We have maintainence workers in the room at night...these workers have no patient care training and are paid by the facility. We have a family member who is upset because his mother and her 3 roomates have a man sitting in the room with them overnight. Any thoughts about this would be appreciated. One last thing, one maintainence man has breached hippa by talking about a sitting situation with a non employee of the facility.

[meownsmile, BSN, RN]

Thats just nuts and i dont blame the family for being upset. This facility needs to upgrade their facilities and do better with security for the good of their patients. Im surprised they can even get anyone to admit their loved ones there if there isnt any means of making sure they dont elope besides some maintence guy being a sitter all night. Whom im sure sleeps most of the night anyway.

[Talino]

How many possible exits are there in the room?

If there would be a window and a door, man the door from outside the room. Install a window alarm (less than $8 in Homedepot or Radio Shack) securely to prevent resident from tampering it. Installed outside of the window would be tamper-proof but you might not hear the alarm.

HIPAA is every staff's business. Any violation shall be dealt with according to facility's policy.

[santhony44, MSN, RN, NP]

That is just nuts.

While a maintenance person might help out in some situations when they happen to be handy, purposely putting them into a patient care situation is unfair to everyone involved. (For example, stopping an eloping resident to "chat" while waiting for the nurse or CNA to get there, helping to catch a falling resident, etc).

Seems to me that a facility could get into big trouble for that. I wonder what the regulatory agency would say???

[Daytonite, BSN, RN]

by definition a sitter is just that--a sitter. their only responsibility is to report to the nurses when the patient is getting up. we used sitters with patients in the acute hospital all the time and this is all they were required to do.

now, i have a problem with a male sitting with female patients, particularly at night. not only that, but a sitter in a ward of 4 patients is an intrusion of privacy on the other 3 patients. if the family objects, the male sitter should be removed immediately. this is something the family should be discussing with the facility administration. the facility is leaving themselves wide open for problems by putting male sitters with female patients like this. possible solutions would be to move the patient to a private room, have the family provide their own sitters (perhaps people from their own family), move the patient to a room very close to the nurses station so observation of the patient and the sitters can be accomplished more efficiently, or the family should be asked to move the patient to another facility. if there is a lot of sitting needed, all the patients needing sitters should be moved into one room and one sitter posted in the room with them. it would save the facility some money.

if i were the charge nurse i would be watching this sitter like a hawk no matter how reliable everyone might think he is. by the time one night shift was over, he'd know that my shift was busy and that i was all over the unit just as actively as if it were daytime. i'd also be all over someone's office the next morning protesting this as a patient advocate.

[SharonH, RN]

Just when I thought I'd heard everything in this biz.

[ICRN2008, BSN, RN]

Did these maintenance workers undergo caregiver background checks? That would be my primary concern. Even though they are not doing direct patient care, they are in the patients' rooms at night with no supervision- the facility is asking for a lawsuit in my opinion.

[CapeCodMermaid, RN]

Did these maintenance workers undergo caregiver background checks? That would be my primary concern. Even though they are not doing direct patient care, they are in the patients' rooms at night with no supervision- the facility is asking for a lawsuit in my opinion.

Everyone who works in my facility has a COREY background check...nurses, aides, kitchen people, even volunteers. It's a regulation.

[CoffeeRTC, BSN, RN]

I think the lack of a wanderguard system is a huge problem.

As far as the maint. people doing pt sitting. I was under the understanding that all sitters did was watch the patient and get nursing staff if they need help. If they have the clearances, that should be okay. Maybe not normal, but maybe legal?

[banditrn]

Well, how about window alarms and the guy sitting outside the room? Is there another exit or only one door?

I don't know that I'd want a non-licensed guy sitting in my mothers room at night.