[Handling of potentially critical items in acute psychiatry (a study of the Federal Directors Conference)]

In Germany, an average of 25 people per day died by suicide in 2018. This rate has been declining steadily since the 1980s and has so far halved; however, there is no absolute prevention of suicide; even under optimal protected conditions through therapy and care, approximately 5% of successful suicides occur in psychiatric institutions. Despite the high level of awareness of the risk of potentially dangerous objects, there is a lack of uniform written instructions for action.

The aim of the study was to evaluate the handling of potentially critical objects in acute care units during the treatment of suicidal patients, with special emphasis on the handling of disposable razors.

A 10-item questionnaire on the handling of potentially critical items in closed/facultatively open intensive care/acute care units was developed and sent to 100 psychiatric hospitals throughout Germany.

The nationwide survey provided feedback from 39 psychiatric hospitals throughout Germany. The results confirmed a broad critical awareness of potentially dangerous objects; however, the handling of these objects proved to be heterogeneous. Psychiatric clinics and departments have been practicing the control and securing of these objects for decades but there is a lack of written recommendations for handling them. In everyday life, the handling of these objects is taught within the ward, through the ward rules and/or orally. This illustrates a lack of uniform nationwide regulations or guidelines in Germany and thus the lack of corresponding written instructions for handling.