CHHS16/219

Canberra Hospital and Health ServicesOperational ProcedureDhulwa Mental Health Unit (DMHU): Use of RazorsContents

Purpose.....................................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Assessment and management of risk associated with razor blades.......................2

Section 2 – Storage and Counts................................................................................................3

Section 3 – Disposable Razor Provision.....................................................................................3

Section 4 – Personal Electric Razors..........................................................................................3

Section 5 – Razor Supervision...................................................................................................4

Implementation........................................................................................................................ 4

Related Policies, Procedures, Guidelines, Frameworks, Standards and Legislation..................4

References................................................................................................................................ 5

Search Terms............................................................................................................................ 5

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Purpose

The purpose of this procedure is to provide instruction for the control and safe use of razors by consumers (disposable razors with blades and electric) in the Dhulwa Mental Health Unit (DMHU).

Scope

This procedure is applicable to all staff and consumers within DMHU.

Section 1 – Assessment and management of risk associated with razor blades

The allocation of a razor to a consumer is subject to consideration of the consumer’s current mental state, and risk of harm to self and others. The following outline the steps involved in assessing and managing the risk for individual consumers to have access to razor blades:1. Mental State Examination: the consumers’ mental state and current risk factors,

measured by current and recent Dynamic Appraisal and Situational Aggression (DASA) scores to measure risk of violence, must be assessed prior to allocation of a razor. This will determine whether the consumer can have access at that time and whether the use of the razor will be supervised or unsupervised.

2. Discussion between nursing staff and the Nurse in Charge (NIC) about any concerns they may have regarding the consumer’s or others safety when allocating razors.

3. Communication about risks associated with razor blade allocation at clinical handover.4. Where the risk of a consumer being allocated a disposable razor is too high, the

consumer may be offered the choice of either purchasing an electric razor (to be stored in their personal locker) or using hair removal cream.

5. Any risks identified should be documented in the consumers’ Treatment and Management Plan (TPRIM) (see DMHU Referral, Admission and Transfer of Care Procedure) and Electronic Clinical Record (ECR).

6. In exceptional circumstances such as clinical deterioration or acute behavioural disturbance, the use of electric and/or disposable razors may be suspended until the consumer’s mental state improves so that it is safe for them to have access to these items.

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Section 2 – Storage and Counts

As a restricted item, razors must be stored in a suitable designated lockable storage facility on Cassia and Lomandra Units (see DMHU Prohibited and Restricted Items and Items Requiring Approval Procedure).Both electric razors and disposable razors may be reused. They will be labelled and individually stored securely the non consumer area (see section 3 for integrity checks).

Checks of the log book, stored in the nurses’ station of each unit, will be conducted daily by staff on the through shift or morning shift to ensure those items signed out have been returned intact.

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Section 3 – Disposable Razor Provision

When the nurse is giving out the razor, the nurse must check the integrity of the blade before providing the razor and ensure the consumer is informed of any restrictions surrounding the use and return of the razor.

Upon return the nurse must check the integrity of the whole razor including the blades and ensure the razor is intact, documenting same in the log book.

All razors for disposal must be disposed of in a yellow sharps container by the nurse.

If a consumer fails to return the razor to the primary nurse, the razor is tampered with or the razor is missing, the NIC must be informed immediately. The NIC will determine if a search is required (see DMHU Search Procedure).

Consumers may purchase their own razors (either personal or electric) and store these in the consumer’s personal locker. This is determined by the assessment of the consumer, referred to in Section 1 (see DMHU Valuables, Property and Access to Mail Procedure).

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Section 4 – Personal Electric Razors

Electric razors require the same assessment of the consumers’ mental state and current risk factors, as measured by DASA, prior to allocation. This will determine whether the consumer can have access at that time and whether the use of the electric razor will be supervised or unsupervised.

If a consumer wishes to use a personal electric razor this may be purchased with their own available funds and must meet electrical safety guidelines, including testing and tagging.

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CHHS16/219

After use, the electric razor must be returned to the primary nurse for storage, clearly labelled with the consumer’s name.

Personal electric razors are NOT to be shared with any other consumer to prevent the risk of cross infection.

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Section 5 – Razor Supervision

For any consumer requiring supervised razor use, a staff member must observe the consumer shaving at all times. Another staff member should be within eyesight of the staff member observing the consumer.

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Implementation

The contents of this procedure will be communicated through both orientation and refresher training and provided to DMHU staff.

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Related Policies, Procedures, Guidelines, Frameworks, Standards and Legislation

PoliciesACT Health Work Health and Safety Policy ACT Health Work Health and Safety Management System ACT Health Waste Management Policy ACT Health Electrical Safety Policy DMHU Search Policing

ProceduresCHHS Healthcare Associated Infections Procedure CHHS Mobile Electrical Equipment including Clinical Equipment DMHU – Search ProcedureDMHU – Prohibited and Restricted Items and Items Requiring Approval ProcedureDMHU – Referral, Admission and Transfer of Care ProcedureDMHU – Valuables, Property and Access to Mail Procedure

FrameworksACT Health Waste Management Plan

Standards National Safety and Quality Health Service (NSQHS) Standards

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LegislationMental Health Act 2015Mental Health (Secure Facilities) Act 2016Work Health and Safety Act 2011Health Records (Privacy and Access) Act 1997Electrical Safety Act 1971

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References

1. NSW Government, Health, Justice Health & Forensic Mental Health Network, Forensic Hospital – Razor Blades Patient Access Procedure

2. NHS Foundation Trust, South Essex Partnership University – Protocol for patient’s use of razors within secure services

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Search Terms

Dhulwa Mental Health Unit, DMHU, Razors, razor, Electric Razor, Razor blade, blade

Disclaimer: This document has been developed by ACT Health, MHJHADS, JHS, DMHU specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

Date Amended Section Amended Approved By

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register