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PATIENT SAFETY IN A MENTAL HEALTH ENVIROMENT 9 November 2016
PATIENT SAFETY IN A MENTAL HEALTH ENVIROMENT MENTAL HEALTH CARE ACT, 2002; Act No. 17 of 2002 This Act regulates the admission, care, treatment and rehabilitation of mental health care users in the mental health environment. 2
MENTAL HEALTH CARE USERS Voluntary mental health care user means a person who has given consent to care, treatment and rehabilitation. Assisted mental health care user means a person receiving assisted care, treatment and rehabilitation; the provision of health interventions to people incapable of making informed decisions due to their mental health status and who do not refuse the health interventions. Involuntary mental health care user means a person receiving involuntary care, treatment and rehabilitation; the provision of health interventions to people incapable of making informed decisions due to their mental health status and who refuse the health interventions but require such services for their own protection or for the protection of others. 3
GENERAL REQUIREMENTS Psychiatric Hospitals, care and rehabilitation centre's and health establishments providing care to mental health users must comply with the provisions of the presiding Mental Healthcare Act as well as the regulations to this Act. Regulation 158 Regulation governing all private patient care facilities Notice 187 Regulations governing private health establishments Province of the Western Cape 4
GENERAL REQUIREMENTS The following general and safety requirements must also be adhered to in private facilities - Patient accommodation Nursing unit Patient rooms Lockers Dining room Lounge Individual therapy rooms Occupational therapy room Procedure room Storage space Clean utility room Sluice room and cleaners' room Emergency generator Emergency water supply 5
SEPARATE FACILITIES Except in the case of a parent and child, adults and children under the age of 12 years must be accommodated in separate rooms. Children under the age of 12 years and adolescents must be accommodated in separate rooms. If separate accommodation for adolescents and children under the age of 12 years or separate accommodation for adults and adolescents under the age of 18 years is impractical for reasons of treatment, proper screening facilities and constant direct supervision of mental health users must at all times be available. Recommend:- separate units for adults, adolescents and children under the age of 12 years 6
STAFFING REQUIREMENTS For the safety of the voluntary mental health care user sufficient nursing staff shall be on duty so as to achieve an average minimum of three to four hours nursing care per occupied patient bed per 24-hour period, thus a maximum patient-nurse ratio of 6:1 to 8:1. Nursing staff excludes care workers and care givers. A registered professional nurse (RPN) shall be responsible for each nursing unit and at all times be physically on duty while in charge. All nursing staff to be covered by an indemnity policy. All nursing staff must be registered with the SANC. A minimum of two (2) nursing staff on duty per shift, of which one should be a RPN, if the bed occupancy is less than 12 occupied beds. 7
PATIENT CODE OF CONDUCT Most private mental health care facilities do have their own Patient Code of Conduct To achieve the best possible outcome from an admission to a private mental health facility it is imperative that the voluntary mental health care user understand the content of the Code of Conduct of that facility and agree to abide by the rules and regulations of the facility. The Code of Conduct has been developed and formulated for the safety and therapeutic benefit of the mental health care user, the following: 8
PATIENT CODE OF CONDUCT Group and Individual Therapy Programme Confidentiality Electronic equipment Sleeping Quarters Personal Appearance Refusal of Hospital Treatment Medication Banned Substances, Weapons and Sharp Objects 9
PATIENT CODE OF CONDUCT Pornography Search and Seize Policy Complaints and Grievances Freedom of Movement Unacceptable Behaviour Self Harm Relationship between Patients Smoking Damage to Property Abusive Behaviour 10
SAFETY REQUIREMENTS Access and security control - at entrances, exits, emergency exits and windows Clothing hooks patient rooms and ablution areas, a breaking strain of not more than 5kg. Special safety features - in respect of electric sockets and switches, heaters, door and window locks and hot water supplies and heaters and hot water supplies must be thermostatically controlled at a maximum of 60 o C. Doors - all internal doors equipped with a standard emergency release lock. The doors must be able to be opened from the outside. 11
SAFETY REQUIREMENTS Burglar bars in front of windows opening restrictors might also be installed in in multi-storey buildings to prevent suicide. Signage guiding the visitor / patient to all areas and indicating restricted areas Safety glass and non-slip floors - all patient areas Mirrors smash and grab film 12
SAFETY REQUIREMENTS Fire protection and prevention Fire and smoke detection system Written fire/emergency evacuation protocol Effective emergency evacuation plan CCTV system in all non-patient areas Observation room safety one-way glass panel, constant presence of a nurse in the room or equipped with a CCTV camera. Medication and ward stock secure storage of - Emergency trolley / crash cart Schedule 5 & 6 medication 13
SAFETY REQUIREMENTS Nurse s call system - At each patient bed, which can only be re-set at the bedside or patient control Patient ablution areas toilet and shower Individual therapy rooms Procedure room Recreational areas dining room, lounge and group activity room Recommend:- Vellux system 14
Vellux Nurse s call system 15
Vellux Cleaning services 16
Vellux Cleaning services 17
Vellux Cleaning services 18
Vellux Cleaning services 19
M-Care contact details Ferdi Preller (M-Care Management Company CEO): ferdi.preller@mcare.co.za 083 283 0923 20