Lesson 16

 Student will be able to explain the NA role in protecting resident’s rights to be free of physical and chemical restraints  Student will be able to explain the NA responsibilities related to monitoring and releasing resident’s in restraints  Student will be able to explain the difference between devices that are restrictive and enabling and give examples  Student will be able to describe the potential negative outcomes of side rails

-Manual method which restricts freedom of movement or normal access to one’s body  8 times more likely to be injured  Many facilities Restraint Free  Often causes anger, agitation, embarrassment, humiliation and mistrust  Doctors order to treat medical conditions  Not allowed for purposes of discipline or convenience

 Includes free of verbal, mental, sexual, physical, corporal punishment, and seclusion  NA must report any suspected abuse to the nurse immediately  NA must ask for help if resident becomes aggressive or uncooperative  NA must Never use a protective device without the nurse’s permission

 Must be checked by nursing staff at least HOURLY and more frequently if warranted  Released at least every 2 hours for 10 minutes  Check skin, security of device, comfort, toileting needs, ROM, position changes, ambulate if able

 Limb (arm or leg)- prevents free movement of arms and/or legs  Mitts/Mittens- prevents finger movement  Soft tie belt- prevents getting out of bed or chair  Vest Restraints- prevents getting out of chair or bed  Lap cushions/trays- prevents getting up or out of chair (ones not easily removable)

 Side Rails  Tucking in sheets, fabric, clothing so movement is restricted  Using trays, tables, bars, or belts to prevent resident from rising or getting up from chair  Using a chair that prevents resident from rising  Placing chair or bed too close to a wall that prevents resident from rising our of chair or being able to get up

 Self-releasing devices: not considered a restraint if resident can easily release on his/her own without assistance Enclosed, framed, wheeled walker- if resident not able to release self from frame= restraint

 Prevention of injuries from falls  Allowing necessary medical treatment without interruption (IV infusions, feeding tubes, etc.)  Protecting staff, resident, or others from harm Can only be applied by individuals properly trained to do so (know facility policy and the manufacturers instructions) Never tie to side rail or the fixed frame of the bed Requires quick release ties to easily be released in case of emergency

 Diversional activities  Pillows or positioning devices  Meeting basic needs  Encourage more frequent visits from family & friends  Companions/Sitters  Increased staff contact  Allow for wandering in safe area  Exercise programs and outside activities  Electronic warning devices  Moving resident closer to nursing station  Reality orientation  Consistent staff assignments

 Required doctors order  May or may not be considered a restraints, depends on the individual circumstances  Entrapment Zones

1. Under what conditions can a physical restraint be applied? 2. How often must a resident with physical restraints be checked? 3. How often must a resident be released from physical restraints? For how long? 4. True or False? Under certain conditions, side rails are considered to be a restraint.