Western Governors University

College of Health Professions

Abstract

The issue of patient safety continues to inform the psychiatric care of inpatients suffering from mental illness through the institutionalization onto the modern practices of psychiatric nursing. In most cases, confinement will arise from safety out of both the fear or public safety and societal stigma. Others will include benevolently aims in protecting these individuals from any kind of body harm. The main challenge for many hospitals however has been detection and confiscation of such items.  The following project argues that within the environment of a psychiatric unit, safety should be maintained as one of the predominant value and management of risk in psychiatric nursing and care.

The aim of this project is to develop a standardized list of items deemed to be unsafe from entering a locked-down inpatient psychiatric hospital and to educate staff, patients, and visitors about the listing.  With the guidance of the Director of Nursing, an inter-professional team used evidence-based practice to identify items considered to be unsafe. The project also identified how unsafe items were entering the unit, and determined strategies that could be used to prevent these items from entering a psychiatric hospital.  This project was done through a standardized search process as part of the best practice to avoid items from reaching the psychiatric unit.

The capstone project was done for a period of five weeks. Where the researcher conducted a literature review of credible sources, and best practices were obtained to come up with a contraband management protocol. To complete the project, the student came up with a team of professionals who supported the implementation process, conducted meetings, made presentations, created posters, and came up with a checklist to educate staff, patients, and visitors about banned objects from entering the units. The team was also trained with a nurse educator and developed competency sessions for the staff. The implementation resulted in a standardized contraband management process that was designed based on evidence-based practice. The student collaborated with various stakeholders and, through the application of this project, was able to affect change within the organizational practice.

CHAPTER ONE

1.0   INTRODUCTION

Then chapter provides an introduction to the development of search protocol as a way of improving the management of contraband in psychiatric institutions. The section will come up with the background to the problem, objectives of the project statement and rationale.

1.1 Background to the Problem

The entry of contraband items in a mental hospital is unavoidable. However, it is worth all staff efforts to try to stop what will inevitably enter the unit. Tracking process for contraband is consistent from unit to unit in the hospital. One staff may give a patient an item that another team member deemed contraband; therefore, it requires every staff effort and cooperation to keep these items out of the facilities.  There are various reasons why nurses and paraprofessional personnel are not consistent with the current contraband process involving patients and visitors at the pavilion.  Some of the causes identified were variation in items staff considered to be contraband, inconsistency of admission process, the high turnover rate for direct care staff and frequent movement of personnel to work in an unfamiliar population of patients with different rules and cultural norms. According to Chizh (2015), when a team member is familiar with the milieu it is very critical to maintaining safety (p.63).  A retrospective review of all contraband reporting was read. A significant factor was staff interpretation of what was considered contraband and the rules surrounding contraband confiscation and accommodation. Woodthrope, Bakhsh, and Paton (2013) states, “The lack of a commonly shared definition of quality or patient safety are consistent with the lack of prominence of these concepts in training" (p.388). Vincent advised, “until you have the concepts, the practice will elude you" (as cited in Woodthropet et al., 2013   p.388).

 Problem Statement

Detecting prohibited items within the Pavilion is essential in maintaining the safety of patients, staff, and visitors. However, detecting such banned items can be very problematic. These unsafe items can contribute to dangerous behavior towards self and others.  Without a clear and concise process currently defined, the gap in the current contraband process jeopardizes the safety of patients, staff, and visitors.

Practice Change, Quality Improvement, or Innovation