Behavioral health holds in ER

[lorirntobsn]

I am an ER nurse researching medication reconciliation and administration for prolonged behavioral health holds in the ER. Does anyone know your company's policy regarding med rec and starting home meds while holding in the ER?

My main goals are to decrease restraint use and adverse events for the psychiatric population holding in ER.

Questions:

1. When do behavioral health patient's home meds become reconciled and administered at your faculty and is there a policy regarding this?

2. At what point do you believe psych home meds should be reconciled and administered? (At time of arrival, before/ after intake assessed pt, after admission dispo, or one hour after admit dispo while holding in ER?)

Thank you very much!

[nurse2033, MSN, RN]

I'm not sure what you mean by "intake". Is that mental health? If we can verify their medications from their record we give them what they need on the best schedule we can. Otherwise, we do it at the four hour mark, or if they are admitted- sooner.

[lorirntobsn]

Intake is the social worker that assesses the patient, and reports findings to the psychiatrist. It may take several hours before a intake social worker assesses the patient.

[chul_soo]

In my department, it's done in triage but if they come in kicking and screaming, it might have to wait. =P