Marie50
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yes - medicare/CMS says, even holding to give an injection is a restraint!
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self inflicted harm is unfortunately seen frequently in longer term settings - DBT is one modality..there are many reasons people self abuse; don't work just to help cutters - this is very challenging and very rewarding nursing - be open, learn daily, listen.
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each state has mandated statutes that govern restraint use and process...it is more and more rare these days but still at times a very last resort
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some pts can probably journal -this is a great activity - helps with concentration - and given a topic, could be a positive; also, try goal setting, current events, and other topic groups such as 'What I do well,...or how I helped someone...etc..)
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need some help rewriting policy to conform with CMS standard that 'even holding for meds is considered a restraint' - got any ideas? how can we give emergency med without hold? is that a restraint? we use VERY FEW - maybe 2 instances in last year but still - hold for meds is a restraint??
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We monitor incident reports and trend other data to assure any changes that need to be made for safety issues; survey staff - try to find the easy fixes first so folks know we are listening; complete needs assessments; constantly evaluate program for patient satisfaction; involve local comsumer advocates in planning...