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- Self-inflicted Injury 2
- Client became overstimulated due to increased sound on the unit and began to hit her forehead against the wall, causing a disruption to an existing wound. RN provided client with noise canceling headphones and took her off the unit to clean her forehead. Client later repeated the same behavior and was deescalated by staff. Client placed on self-harm precautions x 7 days.
- Licensing follow-up: Facility has developed and individualized behavior plan for this client that includes recognizing signs and symptoms of escalation and responding with specific interventions. Only staff who have signed off on her behavior plan are to work 1:1 with her during escalation.