What is the definition of least restrictive practices?
Practices that maximise the autonomy, rights, freedom, wellbeing and safe care of the person as much as possible while balancing healthcare needs and safety for all.
What care level is required when seclusion is commenced?
Care level 1
What are the three types of defined restraints as per the policy?
1. Manual
2. Chemical
3. Mechanical
When should staff be contacting family/carers/ guardian of a seclusion episode?
As soon as practically possible
True or false? We can take a consumer prone during a restraint onto a bed
False
What is the definition of seclusion?
The confinement of a person, at any time of the day or night, alone in a room or area from which free exit is prevented.
True or false? The care level should be documented on a care level 1 sheet?
False - it should be recorded within the seclusion and restraint book
When should staff be contacting a senior manager or on call executive when a consumer has been secluded?
As soon as practically possible. As per policy no more than ONE HOUR after it was initiated
How often should seclusion huddles be completed?
On commencement and every 2 hours until seclusion is ceased
Which direction should the consumer be facing in the seclusion room prior to exiting?
What is the definition of physical restraint?
The application by staff of 'hands-on' immobilisation or the physical restriction of a person to prevent them from harming themselves or endangering others or to ensure that essential medical treatment can be provided
What details are required from security/HASA's or police?
Their security/ police license numbers
What are the review periods required by a MO?
1hr, 4hrs, 8hrs, 12hrs, 16hrs, 20hrs, 24hrs
After hour many hours do we need to commence a fluid balance chart?
2 hours
What do you do if you notice colleague using high risk restraint techniques i.e. wrist lock, knees on the back
1. When you notice pull the staff up on it to ensure patient safety
2. If this continues raise it to your manager
What is the definition of reasonable force?
The amount of force considered to be appropriate to the level of danger posed
True or false? You have to put three indications for restraint/seclusion?
Depends .... All that is required is accurate and appropriate information
If seclusion has been ceased prior to the 1 hour MO review is a review by an MO required? If so within what time frame?
As per policy If seclusion or restraint has been ceased prior to review, the person is to be examined by a medical officer as soon as possible after the event.
How often should vital signs be completed whilst in seclusion?
When safe to do so. RR should be documented within the care level as continuous visual observation is required to ensure safety. If vital signs cannot be taken, staff must ensure the reasons are documented
List all the relevant roles in a restraint
- Head
- Arms
- Legs (feet and shins)
- Timer
- Crowd control
- Doors
- Medication administration
- Doctor
What is the definition of positional asphyxia?
Defined as obstruction of breathing as a result of restraint technique. It occurs when the position of a person’s body interferes with their ability to breath. If this is not recognised, death can occur from asphyxia or suffocation. Any body position that interferes with breathing can cause death
If a Kiloh General patient is secluded in the Kiloh Obs seclusion room, which restraint register do you document it in?
Kiloh General book
If a consumer has been in seclusion for over 24 hours which member of the MDT/Staff cannot be apart of the discussion to continue seclusion?
The senior/ authorising nurse who commenced seclusion and external doctor is required. Refer to the extended seclusion events policy
Who should you contact prior to commencing seclusion?
Depends....
True or false? At 3 minutes you are required to cease a prone restraint due to the risks
False