DELIA F. BELMAN MEMORIAL PSYCHIATRIC HOSPITAL INCIDENT REPORT

Patient Name: Sophie Forrester

Date of Birth: 9/12/2006

Date and time of incident: 1/27/23 1:49 p.m.

Type of Incident: Self-injury

RESTRAINTS USED?

image None

image Mechanical

image Chemical

image Physical

image Seclusion

INCIDENT REPORT: Pt cut herself repeatedly on wrists and arms with a spoon. Utensil was taken from cafeteria service and sharpened against a table leg. Event occurred in the lounge, in view of other residents. Pt was restrained and isolated while staff administered first aid. Transfer to Acute Ward recommended if bed available.

RECOMMENDED:

image Internal investigation

image Policy and procedure review

image Staff training

image Disciplinary action to staff