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Ornery Orders
Dogged Documentation
Confinement Curveball
Shackle, Sedate & Snag, Oh My!
Tame Tie-Up
100

This is the time frame for adult Violent restraint order renewal.

What is every 4 hours?

100

Ongoing patient assessment and monitoring for Violent restraints is documented here.

What is the Violent/Self-Destructive Restraint Flow Sheet?

100

If a restraint is removed for any period of time other than for ADL's and assessment you must take these 2 actions within 1 hour.

What is place a new order and complete another face-to-face?

100

This is the least restrictive form of a restraint.

What is therapeutic hold?

100
Medical necessity such as drug or alcohol withdrawal, mechanical ventilation, or pulling at medical devices may require this type of restraint order.
What is Non-Violent Restraint order?
200

A Nurse has this amount of time to notify the physician and place the verbal order for Violent Restraints.

What is 15 minutes?

200

A single Violent/Self-Destructive Restraint Flow Sheet for adults is broken down into these intervals. 

What is 4 hour intervals?

200

This must be done within an hour of violent restraint initiation to evaluate the patient's immediate situation and other conditions to warrant violent restraints.

What is the face-to-face evaluation?

200
To apply the use of force in order to administer medications requires the Nurse to obtain this first.
What is a Physician's order prior to the application of force, which is considered a restraint?
200
Unlike Violent restraints, Non-Violent restraint orders are good for this period of time.
What is each calendar day?
300
This type of order for violent restraints is not acceptable at any time.
What is a standing or PRN order?
300

The restraint checklist includes a list of all documentation requirements. One click here will take you right to it. 

What is the Restraint hyperlink in the documentation flowsheet?

300

These 3 roles are approved to perform the face-to-face evaluation.

What is the Physician, Nurse Practitioner, and trained RNs?

300
This type of restraint restricts freedom of movement and manages behavior, but is not a standard treatment for the patient's condition.
What is Chemical Restraint?
300
Non-violent restraints may be initiated only after this has first been determined?
What is less restrictive measures have been determined to be unsuccessful?
400

For patients in violent restraints for extended periods of time the physician must do this every 24 hours prior to writing a new restraint order.

What is the Physician must complete and document face-to-face?

400

Monitoring skin, circulation, swelling and abrasions in the Violent/Self-Destructive patient is completed this often.

What is every 15 minutes (On the Violent/Self-Destructive Restraint Flow Sheet)?

400

This is the maximum amount of time that can be spent in a restraint chair.

What is 2 hours? Can be released for 15 minutes and then re-restrained.

400
These 2 general classes of medications may be used as chemical restraints?
What are Antipsychotics and Benzodiazepines?
400
For a patient at high risk for aspiration, and their condition permits, it is safest to maintain the restrained patient in this position.
What is on their side?
500

Any violent restraint order should these three elements of restraint utilized within the order.

What is therapeutic hold, mechanical, and chemical?

500

For patients in Violent Restraints that are also suicidal, ongoing assessments must be documented in these 2 places.

What is the Violent/Self-Destructive Restraint Flow Sheet AND the Precaution Monitoring Flowsheet?

500

Someone in seclusion and restraints must be monitored this way.

What is face-to-face and 1:1?

500
If law enforcement is no longer with a Forensic Restraint patient, and the patient is still restraints the Nurse must do this first.
What is place violent restraint order?
500
When a restrained patient is released from restraints, but then again needs to be restrained 60 minutes later, the Nurse must obtain this.
What is a new order for the new episode of restraints?