A nurse arrives to administer 8 AM medications and cannot locate a client who was ambulatory and cognitively intact. After a quick room search, the nurse finds the bed empty and the client not in the bathroom. What is the first action?

Patient elopement/missing patient:

Definition: Elopement = patient leaves a healthcare facility without medical authorisation.

Risk assessment: Patients at risk: confused/demented; psychiatric patients; patients who have expressed desire to leave; impulsive or cognitively impaired patients.

Immediate response sequence: Brief immediate search of room, bathroom, hallways; call to charge nurse/supervisor to activate protocol (this takes <2 minutes while you're searching); facility-wide search initiated; security notified; depending on patient risk: police notified; family notified.

Documentation: Time last seen; circumstances; actions taken.

Prevention: Elopement risk assessment on admission; wander guards (door alarms for dementia patients); check-in procedures; monitoring high-risk patients.

Regulatory: Elopement injuries and deaths are sentinel events requiring immediate investigation and root cause analysis.

Never: Wait and hope the patient returns — every minute increases risk of harm to a confused or medically fragile patient who has left the facility.