Patient Belongings and Valuables for C1 Mental Health Patients Stacey Sands BSN, RN Kelly Thompson BSN, RN-BC December 2012

Goal and Objectives Goal: To familiarize staff with changes in the philosophy and management of patient belongings and valuables for C1 Mental Health patients. Objectives: Differentiate between belongings and valuables. Explain documentation and management of patient belongings/valuables upon patient admission. Describe the proper procedure for returning valuables upon patient discharge.

Introduction Helping patients keep track of their belongings is a daily challenge and, in the past, there have been several ways that belongings have been handled at Munson. The primary focus of the NEW “Patient Personal Belongings and Valuables” Policy #042.P001 is to: Maximize patient and staff safety issues knowing that certain items (medications or potential weapons that could be used to harm self or others) will not be in patient rooms. Minimize time, energy and resources spent tracking and paying for lost patient items. Develop a standardized process for handling and monitoring these items, while simplifying documentation requirements.

Definitions Belongings – any personal essential item that needs to be at the bedside. This includes glasses, contacts, hearing aids, dentures, wigs, or ambulatory aides such as a brace, cane, or walker. Belongings = Bedside Valuables – any item that needs to be locked up for safety. This includes, but is not limited to, wallets, money, important papers, jewelry, electronic devices (cellphones, mp3 players, computers), legal medications, and items that have sentimental value. Space to store patient valuables is limited. Staff should encourage patients to send valuables home whenever possible. Valuables = Safe

Notifying Your Patients The hospital will not accept responsibility for items that are kept at the bedside. Patients need to be informed of this upon admission to the unit. This discussion takes place at the patient’s bedside with the unit staff. A good time to mention this is when you introduce the C1 Mental Health Unit Patient Guide. A list of prohibited items is outlined in the guide. Prohibited or restricted items (including cell phones) and/or items determined to be unsafe are sent home or stored in the patient belongings cabinet.

Belongings Personal belongings of C1M patients are searched upon admission for prohibited items by designated staff. All searches will be done by a designated staff person with the patient present. If the patient is unable to participate in the search of belongings, two (2) staff will review the belongings and document items. Items that are kept on the unit during hospitalization will be documented in the chart and the patient will receive a copy of the list of items. Patients are allowed three (3) changes of clothing to store in their room. All excess belongings will be sent home. If excess cannot be returned home, they will be stored in the patient belongings cabinet.

Belongings

BH - Belongings Form - Documentation NEW- Notice that it is required that the belongings policy be discussed with the patient/family. If this is not possible, you may select “Pt/family unavailable for belongings discussion.” If valuables are sent to the safe, it is documented on this form

PAL Task NEW- If “Pt/family unavailable for belongings discussion” is selected, a task will fire in 4 hours to remind the nurse to review the belongings form and reassess the ability to discuss the belongings policy with patient or family. This task looks exactly like the admission task, but details are different. Look closely!

If there is a change in disposition of belongings during that patient stay, open a new BH - Belongings Form and make any necessary updates. Do NOT modify the original BH - Belongings Form. This allows belongings to be tracked more accurately. BH - Belongings Form – Documentation Do NOT modify the BH-Belongings Form. Open a new one!

Valuables

Valuables Envelope When it is not possible for a patient to send their valuables home, a “valuables envelope” will be provided. This indicates that the valuables were surrendered to MMC, sealed in an envelope, labeled with the patient’s ID, and secured in a safe in the Nursing Administration office. Items too large to fit into the envelope (such as a laptop computer) can still be stored in the safe. NEW - It is important to note that valuables are not itemized or inventoried. Rather, items are placed in the envelope, in the presence of the patient, and sealed. The patient signs the seal of the envelope. If the patient is unable to sign, two (2) staff members will sign the seal. This change in practice will decrease liability and workload for the nursing team staff.

Storing a Valuables Envelope Fill out a “Patient Valuables Record Form”. If patient requests a copy, a photo copy is made. Put a patient ID label on the form and on the actual “Valuables Envelope”. Place the items in the envelope. They are not itemized or inventoried before placing them in the envelope. Seal the “Valuables Envelope” in the presence of the patient. The patient then signs the seal of the envelope. If the patient is unable to sign, two (2) staff members may sign instead. Take the envelope to the Nursing Administration Office so it can be logged and secured. File the “Patient Valuables Record” in the patient’s chart.

“Valuables in Safe” sticker A Valuables in Safe sticker may be placed on the front of the patient chart to serve as reminder.

Returning a Valuables Envelope During the patient stay, the valuables envelope may be returned to the patient. The patient must: Sign the release note on the “Patient Valuables Record Form”. They can have the envelope released to a designee, if needed. The envelope is returned unopened. Desired valuables may be removed by the patient. A new envelope is utilized if other valuables are returned to the locked area. Upon discharge, the nursing team member must: Review the “BH-Belongings Form” on the patient’s chart. Search the patient’s room for all belongings. Remove the “Patient Valuables Record Form” from the chart and give it to the patient in order to claim their “Values Envelope” from Nursing Administration upon leaving. The patient can present the “Patient Valuables Record Form” to Nursing Administration to authorize pick-up. The release note must be signed and the envelope is returned unopened.

Belongings and Valuables Returned Upon discharge, remember to address patient belongings per Behavioral Health Unit specific policy. PowerChart documentation must be updated. Do NOT modify the BH-Belongings Form. Open a new one!

Medications Many times, patients bring their medications to the hospital. Names of the meds brought from home should be noted in the chart, but the actual medications should be returned home. If that is not possible, they need to be in the valuables envelope. Do not itemize the medications. Seal them in the envelope with the other valuables. No medications are allowed to remain at the bedside. NEW - The safe is now in the Nursing Administration office.

Illegal Medications Please be aware that any illegal drugs, medical marijuana and/or bottles of medicines that are prescribed for someone other than the patient will be disposed of according to policy. See the Weapons and Contraband (including Search Procedure) Policy # for more information.

Suicidal Patients Belongings and valuables for all suicidal patients should be managed per Management of the Suicidal Patient Policy # Regarding suicidal patients in the patient care areas: If patient belongings are brought to the nursing unit they should be sent home with family or designee at the time of admission. If patient belongings must remain on site, they should be bagged and labeled, then sent to the Nursing Administration office. Valuables will be managed per Patient Personal Belongings and Valuables Policy #042.P001. Valuables and belongings will be returned to the patient at the time when the patient is evaluated as no longer at harm to self or others, or upon discharge. Family/visitors must be instructed not to bring personal items in to the patient.

Conclusion Remember, the primary focus of the updated “Patient Personal Belongings and Valuables” Policy #042.P001 is to: Maximize patient and staff safety. Minimize time, energy, and resources. Develop a standardization process for handling and monitoring patient’s items.

Key Points Summary Belongings = Bedside, Valuables = Safe Personal belongings of C1M patients are searched upon admission for prohibited items by designated staff. Items that are kept on the unit during hospitalization will be documented in the chart and the patient will receive a copy of the list of items. The hospital will not accept responsibility for items that are kept at the bedside.

Key Points Summary (cont.) Valuables are not itemized or inventoried. Rather, items are placed in the envelope, in the presence of the patient, sealed, and secured in the safe in Nursing Administration. When valuables are sent to the safe, document on the “BH - Belongings Form” in PowerChart. If there is a change in disposition of belongings during that patient stay, open a new “BH - Belongings Form” and make any necessary updates. Do NOT modify the original “BH - Belongings Form”. If a patient should bring home medications into the hospital, names of the meds brought from home should be noted in the chart, but the actual medications should be returned home. If that is not possible, they need to be in the valuables envelope.