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Reducing Ligature Risks in Healthcare Facilities

February 19, 2019
Brian Garbecki
As the need for behavioral healthcare facilities is on the rise, it’s important to note the special provisions required in these types of buildings. Patient safety is of particular importance, as oftentimes patients in behavioral healthcare facilities are in an emotionally or psychologically sensitive state. Their mental health can be unstable and/or prone to depression with tendencies to hurt themselves or others. At best, behavioral healthcare facilities should mitigate opportunities for self-harm by offering a calming, therapeutic environment. Both The Joint Commission and the Department of Veterans Affairs have developed recommendations and requirements to minimize mental health issues and promote patient wellness in behavioral healthcare environments.

Gilbane understands these requirements and we are currently installing anti-ligature devices on a behavioral health inpatient facility at  the Maricopa Integrated Health System Maryvale Alternative Project in Phoenix, Arizona, which is set to open next month.

Effective design considerations include numerous safeguards for patients, staff and visitors that help reduce risks and injury. Potential hanging or choking points, also known as ligatures, should be identified and mitigated. Any observable risk, no matter how small, should be immediately corrected. Examples may include:

  • Using a low-mounted push-button instead of a pull-cord for the nurse alarm
  • Replacing drop ceilings with solid ceilings in patient rooms and bathrooms
  • Using breathable paper trash can liners instead of plastic ones
  • Eliminating glass by using shatter-resistant mirrors and adding security glazing over existing interior windows
  • Removing closet doors and rods and replacing them with shelves
  • Setting the television behind a polycarbonate cover that is built into the millwork
  • On the headwall, locking medical gas outlets, CPAP machines and other medical equipment inside locked cabinets featuring polycarbonate panels to allow viewing of gauges
  • Using vanity-like pipe enclosures with tamper-resistant fasteners and recessed flush valves with no exposed piping
  • Using a countertop-mounted sink with a ligature-resistant faucet in patient bathrooms

Careful consideration should be taken when designing or renovating patient rooms in a behavioral healthcare facility. When ligature risks are mitigated, patient safety increases. Reducing environmental risks and opportunities for self-harm is vital for reducing incidents in healthcare settings.




About Authors
Brian Garbecki is Gilbane’s Healthcare Center of Excellence leader. In this role, Brian works in partnership with our healthcare clients and project teams to advise in the programming, design, construction and occupancy of healthcare projects. Brian offers unique expertise gained from more than 25 years of experience in the healthcare sector as an engineer, builder and facilities professional.
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