What issues are documented during a safety check and how are they documented?
  1. Whereabouts of patients, safety of patients, amount of suicidal patients are written on a board and wand to wall in each room.
  2. Patient location & behavior on a 24 hour rounding sheet
  3. Per visit note, per question asked and answer received.
  4. Patient activity is documented on the patient checklist
  5. Each patient has a hand written check sheet which lists patient’s location, behavior, and presence or absence of visible contraband is documented.
  6. Location and mood of patient
  7. Location of patient, who is with them, what are they doing at time
  8. Location/activity
  9. Patient location and activity. This process is still on paper. Staff carry a clipboard and document concurrently.
  10. Activity at present is documented by computer clicks in flow columns on computer and on hard copy sheets that technicians carry.
  11. Outlets, clutter, contraband, fall hazards, sharps, cords & pills
  12. Location of patient and if they are awake or asleep.
  13. What the person is doing (sitting, standing, showering, etc) and their location (room, day room, bathroom etc).
  14. Location of patient and activity of patient on a paper form with boxes for every 15 minutes - use codes in the boxes to indicate location and activity
  15. Activities of the patient including respiration when sleeping.
  16. Environment checks are done every hour
  17. Client safety, on a check sheet
  18. Environmental issues through our Peminic reporting system
  19. Restraint safety, fall risk, suicide precautions all documented on flow sheets in EMR
  20. Where patient is is documented on a check off list
  21. Behaviors & whereabouts on a flow sheet
  22. Change in patient condition documented in medical record. Milieu or physical issues on the rounds sheet itself / repairs are documented on work orders
  23. Location of patient, if they are sleeping, in restraints, lock door checks, 1:1, staff signature, times, date shift.
  24. Location of patient and behavior
  25. Brief behavior codes on a check sheet and for 15/30/60 min checks. Broset Scale each shift all points are filled out for each patient
  26. Patient location and observed activity
  27. Check mark on the Q 15 check form with the code for where\was the client:
  28. Room check
  29. Client environment check
  30. Location of patient and sleeping if they are sleeping
  31. A check off on the electronic record indication 15 minute rounds conducted for safety and a paper 15 minute check off which notes location of patient only
  32. Rooms are checked, locks are checked, looks for hazards (water on floor, obstructed exits, etc.)
  33. Patient location & activity; room/contraband search
  34. Location of pt
  35. Pt location, activity, mood, behavior
  36. Pt. rooms, door checks, bathroom and fall safety
  37. Location and patient activity
  38. Location of the patient.
  39. The patient’s location and activity/ behavior, with the level of detail depending on the acuity
  40. Where pts are located and awake or asleep--signed off on flow sheet
  41. Unit safety checks--search rooms, signed off
  42. That doors are securely locked no one in hallways that should not be there.
  43. Location of the patient, that the "sharps" have been accounted for, and other environmental issues have been checked - there are specific areas to initial on a spread sheet.
  44. It is a check sheet identifying location for the 30 min checks. If more frequent checks like q15" are needed the form has you indicate specific behaviors using a key guide
  45. There really is no place on the checks board to document anything
  46. A check mark on paper
  47. Patient chart and PSN (incident report) any item that should have been secured. We have found lighters, bullets, string, pills etc
  48. Location of patient, activity that patient may be engaged in (attending CBT group, etc and if on nights and/or sleeping that respirations were noted at time of check
  49. Alert/asleep, where they are, unsafe items, unsafe environment (loose screws, damage to furniture, etc.)
  50. We primarily document location of patient; on night shift we also document whether asleep or awake
  51. Patient accounted for
  52. Patient location, physical appearance, behavior/mental condition, interventions. These are documented on a rounds sheet with check boxes.
  53. Ex; counting dinner ware, providing felt tip pen vs. ballpoints that have metal, item by item inventories, unannounced room checks.
  54. Location
  55. Location and behavior
  56. Whearabouts and activity of patient at the time environmental safety checks done daily
  57. Patient whereabouts are documented on a flow sheet to include location and if it is at night, then the sleep status is also included.
  58. It depends on what is occurring at the time of the safety check.
  59. Activity, Location, who with; Document on flow sheet
  60. Contraband, patient having a difficult time, discussed with other staff and document in the chart and in the Resource Nurse Binder: Location, mood, sx.
