Pt. belongings in the ER

[psu_213, BSN, RN]

We had a situation recently where a pt was intubated in the ER and subsequently admitted to the ICU. The pt claims that he brought certain valuables with him to the ER (cash, wallet content, rings, etc....not sure of the exact nature of said valuables) and they were "stolen" by ED staff as they were not with him when he was unsedated/extubated. An annoying state DOH investigation ensued and yadda, yadda, yadda...we are now "under the microscope" for how we handle belongings in the ER.

The questions:

1. Has any other ER faced a similar situation?

2. Even if not, how do you handle a pt's valuables? I understand the difficulties with a sedated and/or intubated pt. However, what about a A&Ox3 pt who goes to MRI? Or even to the bathroom? Someone could slip into the room and swipe something sitting on the BS table.

3. Does anyone's ER go to the point on inventorying every belonging a person has with them? Is this even possible? In my mind, this still does not solve the potential for theft of an item from a sedated pt.

Any other random comments are appreciated. :)

[schnookimz]

We inventory every single patient item and then the patient or family member and a staff member sign the inventory. If something from that inventory ends up missing, the hospital is responsible for it.

[psu_213, BSN, RN]

We inventory every single patient item and then the patient or family member and a staff member sign the inventory. If something from that inventory ends up missing, the hospital is responsible for it.

To play devil's advocate, a couple questions:

1. Pt collapses at the grocery store. Intubated on scene by medics. No family is present in the ED. I presume the pt's belongings are still inventoried. When the pt recovers, the state "yeah, but I had 200 bucks in my pocket." Who is responsible at that point?

2. Are the entire contents of a bag/purse inventoried? Is just "purse" written on the inventory? What happens an item that was in the purse (or that the pt claims was in the purse) comes up missing?

3. After the inventorying is done, staff finds a pt emptying the purse/bag/pockets/etc. Later on an item comes up missing. Would this still fall on the hospital (I know this is more a legal issue than an actual hospital policy issue)?

[nurse2033, MSN, RN]

If the patient is not A/Ox4 we chart the basics and hand it off to security. Like; purse, glasses, clothes. If there is jewelry we remove it and also give to security. I would chart that as well; ring, necklace, whatever. Security then becomes responsible for documenting how much money and so on.

[nurse2033, MSN, RN]

For patients coming in via EMS they would have to prove that EMS documented the item for them to claim we lost it. As a paramedic also, I do chart valuables and that I hand them off to ER staff.

[VICEDRN, BSN, RN]

Agree with posters above. We document every single item one by one in chart with two rns. Ems is supposed to do the same. We are responsible only if ems documents they had something and we claim we didn't.

I absolutely hate this part of my job. Think security should do it but yeah it's been an issue.

[thelema13]

Upon admission items are inventoried. I am faaaaaar too busy to inventory every patient's belongings that come into my rooms when the majority are DC'd home.

[Altra, BSN, RN]

Yes, claims of theft/loss have come up and been reported to the DOH in every ER in which I've worked. The hospitals have sucked it up and reimbursed patients for items of value, unworkable, unrealistic policies ensue in the short term, then things return to more normal practice. And sooner or later there will be another claim of theft/loss and the cycle will start again.

For patients who arrive to the ED unconscious/intubated, or patients evaluated by the trauma team, we do get security staff in the room soon after arrival to pick up belongings. They make an effort to list items of value - cash (counted by 2 people), credit cards, pieces of jewelry, electronic items - but do not otherwise list every item.

For all patients admitted to the ICU we strongly encourage family to take all the patient's belongings home, as there is no storage in ICU patient rooms.

I've never worked anywhere that attempted to inventory the belongings of everyone that walks in the door. It's invasive and unnecessary.

EMS services inventory belongings where some of you are? Just shaking my head at the visual image of inventorying the pockets of the STEMI patient while rolling in with lights & sirens ... On any given day I receive patients from 8 or more different EMS services in my large metropolitan area and from regional transfers - I've never encountered a service which required that.

[sandyfeet]

When I was a new nurse, I had a patient roll in ALOC that we quickly intubated. Nurses, techs, RT and the doctor flying around the room and I was charting. My charge nurse handed me a gold necklace from off of the patient's neck and said "Don't lose this". I was new and flustered, and set it on the counter next to a myriad of IV and intubation supplies, and left with my patient to go for a CT brain. We came back, things started calming down and I started cleaning up the room. I started making the belongings list and realized the necklace was gone. Looked in the trash. Looked all over the room. Asked every person I could remember being in the room. Had housekeeping go through all of the trash. GONE. I felt like the life was sucked out of me, like I was working with a pack of snakes. Or was it another patient? A family member who walked by and saw it? I never found out. Now I make my patients take their purses, iPads, etc with them if they leave the unit for testing.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Happens all the time in my ED,...we roughly inventory everything and place it with security or in a bag at the bedside if it is nothing real valuable. We try to always document where the belongings were placed, especially if given to family/visitors.

[canoehead, BSN, RN]

We give anything of value to the family. If there is no family, the patient is unable to participate, and something very valuable is found it is inventoried and locked up by security. There are big gaping holes in the system, it's easy for someone to claim anything, but to be reimbursed for any amount they have to prove it was here, (ER) and necessary for their care, (admitted patients) like dentures. On admission everyone signs that they will send valuables home, and that the hospital is not responsible for losses.

We only inventory if:

- the patient is being admitted and the patient is not keeping their stuff with them

- the patient is placed on a hold