Top 10 Tips to Ensure a Safe Environment of Care for Detox Patients
What happens when someone with an addiction decides to stop using drugs or alcohol? The process of detoxification or “detox,” clearing the body of these harmful substances, can be dangerous and painful if done without medical supervision.
Drug and alcohol abuse has become a serious threat nationwide, increasing the risk of life-threatening self-detox. In Louisiana, opioid deaths increased by 25% from 470 to 588 in 2019. During the first year of the COVID-19 pandemic, the CDC reported that overdose deaths from opioids in Louisiana rose 56% from March 2020 – March 2021.
Detox is different for every person and the length and degree of withdrawal symptoms will vary depending on numerous factors, such as the type of substance being abused, duration of the addiction, family history, and other co-morbidities. Without proper medical supervision, a person who suddenly quits substance abuse could suffer from serious issues such as dehydration or seizures that could result in death. Nevertheless, the process of detox is only the beginning of treatment. On-going professional supervision and support are necessary to ensure that individuals do not fall back into their addiction.
Fulfilling the need for ongoing support is why hospitals have implemented short-term detox & withdrawal management programs to help community residents that are struggling to break free of their addiction.
Hospitals often partner with third-party organizations that specialize in withdrawal management. These partnerships allow healthcare facilities to provide a medically monitored detox process that assists admitted patients with a smoother transition to an inpatient addiction center or outpatient treatment program for further treatment and follow-up care.
Recommendations to Ensure a Safe Environment of Care During Withdrawal Management
To ensure a therapeutic, safe environment of care and a positive detox experience for the patient, the hospital should put proactive measures in place. If your healthcare facility is providing or plans to provide this type of service, consider these recommendations:
- Ensure medications are secure from unauthorized access to narcotics/sedatives etc.
- Have a hospital policy and process in place to limit any contraband from entering the facility.
- Allow family members to visit but encourage limited visitation to promote rest and minimization of withdrawal symptoms. Request that visitors do not bring in any personal items such as a purse, bag, etc. when visiting the patient. This would limit the chance of families bringing in items that could prevent the patient from having a successful detox experience.
- Provide a comforting visitation area on the same floor where patients/visitors/families can visit out in the open instead of in the patient’s room. This would allow the patient to have a change of scenery during their detox experience instead of staying in the hospital room all the time and it allows the staff to observe the visitation setting.
- Ensure all staff is trained in identifying and de-escalating violence techniques in the event the patient experiences agitation or aggression during the detox process.
- Offer the patient a room in a quiet designated area to limit the amount of foot traffic and noise that occurs in the hospital. This would help to promote a therapeutic environment for care and treatment.
- Have a designated group of caregivers, who are trained in the withdrawal management & detox process, providing care for the patients involved in the program. This would develop a level of comfort for the patient where they have consistent caregivers instead of someone new each day.
- Follow the hospital’s smoking policy. If the hospital does not allow smoking and the patient request to smoke, contact the physician for orders to provide other measures to address their smoking needs.
- Encourage staff to keep hallways and rooms free of trip/fall hazards.
- Ensure all hospital policies are adhered to concerning the safety and security of all patients, visitors, and staff. Have security conduct rounds on the unit as an extra level of security for all patients.
By proactively implementing the measures listed above, the organization would be promoting a safe and secure environment of care for patients.
Pay Attention to Details When Partnering with Third Party Providers
Your organization also needs to take care to limit liability when signing a contract with a third party for these services. The hospital should be indemnified fully by the company managing the program, or at least an indemnity protecting each party from liability for the other’s negligence should be included.
In connection with the contractual agreement, the contract company should be insured for all claims arising from the program’s existence at the hospital premises and provide proof of coverage. Coverage should extend for the contract company employees’ claims, patient claims, and visitor claims for personal injury. There should also be coverage for premises liability.
Need More Resources?
If you have concerns related to the contract, please contact LHA Trust Funds to discuss the language with one of our claims specialists that are ready to assist you.
Access the Opioid Management, Environment of Care, and Medication Safety toolkits to gain greater resources to implement into your organization’s best practices today.
About the Authors
Stacie Jenkins, RN, MSN, CPSO
Vice President of Patient Safety and Risk, LHA Trust Funds
Stacie Jenkins is a registered nurse with a master’s degree in nursing informatics. She has more than 20 years’ experience in healthcare, working in patient care and quality/performance improvement positions. As the Vice President of Patient Safety & Risk at LHA Trust Funds, she works closely with hospital administrators, risk managers and nursing staff to improve patient safety and establish best practices. She conducts on-site assessments and gives presentations designed to help clients address their patient safety risk management challenges.
Caroline Stegeman, RN, BSN, MJ, ONC, CPHRM, CPSO
Director of Patient Safety, LHA Trust Funds
Caroline Stegeman has 28 years of nursing and clinical risk management experience in a variety of healthcare settings. She has extensive experience in the management and handling of patient safety issues/ incidents, clinical and environmental risk assessments, root cause analysis, regulatory and industry best practices (TJC, CMS, DHH), hospital emergency preparedness and disaster management, and quality improvement initiatives.