  61. Pre-printed form: Contraband, interactions, restraints, beds
  62. Checklist: Location of patient
  63. Where is the patient, what are they doing, what does their behavior indicated. Documented with initials.
  64. The patient's behavior and their location. This information is documented on an observation round form. Each patient has their own individual observation form.
  65. Are doors locked that are not in use?  Scan empty rooms for sharp objects, that patient is alive, safe & breathing - documented with a checkbox method on clipboard
  66. Location of patient and, if there is a concern, patient behavior
  67. Where patient is and sometimes mood behavior
  68. Location, outstanding issues, need for prn med, effectiveness
  69. Patient safety checks/observations are only whether patient is awake or sleeping and breathing. Documentation is on a paper sheet that has staff signatures and all patients listed with a photo, room assignment and observation level. Fall risk is indicated on this form as well as elopement risk.
  70. Patient location
  71. General appearance, activity - in short narrative.
  72. Location (Day Rm, Group Rm, Bedrm), Behavior (Calm, Agitated) Actions (Talking, Sleeping) Check sheet w/ codes (DR, C, T) (Day Rm, Calm, Talking) Staff sign the sheet and initial each entry.
  73. Checked that patient was visualized, and if sleeping, respirations noted
  74. Awake or asleep is documented
  75. Time, location, demeanor, any escalation or interaction
  76. Pt whereabouts on a board with a key legend indicating areas of the unit and activity
  77. Head counts, any irregular activities, issues for specific clients
  78. Any reported near miss, or error, or unsafe environmental issue, practice, or process is documented and followed up with action plan by a combination of the unit/program leadership and the system quality/safety committee.
  79. Doors locked, glass or other breakable, sharps, pop cans, hangers, plastic bags, lighters, matches, home meds, damaged equipment, other
  80. Location of patient and awake or asleep
  81. Patient's location and whether they are awake or sleeping.
  82. Room deemed safe, si, hi with plan and/intent as applicable
  83. We have a "Special Alert Status Checks sheet" for patients on any kind of precaution with documentation lines and check boxes; the minimum expectation if not on special precautions is a Census and Wellness Form that allows for 15 minutes checks as well, but is usually used for 60 minutes checks.
  84. Whether the client is asleep, awake or on pass is indicated on the check sheet every 15. Any other significant behavior or event is documented in a progress note.
  85. Check marks and comments. Where they are, what they are doing, and behaviors needing notes.
  86. Where the patient is located, awake or asleep; we document that it was done & by whom
  87. Broken equipment, patient room doors closed, other environmental hazards
  88. The patient location and if asleep or awake is q 15. The patient room check is documented in the flow chart.
  89. Location, awake or asleep, and any out of ordinary emotional state
  90. If the patient is or is not suicidal (if patient is suicidal then they will be asked to come to dayroom for closer observation) and if they can agree to tell staff if they do become suicidal
  91. Where the patient is and activity level
  92. Time, location of patient on the unit (requires only a # related to a key), Behavior (requires only a letter, related to a key), staff signature.
  93. Check off for apin, potty, positioning, clutter on floor, lights, and safety hazards in room.
  94. Patient’s alive status on unit
  95. Documentation is by a check mark on a form and the location. The CNA's are primarily responsible for safety checks. If there is an issue, they report to the charge nurse.
  96. Safety check issues are divided on two separate categories: clinical vs. structural. Documented on a safety check list and communicated to maintenance or CE immediately. Clinical check of findings documented on the patient’s daily notes.
  97. Patient location and activity. Initials on rounding sheet
  98. 1. Location of patient, 2. Condition of patient 3. Conditions in the environment that may affect the safety of the patients
  99. Where the patient is, what they are doing - in the electronic record
  100. What the patient is doing and where the person is if patient is on q15 checks. Documented on a flow sheet. If person not on q15 minutes check is not documented.
  101. Patient’s location only. We tried documenting location, activity and behavior/mood, but staff felt it was too cumbersome
  102. Patient location, room environment checks... Documented on flow sheets
  103. Patient location
  104. Behavior/activity, e.g. sleeping, eating, etc.
  105. Are they awake, sleeping or off the unit.
  106. Sleep, location, what discipline they are with, patio, room, dayroom,
  107. Presence, location
  108. Respiration, location and time
  109. Location of patient
  110. It's documented if they are awake, asleep, calm, or agitated,
  111. We have a q15 check list for our NAs and MHAs and I document in my notes
  112. Our unit uses a safety check "matrix" that includes pt's name w/ small boxes indicating 1/2 hr time intervals. We use pre-set initials to indicate what pt is doing or where pt is at that time; i.e., LR (in living room), MD (w/ doctor), BR (in bathroom), etc.
