I work on an adult acute-care psych unit. When I first started at this hospital 12 years ago, we had 2 levels of visual checks/documentation: either every 15 or 30 minutes on a flow sheet. All patients had a flow sheet for at least 3 days. Of course, suicidal/violent or secluded or restrained patients always had a flow sheet with every 15 minute checks.
Now 12 years later, EVERY SINGLE patient has a flow sheet for their entire stay. It doesn't matter what the diagnosis or patient's condition is. And now we have 10 minute checks (called "Risk Level 1"). Most of the doctors order this Risk Level 1 on all patients upon admission and just leave them on this level for days....even weeks! Alot of patients definitely do need very close supervision and ALL patients should be visually checked regularly. But I am frustrated at documenting (with a number code and my initials) every 10 or 15 minutes on 16 patients. It seems that this "Level 1" loses its power when I'm doing it on someone secluded and then also on someone who has dysthmia & just wants a "med adjustment."
How do you document your visual checks? Do you use flowsheets?
I am mainly just venting and am curious how other psych facilities do this.
(But my right hand aches from all the paperwork!!)
Sep 23, '02
Hi Dachweiller, we used to have 3 levels of checks but due to recent events we now have 5 levels which range from never out of your sight(suicide watch),10/60 for seclussion, 15/60 for high dependency unit ,30/60 checks and last but not least 1hrly check.
These are all done on a check sheet for each individual client 24/7.
The check levels are initially set by the Doctors on admission they can only be decreased by the docs however we the nurses can increase the score .
The level of checks are reviewed each day by the treating team(docs)in discussion with the nurses.MHN
Last edit by MHN on Sep 23, '02