September 27, 2018 | | Comments 0
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Pay a great deal of attention to the man behind the curtain: More ligature survey stuff!

This week’s installment is rather brief and (at least for the moment) is germane only to those folks with inpatient behavioral health units. During a recent TJC survey of a behavioral health hospital, I was able to catch a glimpse into the intentions of the information revealed last November (holy moly, it’s almost been a year!). I have to admit that the “cadence” of this particular guidance was a little confusing to me at the time, but now I “get” it.

In discussing the recommendations regarding nursing stations (nursing stations with an unobstructed view so that a patient attempt at self-harm at the nursing station would be easily seen and interrupted), the article in Perspectives goes on to indicate that areas behind self-closing/self-locking doors do not need to be ligature-resistant. The consideration that I want to share with you is that a self-closing/self-locking door is not the same as a door that is always locked (maybe you figured that out as a proactive stance, but I always considered control over locked spaces to be sufficiently reliable, but it would seem not to be the case). At any rate, if you take the guidance at its word, if you have a space on your behavioral health unit that has ligature risks contained therein, then you best have doors that self-close and lock. You may have a lot of doors that secure ligature-present spaces that do not self-close and lock; if that’s the case, you may want to reach out to the Standards Interpretation Group for official feedback on this. All I can tell you is that it’s been cited in at least one recent survey and it does reflect the content shared last November (I think it would have been my inclination to separate the nursing station concept from the “other” areas for the sake of clarity, but I can see where things “fall” now that it’s come up during a survey), so it’s definitely worth some consideration in your “house.”

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Filed Under: The Joint Commission

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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