{"id":675,"date":"2017-06-12T19:10:26","date_gmt":"2017-06-12T19:10:26","guid":{"rendered":"http:\/\/blogs.cooperhealth.org\/ctd\/?p=675"},"modified":"2017-06-12T19:10:26","modified_gmt":"2017-06-12T19:10:26","slug":"restraint-order-tips","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/ctd\/2017\/06\/restraint-order-tips\/","title":{"rendered":"Restraint Order Tips"},"content":{"rendered":"

Today we \u201cPinPoint\u201d:<\/em><\/strong> Restraint Order Tips<\/em><\/strong><\/p>\n\n\n\n
Use of restraint and seclusion is highly regulated due to the high risk nature of the behavior and intervention.\u00a0 <\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff.<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

Restraint or seclusion may only be imposed to ensure the immediate physical safety of<\/strong><\/p>\n

the patient, a staff member or other and shall be discontinued at the earliest possible time.<\/strong><\/p>\n

\u00a0<\/em><\/strong><\/p>\n

Can restraints be initiated without an order?<\/em><\/strong><\/p>\n

Yes, in an emergent situation, a registered nurse may initiate restraints in advance of a physician\u2019s order; the RN will notify the physician and obtain an order within one hour of initiating restraints\/seclusion.<\/p>\n

 <\/p>\n

What if the RN cannot get a response when attempting to get a restraint order\/reorder?<\/em><\/strong><\/p>\n

The Restraint Escalation Pathway will be followed to escalate obtaining the order.<\/p>\n

 <\/p>\n

Why must the patient be seen face-to-face within 1 hour after the initiation of the intervention?<\/em><\/strong><\/p>\n

To evaluate<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The patient\u2019s immediate situation;<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The patient\u2019s reaction to the intervention;<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The patient\u2019s medical and behavioral condition to determine if other factors, such as drug or medication interventions, electrolyte imbalances, hypoxia, sepsis, etc., are contributing to the patient\u2019s violent or self-destructive behavior; and<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The need to continue or terminate the restraint or seclusion<\/p>\n

 <\/p>\n

Can PRN restraint orders be written?<\/em><\/strong><\/p>\n

Orders for the use of restraints or seclusion must never be written as a standing order or on an as needed basis.<\/p>\n

 <\/p>\n

At what interval shall restraint orders be renewed?<\/em><\/strong><\/p>\n

 <\/p>\n

Non-violent\/non self-destructive restraint orders need to be renewed every 24 hours.\u00a0 (This time frame is from the last current order time.)<\/strong><\/p>\n

 <\/p>\n

Violent\/self-destructive restraint orders need to be renewed as follows:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 every 4 hours for patients 18 years of age and older;<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 every \u00a02 hours for patients between 9-17 years of age;<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 every hour for patients 8 years of age and younger<\/p>\n

 <\/p>\n

When should restraints be removed?<\/em><\/strong><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Patients have the right to know what behavior is expected in order to be released from restraints.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Restraint or seclusion must be discontinued at the earliest possible time, regardless of the length of time identified in the order.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The decision to discontinue the intervention should be based on the determination that the patient\u2019s behavior is no longer a threat to self, staff members, or others.<\/p>\n

 <\/p>\n

If the patient\u2019s restraints were discontinued or changed (e.g. 4 point decreased to 2 point) can they be increased or reinstituted within the original order timeframe?<\/em><\/strong><\/p>\n

No, when a staff member ends an ordered restraint or seclusion intervention, the staff member must obtain a new order to reinitiate or escalate.<\/p>\n

June 5, 2017<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

Today we \u201cPinPoint\u201d: Restraint Order Tips Use of restraint and seclusion is highly regulated due to the high risk nature of the behavior and intervention.\u00a0…<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[],"class_list":["post-675","post","type-post","status-publish","format-standard","hentry","category-quality-and-safety"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/posts\/675","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/comments?post=675"}],"version-history":[{"count":1,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/posts\/675\/revisions"}],"predecessor-version":[{"id":676,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/posts\/675\/revisions\/676"}],"wp:attachment":[{"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/media?parent=675"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/categories?post=675"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/ctd\/wp-json\/wp\/v2\/tags?post=675"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}