UNIVERSITY HOSPITAL AND CLINICAL PROGRAMS

 

PROFESSIONAL NURSING ORGANIZATION

 

POLICY STANDARDS

 

 

ADDENDUM:       G.6

 

EFFECTIVE:         12/07

                     

REVISION:           8/08

 

APPROVAL:         8/08

 

  

 

SUBJECT:  PSYCHIATRIC EMERGENCY EVALUATION PROGRAM, PEEP PROGRAM PRECAUTIONS FOR PATIENTS AT RISK FOR HARM TO SELF OR OTHERS

 

  
PURPOSE:  To identify and assure appropriate, safe care for patients at risk for self-harm, harm to others, substance abuse and/or psychiatric illness with or without medical or surgical conditions. 

REFER TO: 

Guidelines for Evaluating Patients With Identified Psychiatric Or Substance Abuse Problems (MS.5.07)

Protocol for the management of the Patient at risk for harm to self and/or others (Protocol #133)

 

The patient that has been admitted to the PEEP program shall have the following precautions implemented:

 

1.         The patients clothes shall be removed and a patient gown will be provided to the patient.

2.         All personal belongings will be removed from the patient and kept in a safe place or given to a family member.

3.         Only healthcare team members may enter the room.  Family and friends may only visit if approved by the healthcare team.

4.         Visitors will not be allowed to bring purses, packages or objects into the room.

5.         The patient will be accompanied at all times by staff when they leave their room.

6.         Order a disposable food tray.

7.         Remove the overbed table (due to glass mirror).  May be used only for meals. 

8.         Patient will be placed in line of sight of a sitter.

H.10  Sitters

9.         Contraband will be removed from any roommate the patient may have as a precaution.  Contraband could include the following, but not be limited to:

        Medications

        Sharp objects

        Belts

        Razors

        Shoes

        Cigarettes, lighters, matches

        Weapons: knives, pistols, brass knuckles

        Mirrors (compacts)

        Pencils, pens

        Liquids and sprays

 

10.       All oral medications will be observed as being taken.  Check the mouth to ensure swallowing or oral medications.

11.       Cell phones will be removed from the patient.

12.      In the ED, Patients presenting during triage with suspect behaviors to include but not limited to homicidal ideation, suicidal ideation, acute psychosis, drug or ETOH intoxication should be considered for the PEEP program until medically cleared by the MD.

Based on the room configuration, the ED PEEP patient capacity is between 2 and 4 patients. For the purpose of patient and staff safety, ED PEEP patients will not be assigned to room with other ED patients or with ED PEEP patients of the opposite sex. In the event that there are multiple patients requiring admission to the ED PEEP location and all available safe rooms are occupied, the ED attending on duty may request that the ED be placed on psychiatric diversion. the diversion policy outlines the steps necessary.

 

Environment:

 

To provide a safe environment for the patient who is a risk for harm to self or others, the following precautions may be taken.

 

1.         Remove room devices such as metal objects, sprays, cords, curtains, telephone, furniture and all sharps.

2.         Place the bed away from the window if possible.

 

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