HospitalInspections.org

Based on review of facility policy and interview with staff (EMP), it was determined the facility failed to ensure patients in the Emergency Department (ED) diagnosed with Suicide Ideations (SI), the right to psychological dignity by requiring an ED patient to be dressed in a specific attire which the attire identifies the ED patient with the diagnosis of SI.
Findings include:
Review on September 26, 2019, of the facility"s policy "Patients Rights and Responsiblities" last revised August 21, 2017, revealed "Penn Presbyterian Medical Center (PPMC)...recognize the individuals's rights to freedom of expression, independent decision and action, and has concern for his/her personal dignity and human relationships. PPMC...endeavors to create an environment supporting patients' rights pursuant to federal and state regulations."
Review on September 26, 2019, of facility policy "Suicide Precautions" last revised November 2018, revealed "Suicide Precautions" are instituted for patients who pose a risk of physical harm to themselves. The policy applies to all patients in a non-behavioral health unit. ...It also applies to any other patients who demonstrate behavior suggestive of a suicide risk. ...II. Suicide Precautions Continuous Observation Requirements...G. The patient is to be clothed in approved ligature risk reducing attire (e.g. 3 hole stringless hospital gown (contact distribution for delivery to patient room), zippered jumpsuit, sweat suit). ..."
A request was made of the facility for evidence of the blue jumpsuit in the emergency department used for SI patients. The survey team was provided with a blue jumpsuit by EMP1 and informed that this was the required dress for SI patients in the ED at PPMC.
An interview conducted on September 26, 2019, at 11:59 AM with EMP1, a registered nurse confirmed that SI patients in the ED are required to change from street clothes into the blue jumpsuit. EMP1 further stated "It is the policy of the hospital that ED patients diagnosed with SI are placed in a blue jumpsuit. We do not put SI patients in hospital gowns in the ED. By placing a ED patient diagnosed with SI in a blue jumpsuit it allows the staff to recognize the patient diagnosed with SI from all other ED patients."
An interview conducted on September 26, 2019, at 12:15 PM with EMP3, a registrar confirmed ED patients wearing the blue jumpsuit were considered patients diagnosed with SI.
An interview conducted on September 26, 2019, at 12:30 PM with EMP4, a security guard who stated "If a patient in the ED is wearing a blue jumpsuit he or she is likely to be a SI patient."
An interview conducted on September 26, 2019, at 12:50 PM with EMP5, an environmental service technician confirmed ED patients that have a diagnosis of SI wear the blue jumpsuit. EMP5 further stated "It makes it easier to recognized them from other ED patients."
An interview conducted on September 26, 2019, at 1:00 PM with EMP6, a registered nurse who stated "SI patients in the ED are required to wear the blue jumpsuit . We only keep a small par level of the hospital gowns for the rest of the ED patients."
An interview conducted on September 26, 2019, at 1:20 PM with EMP7, an ED Technician confirmed that ED patients with the diagnosis of SI are dressed in the blue jumpsuit. EMP7 further stated "ED patients who refuse to wear the blue jumpsuit are made to understand that wearing the blue jumpsuit is not optional but a ED requirement. "They must wear the blue jumpsuit"
An interview conducted on September 26, 2019, at 1:40 PM with EMP8, an ED Technician confirmed that if an ED patient has a diagnosis of SI he or she must wear the blue jumpsuit. EMP8 further stated "We let the ED patients know from the beginning that they must wear the blue jumpsuit in the ED when diagnosed with SI. Those patients who refuse to wear the blue jumpsuit are made to understand why they are to change from street clothes into the blue jumpsuit."