Time Limit on Time out for patients

Specialties Psychiatric

Published

Please help answer this if you can as I've been reading everything with no real answer. Is there any LEGAL time limit on how long a patient remains in open door Time Out room.

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Joint Commission recognizes ANY time you tell a patient they can't leave a room or physically prevent them to do so as a seclusion. I work C&A and we got dinged when they asked a kid if he was allowed to come out of his room and he said no. We're not allowed to use time outs at all anymore.

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It's my understanding that if a pt goes to their rooms voluntarily and the door is left open the pt can be in their room as long as it takes for them to calm down, if it is made a coping skill you can encourage using it, although I know this will not always work, I feel like it's a therapeutic and safe option

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What about if its for their own safety from another pt?

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Specializes in Psych.

In my facility a pt can be in his or her room or the quiet room as long as they need to be to calm down. For the kids its usually not that long. 15 mins, half hour at most. If they are making suicidal statements and wont contract or they are presenting a danger to staff or other pts, they get to work on packets in their room or one of the observation rooms at the nurses station. There is a time limit on physical/mechanical restraint and locked door seclusion and it depends on age. Once you've reached that limit, you have to get a new order. I have only ever seen one locked door and it was a teenager who had serious out of control aggression. Usually if we give IMs they remain in the quiet room and they sleep it off in there.

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Specializes in Psych.

When we do open seclusion we basically tell the patient when they feel like they are in control they are permitted to leave the room. we have no time limits because they can leave the room whenever they want.

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No, This is 24/7 and pt is not there voluntary. Supposedly IF there is no incidents in 7 days THEN they can be out 1 hour and read a magazine or something.

NO magazine, no ANYTHING, nothing but a mattress on floor is allowed in Time Out room. ANd you are right, it is considered "SECLUSION" regardless if door open . IMO Isolation also as pt is not allowed to talk except to ask for "needs". (ie I need to go to restroom, I need to shower, etc). Meals are even in there on plastic tray.

I was also told we are not under "STATE" rules (which say 12 hours) but under DADS. Does that make a difference REALLY? Doesn't state laws govern over them?

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Specializes in Psych ICU, addictions.
No, This is 24/7 and pt is not there voluntary.

It wouldn't matter if the patient was there voluntarily or involuntarily--the regulations would still be the same.

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Specializes in Psych.
No, This is 24/7 and pt is not there voluntary. Supposedly IF there is no incidents in 7 days THEN they can be out 1 hour and read a magazine or something.

NO magazine, no ANYTHING, nothing but a mattress on floor is allowed in Time Out room. ANd you are right, it is considered "SECLUSION" regardless if door open . IMO Isolation also as pt is not allowed to talk except to ask for "needs". (ie I need to go to restroom, I need to shower, etc). Meals are even in there on plastic tray.

I was also told we are not under "STATE" rules (which say 12 hours) but under DADS. Does that make a difference REALLY? Doesn't state laws govern over them?

If those stipulations exist why is the door even open? As for length of time, we have to have orders to continue renewed based on patients age. Since we only have over 18, the order has to be re-evaluated every 4 hours. We can D/C as a nursing measure when pt meets criteria. I dont know if there is a maximum amount of time, but the patients must meet criteria to continue ( imminent risk to self or others)

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Specializes in Psych.

Oh no, when a pt is in time out they can talk as much as they want/use the bathroom etc. Usually staff is with them. Honestly for time outs is mostly kids and we give them an expectation that once they cane be calm for 10 mins they can go back on the unit. Adults that go there usually get IMs and they sleep it off in there.

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I just finally made my mind up that I have to call & report to company. I KNOW it isn't legal and I can't go with my head in the sand anymore just cause it makes me uncomfortable to speak up. Just have to push it.

I keep hearing "WELL WE HAVE A DR"S ORDER!"....

AND!

Like a Dr is always RIGHT! Esp. abt rules/reg's. ha ha

One would think as many times as we've had to clarify orders/get them to rewrite orders for some reason/people would know DR's

"PRACTICE" medicine. They are not certainly are not always in the know OR right!

Thanks everyone. Least I got to vent while making my mind up how to stop it! LOL

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Specializes in Psych ICU, addictions.

I would also suggest you start looking for another job to get out of Dodge, because in case it ever comes out that you were the one who called to report it, you'll be a marked nurse.

Best of luck.

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