Hold Me Close
Tiny Dancer
Tiny Dancer
ongoing patient assessment and monitoring for restraints' are documented here
Restraint Episode/Evaluation
Document all applicable fields with in the dynamic order set
Description of patient’s condition or symptoms/behavior warranting the use of restraint or seclusion
What must be documented and updated in the patient's medical record.
Violent-Self destructive: Patient exhibiting aggressive or violent behavior in a manner and to the degree that, in the judgment of qualified staff, there is a significant potential for injury to the patient or staff.
What must be renewed every four hours MUST BE RENEWED EVERY 4: Physicians Order
Every 15 minutes
Document restraint or suicide observation
Restraint Removed
What is discontinuation of restraint required documentation
Any manual method, physical or mechanical device or equipment that immobilizes or reduces the ability of a patient to move their arm, legs body, or head.
What is a Restraint
A death that occurs while a patient is in restraint or seclusion; A death that occurs within 24 hours after the patient has been removed from restraint or seclusion.
What Must be reported to CMS
Holding to give medications or treatments
What is a restraint
implement every 15 minutes violent, every 2 hours non-violent)
What is documentation time frames according to type.
Required evaluation and documentation, intervention , medical and behavioral conditions , every hour.
What is the required assessment and evaluation documentation for a violent patent.
harmful to self or others; threatens placement and/or patency of necessary therapeutic lines/tubes, interfering with necessary medical treatment; and ● unable to follow directions to avoid injury
What is a clinical situation where a restraint or seclusion are indicated.
At least every 2 hours
What is non violent documentation requirements vital signs, circulation, hydration needs, elimination needs, level of distress and agitation, mental status, cognitive functioning, skin integrity, etc. and provide for nutritional needs, range of motion exercises, and elimination needs; and mental status and neurological evaluations. Assess if the use of restraint or seclusion can be discontinued at the earliest possible time.
Used to keep the patient from falling out of bed.
What is not a restraint.
REASON FOR RESTRAINT
What are lesser restrictive intervention that have failed.
Chemical , Physical and Environmental
What Are Three Types of Restraints
Moving patient closer to nursing station ● Encourage family support individuals to stay with patient ● Increase observation of patient/increase frequency of nursing rounds ● Reduce the stimulation and noise ● Change the appearance of equipment/re-evaluate need for equipment ● Offer diversion/physical activities, appropriate to development and preferences
What are attempts to provide the least restrictive environments.
Side rails raised on a stretcher, recovering from anesthesia, sedated, experiencing involuntary movement (seizures precautions), or on certain types of therapeutic beds (airflow, padded bed rails) to prevent the patient from falling out of the bed.
What is not considered a restraint.
IPOC Restraint’ in Search Bar
How do you find the POC in cerner
Within a Hour
What is Doctor face to face requirement and documentation
Family Notified
What is partnering with family for an improved outcome.
Face to Face observation within 1-hour of the initiation of the restraint order and renew orders in accordance with the following time limits for up to a total of 24 hours.
What must an RN do to manage restraint application.
4 Bedrails Up
What is an incorrect restraint
Review Restraint Use-Nonviolent/Non-Self-Destructive Behavior.
How do you select the outcomes and intervention to tailor IPOC to be patient specific
Documenting explanation to patient to avoid restraints
What is restraint debriefing
Notify within 12 hours
What is Physician notified of application of non-violent restraints