Consent
Nurse Joy asks an injured Charmander if it is okay for her to administer some medication
What is consent
The last resort when prevention, de-escalation, and crisis management strategies have failed to keep the individual and/or others safe
What is restraints
List two examples of PHYSICAL restraints
Handcuffs, brakes/bars on wheelchair, etc.
This act discusses the appropriate use of restraints within the healthcare settings across Ontario.
What is the Restraint Minimization Act (2001)
In it’s confusion, Psyduck begins violently attacking herself with no regard for her life. After trying other interventions, Nurse Joy has no choice but to temporarily restrain Psyduck.
What is an emergency situation
Nurse Squirtle knows that because their patient presents with confusion, one of the things they should do in the morning is to ensure the patient knows where they are.
What is re-orientation
Making changes to the patient's environment to restrict their mobility.
What is an environmental restraint
Why should restraints be discontinued as soon as possible, according to the CNO?
Restraints are likely to be problematic in some patients as they can cause harmful physical and psychological effects
Ash, a pokemon trainer, is the guardian of his pikachu and makes all healthcare decisions on pikachu’s behalf
What is the hierarchy of decision making
When approaching an increasingly agitated patient, Nurse Wobuffet ensures that they are using simple and concise language.
What is a de-escalation technique
The intentional use of medications to inhibit an individual such that they are unable to express a particular behaviour, rather than treating medical symptoms
What is a chemical restraint
List one reason why restraints might be considered for use
I. To prevent the patient from hurting themself or others
II. If alternative measures have already been considered and failed with respect to maintaining safety
III. Consent was given from the patient and/or the patient’s substitute decision maker
List the 4 principles of consent
I. Relate to treatment
II. Voluntary
III. Not obtained through misinterpretation
IV. Informed
Encourage family to visit, bring in pictures of family/notes from family, put up signs (e.g. stop signs) to deter wandering, plan activities for distraction, perform more frequent reorientation, coordinate for consistent care, etc.
List 5 examples of restraints.
Bed rails, chair/bed alarms, wheelchair brakes, handcuffs, tucking in sheets too tightly, sedatives and tranquilizers, closing the door, etc.
List one example of when it would not be appropriate to use restraints.
I. Alternative restraints not considered before restraint use.
II. Patients are not monitored and reassured in accordance with the regulations of the hospital.
III. Restraints are not discontinued as soon as possible.
IV. Nurse did not obtain consent from the patient/patient’s substitute decision maker.
Rosa is taking their child Snivy to receive a varicella vaccination. As you are administering the vaccine, Snivy is teary and adamant that they don't want to be injected. Given what we know about consent, why would you still be able to inject the child?
Although the child may understand the procedure itself, they are unable to understand the consequences of not receiving the vaccination
I. Prevention, alternative approaches, and assessments
II. De-escalation and Crisis Management
Who is at highest risk of restraint use? Why?
A. 55 year old female who had a hip replacement surgery and is bedridden.
B. 74 year old male who has dementia, and can be aggressive and stubborn.
C. A 40 year old male with urinary incontinence and may appear to be aggressive at times.
B.
Dementia can cause him to forget his limitations and increase his risk for falls. He is also aggressive and stubborn at times meaning the staff and other patients may be at an increased risk of harm.
In accordance with the Patient Restraints Minimization Act, what are two ways nurses/hospitals can ensure that the use of restraints is appropriate?
I. Staff training on restraints
II. Use of restraints is documented, patients are monitored and reassured in accordance with the regulations of the hospital
III. Hospital policies with respect to restraints are readily available to the public.