UT-Harris County Psychiatric Center
Nursing Procedures

Patient Supervision for Off-Unit Activities

Nursing

Harris County Psychiatric Center: Office Administration

Assigned licensed staff establish that the patient is appropriate to participate in an off-unit activity. Escorting staff must ensure that all patients have a white ID bracelet (armband). Patients with red armbands are not permitted off-unit

off-unit activities, patient supervision, staff-to-patient ratio 1:5, escort, walkie-talkie

The University of Texas Health Science Center at Houston

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

It is important for patients to attend activities and programming located off-unit. This attendance must be based on an evaluation of safety, the patient's clinical presentation, readiness, and need. Patient supervision is the responsibility of all staff assigned to escort patients on off-unit activities.

Procedure:

1. Assigned licensed staff establish that the patient is appropriate to participate in an off-unit activity. Escorting staff must ensure that all patients have an armband.

2. One (1) staff member for each five (5) patients is the ratio of supervision for escorting patients to off-unit activities, except for cafeteria and in-building activities (see #3).

3. One staff to 5-8 patients is recommended ratio for in-building activities and cafeteria.

4. The staff member is responsible for visual supervision of his/her assigned patients at all times until return to the unit. For example:

· A staff member escorting 5-8 patients should be positioned behind the patients.

· For two staff members escorting: one should be to the side positioned two-three patients back in order to visualize patients that are being escorted and one staff behind the patients.

· For three staff members escorting: one should be to the side positioned two-three patients back, one at the mid-point, and one behind the patients.

· Staff should positioned themselves closest to the door or elevators to prevent egrees.

5. The staff member brings the walkie talkie, see procedure on “Walkie-Talkie Usage”.

6. Transporting by elevator is preferred (Staff should avoid use of freight elevators). When transporting by elevator, split the group into groups of 5-8 to maintain a staff-to-patient ratio of 1:5-8. The staff member exits the elevator and lets the patients exit single file, and walks behind the patients to the final destination.

7. Staff members monitor the patients continuously while on the off-unit activity. Staff members are geographically positioned for ease of supervision/appropriate interventions (if required). NOTE: Staff members must not congregate or engage in social conversation as this could impede supervision/observation.

8. The same procedure is followed when escorting patients back to the unit (see #3-5).

9. Upon arrival to the unit corridor, the staff accounts for the return of all patients to the unit.

Related Standards:

JCAHO NR 2