Patient bathrooms present significant challenges in regard to design and patient safety. The Joint Commission and other authorities have identified patient bathrooms as being one of the highest risk locations for inpatient suicides in behavioral health facilities.
These challenges arise because patients are alone in these rooms for long periods of time and the design of many typical toilet accessories and plumbing fixtures may present potential hazards to patients. In other instances, however, typical residential finishes and products may be safe for use in behavioral health settings.
Bathroom finishes may be similar to those of residential bathrooms and utilize various tiles for floor, base and walls. Usually, larger pieces are preferred to reduce the number of joints. Care must be exercised to assure that the tiles remain in good condition and rounded outside corners should always be provided.
One piece countertop mounted lavatories are preferable to typical hospital wall hung lavatories for several reasons. They are more prevalent in residences and they provide some space to set toiletry items. This offers a significant level of convenience and reduces the need for other ligature-resistant shelves that are not considered "normal" in appearance.
It is best if the countertops for this use are made of solid surface material and the lavatory is bonded to the top to reduce the number of joints and open cracks that may occur. This is desirable not only as an infection control measure, but as an antitampering measure as well. The faucet and valves must not be standard units and will be discussed later in another section.
Countertops with integral lavatories also provide the opportunity to cover of all pipes below the lavatory with a modified vanity cabinet. The vanity cabinet can be normal in appearance, but openings must be securely locked or secured with tamper-resistant screws to prevent entry, concealment, or access to pipes. For wheelchair accessible rooms, a lavatory sink should be mounted on a similar wood enclosure that conforms to an ADA-required profile.
Finding a compromise
Combining safety considerations and residential appearance can be accomplished in some cases to achieve a balance between these two often competing goals. Because so much control is taken away from inpatient psychiatric patients, it is preferable to give them as much control of the water temperature and duration of flow...
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