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
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.
What prompts a chemical restraint?
When patient is a danger to self and others and all least restrictive measures have failed.
When does the order expire for TAT's?
4 hours
Can you obtain a verbal order for restraints?
True or False
False, Only TELEPHONE ORDERS to be entered by RN in case of an emergency.
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 when patient is in TATs?
q 2 hours
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 TATs?
Patient is CALM, RESTING, LAYING DOWN, ASLEEP
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 TATs is agitated, threatening, and cursing, but TATs 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.
Why would we change a pt from seclusion to TAT's?
If pt is self-injurious while in seclusion, such as pulling out hair, attempting to cut self, bang head on wall or door.
What needs to be added to the flag note, once the event is complete.
Medications that were given and time, Physical hold yes or no, pt behaviors, alternatives done before restraint