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Discussion

Policies

I just want to put this out as I am trying to find common practices when it comes to inpatient mental health unit. All the input I can get will be helpful. Here is the question, how do you handle patients on an accute mental health unit that have to use a orthopedic brace for knee, leg, wrist whatever? Is it constant observation, 15 minute checks or just dont allow the patients to use the device. Please share your input from your areas so I can gather data.

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    The type of monitoring would be according to the individual Patient and their level of functioning, as well as the type and need of the device. For example, if the Patient is high functioning, and makes a commitment to safety, has had no history of physical agression, the standard 15 minute check would be appropriate. However, if the Individual is psychotic and has a history or some other indication for being a posilble threat of harm, 1:1 Safety Precautions would neeed to be implemented. The stringency of the intervention would need to cumulatively match the status of each Patient.

    I know of no written policies defining each specific circumstance. The decision has been made by the Leader and/or Treatment Team.

    The areas I have worked with Inpatients has been State, Community Psychiatric, and Medical Hospitals.

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    At my facility the precautions that were in place prior to needing the brace/sling (assuming pt. was injured at facility) remain the same. If the pt. was on q15's only, then they remain on q15 only. If they were LOS they remain LOS. If they were 1:1 they remain 1:1. The difference comes in when we're talking about night time.

    The pt. must return the brace/sling if they are on q15 checks or LOS. If they are a 1:1 then they need not return the brace at night as there will be a staff member at arms reach at all times.

    Same goes for if they are admitted with a brace. The precautions on admit stand.

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    Thank you for your input

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