Safety Surveillance Program PDF
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Summary
This document outlines a safety surveillance program for patients in a healthcare setting. The program details staff assignments, responsibilities, and procedures for monitoring patient safety in various areas.
Full Transcript
BSSH OPM EC.12 (NSG) Effective: April 2004 Nursing Services Rev.: 11/04, 8/05, 4/06, 4/07, 7/08, 4/09, 4/10, 6/10, 9/10, 3/11, 6/11, 8/11, 1/12; 8/12, 2/13, 6/13, 4/14, 9/14, 2/15, 11/16, 7/17, 10/18, 11/19, 1/2020, 4/20, 5/21 SAFETY SURVEILLANCE PROGRAM =========================== I. **[PURPO...
BSSH OPM EC.12 (NSG) Effective: April 2004 Nursing Services Rev.: 11/04, 8/05, 4/06, 4/07, 7/08, 4/09, 4/10, 6/10, 9/10, 3/11, 6/11, 8/11, 1/12; 8/12, 2/13, 6/13, 4/14, 9/14, 2/15, 11/16, 7/17, 10/18, 11/19, 1/2020, 4/20, 5/21 SAFETY SURVEILLANCE PROGRAM =========================== I. **[PURPOSE]:** II. **[APPLICATION]:** III. **[REFERENCES]:** **IV. [CONTENTS]:** **V. [DEFINITIONS]:** 6. **[IMPLEMENTATION RESPONSIBILITIES]:** VI. **[PROCEDURE]:** A. 1. The SSS will be a PNA assigned by the STL. This assignment will be given top priority over all other unit assignments and it will be the **ONLY** assignment for this PNA. The STL is responsible for making assignments and for ensuring that everyone assigned SSS will be provided break times. 2. Staff pulled to work on another program will not be assigned to be SSS on that program (except for the Pine unit where pulled staff can conduct SSS) unless approved by the BSSH Shift Coordinator (RN) in Supervisor's Office. If this should happen, the Shift Coordinator will assess the situation and approve, if appropriate. The Shift Coordinator will send an e-mail to the CNE and Assistant CNE II explaining the circumstances of the pulled staff being assigned to work SSS including staff name, unit and shift the staff worked. 3. All shifts on all units will have one SSS assigned to each wing of the building wearing yellow vests. 4. The Safety Surveillance Staff will be assigned the duty for **[four hours]** (with exception of the night shift who will be assigned SSS duty for 2-hour increments) of the eight-hour shift. The STL is responsible for making this assignment and for ensuring that everyone assigned SSS will be provided break times. 5. 6. 7. B. 1. 2. 3. 4. b. c. d. e. f. g. h. C. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. a. b. 34. 35. 36. D. - - E. 1. 2. 3. 4. 5. F. G. The Pine Unit Safety Surveillance (When Program Is Open) 1. Staff Assignment and Breaks a. The Pine unit is the only unit where staff pulled from another unit can be utilized without first obtaining permission from the Shift Coordinator. The Pine unit patients have generally been temporarily transferred from other units to the Pine unit and staff may therefore be more familiar with the Pine unit patients when they are pulled to work the Pine unit. b. All shifts on the Pine unit will have one SSS assigned to the male dorm/dayroom area (yellow vest), one SSS assigned to the female dorm/dayroom area (yellow vest) and one SSS assigned to each hallway (orange vest) as a floater. **NOTE:** **If there is only one patient to one corridor/hallway (east or west), a floater is NOT necessary for that corridor/hallway, and the SSS yellow vest will assume the floater duties.** c. The Safety Surveillance Staff will be assigned this duty for **[four hours]** of the eight-hour shift during daytime hours. Night shift will be assigned to SSS duties for 2 hour increments out of the 8hour shift. The staff may be assigned more shifts of SSS during the 8 hours of the shift, but the assignments should not be consecutive, allowing the SSS a break from walking. d. The PNA assigned to the hallway as the floater, will primarily be responsible for escorting patients to and from the restroom but may be utilized for other duties such as medication line monitoring, fresh air breaks, bathing supervision, etc. e. If the Pine unit only has 2 patients and both patients can be visualized, the SSS will be allowed to sit while observing. 