What is a restraint?

Transcription

1 What is a restraint? Definition of Restraints Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to freely move his or her arms, legs, or head

2 Is a Restraint Freedom Splint Used to prevent tube pulling Place the patient s elbow in the middle of device have buckles facing patient Ensure 2 fingers can fit between the splint and the patient

3 Peek a Boo Mitt This also works for tube pullers and scratchers For IV pullers,consider mitting ONLY the hand without the IV Place palm down on the padding, when peek a boo flap pulled back. The back on the hand should be seen Should be able to fit 2 fingers into the mitt

4 Soft Limb Restraints Used for tube pullers and patients pulling at treatment devices Secure short strap around wrist and buckle Straps may be tied to the bed frame in one spot or two Consider if one restraint can manage the behavior

5 Tough cuffs Are used for more aggressive patients Velcro and buckle around the wrist Tie to bedframe with slip knot in one or two places Can be obtained by protection services Ensure that 2 fingers can fit between device and patient

6 Devices for Fall Prevention Fall Alarm This is NOT a restraint Kept in clean utility rm String/magnet is on supply cart and are single patient use item DO NOT use with patients with pacemakers Test alarm Q shift to check battery and audibility

7 Newest Fall Alarm New Fall Alarm has voice and alarm response Has a safety clip to prevent patient from unclipping ST3 and South 3 has an even newer green alarm that connects to a sensor pad (disposable) and the call light

8 Activating ICU Bed Exit Alarm Press the KEY button Press Bed Alarm ON For bed alarms to work, they must Be zeroed before patient is in it

9 Stryker Bed Exit Alarm For bed alarms to work, they must Be zeroed before patient is in it

10 ALL Patients at Risk for falls or injury must have a FALL ALARM AT ALL TIMES Regardless of family or observation worker presence For bed alarms to work, they must Be zeroed before patient is in it Level 1 Alarm Level 2 Alarm Level 3 Alarm Communicate the Level of Alarm for each patient on the white board and at handoff / reports so it gets reset consistently

11 4 Siderails 4 Siderails is a RESTRAINT Padded Siderails are a RESTRAINT Siderails can pose a greater danger than no siderails as patients view them as an obstacle and climb up and over sustaining injury from a higher viewpoint Siderails can pose an entrapment hazard as patients get limbs caught between the mattress and railing or mattress and head or foot of bed

12 Belt Restraint Used for patients at risk for fall for whom a fall alarm alone is ineffective Used when patients are in chairs ONLY Ensure device does not restrict breathing and is positioned at the patient s hips Wrap at patient s hips and around chair

13 Restraint Application Apply ONLY to the bed frame NEVER the siderail Apply ONLY using a slip knot Check proper fit minimally Q2hrs Check to ensure 1 finger can fit between device and patient Check to ensure device does not impede respirations

14 Critical Care beds and Restraints Tie restraints to the hole in bed frame not the thin wire hanging lower

15 Making a Slip Knot Make a loop with the tie

16 Making a Slip Knot Pull a small loop of the tie through the middle of the loop. Pull the loop from behind the loop toward you

17 Making a Slip Knot Pull the small loop tight making sure not to pull the full length of the tie through

18 Psych Emergency: Code Gray Team includes: Protection Services, Psych MD, Wyman 2 RN, Nursing Supervisor They will try to de-escalate the patient but will have tough cuff restraints if needed All patients in 4 point restraints are monitored by an observation worker All patients restricted to their room with a 1:1 must have orders for seclusion

19 When holding an extremity to restraint: Physically holding a patient should only be done when the patient is at risk to hurting themselves or others An extremity should only be held in its normal body alignment position (arms by the patients sides) In rare situations, a one hand up and one hand down position may be recommended by the MD to contain the patient. This position should be adjusted to both hand down ASAP as the one arm up can increase risk of aspiration and impair circulation The force of any hold must only be a firm as needed to maintain the patients and your safety