We are about to implement a hospital wide policy that prohibits the patients from leaving the unit if not for medical purpose. There is an exception that with physician order the patient may go off the floor but only with a staff member. It is a patient safety initiative. The thought behind it is, "if you are sick enough to be in the hospital, you need to stay on your unit where you are provided care".
I agree to this policy to an extent. It will cut down on the frustration of trying to do your job and the patient not being there. It also might distinguish the hospital from a hotel. What I am not looking forward to is having to be the enforcer and also catching patients smoking in their rooms.
Where I work some patients stay for weeks or even months at a time. Getting off the floor is an element of sanity in those cases. If it has to be with a staff member, I would like to know who that will be with.
Anyone have any experience or thoughts regarding this policy?
If a patient is intent on leaving the floor, how will you stop them?
Instructing them about the policy might change the mind of some patients, others are going to shrug it off and keep on going. What then? Does your administration address this issue at all?
Before we went completely smoke free we had patients that would want to go downstairs to smoke. We started making them sign waivers that said they had been fully explained the risk to their health and their ongoing treatment and the facility/doctors/nurses were not responsible for them or their safety while they were off the unit smoking. It may or may not have held up in court but the patient didnt know that. Some signed some didnt and stayed on the floor.
We went completely smoke free last year,, its been about 8 months and people dont smoke,, if staff smoke they go off property on breaks and lunches after punching out, and punch back in when they return to the building.
But again,, and ive said it before, im not their smoking police. Someone else can do that.
So far, no positive replys on this one. I work at a large medical facility. One thing that I have found about working there that I do not like is the competition to do what other hospitals of their size are doing.
The goal of the elopement policy is to prevent codes and patient accidents while off the floor. I think January 07 we are becoming a smoke free campus, with standing delegated orders on nicotine replacememt and employee assistance with nicotine replacement.
I'm interested to see how both of these play out....
Someone asked if I work on a psych unit. Sometimes it feels like I do, but I take care of liver and kidney transplant patients.
If they are transplant patients why are they leaving the floor?
I know our Med A people aren't supposed to leave, although some might go out for something to eat with their family. I don't hold them to it as I feel a bit like a jailer.
Our facility has been smoke-free for going on 2 years. no pt's may leave the floor. only one really ugly scene that I can recall, tried to "fool" us into thinking his family was going to "wheel him around" for a while. was found outside smoking. on his return to his room I had the very pleasant chore of politely informing him it could not happen again. My manager told me to inform him his choices were a nicotine patch or AMA. He wasn't happy but he did comply. Lots of pt's make a fuss, but most don't have a serious problem with it
Specializes in Education, Acute, Med/Surg, Tele, etc.
I believe our facility discourages this unless you have a specific MD order and sign release papers for anything that may happen to you while you are off the floor. So people can go about, it just is a huge paper trail before hand.
However, if someone demands it without the paperwork they may leave, but they will be reported as going AMA...which is true, against medical advice to go wondering off at that point. The only thing I remind pts is the truth about AMA...insurance will not cover you if you go AMA. That usually stops it from happening till I can consult with the MD.
I don't typically have a probelm with this unless a patient is being D/C'd in the day and is impatient. Or a smoker that wishes to have a ciggie (which I will advocate for under reason because they have the right..and some just want some outside time anyway). Typically I let them know about the red tape of AMA, and have them be an interactive part of allowing their needs in their care plans and orders...and that seems to help everyone :).
unapt576
7 Posts
How will they enforce this policy?
If a patient is intent on leaving the floor, how will you stop them?
Instructing them about the policy might change the mind of some patients, others are going to shrug it off and keep on going. What then? Does your administration address this issue at all?