Do you have this new protocol??

SICU Queen · Apr 14, 2002

This is how I feel about it all. :devil:

ratchit · Apr 14, 2002

Fgr8Out · Apr 15, 2002

The way I see it, the protocol for restraints actually assist us and are not a hindrance. It specifies that physical restraints, including 4 side rails, wrist, vest, 4 point, can be implemented for any patient whose behavior presents a risk to either themself or anyone else. Retraints can be placed without an initial physician order if the patient has an IV, catheter, NG or any other appliance that might be pulled by the patient. Of course, the need for those items must be noted, but I don't see the policy as restrictive at all. It sets guidelines that protect everyone involved. Sure, if you want chemical restraining methods, or if the patient doesn't have an IV or other device that allows you to place restraints, a physician must first see the patient. But, in every other instance, it is acceptable to use restraints when the criteria indicates necessity.

The order must be renewed/reviewed every 24 hours. Our hospital has a bright orange sticker that's placed in the patients chart under orders, early enough in the day that physicians will see it when they make their rounds - alerting the need.

Just an observation, but... What is it about Nurses that evoke such an aversion to change? Ours is a continually evolving Profession and as such, we need to be flexible and keep our minds open. If not for change... Florence Nightingale wouldn't have had a chance, and THEN where would all of us be? :)

P_RN, ADN, RN · Apr 15, 2002

The OT was mad because we had this elderly, confusesd, just suffered a CVA lady in a geri chair with a tray.

I believe this could be the same OT or PT who put a patient in the bathroom, then went to lunch and called back about 25 minutes later to remind someone to "check on her." Fortunately someone got to her long before the "reminder call." grrrrrrr

On the unit below ours a physician's mother was hanged by a Posey Vest.....while he was making rounds on our unit. Very tragic situation.

mother/babyRN, RN · Apr 15, 2002

We have a huge new and involved restraint policy. It is taking some getting used to...I overheard a surgical nurse say that by the time they comply with all the new rules, the patient would have either expired or escaped. She was not impressed....

micro, RN · Apr 15, 2002

reality nursing 101.....think state agencies and JCAHO needs to take it.....

crack me up....."like while waiting for supervisor to bring restraints.....like "but very gently sit on patient to remind them not to kill us or themselves or something"......because if you are sitting on them.....this too could be considered a restraint.....

I truly do get the seriousness of the issue.........but reality with knowledge and intelligence should reign.........

where I am at least it is q 24 hr...........just remember to remind the doc to sign the order q day.........

bjpeace · Apr 15, 2002

In my facility restraint orders are renewed q24h unless the restraints are needed for behavioral issues, then the pt needs to be seen by a doc within 2 to 4 hrs (can't remember specifics). We were cited for restraint documentation last review so now we have very simple check sheets, and the hospital pays someone to go to each unit everyday to visually verify who is in restraints and then make sure the order is on chart and flowsheet is completed. If restraints are applied at any time for reasons other than intubation the nursing supervisor is paged to make sure that protocol is followed to the letter.