  113. Location of patient; activity engaged in
  114. Behavior, location, time
  115. The key on the checks sheet reflects: on hall, off hall, awake in bed, sleeping and breathing
  116. Where a patient is at the time check
  117. For patient safety checks, patient exact location is documented. For environmental safety checks each pt room is observed for potential hazards, contraband and repair needs.
  118. We document them in the computer
  119. Location of patient - on unit, in group, appears to be sleeping
  120. We document where the person is and what they are doing
  121. Location/activity- time- staff initials on a check sheet with all the names of patient
  122. If a routine separate sheets on same board if on 15 min checks one-one also have a separate check sheet and one person is responsible for maintaining this assigned board
  123. Multi-patient flow sheet by location only
  124. Using a numbered list, the check describes the placement of the patient or the behavior
  125. It depends on the safety check. The routine safety checks documents where the patient is located. It is a visual check unless the patient in off the ward. During special observations and 1:1s, the patient’s location, mood, and activity is documented.
  126. Hourly and q 15 minutes - none; 1:1 - Pts. location, behavior, activity
  127. Each patient's location at the time of the rounds, each patient's behavior at the time of the rounds, each patient's risk issues / precautions.
  128. Patient's location, Patient' activity, Patient awake or asleep
  129. We started just documenting on a sheet what was found and removed from the room on room checks. This is to assist in tracking and help with new staff orientation.
  130. Found items and where, plastic bags, glass items, cords, razors, tin cans, pills, exits locked, windows intact, cigarettes matches lighters
  131. Any hardware deficiencies, hazardous items etc
  132. Status and location well documented
  133. Physical whereabouts of the patient
  134. Location for all; during hours of sleep we note if they have eyes closed or eyes open - we monitor sleep times; if the patient has a 1:1 it's noted
  135. Flow sheet; can't say specifically what is checked as I do not work on the inpatient unit
  136. Based on description above #1 location of patient, and at night, whether or not the patient is sleeping; #2 presence and description of any contraband found; #3 doors that are to be locked are locked, hardware working properly, pagers and alarms working, intercom system working...etc. If any repairs are indicated, a work order is completed.
  137. Do a personal and belongings search on admission and after a TLOA. Document electronically on a flow sheet. Specify items locked or removed from patient room.
  138. What person is doing, level of alertness, surrounding, door security, look for cords, items that could be used for self harm, sharp edges, behavior of person- depends if routine or if related to a concern- During sleeping hours make person is breathing, look for position change
  139. For the 15 min checks on each pt we have one sheet with every pt's name on it. Codes are used to indicate where the pt was and what their behavior was at the time. For the checks done once a shift a different check sheet is used that includes whether or not doors are locked, wet towels removed from bathrooms, staff wearing name pins etc
  140. Rounds sheet with check boxes. If something is amiss, it is immediately rectified by the person responsible for rounds at the time.
  141. Rounds were competed by wand, computer generated
  142. Unusual behavior or problems are charted on computer
  143. In what activity was the person engaged? (Group, sleep, etc)
  144. Patient behavior environment patient location
  145. Environment, pt location, verbalization of self harm, level of precautions and for what reason pt is on precautions. Documentation is only performed on the hour.
  146. Patient location
  147. Patient clinical status: depressed, anxious, situationaly appropriate, etc.
  148. Charting on flow sheet. Document additional information under current behavior
  149. Door locked, rooms locked, stairwells locked etc.
  150. In a book: patient location, patient activity
  151. Patient location, activity, behaviors
  152. Patient whereabouts, pt. complaint. Documented on the rounding sheet and shift summary report
  153. We document where the patient is located when we do the safety check. We document if someone signs out a sharp item, which is an item that could be used as a weapon to harm themselves or others examples would be a portable DVD player, a razor which needs to be used in staff supervision and turned back in immediately. Cds music or DVD’s, portable CD players, notebooks with wire binders etc.
