Thumbs tacks, bulletin boards, and risk

I was corresponding with a plant operations manager recently about using thumb tacks on bulletin boards in patient care corridors.

Because there are no standards-based requirements for bulletin boards, you can pretty much do whatever you feel is a safe practice--which, of course, invokes the mighty risk assessment.

There are one or two concerns you might want to consider along the way:

• The likelihood that a person could use thumb tacks as weapons
• The possibility that someone could ingest the thumb tacks

Don't just think of this in terms of suicidal patients--you might want to extend consideration beyond that patient population and include visitors. And how about pediatric patients? They might be an "at risk" population for mischief.

The other possible issue relates more to the amount of postings on the bulletin boards. Some surveyors have been known to pick on generously configured bulletin boards for increasing the combustible load. In fact, I've witnessed George Mills of The Joint Commission (formerly JCAHO) push the issue a little bit during a survey.

You may end up deciding that the best way to manage the whole thing is to have enclosed bulletin boards with some sort of security hardware. That way the tacks are out of harm's way and the combustible load aspect becomes a non-issue.