A suicidal client agreed on day 2 of hospitalization to write and sign a "no self-harm contract." As a result of this contract, the health care team should plan to:
1. Discontinue suicide precautions
2. Reduce one-to-one observation to observing the client every 15 minutes
3. Reduce observation to observing the client every hour
4. Base the level of observation on staff assessment
ANS: 4
Research suggests that no-harm contracts may not prevent self-harm; therefore any reduction in suicide precautions is incorrect. Staff assessment needs to continue; therefore option 4 is correct.
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