  154. What the patient is doing (behavior) is documented on a Checks board document
  155. Any sharps or contraband, any environmental concerns, dangerous items, unauthorized materials such as notes from other patient's
  156. Where a patient is.....and there is a flow sheet that is used
  157. Just a check showing that a 15 minute check was completed. The check is placed by the name of the patient.
  158. Patient whereabouts
  159. Where the pt is and what the pt is doing
  160. Q 15 min-q 2 hr
  161. Specifically list rooms; and what we are looking for: doors locked, items secured, no shoelaces, belts, etc. PS I would be happy to share our unit specific form
  162. Their location
  163. Location, activity: Number codes for location, letter codes for activity
  164. Safety checks are initials by staff performing safety checks as well as if a problem as identified or a concern.
  165. Location and activity of patient
  166. For 30 min checks we have a one page grid with times across the top and patients names down the side. We document their location on each safety check. For 15 min. checks there is an individual form for each patient; staff document location and initial each time.
  167. All potential weapons, trays, dishes, cups, mugs etc as well pt status i.e. awake, sleeping, etc
  168. Location and activity of patient. Documented on 8 hour "rounds board" divided into 15 minute segments. Person doing rounds must initial each segment.
  169. Behavior and location on a rounds form for each patient. A legend and numbers are used for the location and behavior respectively.
  170. What patient is doing
  171. Where the patient is. What activity they are performing
  172. Where the patient is and what he is doing
  173. Safety checks: tattoos, injuries, contraband; Rounding: patient sedation level, location, environmental concerns, noted on special board/ documentation saved.
  174. Location of the patient, activity of the patient and behavior of the patient (LAB)
  175. Check boxes denote if pt has questions, concerns, or needs to be reminded to participate in groups.
  176. They are documented on our Epic System and it describes patient's activities 24/7
  177. Exactly what you did and the result of your check
  178. Location, activity, and if notable level of anxiety
  179. Location and behavior, on rounds sheet.
  180. Location is documented on rounding form. Safety issues are reported to charge RN and charted in pt record.
  181. Location of the patient, what activity the patient is involved in, who the patient is with,
  182. Any contraband items found or unusual behaviors observed
  183. Where they are, and if awake or asleep
  184. Type of monitoring (medical, SI, HI, psychosis, falls etc), personal safety & environmental checks
  185. Presence medical equipment or other potentially "unsafe" items, e.g. call light cord; restraint gurney is checked for readiness; doors locked; documented on mental health tech's flow sheet
  186. Location, activity - checks
  187. Where the patient is and what they are doing. If exit door are locked. Bathrooms do not have anything in them. Dryer is clean.
  188. Where and, problems, on a checklist
  189. Rounds board for location, any contraband found is documented in medical record, policies followed for removal of contraband and/or safety issues (i.e. broken chair) broken items reported to facilities
  190. Location, mood and behavior are documented on a Flow Sheet.
  191. Usually where the patient is at the time and the activity they are engaged in - done through a simple check off sheet with staff initials.
  192. Check off and kept for 7 years. One place to document on the chart each shift
  193. Where the patient is and what they are doing is documented. There is a safety check sheet for each patient, with a key to designate location and behavior, and a small space to add comments.
  194. The patient's physical location is documented by using a code system i.e.: B=bathroom, D=dining room S=sleep
  195. Patients’ whereabouts
  196. The time, date, patient identifiers, location of the patient are kept on "rounds" sheets.
  197. They are documented on paper. We note the place and the activity
  198. Staff initials and signature, pt location
  199. Where the patient is and what the patient is doing.  Documentation is done on individual flow sheets
  200. Patient location, risky behaviors, environmental safety
  201. Asleep/awake, location, initials of staff documenting
  202. No documentation other than to check off when a pt is accounted for
  203. Any opened doors that are supposed to be locked, objects that are found that are high risk for the environment (razors, laces, tourniquets, draw strings...) and patient location (IE off unit for PT, x-ray, RT...)
  204. Where client is at, what client is doing, and their behavior.
  205. What the patient is doing are they stable
  206. Paper sheet for individual pts, paper sheet for unit checks, documentation in the electronic record, verbal handoff during shift sign off
  207. Check off sheet with pt name and room number
  208. Patients whereabouts and a checklist is used for rounds
  209. Where patient is, what patient is doing, what was done about problems, patient's ability to follow directions/level of agitation, contraband found, MD contacted, etc.
  210. On the intensive care unit the patient's location & activity/behavior on individual flow sheets. On the step down unit just their location on 1 common flow sheet.
