In a Behavioral Health Unit team meeting, a registered nurse Says, "l am concerned if we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated issues calls for one-on-one supervision."

Which ethical principle most clearly applies to this situation?

a. Initiate one to one constant supervision around the clock: A client who has attempted suicide is at high risk for further harm, and close monitoring is necessary to prevent further attempts. Initiation of one-to- one constant supervision around the clock ensures that the client is continuously monitored, and any signs of suicidal ideation or behavior can be immediately addressed.

e. Check the environment for possible hazards: It is important to check the client's environment for potential hazards, such as sharp objects, cords, or other items that could be used to harm oneself. This step helps to ensure the client's safety and prevent further attempts.

The other options are not appropriate or necessary in this situation:

b. Ensure the client's hands are always visible: This action may be necessary if the client has a history of self-harm or aggressive behavior, but it is not specifically related to preventing suicide attempts.

c. Tuck bedcovers over client's hands and arms: This action may be necessary if the client has a history of self-harm, but it is not specifically related to preventing suicide attempts.

d. Inspect the client's personal belongings: While it may be important to inspect the client's personal belongings for any items that could be used for self-harm, this action is not as urgent as initiating constant supervision and checking the environment for hazards.

f. Assign the client to a private room: While a private room may be beneficial for the client's comfort and privacy, it is not specifically related to preventing suicide attempts.

g. Place only plastic utensils on the client's meal tray: This action is not specifically related to preventing suicide attempts, unless there is concern that the client may harm themselves with utensils.

Involuntary hospitalization for mental illness is typically reserved for situations where an individual poses an immediate danger to themselves or others due to a severe mental illness. In option A, the individual is experiencing command hallucinations, which are often a symptom of a severe mental illness such as schizophrenia. The fact that they want to hurt their neighbor is a clear indication that they pose a danger to others and require emergency intervention.

Option B may indicate a mental illness such as schizophrenia or bipolar disorder, but it does not necessarily pose an immediate danger to the individual or others.

Option C may indicate a relapse in addiction, but again, it does not necessarily pose an immediate danger to the individual or others.

Option D may indicate a need for follow-up and intervention, but it does not indicate an immediate danger to the individual or others.