Patient Searches in Behavioral Health Units Competency

Patient Searches in Behavioral Health Units Competency

Providing a safe environment while respecting individual privacy rights

• To maintain a safe environment while respecting individual rights
• To consistently and safely remove potentially dangerous items
• Identify items commonly missed during patient searches

Objectives

What are prohibited items?

The following are prohibited at VPH:

• Weapons,
• Unauthorized or illegal drugs,
• Sharp objects,
• Flammable substances, and
• Any other item that staff deem potentially harmful to patients or others.

Individual patient circumstances may cause typically “safe” items to be prohibited.Certain personal items may be used with staff supervision, and are stored with personal belongings when not in use (e.g., hair dryer, electronic toothbrush, headphones).

When are searches performed?

All patients have a Level 1 search conducted upon arrival. These take place in the following areas:

• VPH PAS vestibule,
• PAS walk-in patients,

• Direct admits to adult units coming through PAS, and
• VPH inpatient unit (typically, admissions on Child/Adolescent do not go through PAS).

A Level 1 search may also be initiated any time there is a question of patient or unit safety.Patients in the PAS will have a Level 1 search repeated prior to patient transfer to an inpatient unit.

What about metal detectors?

• Upon entry through VPH's main lobby, all visitors and employees are screened by walking through a metal detector.

• In PAS there is a walk-through metal detector in the vestibule.
• All patients and visitors walk through this detector.

• There is also a hand-held detector in PAS for secondary screening.

• All inpatient units have a hand-held metal detector to use during patient admission.

• Any patient in a wheelchair or using a walker should be assisted to a non-metal chair and screened with the hand-held wand.
• The walker or wheelchair is to be visually inspected as well.

Level 1 Searches

• A Level 1 search includes:
• Patient cooperation,
• Two staff members, one of whom should be the same gender as the patient,
• One may be the Community Safety Officer (CSO) in PAS.
• The patient is asked to:
• Remove shoes, coats, sweaters, hats, and other outerwear,
• These items are inspected by staff,
• Empty and turn out pockets,
• Show waistband to be visualized by staff,
• Cooperate with the use of a handheld metal detector/wand, and
• Cooperate with a search and labeling of belongings.

• If the patient refuses a Level 1 search, they are placed on continuous observation until they cooperate with the search.

Level 1 Search Considerations

• Do not leave a patient alone with their belongings until a search is completed.
• Cell phone cases with pockets or attachments are stored with patient belongings.
• Patients are allowed to use cell phones in some patient care areas under supervision of unit staff. When not in use, cell phones are stored securely.
• Currently, Adult 4 and the PAS are areas where patients have access to phones and personal devices at selected times.

Level 2 Searches

• Patients may require a higher-level search based on assessments conducted by the providers, and/or unit staff. Providers and unit staff work collaboratively to determine if a higher-level search is needed.

• A Level 2 search requires:
• A provider order,
• Patient cooperation,
• Two staff members to accompany the patient to an area affording privacy,
• An explanation of the procedure, and
• One staff member being the same identified gender as the patient.

Level 2 Searches

• A Level 2 search includes all the components of a Level 1 search AND:
• Ask the patient to remove clothing except for underwear.
• Provide scrubs if needed.
• Visualization to determine if contraband has been attached to the skin.
• Ask the patient to turn around 360 degrees.
• Note any bruising, rashes, lacerations, or other signs of injuries and document.

• In the presence of the patient, inspect all clothing and jewelry carefully.
• Include pockets, hems, seams, cuffs, collars, and shoes in the search.
• Return clothing to patient and have them dress.
• Retain any items that are not allowed or appear suspicious.

• If the patient refuses a Level 2 search, they are placed on continuous observation until they cooperate with the search.

Level 3 Searches

• A Level 3 search is only used in extreme circumstances and only when there is significant reason to suspect the patient is utilizing body cavities to conceal contraband.

• A Level 3 search requires:
• A provider order and the presence of a provider,
• Two staff members to accompany the patient to an area affording privacy,
• An explanation of the procedure, and
• One staff member should be the same identified gender as the patient.

Level 3 Searches

• A Level 3 search includes all the components of a Level 1 & 2 search AND :
• Completion of a search including body cavities performed by the provider.

• If the patient refuses a Level 3 search, they are placed on continuous observation until they cooperate with the search.

• All patient belongings are searched, and bags are labeled once the patient arrives to an inpatient unit:
• In PAS, patient belongings are secured in a locker, but not searched.

• After the search, store belongings in the appropriate area on unit.
• Valuables:
• Take photos using Haiku app for accurate recording.
• Store in a grey security bag and have it placed in the hospital safe.

Refer to the "VPH SOP- Patient Property" policy for more information.

Patient Belongings

• Document the patient search:
• the level of search performed,
• the patient’s response, and
• any concerning items found and what was done with those items.

• Document belongings:
• Itemize belongings and valuables in eStar, and
• Describe belongings objectively (e.g., “yellow ring with clear stone” instead of “gold ring with diamond”).

Documentation

Visitors at VPH

• The following steps are followed for all visitors who arrive in PAS:
• Walk through metal detector or use hand-held wand, and
• Secure visitor belongings in locker area.

• The following steps are for all visitors to inpatient units:
• Have visitors store belongings in locker area in front lobby before visiting, and
• Search any items visitors bring for patients.

• Visitors may not access the patient’s belongings without the patient’s permission and signing the property record.

Contraband discovered in Inpatient Unit (First Episode)

• Illicit drugs / unidentifiable pills / substances
• Provider notified as a safety precaution (possible holding of medications)
• Unit restrictions for 24 hours
• Suspended visitation for 48 hours

• Non-illicit drugs / prescriptions
• Unit restrictions for 24 hours
• Supervised visitation for 48 hours

Refer to "VPH SOP- Contraband Procedures" policy for more information.

Contraband discovered (Continued Episodes)

• Unit restrictions for 24 hours
• Visitation suspended
• Additional modalities such as written treatment plan considered
• Discharge may be considered along with other factors, including involuntary status

Distribution of contraband

• Minimum of the following consequences (depending on the nature of the contraband)
• Unit restrictions for 24 hours
• No visitation for 24 hours
• Discharge may be considered

• Patient searches are important to perform consistently to ensure a safe environment for patients, visitors, and staff.

• Level 1 searches are performed routinely

• Level 2 & 3 searches are performed as needed based on patient presentation and team discussion

• All searches require 2 staff members

Conclusion

Knowledge check

Thank you

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