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CHAPTER 9 RESTRAINT ALTERNATIVES

CHAPTER 9 RESTRAINT ALTERNATIVES. RESTRAINT ALTERNATIVES. TRY TO DISTRACT THE PERSON FROM THE BAD BEHAVIOR MAINTAIN THE PERSON’S DAILY SCHEDULE AS MUCH AS POSSIBLE SIGNAL LIGHT WITHIN REACH ELIMINATION NEEDS ARE MET A SITTER MAY BE NEEDED EXTRA TIME IS SPENT WITH THE PERSON

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CHAPTER 9 RESTRAINT ALTERNATIVES

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  1. CHAPTER 9 RESTRAINT ALTERNATIVES

  2. RESTRAINT ALTERNATIVES • TRY TO DISTRACT THE PERSON FROM THE BAD BEHAVIOR • MAINTAIN THE PERSON’S DAILY SCHEDULE AS MUCH AS POSSIBLE • SIGNAL LIGHT WITHIN REACH • ELIMINATION NEEDS ARE MET • A SITTER MAY BE NEEDED • EXTRA TIME IS SPENT WITH THE PERSON • WARNING DEVICES ON BEDS, CHAIRS, DOORS • MOVE THE PERSON CLOSER TO THE NURSE’S STATION • CHECK ON THE PERSON FREQUENTLY • NOTE ANY INTERVENTIONS ON THE CARE PLAN

  3. ALTERNATIVES TO RESTRAINTS LAP PILLOW ALARM

  4. SAFE RESTRAINT USE • RESTRAINTS ARE NOT USED FOR DISCIPLINE OR STAFF CONVENIENCE • RESTRAINTS ARE USED ONLY WHEN NECESSARY TO TREAT A PERSON’S MEDICAL SYMPTOMS • RESTRAINTS ADD TO A PERSON’S CONFUSION AND COMBATIVENESS

  5. RESTRAINTS A RESTRAINT IS ANY ITEM, OBJECT, DEVICE, GARMENT, MATERIAL, OR CHEMICAL THAT RESTRICTS A PERSON’S FREEDOM OF MOVEMENT OBRA STATES THAT RESIDENTS HAVE THE RIGHT TO BE FREE FROM RESTRAINTS OBRA ALLOWS RESTRAINTS TO BE USED ONLY “TO ENSURE THE SAFETY OF THE RESIDENT OR OF OTHER RESIDENTS”

  6. RESTRAINTS • PHYSICAL RESTRAINT • MAY BE ANY MANUAL METHOD, PHYSICAL OR MECHANICAL DEVICE, MATERIAL, OR EQUIPMENT • ARE ATTACHED TO OR NEXT TO THE PERSON’S BODY • CANNOT BE EASILY REMOVED BY THE PERSON • RESTRICT FREEDOM OF MOVEMENT OR ACCESS TO ONE’S BODY

  7. EXAMPLES OF PHYSICAL RESTRAINTS • RESTRAINTS APPLIED TO THE CHEST, WAIST, ELBOWS, WRISTS, HANDS, OR ANKLES • GERI CHAIRS • BED RAILS • SHEETS TUCKED IN SO TIGHTLY THAT THEY RESTRICT MOVEMENT

  8. RESTRAINTS • CHEMICAL RESTRAINTS • DRUGS THAT ARE NOT STANDARD TREATMENT FOR THE PERSON’S CONDITION • DRUGS USED TO DISCIPLINE A PERSON OR FOR STAFF CONVENIENCE • DRUGS ARE CONSIDERED CHEMICAL RESTRAINTS WHEN THEY AFFECT THE PERSON’S PHYSICAL AND MENTAL FUNCTION

  9. HARMFUL EFFECTS OF RESTRAINTS • MUSCLE WEAKNESS • LOSS OF MOBILITY • INCONTINENCE • SKIN BREAKDOWN • DECREASE IN ACTIVITY • INCREASE IN CONFUSION AND AGITATION • CUTS AND BRUISES • DEPRESSION • EMBARRASSMENT AND HUMILIATION • FRACTURES • STRANGULATION

  10. LEGAL ASPECTS • IF A RESTRAINT IS USED, THE LEAST RESTRICTIVE METHOD MUST BE USED • RESTRAINTS ARE USED TO PROTECT THE PERSON, NOT FOR STAFF CONVENIENCE • RESTRAINTS REQUIRE A DOCTOR’S ORDER • THE DOCTOR MUST GIVE THE REASON FOR THE RESTRAINT AND THE TYPE TO BE USED • THE ORDER MUST ALSO INCLUDE HOW LONG THE RESTRAINT IS TO BE APPLIED • RESTRAINTS ARE USED ONLY AFTER TRYING OTHER METHODS TO CONTROL OR PROTECT THE PERSON

