So we've talked a lot about restraints,
I want to talk about one more
important topic before you leave today.
I know there's a lot of considerations,
but all of that is important because
a patient really can get injured,
while in restraint use.
So one thing to consider,
is death and restraints.
Okay, this is a pretty dark topic,
but this really can happen and it has
occurred while patients are in restraints.
We call it a "Never Event",
what do I mean by that?
Meaning, a death and
restraint, should never happen.
This is actually called a "Never Event"
by the Center for Medicare and Medicaid Services.
So, this is an over urgency reporting agency,
that, if a death happens,
that we must report it to them
and they track all of these.
As of how it happened, why,
what type of restraints,
were we giving the appropriate amount of care?
So a death while in restraint or
seclusion again must be reported
immediately to the Center for
Medicare and Medicaid Services.
Now, this seems a little odd, but this is
something that's key to remember as a nurse.
If a client death occurs within 24
hours of the patient being in restraint,
it still has to be reported to the Center
for Medicare and Medicaid Services.
Okay, I'll say that again,
now, if a patient has passed
and it was within 24 hours the
patient was either in the restraint
or the restraint has been discontinued or stopped,
if it's still within 24 hours we
still have to report it to CMS.
Now, even though the death, maybe
we think it was a complication
of not having to do with restraints,
even if the death was not due to the restraints,
we still are required to report it to CMS.
Now, some other complications to think
about is what we call entrapment.
So as you can imagine there's
some extra restraint pieces there.
There's lots of things that can get hung up,
the patient can get hung up within
the side rails and restraints
this can potentially cause a
lot of issues for your patient.
Also skin breakdown
and why toileting and making sure
we do those routine checks
and those skin checks for our
patients while in restraints.
While we're doing those skin checks
make sure you're checking
those circulation points again.
Making sure you're checking
the warmth of their skin,
their pulse points, also their capillary refill.
And you can imagine while in a restraint,
unfortunately the patient is not comfortable.
They're restrained down and
there's not a lot of movement.
This can definitely cause some immobility,
some contractures and some issues for our patient.
Now, before we leave,
a few more things to leave you with.
If you remember at the
beginning of this presentation,
try alternatives before considering restraints.
There's so many alternatives
out there, for example,
a sitter or reorientation or distraction.
Make sure you try these, because a lot of times,
these can help to keep the
patient out of restraints.
Now, re-evaluate restraints every time,
it doesn't mean just because they're in
a restraint that they have to stay in it.
Our goal is to get the
patient out of the restraints
as soon as we think it's safe to do so.
Make sure you check your order and
include this in the plan of care.