Are seclusion/isolation rooms considered a restraint?

[babaloo, BSN]

Are seclusion/isolation rooms considered a restraint even though its not a manual or chemical restraint? I'm trying to think of less restrictive measures if a patient is escalating and I was thinking of offering the pt the choice of going to his/her room or offering the seclusion/isolation room, but i'm not sure if the seclusion/isolation room would be considered a restraint. What other types of less restrictive measures can be taken? p

[lasair]

I don't see offering seclusion room as being appropriate, I would see it as a last resort that is often accompanied by physical and/or chemical restraint. Offering a quiet room away from others could work, it also helps asking the individual what helps them when they feel or act in a certain way.

[Cackalacky]

I was taught that as long as the door isn't locked and the patient can leave on their own it is not a restraint. That means that even holding your foot on a door to keep it closed can make their room a seclusion/restraint because the patient cannot leave without you letting them out. Seclusion rooms were usually not an option for patients to use because we needed them open in case it was needed. Many of my facility's units had quiet rooms patients could use to cool down or they could go to their room.

Other less restrictive options: The De-escalation techniques - asking where the patient would like to calm down or what would help him/her to calm down.

[MrChicagoRN, RN]

It's not a restraint, but is is a restriction of rights if they are locked in the room, or otherwise prevented from leaving.

Locked seclusions are one step down from restraints in terms of restrictions. If they go into the seclusion room, agree to stay for the 1/2 hour or so, and the door isn't locked, it's not seclusion.

In Illinois, it's pretty much the same process as restraints; doctors order, restriction of rights form, flow sheet, etc. But a secluded patient is at risk for harming themself or tearing up the room, and requires 1:1 observation. (video observation is appropriate).

If a patient agrees to stay either in the quiet room, or their own room until calmer and more in control, it's not seclusion, but a timeout.

[TerpGal02, ASN]

Not if the door is open, or is closed, not locked or held shut. We use the quiet rooms pretty frequently with kids having meltdowns and they aren't willing to return to their room. Rarely for adults.

[Mandychelle79, ASN, RN]

As others have said, as long as the patient is permitted to leave the room at will it is not a restraint. In all honesty I use "open seclusion" a lot more than I used actual seclusion. I usually just tell the person when they feel that they are in control again they are welcome to re-join us on the unit. They normally stay in there for 15 mins or so. If they dont have a roomate, I may suggest their room, but there are things that they can throw.

[twinkerrs]

Remember if you block them from exiting the door it is a seclusion. There are times where I have removed everyone else and let the patient have the room they were having a meltdown in to calm down in.

[TerpGal02, ASN]

Usually with the kids (its usually the kids that are using the quiet rooms) we ask them to sit on the mattress and give them an expectation (something short like 5 or 10) minutes of being calm, then we transition them to their room and if they're ok there for another half hour or so they can rejoin the milieu.

[JuliRN]

If a pt. is escalating we will often offer the use of the "quiet room" aka the seclusion room with the door open. For some pt's it's helpful for them to be able to go somewhere quiet and collect themselves. This isn't considered a restraint. Whenever that door does get locked, it is a restraint.

[hiphopRN]

If a pt. is escalating we will often offer the use of the "quiet room" aka the seclusion room with the door open. For some pt's it's helpful for them to be able to go somewhere quiet and collect themselves. This isn't considered a restraint. Whenever that door does get locked, it is a restraint.

This. We try to keep it empty in case we need it for an emergency, but since we have all double rooms, we frequently offer it for patients to use when they are getting overwhelmed by the activity in the lounge and want some time completely by themselves for a while.

[757RN]

The least restrictive method is verbal intervention. The patient should be allowed to stay in public areas if possible, and then moved to isolated spaces. Finally, if nothing else works, the patient can be physically restrained for safety purposes. (Prioritization, Delegation, and Assignment, 3rd Edition; By Linda A. LaCharity, PhD, RN)