Our staff is developing a new flowsheet for restraints and the topic of chemical restraints has come up. Is there anyone out there with a good flowsheet that incorporates both physical and chemical restraints. All suggestions are welcome......

Thanks

I have worked for the last several years as a surveyor for my state and CMS. The CMS requirements for orders, assessment, and ongoing monitoring of patients are exactly the same whether it is physical or chemical behavioral restraint. All you need to do differently is make sure that the record clearly specifies what kind of restraint (physical or chemical) is being used. I have seen flowsheets where that was as simple as checking or initialing one blank (or box) or another at the top of the sheet to indicate the form of restraint.

Remember that the order must also clearly specify the type of restraint being ordered. Also, if the person is moved from one restrictive intervention to another (say, from restraint to seclusion), it needs to be clear on the flow sheet and/or the narrative notes (somewhere in the record) when, specifically, that happened.

The clearer and more complete you can make your "paper trail" in the medical record, the better for you and the facility (for so many reasons, not just surveys ...)

Thanks for input. I thought we were on the right track with this. It helps to have clarification of this. Restraints are such a tricky subject.... :)

Could someone send me a flowsheet that they use for restraints?