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- Feb 25, '10 by systolyFirst, I will say that we don't use merri walkers any more, after several minor injuries (mostly to other residents) and finally a tip over incident. However, I'm
not ready to discard this as a beneficial tool for some, perhaps at different times of the day. If she's fine in it during the day, why not use it during the day? It doesn't have to be all or nothing. First, I'd approach PT and say something like, "we're having some issues with this chair on my shift. Can you show me how to properly place this resident in the chair?" This has a dual purpose: it not only rules out any technical issues, but it will make PT more receptive to the idea that there, indeed, are some issues during other times of the day. Maybe the merri walker is not always appropriate for this resident, maybe the resident needs to be walked or toileted when she tries to climb out.
- Feb 25, '10 by SuesquatchRNOh, we have Houdinis in them, no question.
I know that the disciplines work together, but since when does PT get the final call on care-planning for safety? Maybe the guy needs a geri-chair in the evening, or a simple stationary chair. And to be in sight of the nurses' station.
- Feb 26, '10 by FinallydiditYes it has been witnessed, and No we are not allowed to video, or take pix of residents, ( that was my first thought). However that being said, I sat down with the powers that be in PT, yesterday and we agreed to try a comprimise, first indication of her trying to get out that she will be tolited and offered the option of lying down, or getting back in the chair. If she choose the chair, the first indication of escaping we will place her in the w/c with the soft lapbelt. Tried this last evening, and she chose the merrywalker, about 15 minutes later I saw her quietly setting at the nurses station, biting her fingernails, with the strap on the outer side of her leg!! Gotta love her!.. Asked if she wanted to go to bed, she replied, Daddy will get ahold of my butt, if I go to bed here, there are boys here!......How can I argue with that, so in the w/c she went.......
- Feb 26, '10 by debRN0417Thoroughly document everything! Make sure it is on the care plan that she can get herself out of the thing. Let the physician know she can get out of it too. If she gets out and falls and breaks a hip or worse then you need to make sure you have documented that she can get out of it. Make sure you document that PT is aware that she is exiting the chair. If she is getting out of it, it is doing her no good, it is more of a danger than a benefit. Ask the doc for a medication re-evaluation to see if there is something that can help there. Make activities involved in giving her something diversional. Let the DON know that you are going to need someone to keep an eye on her if she is ambulatory and falling down...you don't want to restrain her but you need to do your best to keep her safe...geri chair or wheelchair with a table top with the activity board (may be a reatraint so make sure you look at it for assessment, care planning and informed consent)..sundowning is so challenging!