HospitalInspections.org

Based on review of documentation and interview, it was determined that the facility did not always provide a safe environment for it's patients and staff.

Findings were:

Texas Administrative Code Chapter 415 Subchapter F Division 1 Rule 415.253 stated in part,
(23) "Seclusion--The involuntary confinement of an individual away from other individuals for any period of time in a hazard free room or other area in which direct observation can be maintained and from which egress is prevented."

Facility policy entitled " Behavioral Restraint and Seclusion at Seton Shoal Creek " stated in part, " The SETON Healthcare Network operates under the philosophy that ' We serve each person as a Christian would serve Christ Himself and that we respect the dignity and needs of one another. ' This philosophy requires that Network staff recognize the potential risks to patient safety, psychological well-being, dignity and personal rights when restraint/seclusion are utilized during the course of treatment. SETON leadership is committed to preventing, limiting, reducing and ultimately eliminating the need for use of restraint when possible and works to create an environment that minimizes circumstances that give rise to restraint/seclusion use. Patients have a right to be free from either physical restraint or drugs used as a restraint, as a means of coercion, discipline, staff convenience, or retaliation by staff. Use of either physical means or drugs for such purposes is never appropriate and is not permitted. "

On February 5th, 2013 there was a crowded Admissions waiting room at Seton Shoal Creek Hospital. This room was filled with adults and children and many walk ins (Voluntary Admissions) awaiting screening by the triage nurses. The door to the Admissions waiting room was kept locked to prevent egress of the nonvoluntary patients. On this day, a psychotic man began "pacing, cursing and yelling." "He threatened to kill everyone." There was no available staff in the waiting room to assist and because the door was locked, egress to safety was prevented.

In an interview with the Director of Admissions on 3/6/13, she stated "The door to the waiting room is kept locked. If a walk in (voluntary) patient wanted to leave, we would not allow them to go until that had gone through a physical assessment."