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Restricted items on inpatient unit

By Patricia Bezek posted 07-26-2016 09:00 PM

  
It seems we are always redefining items that could be considered a risk for self harm on our 26 bed adult inpatient unit. We are considering NOT restricting drawstrings from sweatpants and hoodies and shoe laces from shoes. We currently allow shoes w laces to be signed out during the day and we remove drawstrings form clothing. Basically, we know that patients can use any item to be used as a ligature so we question the extra effort that we spend eliminating strings and signing shoes in and out in a day. Any thoughts or other practices along these lines would be greatly appreciated. 
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Linda Kidder
02-16-2018 08:37 AM

We recently changed our practice and we no longer allow ties, drawstrings, belts or shoe laces. We offer to cut drawstrings or the option of the garment being locked in their belongings box until discharge. We offer zip ties for shoes and in p lace of a belt if needed. Patients have been receptive to this change.

Robin Gecko
01-05-2017 12:19 PM

Suicide is top reason mentally health patients die inpatient.    That being said we don't allow hoodies, nothing with strings,  for shoes we use zip ties.   Of course my hospital is acute inpatient so our eye on prevention is very critical.

Kathryn Kulungowski
09-11-2016 09:24 PM

I had a pt who tried to hang himself in the bathroom using his shoe string. Fortunately, it broke.

Mark Vega
09-11-2016 10:39 AM

My work also doesn't allow any type of strings.  We ask the patient if they want us to cut out the drawstring to their pants so they can wear them for their stay and often they say yes.  I did work at another facility where they would remove shoestrings and replace them with clips so patients could wear their shoes.  It was an effective compromise.   

Yelba Zoe McCourt
08-06-2016 01:29 AM

Where I work laces are never allowed. Recently pillow cases were used, so I hear your point about how "anything can be a ligature." At our facility we do offer to pull out drawstrings, but we also ask/offer to cut the laces (which is less time consuming than keeping them stored and retrieving them.) Many patients opt to cut the drawstrings. Maybe you can offer that... usually patients say yes to cutting the drawstring if it doesn't damage the clothes.  I would be interested to find out if you are able to streamline the process.