Seclusion in the ED

EDchrisRN · May 23, 2000

I have worked in a Level II trauma center in Lancaster, PA for the past 12 years. Our ED is currently seeing about 50,000 pts. per year. Our ED has 25+ beds and the hospital has about 350 beds. When I started working here 12 years ago, a mental health pt. in the ED was a rarity. Now, it is multiple mental health pts. daily, mostly on evenings and nights. We have a seclusion room which if more of a dungeon than anything.(It is also our decontamination washdown room should that be necessary) The room is concrete and cold. However, we do have very specific protocols in place and very specific policies in place. This was driven mainly by JACHO which was really focusing on restraint/seclusion issues a few years ago. We also have a restraint/seclusion QA process in place. Would love to share wisdom and forms if you'd like. E-mail me.

keaston · May 26, 2000

I work in a hospital in Vancouver, BC. We have 27 beds in the depatment of which 4 are lockable seclusion rooms. We have a special unit which is funded to treat subsatnce abuse and psych patinets. It is staffed by a psych RN and two ER nurses. We have four streatcher beds as well as the four lockable seclusion rooms. They are small rooms with moulded concrete beds and just a mattress. They have a toilet and sink and are on constant observation via closed circut camera.

We have a protocol for observation and care of a patinet in the room. While the door is locked they are physicaly looked at through the glass window every 15 minutes to ensure their safety. As well at least one time per shift the room must be entered to ensure the patinet is safe, not in furthur need of medical attention and whether or not the door still needs to be secured. The entry is made by a staff nurse, a psych nurse and if thought to be nessesary members of the hospital security staff ( to a total of five people).

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Kevin