HCMC: Pediatric Standards for a Suicide Precaution Patient

Pediatric Standards for a Suicide Precaution Patient 
General:
RN: Review the standards below with HCA at the start of every shift.
HCA: Remain one arm’s length away from the patient at all times.  This includes while the patient is voiding or showering. If the patient is showering, they are able to have the bath curtain drawn but the HCA will be in the bathroom with the patient. If the patient is voiding, the HCA will stand in the bathroom doorway to observe the patient.   
The HCA should make all efforts to engage patient by suggesting and participating in activities along with patient. The HCA should attempt to get the patient out of the room, have the lights on, have the patient eat meals in a chair (not in bed), and adhere to the daily schedule below. Some suggested activities include:   
·         Art activities 
·         Board games/puzzles
·         Read books/magazines
·         Video games outside of room 
·         Computer use
·         Listening to music
·         Exercise (walking around the unit, Wii games)
·         Doing hair, painting nails, etc.  
The HCA is not permitted to be on their phone, on the computer, or distracted by other means while watching the 1:1. If the family is in the room, the HCA still needs to remain in the room. The only time they are able to leave the room is if psychology is interviewing the patient and deems it is safe to have the HCA outside the room.  
If possible, we will request a same sex HCA 
For each patient, the child life specialist will connect with and provide therapeutic distractions. 
If the patient has been here for three days, with an anticipated long term stay, please contact social work to reach out to school to get homework sent and/or tutor services set up.  
Admission: 
Patient’s personal belongings must be collected and locked in the medication room. This includes:
·         Cell phones and chargers
·         Clothes/Shoes
·         Makeup and personal hygiene items (including mirrors/compacts) 
Place patient in spice colored scrubs.
All visitors need to be approved by parent or legal guardian. If none present, family must be contacted to obtain a list of approved visitors. 
Set personal recovery goals with patient (e.g. What does the patient want to work on during this hospital stay?)
Daily:
Patient is to be woken up at 0900 for rounds. At that point, the lights in the room will be on and the shades will be open. 
Shower, change of clothes, and linen change should be completed every morning.
Patient will be sitting up in a chair and offered three meals a day.
Vital signs to be completed as ordered. 
The patient’s schedule will be written up on the white board and changed daily.
The patient will be in bed with the lights off at 10:00 pm. 
Supervised cell phone use permitted as a reward to meeting set expectations.
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