Restraints
It is to be used as the last resort
What is a restraint?
This observation is conducted at arms length distance at all times
What is a 1:1?
This is the patient’s ability to understand and appreciate the nature and consequences of the proposed health care, including the risk, benefits and alternatives to proposed healthcare, as well as the ability to reach an informed decision.
What is Decisional Capacity?
The order time limit of this restraint expires in 2 hours
What is a 4 point restraint?
One reason why a 1:1 observation is ordered.
What are falls (1), suicide (2), self-harm (3), violence (4), sexually aggressive behavior (5), elopement (6)?
This is defined as when a patient chooses to leave a hospital before the healthcare team recommends discharge from the hospital and has decisional capacity.
What is discharge against medical advice (AMA)?
The order time limit of this restraint expires in 10 minutes
What is a manual hold?
Staff are not allowed to do the following when conducting a 1:1 observation. [give one example]
What are:
Eating
Sleeping,
Leaving the patient by themselves [abandonment]
This is defined as a patient without capacity that leaves the hospital/hospital grounds unsupervised, unnoticed, and/or prior to their scheduled discharge.
What is Elopement?
Confining an individual in a room where he or she cannot leave at their own will and is never to be performed at Metropolitan
What is seclusion?
During the 1:1 constant observation, can the staff allow patient to close the door in the bathroom?
What is Door must be open at all times and patient must be within visual field
This needs to be completed if a patient elopes from hospital grounds.
What is VOICE - incident report?
This must be documented every 15 minutes (violent/self destructive) / every 30 minutes (non-violent/non self-destructive) during a restraint. [name one example]
What are:
-patient behaviors
-vital signs
-food/fluid intake
-bowel/bladder movements
-skin integrity
These items are used to record 1:1 observations
The team determines a patient can leave AMA - against medical advice, however the patient leaves the hospital before the AMA papers are signed.
What is missing with AMA?