Angel McGarrity-Davis, RN, CDONA, NHA

My director of nursing asked me to start an elopement program. Since I’m new to long-term care, can you tell me what I should do, and where I should start?

To begin an elopement program, an evaluation/assessment for elopement should be conducted for all your residents. Review contributing and/or risk factors that would cause a resident to be high risk.

They would include: Wandering, cognitive impairment, resident states desire to leave, and/or independently mobile. 

Review current policies and procedures to ensure you are following what they say.  

Also, always err on side of caution when it comes to this evaluation/assessment. When I oversaw more than 60 nursing facilities, I also got the risk management calls. The first thing the person would say was, “This is the first time this resident has done this.”

Exit doors should be equipped with alarms that can be heard throughout the facility. Also, elopement drills should be performed regularly to ensure all staff know the proper protocol and action to take. 

All documentation post-incident should be reviewed. Was the assessment accurately reflected in the medical record? Were interventions in place? When a resident refuses an intervention, determine whether the care plan reflects efforts to seek alternatives to address the needs identified. 

Once interventions are done, education should be provided to residents/representatives to have knowledge of prevention and treatment, including guidelines to implement appropriate measures related to condition. 

Nursing assistants should know what, when, and to whom to report changes in condition. They should be aware of interventions needed to meet each resident’s needs.