  11. LEGAL ASPECTS • UNNECESSARY RESTRAINT IS FALSE IMPRISONMENT • RESTRAINTS REQUIRE THE PERSON’S INFORMED CONSENT • IF THE PERSON CANNOT GIVE INFORMED CONSENT, THE PERSON’S LEGAL REPRESENTATIVE MUST BE GIVEN THE NECESSARY INFORMATION • RESTRAINTS MUST BE USED ACCORDING TO THE MANUFACTURER’S INSTRUCTIONS • YOU COULD BE FOUND NEGLIGENT FOR IMPROPERLY APPLYING A RESTRAINT • THE RESTRAINED PERSON’S BASIC NEEDS MUST BE MET BY THE NURSING TEAM.

  12. SAFETY GUIDELINES • OBSERVE FOR INCREASED CONFUSION AND AGITATION • PROTECT THE PERSON’S QUALITY OF LIFE • FOLLOW THE MANUFACTURER’S INSTRUCTIONS • APPLY RESTRAINTS WITH ENOUGH HELP TO PROTECT THE PERSON AND STAFF FROM INJURY • OBSERVE THE PERSON AT LEAST EVERY 15 MINUTES OR MORE OFTEN AS REQUIRED BY THE CARE PLAN • REMOVE THE RESTRAINT, REPOSITION THE PERSON, AND MEET BASIC NEEDS AT LEAST EVERY 2 HOURS

  13. SAFETY MEASURES • USE THECORRECT RESTRAINTIN THE CORRECT SIZE • DO NOT USE SHEETS, TOWELS, TAPE, ROPE, STRAPS, BANDAGES, OR OTHER ITEMS TO RESTRAIN A PERSON • DO NOT USE RESTRAINTS THAT ARE TORN OR FRAYED • FOLLOW AGENCY POLICIES AND PROCEDURES • POSITION THE PERSON IN GOOD ALIGNMENT BEFORE APPLYING THE RESTRAINT • PAD BONY AREAS AND SKIN • THE RESTRAINT SHOULD BE SNUG BUT ALLOW SOME MOVEMENT OF THE RESTRAINED PART • SECURE STRAPS OUT OF THE PERSON’S REACH • SECURE THE STRAPS TO THE BED FRAME, NEVER THE BEDRAILS • CHECK THE PERSON’S CIRCULATION AT LEAST EVERY 15 MINUTES • KEEP SCISSORS IN YOUR POCKET FOR EMERGENCY RELEASE • REMOVE THE RESTRAINTS EVERY 2 HOURS

  14. CHECK FOR TIGHTNESS YOU SHOULD BE ABLE TO INSERT YOUR HAND BETWEEN THE PATIENT AND THE RESTRAINT

  15. TYPES OF RESTRAINTS JACKET LIMB

  16. THE OPENING OF THE JACKET RESTRAINT IS ALWAYS PLACED IN THE FRONT. THIS ALLOWS THE PERSON SOME FREEDOM OF MOVEMENT

  17. A MITT RESTRAINT IS USED TO PREVENT THE PERSON FROM PULLING ON TUBINGS OR DRESSINGS. CHECK THE RESTRAINT EVERY 15 MINUTES TO MAKE SURE IT DOES NOT INTERFERE WITH CIRCULATION. YOU SHOULD BE ABLE TO INSERT TWO FINGERS BETWEEN THE RESTRAINT AND THE PATIENT’S LIMB.

  18. A HAND ROLL SHOULD BE PLACED UNDER THE PERSON’S FINGERS WHEN USING A MITT RESTRAINT TO KEEP THE FINGERS IN PROPER POSITION

  19. REPORTING AND RECORDING • RECORD THE TYPE OF RESTRAINT BEING APPLIED • THE BODY PART RESTRAINED • THE REASON FOR THE APPLICATION • SAFETY MEASURES TAKEN ( PADDED BED RAILS, BED RAILS UP ) • THE TIME YOU APPLIED THE RESTRAINT • THE TIME YOU REMOVED THE RESTRAINT • THE CARE GIVEN WHEN THE RESTAINT WAS REMOVED • SKIN COLOR AND CONDITION • THE PULSE FELT IN THE RESTRAINED PART • CHANGES IN THE PERSON’S BEHAVIOR • COMPLAINTS OF PAIN OR DISCOMFORT CAUSED BY THE RESTRAINT

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