Tie One On (Safely!)
By the Book
The Write Stuff
First, Do No Harm
Before You Tie
100
According to the Joint Commission, this is anything that restricts freedom of movement or access to one's body.

What is Mechanical Restraint

100

True or False, Essentia policy allows patients on suicide precautions to walk in the hall.

What is True. Pt's on suicide precautions can go for walks in the hallway with their SCO unless it is documented in their chart by a provider why they can't.
100

If it isn't this, it didn't happen.

What is charted/documented

100

When a patient is restrained, safety checks must be done at least this often.

What is every 15 minutes (for violent/self-destructive)?

100

This communication style is often most effective in calming an agitated patient.

What is calm, clear, and respectful tone?

200

A type of restraint that uses medications not required for medical treatment.

What is a chemical restraint

200

Within this amount of time, a provider must conduct a face-to-face evaluation for violent restraints.

What is one hour
200

This type of staff can document the 15 min checks of a violent restraint.

What is RNs, BHTs, and trained CNAs

200

Circulation checks should include these 3 things.

What are color, warmth, and pulse?

200

Offering a quiet, low-stimulation environment is an example of this type of intervention.

What is an environmental modification?

300

True or False: You need a provider order before initiating any type of restraint.

What is False. Restraints can be initiated by a nurse in the moment, however, the provider must place the order and complete a face to face with the pt.

300

Restraint orders cannot be written this way.

What is PRN

300

How often are nurses required to document on non-violent restraints?

What is every 2 hours

300

Name one major complication of improperly applied restraints.

What is impaired circulation, skin breakdown, asphyxiation, or psychological trauma?

300

Name one therapeutic activity that may prevent escalation.

What is listening, distraction, relaxation techniques, or offering comfort items?

400

Name two less restrictive measures that can be tried before resorting to restraints.

Verbal de-escalation, distraction/redirection, PRN medication, trying a different staff member, giving space and reapproaching, decreasing stimuli

400

True or False, It does not matter what state a patient is from when initiating a hold. 

What is false. Wisconsin residents can only be place on 72-hour holds. MN residents can be either peace/health officer holds or 72-hour holds.
400
Name three things that should be included in the progress note of a restraint event.

What is time restraints were initiated, what was tried prior to restraints, injuries to staff or patient, time order was obtained, time MD face to face completed, time of discontinuation, time of guardian notification

400

This ethical principle is most challenged when restraints are used.

What is autonomy?

400

True or False: Offering a PRN medication before applying restraints is considered an alternative intervention.

What is true?

500

How long is an adult violent/self-destructive restraint order good for. 

What is 4 hours.

500

This governing body accredits hospitals and has specific restraint standards.

What is The Joint Commission

500

After restraints are removed, the nurse must always document this type of evaluation.

What is the patient's physical and psychological response.

500

The nurse must offer these needs regularly while a patient is restrained (name 3).

What are fluids, toileting, nutrition, repositioning, and range of motion?

500

Using verbal de-escalation respects this core psychiatric nursing principle.

What is least restrictive alternative?

M
e
n
u