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Expectations for the Patient Safety Attendant (PSA)/Personal Safety Observer (PSO) Caring for Patients at Risk for Suicide

Expectations for the Patient Safety Attendant (PSA)/Personal Safety Observer (PSO) Caring for Patients at Risk for Suicide - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Psychiatry, Related


Expectations for the Patient Safety Attendant (PSA)/Personal Safety Observer (PSO)
Caring for Patients at Risk for Suicide
Refer to Suicide Screening, Assessment and Intervention Guideline for more details.
Page 1 of 2
Why We
Need
Your Help
ξ Your job is to keep the patient safe. It is vital for patient safety that the items below are followed; if
unsure speak with the nurse (RN).
ξ Patients at risk for suicide need continuous supervision.
Do’s
ξ Keep the patient(s) in view at all times. Complete an up close check every 30 minutes.
ξ Stay within arm’s length of the patient at all times (including in the bathroom), unless you are
replaced by another staff member. If the patient is violent, stay at a safe distance (such as by the
door) where you can safely see the patient at all times.
ξ Go with the patient to any medical procedures that must be completed off of the unit or outside the
emergency department.
ξ Promptly report any significant changes in the patient’s behavior or mood to the RN.
ξ The patient must have their hands visible at all times (on top of blankets/out of clothing/etc.).
ξ Remember that this is a difficult and sensitive time not only for the patient, but for the family as well.
ξ If 1:1, sit in your chair at the patient’s bedside. If 2:1, position yourself to see both patients.
ξ Be aware of what family/friends bring into the room (e.g., medications or other items that can be
used for self-harm). Inform the RN immediately if any harmful materials are found.
ξ Communicate with the patient(s) throughout the shift. Start small, attempt to build a therapeutic and
professional relationship with conversations not related to their suicidal thoughts or actions.
ξ (Pediatric patients only) If appropriate, offer a Safe Distraction Kit provided by Child Life.
Don’ts
ξ Do NOT leave the patient(s) with family members or friends.
ξ Do NOT remove restraints (if placed).
ξ Do NOT eat, drink, or sleep.
ξ Do NOT read, use your personal cell phone or the internet, study, or do other non-patient related
activities. The Work Station on Wheels can only be accessed for documentation.
ξ Do NOT allow the patient to leave their room (unless orders placed to allow on the unit)
Health
Link &
Hand-offs
ξ Document in Health Link every 30-60 minutes.
ξ Documentation should include the following:
o Vital signs- frequency based on the stability of the patient
o Patient status (e.g., sleeping, agitated)
o Safety measures (e.g., lights on, door open, cables removed, etc.)
o Presence of care providers, family or friends
o Patient’s questions/needs
o Other information the PSA/PSO feels is important in the care of the patient
ξ You can expect to receive a hand-off report at the beginning of the assignment and you will need to
provide a report at the end of your shift.
ξ Follow the SBAR format when providing a hand-off to other staff.
o Situation (demographics, care team, presentation)
o Background (communication barriers, fall risk, isolation, precautions, psychosocial
concerns)
o Assessment (current condition)
o Recommendations (plan, to do list, what to watch for)
ξ Documentation may be as simple as, “SBAR hand off completed to ED Tech Mike.” Mike should then
document, “SBAR hand off received from Tom.”
Copyright © 2017 Univ ersity of Wisconsin Hospital s and Clinics Authority
Contact: Lee Vermeulen, CCK M @uwhealth.org Last Revised: 04/2017
CCKM@uwhealth.org

Expectations for the Patient Safety Attendant (PSA)/Personal Safety Observer (PSO)
Caring for Patients at Risk for Suicide
Refer to Suicide Screening, Assessment and Intervention Guideline for more details.
Page 2 of 2
Should I follow the patient in the bathroom?
ξ Yes, the bathroom is a high risk area. Do NOT leave the patient alone.
ξ The bathroom door should be open at all times, even when the patient is using the bathroom or showering.
ξ If you are uncomfortable watching the patient while in the bathroom, call for additional staff assistance.
What if the patient becomes agitated or angry?
ξ You should never risk your own safety. Tell the RN to call for additional help if needed.
ξ Have any people who are targets for the behavior step out of the room.
ξ Keep as few staff as possible in the room, but keep enough to provide for safety.
ξ Do not engage in bargaining or argument. Remain objective and factual.
ξ Use simple, declarative statements to tell the patient what to do with their body to stay safe.
ξ Consider calling Security right away. They are unlikely to put hands on the patient but can be a calming “show of
force” whose presence can remind the patient to be civil.
What if the patient tries to leave?
ξ You should never risk your own safety. Tell the RN to call for additional help if needed.
ξ Patients are not safe to leave the hospital against medical advice. Notify the following people immediately with the
specific location of where the patient left the unit: Security and CTL/STM, Nurse Manager, and Medical Team.
ξ DO NOT use force to try and stop them.
ξ DO NOT put yourself in an enclosed space with the patient (e.g., elevator, stairwell)
What if the patient starts talking about deep, emotional issues?
ξ You should never risk your own safety. Tell the RN to call for additional help if needed.
ξ Explain that there are other providers that will help the patient with those issues and thank the patient for sharing the
information with you.
ξ Clarify your role: “My job on the team is to help make you be comfortable. I know you are going through a lot of
uncomfortable things right now, and there are other people on the team who are going to help you with those.”
ξ Redirect the patient’s focus by asking them what kinds of things they are good at or like to do.
Copyright © 2017 Univ ersity of Wisconsin Hospital s and Clinics Authority
Contact: Lee Vermeulen, CCK M @uwhealth.org Last Revised: 04/2017
CCKM@uwhealth.org