Chapter 13 Flashcards
Restraint Alternatives & Restraints
chemical restraint
drug used for discipline / staff convenience
- not required to treat medical symptoms
enabler
device that limits freedom of movement but promotes safety / comfort
physical restraint
manual / physical device, material, equipment:
- attached to / near person’s body
- cannot be removed easily
- restricts freedom of movement / access to body part
when are restraints used ?
- when less restrictive measures fail
- LAST RESORT
when are restraints discontinued ?
as soon as possible
restraints should not be used for what two reasons ?
- to discipline
- for staff convenience
manual method
hold / limit movement by using body contact
remove easily
physical restraint can intentionally be removed by person in same manner restraint was applied
- bed rails, open a buckle, untie knot, etc.
why should restraints concerning when used for persons w/ dementia ?
can increase confusion, aggression, agitation,
- induce stroke / death
risks from using restraints ?
injuries (trying to get free, applying too tight, etc.)
common injuries from restraints ?
- cuts
- bruises
- fractures
- death from strangulation
how often should you check up on person w/ restraint ?
every 15 min
CMS requires the report of any death within what time frames of restraint usage ?
- while person is restrained
- within 24 hours after restraint was removed
- within a week after restraint was removed
what to do when person is strangling due to restraint ?
- release / cut straps if possible
- shout for help and nurse
- stay w/ person
- perform CPR according to guidelines
what rules must you follow when using restraints ? (6)
- dr. order is required
- restraint must protect person
- least restrictive method is used
- restraints are only used if all other measures fail
- unnecessary restraint is false imprisonment
- informed consent is required
safety guidelines to follow when using restraints ? (5)
- observe person for increased confusion / agitation
- protect person’s quality of life
- must follow manufacturer’s instructions
- observe person at least every 15 min
- remove restraints / reposition / meet basic needs every 2 hours
constant observation may be needed for what kind of people ?
- extremely aggressive, agitated, combative
- at risk for aspiration
- at risk for suicide
when reposition person w/ restraints, how long are restraints released for ?
at least 10 min
if applied to chest / waist how much slack should be allowed between restraint and person ?
flat hand should be able to slide in-between restraint and person
where should straps of restraints be secured if used in a bed ?
part of bed frame that moves w/ raising / lowering
- never bed rails, head / foot board
where should straps of restraint be secured if used in a wheelchair ?
under the seat
how to apply vest restraint properly ?
“V” neck is in front
how to apply jacket restraint properly ?
opening is in back
how to apply belt restraint properly ?
at 45
