trudyarn

Our unit has used enclosure beds for the past couple of years. Patients have freedom to move about in their bed, call lights, 02, and other equipment required to be used by the patient can remain in the bed with the patient. All 4 sides are zipped, and the mesh sides are easy for the patient to see out of, even when he/she wants to watch TV. Most patients who have been ordered the enclosure bed have had a history or at the time of the order, have shown some way of harming himself/herself or others. These patients are usually hip/leg fx patients, demented patients, and patients who have no one (staff, family or friend) to stay one-on-one to observe him/her. Patients' reactions to the enclosure bed vary. Many dementia patients are in different levels of confusion (crying, screaming, calm). My experience has been that the crying and calm patients accept the bed as a comfort zone. The screaming patients take a while longer to adjust. Our main goal when a patient is restrained in the enclosure bed is to continue assess orientation, to educate the patient and family on criteria to d/c the bed. Once the patient is compliant with the criteria and has shown that he/she is safe from falling (or the cause of the bed being ordered in the first place) one side is left open while someone is in the room, progressed to one side open at all times (which ends the restraint order). Posey vests are usually used while patients are in wheelchairs to prevent the patient from falling out of the wheelchair or self-ambulating. Wrist restraints are rarely used on our unit, unless the patient attempts to remove a Peg Tube or NG Tube or IV line. Trudy RN Baton Rouge