Behavioral Health Question

How are behavioral health organizations handling the documentation of very
short hands on of individuals such as stopping an action that potentially
could hurt someone else or themself, or to escort the individual to another
area. No other hands on is necessary and the intervention may last for 1-2
minutes. This is very short/quick intervention to stop whatever behavior is
immediately occurring and then to verbally work with the individual - no
other seclusion/restraint is used.

Do you just document it in the progress notes? Do you use the
seclusion/restraint documentation process - orders, flowsheet/obs, face to
face eval, etc.? Do you use a log, flowsheet, or other mechanism? Are you
classifying this as a physical restraint? Does anyone know what CPI or
other aggression management programs are advising? We are trying to get a
handle on this as it could occur a number of times during a shift and we
don't want staff to have to do unnecessary paperwork, but we want to be in
compliance with regulatory bodies as well.

Leah Guthrie, MSN, MBA/HCM, BA, RN, LHRM
Director, Quality Improvement/Risk Management
Renaissance Behavioral Health Systems, Inc.
P.O. Box 19249
Jacksonville, Florida 32245-9249
Phone: 904-743-1883 ext. 7106
Blackberry: 904-226-7377
Fax: 904-743-5109
E-mail: lguthrie@rbhsinc.com

Comments

  • edited July 2016
    I will be out of the office until Mon. Oct. 7 and will reply to your
    message upon my return. If you need immediate assistance, please
    contact Debbie Caverley.
    Thanks, Ruth
  • edited July 2016
    We have trained CPI Instructors at our hospital and annually designated
    staffing is required to get training.


    Annette M. Irving, MSW


    Director of Education Department

    Greenwood Leflore Hospital

    1401 River Road

    Greenwood, Ms 38930

    Tel: 662-459-2507

    Fax: (662) 453-2978

    Email: airving@glh.org

    Web Site: www.glh.org


  • edited July 2016
    Hello Annette! Who do you include as designated staff? We use CPI and are
    considering including expanding this training as part of our FMEA
    recommendations.



    Judy R. Effler, RN MSN
    Patient Safety Officer
    Blount Memorial Hospital
    907 E. Lamar Alexander Pkwy
    Maryville, TN 37803
    (865) 980-4903 office
    (865) 749- 5910 pager
    jeffler@bmnet.com

    In the midst of winter, I finally learned that there was in me an
    invincible summer. - Albert Camus

  • edited July 2016
    We are in the process of training all of inpatient and ED nursing staff on CPI at our CAH so they have the tools to help de-escalate situations. We have limited security hours and rely on local police to respond when there are issues. We are training ancillary staff on Support Responder training ( 2 hour class), also.

    Vicki Neidt, RN
    Trauma/Safety Coordinator
    Mayo Clinic Health System-Waseca and New Prague
    501 North State
    Waseca, MN 56093
  • edited July 2016
    Hi Joe,
    Our CPI trained staff include:

    Full CPI: all inpatient nurses and mental health techs, security and
    evaluators

    Verbal and Personal safety only: all outpatient staff

    Would you be willing to share your FMEA?

    Leah Guthrie, MSN, MBA/HCM, BA, RN, LHRM
    Director, Quality Improvement/Risk Management
    Renaissance Behavioral Health Systems, Inc.
    P.O. Box 19249
    Jacksonville, Florida 32245-9249
    Phone: 904-743-1883 ext. 7106
    Blackberry: 904-226-7377
    Fax: 904-743-5109
    E-mail: lguthrie@rbhsinc.com

  • edited July 2016
    We transitioned to Security Officers that were former policy officers and/or trained security professionals who carry fire arms. We also provide training to our staff and the we especially focus on the emergency room staff. We have also been working with the building on responding to a "shooter" situation and complete lockdown of the facility.

    Joanna K. Hailey

  • edited July 2016
    Violence reduction has been a work in progress for us for many, many years. We are using Pro-Act and this past year piloted a violence milieu assessment tool to raise shift to shift awareness about pre-cursors to violent behavior. About 5 years ago we implemented several of the strategies outlined in the trauma informed care protocols (e.g., telling people this is a safe space for all, informing them of our expectations, etc). We also have worked hard with our nursing staff to make sure they are vocal when we may not have enough meds on board. And, now are working with our county/state, to see if we can streamline the legal so we can court orders for meds more readily. Here, hearings are held every 3-4 days, but a managing a pt who is acutely manic/psychotic and refusing meds for days in the milieu is dangerous and really hard on others pts/staff. Security and police do respond to S&R events to assist staff. Hope this is helpful. It is a very big focus for us.

    Andrea DeRochi, LCSW
    Director of Patient Care Services
    Langley Porter Psychiatric Hospital & Clinics
    401 Parnassus Avenue, HOS 0984
    San Francisco, CA 94143

    Phone (415) 476-7874
    Fax (415) 476-7404
    EX01netucsfedu_--
  • edited July 2016
    I would love to see the FMEA as well



    Karen

    Karen Renson

    215-938-4652

    krenson@holyredeemer.com




  • edited July 2016
    Thank you Andrea! What is Pro-Act? Is there someplace I can get more
    information on it? Would you be willing to share your violence assessment
    tool?

    Thanks

    Leah Guthrie, MSN, MBA/HCM, BA, RN, LHRM
    Director, Quality Improvement/Risk Management
    Renaissance Behavioral Health Systems, Inc.
    P.O. Box 19249
    Jacksonville, Florida 32245-9249
    Phone: 904-743-1883 ext. 7106
    Blackberry: 904-226-7377
    Fax: 904-743-5109
    E-mail: lguthrie@rbhsinc.com
  • edited July 2016
    I would also like to see the FMEA as well.


  • edited July 2016
    As would I! thank you, Denise



    Denise Peterson, RN, MM
    Sr. Director Risk Management and Patient Safety
    Cambridge Health Alliance
    Somerville Hospital Campus, N-2
    230 Highland Avenue
    Somerville, MA 02143
    • 617-591-4427 (Phone)
    7 617-591-4490 (Fax)
    • ddpeterson@challiance.org
  • edited July 2016
    I would like it as well. TY Lori

    Lori Chabot, BSN, MS, RN, CPHRM, FASHRM
    Director of Risk Management
    Exeter Hospital
    5 Alumni Drive
    Exeter, NH 03833
    P: 603-580-6587
    F: 603-580-7263

  • edited July 2016
    I like to have a copy of FMEA

    Dev Raheja
    draheja@aol.com

  • edited July 2016
    Would love to see as well - thanks!

    Elaine Long, BSN, RN
    Director Patient Safety, Quality & Regulatory Affairs
    Duke Raleigh Hospital
    (919) 954-3349
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