This Edition contains 114 pages of up to date information on products that are better for use in behavioral health facilities than items commonly used in general hospitals.  The Appendix has a total of 234 products.  Thirty-six of them are new listings that were not included in the November 2012 Edition.  The first edition in 2003 had 37 pages and featured 45 products.

David Sine and I wish to thank the NAPHS and especially Mark Covall, Kathleen McCann and Carole Szpak for their support and having faith in us and this project, without which this would not have been possible.

Click here for free download

Another option is to provide two doors at the entrance to the room from the corridor. One door is for normal use and the other for emergency use only. This is usually termed a “double egress” door. A more typical use of this type of door are the cross-corridor doors in smoke or fire separation partitions. In this use, both doors are the same width.

In this application, the door for normal use is the required width for access (usually 36” to 48” depending on the circumstances and code requirements) and swings into the room. The other door can be more narrow (18” to 24”) and swing out into the corridor when needed for emergency access. This will require a minimum of 5’-0” of corridor wall in the room to accommodate the width of this assembly, which can be a difficult issue in remodeling projects. This smaller door should have no exposed hardware on the room side and only a deadbolt cylinder and continuous hinge on the corridor side.

One way to do this is to provide a door frame that is specifically designed for this application and has a vertical frame member between the two doors. These are available as standard products from several manufacturers or are available by special order from any good door frame shop. These allow the use of hardware that is more typically used on these units.

If additional clear opening width is desired to move equipment into the room (or for other reasons) this can be done without a vertical frame member between the two doors. This is a little more difficult to design and requires more specialized hardware. It also may result in more noise being generated in the normal use of the door.

SUMMARY – If space is available in the corridor wall of the room, the unequal pair of double egress doors solution is a very good way to address the potential risk of patients barricading themselves in rooms to avoid staff intervention.

This situation brings to mind a quote from the late baseball great, Satchel Paige.  He started his career in the 1940s in the Negro Baseball League and ended it in the major leagues as a member of the Hall of Fame.  He is known for many sayings.  One of my favorites is the following:  “It’s not what you don’t know that will hurt you; it’s what you know that just ain’t so.”

Click on this link to read the full article:    design-mistakes-part-1-things-many-know-just-ain-t-so

Weizel Security has developed a new toilet paper holder based on a concept originally created by the maintenance department of the Good Shepherd Center in Baltimore, Maryland. This newly released toilet paper dispenser (designated 817-S59 SafeSupport SR Maryland TP Dispenser) addresses both of these common concerns. It is a fully enclosed toilet paper dispenser for use in behavioral health patient accessible toilet rooms. It fully contains the roll so that it remains shielded from patient contact.

The enclosure is made of powder coated, heavy gage steel and the potentially sharp outside edges are eased to provide an added measure of safety. The paper is pulled out of the bottom of the dispenser through a diaphragm that is designed to assure that the paper always tears off outside the dispenser. The design resists hiding contraband inside the dispenser and makes it difficult to remove large amounts of paper at one time. A video demonsration of this product is available in the Blog section of this website.

For more information, contact Weizel Security, 800-308-3627 or www.securinghospitals.com

Acrovyn Door

These are also available in door-within-a-door or “wicket” doors with a smaller panel in the center that is hinged out to allow staff access if the door becomes barricaded.

For more information go to www.c-sgroup.com/acrovyn-doors

Common Mistakes in Designing Psychiatric Facilities - AIA

Suicide prevention and patient and staff safety issues in psychiatric units present a very unique set of issues.  Three newly constructed psychiatric hospitals, one on each coast and one in the center of the country last year had significant patient safety issues.  Other facilities spent substantial amounts of money remodeling existing units and not only didn’t resolve patient and staff  safety issues, but (in some cases) actually made them worse.

National  statistics show that the average 24 bed psychiatric unit will experience one successful inpatient suicide per year and patient-to staff injuries continue to be a major concern for most facilities.

Possibly the most important design feature of a psychiatric unit is maximizing visual observation  of patients from the nurse station.  If this is not addressed early in the schematic design phase, it will likely never be attainable.  The level of concern for
patient safety increases with the amount of time they spend alone in a space,
such as patient rooms and toilets.

The need for patient safety tends to drive the aesthetics of the units toward prison-like
environments.  This is counter-productive to treatment and the healing process of the patients and should be avoided.

The solutions are often the opposite of what is typically done on medical/surgical units.  Design professionals who do not address these issues carefully may be incurring major liability should a successful suicide or staff assault occur in an improperly designed unit that doesn’t meet a reasonable standard of care.

THIS ARTICLE IS CURRENTLY OUT OF PRINT.  A COPY OF THE FULL TEXT MAY BE REQUESTED THROUGH “Contact US” PAGE.

CONVERTING MEDICAL/SURGICAL UNITS FOR SAFE USE BY PSYCHIATRIC PATIENTS: THE PHYSICAL AND FISCAL RISKS, copyright 2011

Many hospitals decide to utilize vacant medical/surgical units as psychiatric units.  This can result in multiple hazards for both patients and staff.  The two kind of units function entirely differently and suicidal or aggressive patients can find many items to use a weapons against themselves or others.

This monograph identifies the major differences between med/surg and psych and suggests ways to make the environment more safe for all and assist with mitigating the financial risks involved.

This monograph is copyrighted by the American Society of Healthcare Engineering and is available from www.ashe.org.

I often suggest the use of a lightweight plastic chair for moveable patient seating in patient bedrooms, dining rooms, etc.  These are durable, don’t break easily and do not make very good weapons for breaking windors or assulting others.

Some facilities have commented that these are not sturdy enough, expecially for geriatric patients and will not support heavier patients or adolescents that like to lean back on two legs of the chair.

I recently became aware of a chair that may resolve these issues.  It is the RazorBack chair by Cortech.  The manufacturer recommends this for patients up to 300 pounds.  It has actually passed the ASTM F1561-03 drop weight test to 400 pounds and withstood an informal static load test of 1,500 pounds.  It has also passed the Cal 133 flame retardant test.  It is stackable and available in a variety of colors.

As always, I have no financial of other interest in this or any other product that is featured here or in any of my publications.

For more information, please contact Cortech directly:

Cortech Correctional Technologies, Inc.

7530 Plaza Court

Willowbrook, IL 60527

800-571-0770

www.cortechusa.com