2. Equipment: a. Each dorm/dayroom SSS will wear a yellow vest that identifies him/her as the SSS. The PNA wearing this vest should never be anywhere but on the dorm wing where they are assigned. b. The hallway floater SSS will wear a bright orange vest that identifies him/her as the hallway floater SSS. 3. SSS Responsibilities a. The dorm/dayroom SSS duties include: - - b. The hallway floater SSS duties include: - Checking to ensure hallway shower rooms and restrooms are always locked unless they are in use. - If a patient needs in the restroom/shower room, the hallway floater SSS unlocks the door and continuously monitors the patient. Prior to exiting and locking the door a thorough check of the shower room or restroom will be completed to ensure there are no remaining patients in the area. - Encourage all patients to stay as active as possible during the daytime hours attending on unit ATD activities, interacting with peers and staff and utilizing the "mini dayroom" and large dayroom as appropriate. - Any changes in patient's behavior, threats or attempts to engage in suicidal or aggressive behaviors, or any other concerns the SSS have are to be reported immediately to their supervisor via SSS radio. 4. Documentation: - H. SSS Failures I. Red Oak Unit (Isolation) Revisions: Thomas Stevens, BSN, RN, Assistant Chief Nurse Executive I, (5/21) Amy Raschke, BSN, RN, Assistant Chief Nurse Executive, (9/10, 3/11, 6/11, 8/11, 1/12, 8/12, 2/13, 5/13, 4/14, 9/14, 2/15, 11/16, 7/17, 10/18, 11/19, 1/2020, 4/2020) Approvers: Deborah Young, MBA, M.Ed., Superintendent George Oteiza, MA, MSS, Assistant Superintendent Fred Morales, BSN, RN, Chief Nurse Executive Barbara Beadles, MD, Medical Director Amy Raschke, BSN, RN, Director of Quality Management Sandy Brooks, MS, Director of Rights Protection [Reviewed by Nursing: 10/08, 4/09, 4/10, 3/11, 8/11, 1/12; 8/12; 2/13, 5/13, 4/14; 8/14; 9/14, 2/15, 11/16, 7/17, 10/18, 11/19, 1/20, 2/20, 8/22] ***[Approved by HEC: 5/10/07, 8/21/08, 6/25/09, 6/24/10, 11/4/10, 12/2/10, 6/24/11; 2/21/13; 6/13/2013; 4/16/2014; 9/11/2014; 1/30/20, 5/6/21]*** **SSS Room Check Sheet for Building 506 (Downstairs)** **Shift: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Staff Assigned: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Date: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]** **Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_]** **Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_]** ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) B C D E ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) B C D E F G H I J K ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Codes: DL=Door Locked √ =In Room IBA=In Bed Awake IBS=In Bed Asleep BR=Bathroom S=Shower A=Absent O=Off Campus DR=Day Room TXI=Transfer In TXO=Transfer Out DC=Discharged New=New Admit ATD GMS HW=Hallway CK=Central Kitchen PAT=Patio CR=Comfort Room SR=Staffing Room VIS=Visitors SA=Sitting Area L=Lobby OR-= Outside Restriction Other: [ ] **Reviewed by: [ ] Date: [ ]** Revised 4/14 **SSS Room Check Sheet for buildings 532 (North and South)** **Shift: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Staff Assigned: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Date: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Codes: DL=Door Locked √ =In Room IBA=In Bed Awake IBS=In Bed Asleep BR=Bathroom S=Shower A=Absent O=Off Campus DR=Day Room TXI=Transfer In TXO=Transfer Out DC=Discharged New=New Admit ATD GMS HW=Hallway CK=Central Kitchen PAT=Patio CR=Comfort Room SR=Staffing Room VIS=Visitors SA=Sitting Area L=Lobby OR-= Outside Restriction Other: [ ] **Reviewed by: [ ] Date: [ ]** Revised 4/14 **SSS Room Check Sheet for buildings 533 (South)** **Shift: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Staff Assigned: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Date: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) A B C D E ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Codes: