HospitalInspections.org

Based on clinical record review, interview with staff and review of hospital policies for 1 of 20 patients (Patient #4), the hospital failed to ensure that staff conducted a medical screening when the patient presented to the Emergency Department (ED) with suicidal ideation. The finding includes:

Patient #4 presented to the ED on 9/6/21 and was registered at 4:36 PM with a chief complaint of suicidal ideation.

Review of the triage nursing note dated 9/16/21 at 5:31 PM identified that the registration staff "never notified this writer" that a patient with suicidal ideation was waiting in the waiting room. When The triage nurse went to the waiting room, Patient #4 was unable to be located. The police were notified, and registration staff provided a description of the patient.

Patient #4 was returned to the ED by police on 9/6/21 at 6:07 PM (1.5 hours after reporting suicidal ideations) and triaged at 6:08 PM with an admitting diagnosis of suicidal ideation. During triage, Patient #4 stated feeling better and stated no longer feeling suicidal. Review of Patient #4's clinical record dated 9/17/21 identified that a medical screening was conducted on 9/16/21, the patient had normal psychiatric thoughts, and was discharged with instructions to follow up with a community physician and return to the ED with worsening symptoms.

Interview with RN #10 on 1/5/22 at 12:30 PM identified that she was never notified by the triage staff that Patient #4 has suicidal ideations and was waiting in the waiting room. RN #10 identified that the expectation is for registration staff to notify the triage nurse immediately if a patient identifies that they are having suicidal thoughts.

The hospital policy for EMTALA directed that the hospital must examine all individuals who come to the Emergency Department seeking treatment.