UT-Harris County Psychiatric Center
Nursing Procedures

 

Milieu Monitoring

Nursing

Harris County Psychiatric Center: Office Administration

Patients have a right to the best available mental health care treatment.  Part of quality treatment is providing an environment that ensures the safety of individual patients.  Patients are regularly supervised in an effort to create a non-threatening environment

room checks, supervision, patient whereabouts

The University of Texas Health Science Center at Houston

 

Date of Last Review: 5/19/08
SME: Associate Director of Nursing

 

Patients have a right to the best available mental health care treatment. Part of quality treatment is providing an environment that ensures the safety of individual patients. Patients are regularly supervised in an effort to create a non-threatening environment.

 

Procedure:

 

The assignment for milieu monitoring will be a component of the shift assignment (see “Nursing Assignments” procedure and associated “Nursing Assignment Sheet”.) To ensure that adequate supervision is provided, the day area must be supervised at all times.

 

The monitoring of the milieu includes dayroom, patient room and bathroom checks which require moving about the area. The shift leader has the responsibility to reflect any changes in milieu assignment on the Nursing Assignment Sheet. The use of judgment on the part of the staff will require checks more than every 30 minutes. At least 2 staff members (except on smaller child/adolescent units) should be moving about in the milieu. (Around and behind the nursing stations is not considered milieu.)

 

Nursing care and close supervision must be provided to patients 24 hours a day. Therefore sleeping on the job is considered a serious offense subject to formal disciplinary action up to and including termination at the first offense. In addition, employees should not fall asleep at any time during their shift or while on breaks on or off UTHCPC premises. Staff is expected to remain acutely alert at all times during their shift. Identified behavior patterns of staff related to sleeping on duty will be used to establish the need for disciplinary action or termination.

 

Cell phones may be carried, concealed, and on vibrate, so as not to disrupt the milieu. Cell phones should not be utilized in any patient care area. (Break rooms are available for such purposes.)

 

The registered nurses are responsible for ensuring that the above levels of supervision take place.

 

Related Standards:  JCAHO NR 2, RI 1.3.3