Specialling



Advice to Staff

Special observation/care to the patient with suicide/self-harm risk concern at CUH.

Information for staff member providing special observation/care:

  • The staff member allocated to special observation/care will not partake in any activity that will distract his/her ability to supervise and observe the patient effectively
  • The patient must be in full view of the staff member at all times, including when visitors are present, when the patient is using bathroom / toilet facilities and when asleep. Even though the patient is being observed within eyesight, the privacy and dignity of the patient must be maintained
  • The following prevention measures in the immediate environment should happen as a matter of routine:
    • Ensure the person does not have any medications or any potential weapons (ie scissors, knives etc) on their person
    • Ensure plastic rather than metal cutlery is used for meals and plastic rather than glass/metal drinking containers, bottles, cups
    • Do not allow access to cigarette lighter or matches
    • Remove plastic bags from the immediate environment
    • Remove or be aware of laces on shoes or belts on dressing gowns or pyjama pants
    • Be aware of potential unavoidable hazards such as IV lines and plugs which could be used as ligatures
    • Be vigilant when patients have visitors and they might need to be checked after every visit in case visitors bring in any of the above items
  • Avoid complacency which can happen if the patient is being specialled longer than 24 hours by the same individuals
  • Give a sufficient handover during changeover with other staff providing special observation/care - particularly in regards to any behavioural disturbance


Content by Prof Cassidy E, Dr Kinahan J, Dr Fouhy J, Dr Hickey A, Dr Quinlan S. CUH Liaison Psychiatry Self-Harm service 2018. Last review Dr ÍOS 3/06/22.