  211. Mood, behavior, cognition. Documented in CRIS.
  212. Safety checks between change of shifts has a formal checklist but issues are not documented just corrected i.e.: plastic bag in the room of pt discarded on proper receptacle (station), routine checks are documented on unit rounds board, more frequent 15 min checks documented on individual patients if ordered.
  213. Where the patient is and what they are doing in general
  214. What the patient is doing, if is responding to internal stimuli, behavior, if patient is watching TV is important to assess if really is concentrated in the TV program
  215. Document on grid with "key" letters designating where the pt is and what they are doing.
  216. We document when check done and initials of person completing the check. If contraband found, that would be documented in patient care notes.
  217. Individual safety checks are ordered and specify in the order what the staff member is to observe and document
  218. On paper the patient's physical location
  219. Location is documented on a paper version of an Excel spreadsheet
  220. Clothes with draw strings, ADL items left in room, etc., items are removed. No process for reporting formally the staff will leave notes depending on the breach of safety.
  221. Mood & behavior of each patient, on the individual's flow sheet for each shift
  222. 1) Typically we monitor, behavior, or medical/safety issues. 2) Special op's here are 15'checks, and 1:1, 15' checks...q 15 & 1:1 q 30'
  223. Nursing Attendants' flow sheet is document of status of each patient: Awake; asleep; w/ doctor; off unit.
  224. Where the person is
  225. Location, activity, pt's presentation/mood
  226. Activity, behavior, location
  227. Where the child is located, if sleeping or awake
  228. Flow / check sheet, where patient is, activity, environment
  229. Location on a sign off sheet
  230. This is a checklist done by our Psych aides
  231. Location and behavior
  232. Awake/asleep
  233. If person engaged in unsafe practices, tech would contact nurse for assessment/follow-up.
  234. For patients: all precautions ordered (fall, aggression, anxiety agitation, etc)
  235. For Rooms; what contraband was found or that nothing was found
  236. Location: abbreviation key
  237. Large unit...nursing assistants can’t always get around to all the patients
  238. We decided to take out behaviors from our checks document so we document location. The only behavior is sleep. We decided no matter where they are if they are sleeping that is important information. So Z is for sleeping. Otherwise it is location such as room, hallway, dayroom, dining room, and group.
  239. We have a board with each patient name, the safety or precaution status i.e. suicide precautions violence precautions, fall precautions, seizure precautions, the staff must see the patient and mark down on the board where they are what they are doing
  240. Patient status, what was checked and if any contraband or safety hazards found
  241. Patient's behaviors, activities, responses
  242. Any structural problems, contraband and removal, safety issues in general--check sheet is filled out and signed by staff member completing the check
  243. In the computer: Purpose-behavioral, Visual check-location
  244. Location of patient, awake or asleep
  245. Correction Officers keep a log on activity observed during that check
  246. Computer charting how often checks done, mood behavior and what activity involved. Complete assessment every a.m.
  247. Documented on check sheet. Patient location
  248. There is a log book for routine rounds and contraband rounds. If there is an issue with a particular resident it is documented in the resident progress note.
  249. Check sheet indicating that you saw the patient
  250. Location, activity and behavior of patients
  251. Sleep/awake, verbal/social, visitors, group, location
  252. Self harm, harm to others, via verbal or behavior cues, and environmental checks. Computer documentation
  253. Neck visible, activity such as in dayroom, sleeping in room, with visitors
  254. The status of the patient is documented. Whether they are in a particular area, awake, or asleep.
  255. Time, location, patient behavior, intervention. They are documented on a single form for continuity.
  256. What is found, consumers whereabouts and activities
  257. Location/activity
  258. Shower rounds, cafeteria rounds, where patients are located, documented via codes on the census rounds sheets.
  259. Where the pt is and their current behavioral state.
  260. Depends on purpose of check: pt location, activity, behavior, statements made, etc
  261. Checklist is used time, behavior, activity, use of seclusion/restraints, neoro/motor/vascular using a check sheet
  262. Each guest has a flow sheet that becomes a part of the chart. On this sheet, besides documenting the location, hours of sleep are also noted
  263. Patient whereabouts checked off on a sheet listing all patient names & room numbers. Alarmed doors checked 3 times per day & marked off on check off list.
