Behavioral Health Issues — Patient, Room Safety and Caretaker Guidance — Clinical Pathway: Emergency

Behavioral Health Issues Clinical Pathway — Emergency Department

Search, Room Safety and Caretaker Guidance

Search Child's Belongings
  • Hospital gown for all children
  • Thorough search of all clothing, including undergarments and personal items, including shoes and bag
  • Check hair; head scarves for religious purposes can remain with children after inspection
  • Remove cell phone chargers, headphones, any cords
  • Send valuables home with caretaker or secure in child locker
  • Use Epic Behavioral Health Navigator to document
  • Tips for Searching
Room Safety Checks
  • Modifications are based on child’s at-risk behaviors and need for medical care.
  • Consider removing or safely storing objects that could be:
    • Ligature risks
    • Suffocation risks
    • Ingestion risks
    • Thrown or broken to harm self or others
  • Environment of Care Safety Modifications for the Behavioral Health Patient contains a detailed list of items for consideration of removal
  • Perform Room Safety Checks frequently
  • At a minimum, checks should occur:
    • On admission to ED Room or EDECU Room
    • During all RN to RN Handover of Care
Additional EDECU Safety Actions
  • Change linens for children with prolonged stay
  • Room check twice daily as above

Tips for Searching Children

  • Introduce the search as something to 'help keep you/your child safe'
  • Describe search; if child initially refuses, offer to have family members take all items home
  • You may also ask for family members to leave the room and then offer child opportunity for search without family present
  • Tell the child what you are doing and/or looking as you complete search
    • e.g., “I am now going to look in the zippered pockets of your bag.”
  • End the search by saying:
    • “Thank you for working with me today to help keep you safe."
    • "I know it is uncomfortable to have someone go through your things, but I am glad to know that you don’t have anything that could hurt you."
  • If you find something during the search that requires you to call Security, you can say
    • I am sorry, but I need to call our security team to remove this. You cannot have this here in the hospital. Our security team will come and remove it to maintain your privacy.
  • If child refuses search, elicit help from Security, Social Work, charge nurse

Caretaker Guidance for the ED and EDECU

The child’s health and safety is our top priority.

Role Responsibility
All
  • Patients with BH emergencies can host up to 2 visitors at a time for safety reasons
  • This includes parents and guardians
  • Visitors can wait in the lobby and take turns visiting
Security Officer Notifies bedside ED or EDECU RN when visitors arrive to the front desk
Psychiatry Tech
  • Ensures room safety check
  • Notifies RN if parents/visitors bring new items into the patient room
  • Notifies bedside RN when visitors arrive to the room
Bedside RN
  • Places items visitors, parents/guardians bring in the locker outside the patient’s room or
  • Searches these belongings for potential hazards prior to entering the patient’s room