Chemical/Physical Help!
What is a chemical restraint?
IM medications administered
True or False.
You can perform a trial release to see if restraints should be discontinued?
False
What should you make sure security does before they leave the unit?
Sign packet... Make sure they sign in either hands-on or observation only columns
Name 3 less restrictive measures that should be tried before initiating restraints
po prn medications, verbal de-escalation, behavioral redirections, limit setting, reality orientation, therapeutic listening, time out
When can an RN enter a restraint order?
If it is an emergency, or if NP is not available to place orders within the time frame.
True or False:
The debriefing is located in IVIEW.
False.
Debriefing is located in Chemical Restraint packets
When does the order expire for TAT's?
4 hours
If I need help with packet documentation, where can I find examples?
Je'Nav's Restraint Project Binder
Which forms do not need to be copied in the packet when filing?
Staff debriefing form
Auditing tool
How much time does the provider have to enter a restraint order, until it's considered late?
30 mins
True or False.
Chemical Restraints is the least restrictive form of restraints.
TRUE
How often do we document on nutrition and hydration which pt is in seclusion/TAT's?
q 2 hours
Patient required IMs with physical hold after displaying aggressive and violent behavior. What packet should be used?
Physical Hold
When should we initiate restraints?
When all other measures have been exhausted. Pt is attempting to hurt himself or others, threatening behaviors
How long does a provider have to perform face to face?
1 hour
True or False:
You need to document in IVIEW if you give an IM medication
TRUE
Bonus: Where do you document in IVIEW?
What should you NOT document in IVIEW if patient is still in seclusion?
Patient is CALM
Patient is med paneled, which packet should be used?
None
What requirements do we need to release pt from restraints?
Pt able to follow staff direction to safety precautions, cessation of violent/destructive behavior, no danger to self or others
In what situation would you need orders for a physical hold ?
When pt needs to be held (i.e. for medication administration/combative)
What behaviors would staff need to use a physical hold on a patient?
Pt attempting to hit you, another pt, or another staff. Pt refuses to be still when giving IM medication. When pt is a danger to himself or others and you need to move pt to safe location
Pt in seclusion is agitated, threatening, and cursing, but the seclusion order is about to expire. When and what should you do?
Notify Provider about pt behavior to get order renewed at least 30mins prior to avoid order expiring.
Patient in seclusion, starts to bang her head, and got placed in TATS. What packet should be used?
Seclusion/Restraints Packet
Why would we change a pt from seclusion to TAT's?
Do we need two packets?
If pt is self-injurious while in seclusion, such as pulling out hair, attempting to cut self, bang head on wall or door.
No, as long as it is under same event.
Name 3 actions we need to perform and add to progress note, once the event is complete.
Modify IPOC, Notify Family, Face to face time and Provider, Medications that were given and time, Physical hold yes or no, pt behaviors, alternatives done before restraint