  264. Patient location and activity are documented. An environmental safety check is also documented every 8 hours that identifies potential risks.
  265. Any potentially harmful objects found
  266. Where patient is, what is happening, what bx are being exhibited
  267. Any positive safety risks are documented on the change of shift report and in the patient's progress notes
  268. Location, behavior and who is doing the check
  269. Check box indicating behavior and location.
  270. Location and activity
  271. Questions asked danger to self or others? Voices? Voices directing harm? Agree to let us know if unsafe?
  272. Patient health, complete environmental safety, high risk area checks
  273. Documented on paper every 15 minutes use numbers to indicate where the patient is located and whether he/she is awake or sleeping
  274. Documented where and what the patient is doing. Use a paper document. Will soon have the option of using the computer but will continue on paper because the computer option is too cumbersome.
  275. Patient location/activity time, date, and staff initial. Documentation is on a flow sheet
  276. Patient location and what they are doing at that time
  277. Location & activity through a check list
  278. Contraband found in rooms during room checks
  279. Where the patient is --all documented on flow sheet
  280. Issues such as increased agitation, responding to internal stimuli, etc are documented in the nurse’s notes
  281. Location and, for the evening, asleep/awake is documented on paper with patient photo/ID label
  282. Our rounds sheet has a paragraph defining all areas that are looked at during environmental safety checks and the staff initial off when they have completed their assigned safety checks
  283. Patient's location documented on rounding form
  284. Pt location and behavior at time of location. They are documented on a flow sheet.
  285. Alertness, ideations, delusions.hallucinations, anxiety, depression, pain, appetite, fluid intake q shift when 1:1 q hr, v/s
  286. Awake, on phone, in shower, etc. a canned text of pt being awake or asleep and where they are
  287. EMR in note and passed on in report
  288. That the pt is safe, not harming self, attempting to hide, etc.
  289. Where the patient is located at the time
  290. They document that the unit is safe, report any environmental concerns or repairs needed. They check all bedrooms, common areas for contraband, hazards, etc.
  291. Patient safe and location
  292. Location of patient, anything atypical
  293. Just the fact that the patient was seen and where. It’s implied that they were safe. We document this in the computerized medical record
  294. If anything unsafe noted on patient, in room, or on unit in front of report book and communicated in report
  295. Location of patient and what they are doing at that time
  296. Patient’s location/activity by abbreviation code and there environment, safe scan by a 1 indicator
  297. Pt's location and behavior, on a checklist.
  298. Pt's location & behavior, on a checklist
  299. Doors locked, absence of sharp objects, furniture in good working order free of disrepair, no broken fixtures...Patient is awake, resting in bed, sleeping, in group or up
  300. Sleeping, awake, location. Check sheet for each patient’s w/specific abbreviations for each
  301. Discovery of contraband items documented via incident report
  302. Location, asleep/awake. Several RNs on the unit are sure to note respiratory status if patients are asleep. Our form has separate sections for depression, anxiety and pain but I have never seen anyone document re those issues on that rounding form.
  303. Code used to document of the location of the patient.
  304. 30 minute checks are only documented at night from 2300-0730. 30 minute checks on days and evenings are done but not charted unless the patient is on 10 minute checks in which case, these checks are always charted.
  305. Location of the patient
  306. Location
  307. On the standard 30 min check, location is the primary documentation. If on 15 min checks, location as well as brief description of behavior is noted.
  308. On paper. Patient's location, patient's behavior, and any unsafe objects present, like extra linen, etc.
  309. Several parameters are noted on a rounding flow sheet that is initialed by staff performing the rounding. They include location, group, room, lounge, sleeping, to name a few.
  310. Time, location, activity of patient, person doing the checks. Documented on a form signed by all staff conducting checks.
  311. Documented in EPIC
  312. If patient feels safe, if patient is suicidal, if patient is agitated, if patient has a problem with another patient or staff
  313. If we are evaluating the dangerousness of a particular individual, we perform a mental status assessment and work to build an alliance with the individual. We try to understand how he thinks--what he thinks. His psychotic logic. We closely observe his behaviors, including quality of eye contact, gesturing, staring etc. The observers must document what efforts they put forth to restore the individual to safety. These patients need cognitive interventions, to assist them in examining their assumptions. They need behavior therapy to create a supportive "Holding" environment where he feels safe and others feel safe. Use peer influences, build from his strengths and know his life goals.