Take these steps to keep staff and patients safe

In light of increasing numbers of psychiatric patients at St. Rose Dominican Hospital in Henderson, NV, the following steps were taken to ensure safety of ED patients and staff:

— A hotline links the ED with the police department for immediate response. After obtaining approval from the local police department for the phone line to come directly into their dispatch, the only cost involved was for installation of a dedicated phone line, which was done in-house.

— ED charge nurses, a nurse educator, and security officers attended a four-day training session on defusing potentially violent situations, given by the Brookfield, WI-based Crisis Prevention Institute at a cost of $1,100 per person. Upon their return, these individuals then trained the entire ED staff.

— Two-way radios were purchased for $250 apiece that connect directly with security. The radios are positioned in the middle of the nursing station and easily accessible by unit secretaries, physicians, nurses, and volunteers.

— A "Code Gray" policy is being implemented for immediate response by security and engineering staff for an out-of-control individual.

— A training packet was created for ED staff to improve care of psychiatric patients with policies on suicide precautions, assessment, and contracting with patients for safety. The policy includes detailed instructions for sitters observing high-risk patients, such as never taking your eyes off the patient and reporting increased agitation to the ED nurse in charge of the patient's care.

— Psychiatric patients are kept in an isolated area whenever possible, with certified nursing assistants acting as mandatory sitters and reporting directly to the patient’s ED nurse. The sitters also perform tasks such as taking patients’ vital signs and assisting with bathing and personal hygiene. All efforts are made to ensure that items that could cause danger to anyone are not allowed within the patient’s reach.

— Patients are unclothed, including removal of shoes and socks, and put into special colored gowns for easy recognition.