At approximately 1330, client became dysregulated while on the unit and began punching herself in the face with her first. She was escorted off unit onto the milieu where staff attempted to verbally de-escalate the situation and physically block her attempts at harming herself but were unable to. A physical hold was initiated by staff to maintain residents’ safety. Because of the severity of emotional dysregulation, a one-time emergency medication was administered to help resident regain control of emotions. Resident was transitioned out of physical hold when she was calm and able to verbalize that she will maintain safe behaviors. Once out of the restraint, she stopped actively communicating with staff and began punching herself in the face again. A brief physical hold was initiated until resident was able to regulate emotions. She expressed she was not interested in processing events but verbalized that she will be able to maintain safe behaviors post release. Once transitioned out of hold, resident went to nurses’ station where a minimal amount of dry blood was cleaned around nose. No visible injuries sustained from event. No further incidents occurred. Because of these events, will remain on current self-harm safety plan with constant line of sight. She will be seen by therapist to determine duration/individualization of precaution. Licensing Specialist reviewed camera footage for a provider reported incident on 4/1/2023.Licensing Specialist observed resident talking on the phone before going onto the Orange Unit. She entered her unit in the day area and sat in a chair. Licensing Specialist was unable to observe resident picking or hitting her nose due to the lighting of the room on camera footage. Staff members (2:1) were observed escorting the resident off the unit. Once off the unit, resident was escorted to the milieu area. Licensing Specialist observed resident being placed in a restraint due to the aggression being displayed. The nurse was observed on the phone. Resident was observed attempting to harm herself more. Licensing Specialist observed resident receiving a medication via syringe. Resident was able calm down and restraint ended .Ms. Sara Kroon (Director of Nursing) informed Licensing Specialist the dried blood that was cleaned from around the resident’s nose came from her picking and hitting her nose area. Resident is no longer on safety precautions. Licensing Specialist: Kendra Rice.
