Cover Sheet

Site Information:

Ward / Department:

Risk Code Factors for Type of Ward/Client/Patient Group:
Emergency Department
Wards
General Outpatients
Short Stay/ Day Surgery
Intensive Care

Conducted on:

Personnel / Department Involved:

Ligature 1

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 2

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

2Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 3

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 4

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 5

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 6

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 7

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2


Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 8

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 9

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 10

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 11

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 12

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 13

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 14

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 15

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 16

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 17

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 18

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 19

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 20

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 21

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 22

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 23

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 24

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 25

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 26

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 27

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 28

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 29

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 30

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 31

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 32

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 33

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 34

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 35

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 36

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 37

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 38

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 39

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 40

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 41

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 42

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 43

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 44

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 45

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 46

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 47

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 48

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 49

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 50

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 51

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 52

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 53

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 54

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 55

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 56

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 57

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 58

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 59

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 60

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 61

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 62

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 63

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 64

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 65

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 66

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 67

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 68

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 69

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 70

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 71

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 72

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 73

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 74

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 75

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 76

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 77

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 78

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 79

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 80

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 81

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 82

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 83

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 84

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 85

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 86

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 87

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 88

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 89

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 90

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 91

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 92

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 93

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 94

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 95

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 96

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 97

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 98

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 99

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Ligature 100

Room No / Identifier / Name:

Room / MICAD Reference:

Select Room / Area Type:
5 = Bathroom / Toilet/ Shower
4 = Bedroom/ Side room/ Private room/ Clinic Room
3 = Quite room/ family room/ Shared ward.
2 = Day / Dining Room / Lounge (communal area)
1 = Corridor / Waiting area

Ligature Anchor Point Description:

Select Ligature Height Code:
5 = 800mm - 2.2m
4 = 500mm - 800mm
3 = 2.2 = 3.5
2 = 300mm - 500mm = 2
1 = < less 300mm or more > 3.5m

Ward Type Values (+ / - )
Emergency Department +5
Wards +4
General Outpatients +3
Short Stay/ Day Surgery + 2
Intensive Care - Divide by 2

Enter Risk Grading:
(Room / Area Type x Height Code, + / - = Ward Type Value)
20 - 30 = HIGH
11 - 19 = MEDIUM
1 - 10 = LOW

Ligature Anchor Point Photo:

Any Mitigating Factors?

Can the Ligature Anchor Point be removed, replaced or modified YES/NO?

If No, can it be managed clinically? If so, how?

Local Action Plan

LOCAL LIGATURE ACTION PLAN

Please use the space provided to record any local actions. If you are recording individual actions; please precede each entry with the Ligature number shown in this report along with the location and description.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.