Safety management plan: environment

As part of the safety plan it is helpful to think about the ward environment and take reasonable steps to mitigate harm.
Involving the child and young person through joint assessment and negotiation will ensure they remain central to your decision making.
Providing the child and young person with reasons for any changes to the environment is essential. This will increase the likelihood that your safety plan will be successful.

Learning Points

The room door should be left open in order to help the observation process and avoid the child or young person feeling isolated
Where appropriate, consider harm minimisation strategies. This means allowing the child or young person to develop new strategies as a safer alternative to self-harm. These could include a rubber band snapped around the wrist or squeezing an ice cube.
Advise the child or young person that there is no safe way to self-poison.
Find the time to talk and listen to the child or young person if they express an interest.
Your plan should acknowledge ways to alleviate boredom on the ward. This can involve distraction techniques (e.g. computer games, music etc.) which will provide the child or young person with comfort.
It is best practice for all risk-related decisions to be developed and agreed by the child or young person and documented on a care plan.
Some children and young people may disagree with the plan of care to keep them safe. In these cases it is important to escalate any concerns and document these in the notes.
The level of risk must be reviewed periodically and the safety plan altered accordingly.
The care plan should be revisited with the child or young person at least every shift. This will ensure the child or young person is given the opportunity to be involved in their care and reconfirms the rationale for risk management decisions.

Activity: identify the risks

Can you identify the 3 risks within the bed space? Click on all of the areas that you consider could be a potential risk:

Start this Activity

Alcohol Gel

There have been reports of patients drinking alcohol-based hand-rubs. If this is identified as a risk with the child or young person, consider issuing staff with their own hand-rubs rather than placing them around the bed space. Alternatively these can be locked away if there is a draw nearby.

Cutlery

Following assessment it may be necessary to remove sharp implements such as knives during mealtimes to reduce the risk of self-harm. Paper plates in place of crockery may also be appropriate if there is a risk of the child or young person breaking and using this to self-harm

Oxygen and Suction Tubing, Curtain Rope and even Shoe Laces

Oxygen and suction tubing, curtain rope and even shoe laces can all facilitate ways for the child or young person to hang themselves. If deemed a risk then these should be attempted to be removed. Anti-ligature pull cords / curtain rails may be available from your hospital trust.

Oxygen and Suction Tubing, Curtain Rope and even Shoe Laces

Activity Complete: Learning Points

You have now completed the activity, please review the "Learning Points"

That was not one of the three risks we were looking for

Unfortunately that was not one of the three risks we were looking for within this activity. Please try selecting another potential risk from within the bed space.

If you are struggling to complete this activity please take a look at the learning points

End Activity and Review Learning Points