DL=Door Locked √ =In Room IBA=In Bed Awake IBS=In Bed Asleep BR=Bathroom S=Shower A=Absent O=Off Campus DR=Day Room TXI=Transfer In TXO=Transfer Out DC=Discharged New=New Admit ATD GMS HW=Hallway CK=Central Kitchen PAT=Patio CR=Comfort Room SR=Staffing Room VIS=Visitors SA=Sitting Area L=Lobby OR-= Outside Restriction Other: [ ] **Reviewed by: [ ] Date: [ ]** Revised 4/14 SSS Room Check Sheet for Building (533 North -- OAK WEST SIDE) ============================================================== **Shift: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Staff Assigned: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Date: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** **Re[li]ef Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out [\_\_\_\_\_\_\_\_\_\_\_\_\_] Relief Staff: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_]** ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E Time of Observation Room \# Bed OR Patient Observed by SSS During Room Check **(code):** Comments (time) 1 A 1 B 3 C 4 D E ------------------------ ----------------------------------------------- ----------------- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Codes: DL=Door Locked √ =In Room IBA=In Bed Awake IBS=In Bed Asleep BR=Bathroom S=Shower A=Absent O=Off Campus DR=Day Room TXI=Transfer In TXO=Transfer Out DC=Discharged New=New Admit ATD GMS HW=Hallway CK=Central Kitchen PAT=Patio CR=Comfort Room SR=Staffing Room VIS=Visitors SA=Sitting Area L=Lobby OR-= Outside Restriction Other: [ ] **Reviewed by: [ ] Date: [ ]** Revised 4/14 SSS Room Check Sheet for Building (540 -- RED OAK SOUTH SIDE) ============================================================= Shift: [ ] Time In/Out: [ ] Staff Assigned: [ ] Date: [\_\_\_\_\_\_\_\_\_] ========================================================================================================================== Re[li]ef Staff:[\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Relief Staff[: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Time In/Out\_\_\_\_\_\_\_\_\_\_\_\_\_\_ [ ] Relief Staff \_\_\_\_\_\_\_\_\_\_\_\_Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] =================================================================================================================================================================================================================================================================================================================================================================== Re[li]ef Staff:[\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Time In/Out: [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Relief Staff[: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Time In/Out\_\_\_\_\_\_\_\_\_\_\_\_\_\_ [ ] Relief Staff[:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]Time In/Out[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_] ======================================================================================================================================================================================================================================================================================================================================================================================= Time of Observation Rm#128 Bed OR Patient Observed by SSS During Room Check (code) : Comments (time) 1 A 2 B 3 C 4 D 5 E Time of Observation RM# Bed OR Patient Observed by SSS During Room Check (code) : 1 A 2 B 3 C 4 D 5 E Time of Observation Rm# Bed OR Patient Observed by SSS During Room Check (code) : Comments (time) 1 A 2 B 3 C 4 D 5 E Time of Observation Rm# Bed OR Patient Observed by SSS During Room Check (code) : Comments (time) 1 A 2 B 3 C 4 D 5 E 6 F Time of Observation Rm# Bed OR Patient Observed by SSS During Room Check (code) : Comments (time) 1 A 2 B 3 C 4 D 5 E 6 F Codes: DL=Door Locked √=In Room IBA=In Bed Awake IBS= in bed asleep BR=Bathroom S=Shower A=Absent O=Off Campus DR=Day Room TXI=Transfer in TXO=Transfer out DC=Discharged New=New Admit ATD GMS
