acute psych unit


Is is a JCAHO violation if bathroom doors are unlocked in acute in patient psych unit....can you call a psych unit officially a locked unit if the door is locked before an ER patient gets to the unit but then the bathroom doors in patient rooms are open at all times even with severly suicidal patients who is not on one to one..?

thanks for your input


14,633 Posts

I've been in psychiatric nursing for >25 years, in five different states, and I've only seen one unit, in all that time, where the bathroom doors were routinely kept locked and clients had to get staff to let them in. As far as I've ever known, a "locked" psych unit refers to the entrance/exit doors to the unit being locked, not how many or which doors are kept locked inside the unit.

On the other hand, I have a hard time picturing a situation in which a "sever(e)ly suicidal patient" would not be on 1:1 observation. That would be a much greater safety concern to me than unlocked bathroom doors ...

I'm guessing there's a lot more to this story and question.


73 Posts

A locked Acute Unit means the doors are kept locked at the entrances and exits to a unit. Patients bathrooms are not kept locked within the unit, unless there is some type of maintenance problem within the bathroom that could be a safety issue. It a patient will not contract for safety, and is verbalizing they are going to hurt themselves then the MD/management needs to be notified, usually pt is medicated or put on 1:1 - depends on situation etc.


267 Posts

Specializes in this and that.

Thanks so much elkpark and gnursjr2...Theres a lot of behind the scenes questions here but dont want to post

Specializes in Psych. Has 12 years experience.

I too see some confusing things on my unit. When I was worked at the state hospital there were no belts, not laces no hoodies etc... Here it's a little different they have their belts and laces and hoodies, but we do take them away if there are on 1:1, seclusion, or if the are on suicide precautions. But we have semi private rooms, so one person doesn't have their belt, or shoes but the other person has everything. Some nurses take all the jewlery away, other times I find all kinds of jewlery on them. Well then we take it on a case by case basis. Gets confusing, so I will check with my boss about things like that.

Oh, love your name, heavymetalrn. Well take care.