HospitalInspections.org

Based on clinical record


20361

Based on clinical record review, observations, interviews and review of hospital documentation for one sampled patient (Patient #1), the hospital failed to ensure that care and services were provided in a dignified manner. The findings include:

Patient #1 was admitted on 11/20/10 with a diagnosis of major depression and was found to be at high risk for suicide. The treatment plan dated 11/21/10 identified violence/suicidal with interventions which included to be placed on lounge restrictions then 1:1 for the night due to verbalizing escalating thoughts to harm self . A review of the hospital lounge restriction policy identified that lounge restriction is a level of care that is utilized for patients who require increased visibility in treating and managing their impulses. This level of observation is provided along with 15 minute checks. When the patient leaves the lounge for any reason including the use of the bathroom facilities or a transport off the locked unit for medical testing, constant staff companionship can also be implemented. The policy further identified that the patient is dressed in hospital attire at the discretion of the Registered Nurse. Observations on 11/22/10 noted the lounge to be a large open area to the general population located as you enter the Behavioral Health Unit. Interview with the Nursing Director of Behavioral Health on 11/23/10 at 10:30AM identified that Patient #1 was placed on lounge restrictions, which means the patient must stay in the lounge area, due to his/her verbalizations to staff about inflicting self harm and is utilized to increase monitoring of the patient without creating negative attention to the patient. She further identified that the doors to patient rooms who are on lounge restrictions are locked as a reminder that the patient must have a staff
member present in order to enter his/her room.

20361

Based on clinical record review, observations, interviews and review of hospital documentation for one sampled patient (Patient #1), the hospital failed to provide sufficient staffing to meet the needs of the patients based on ongoing assessment of their behaviors and/or acuity. The findings include:

Patient #1 was admitted on 11/20/10 with a diagnosis of major depression and was found to be at high risk for suicide. The treatment plan dated 11/21/10 identified violence/suicidal with interventions which included to be placed on lounge restrictions then 1:1 for the night due to verbalizing escalating thoughts to harm self . A review of the hospital lounge restriction policy identified that lounge restriction is a level of care that is utilized for patients who require increased visibility in treating and managing their impulses. This level of observation is provided along with 15 minute checks. When the patient leaves the lounge for any reason, including the use of the bathroom facilities or a transport off the locked unit for medical testing, constant staff companionship can also be implemented. The policy further identified that the patient is dressed in hospital attire at the discretion of the Registered Nurse. Observations on 11/22/10 noted the lounge to be a large open area to the general population located as you enter the Behavioral Health Unit. Interview with the Nursing Director of Behavioral Health on 11/23/10 at 10:30AM identified that Patient #1 was placed on lounge restrictions, which means the patient must stay in the lounge area, due to his/her verbalizations to staff about inflicting self harm and is utilized to facilitate monitoring of the patient. She further identified that the doors to patient rooms who are on lounge restrictions are locked.