Behavioral Health Issues Clinical Pathway — Emergency Department

EDECU Daily Care

RN Handoff Report (between shifts)

  • Name, MRN
  • Reason for admission
  • Medical history
  • Inpatient Psychiatric evaluation complete (Y/N)
  • 201/302 signed, location of document
  • Home medications
  • Agitation Plan
  • 1:1 assignment and breaks
  • Guardian information
  • Bed search updates

RN daily care

  • Bedside nurse will complete Behavioral Health Shift Assessment including safety observation every hour and psychosocial assessment every 8 hours
  • Completes patient’s room and bathroom checklist for potential safety hazard prior to patient arrival
  • Vital signs every 8 hours, when awake

EDECU team, Social Work, and Psychiatry Round Daily

During rounds:

  • EDECU attending: Signs “transport to inpatient psych facility form” during rounds
    • Assures that daily medications have been reconciled and ordered
    • Gives “Getting to know you card” to patient and family to fill out
    • Notify PCP (and special immunology if they follow the patient) of the patient‘s status and need for meds

Patient Schedule, Rules and Expectations reviewed with patient, family, and 1:1

  • Daily schedule includes:
    • Team rounds 9 a.m. – 11 a.m.
    • CLS group activity 11 a.m. and 5 p.m.
    • Health education 1 p.m.
    • Tech hour: AM homework/learning and PM physical activity
    • Hospital bingo 2 p.m.
    • Yoga/stretching evening hour
  • Home medications given
  • Psych tech role
    • Remains with the BH patient at all times
    • Ensures “Getting to know you card” is filled out by patient and family and is displayed on door
    • Facilitates activities and encourages the patient to follow the schedule outlined by Child Life
    • Ensures room safety and checks items parents bring into the room