So on our physician order form for restraint and seclusion (which we often get the order as a verbal from the Dr.) there are check boxes for "type of restraint/seclusion" and the little boxes to select for: seclusion, manual restraint, physical extremity restraints, etc. My question is, what if you initially start the patient out in locked seclusion (less restrictive measure than restraints in most cases) and then they escalate and end up needing physical restraint (extremities) as well? When you first put them in seclusion, you may very well not know that they are going to end up requiring extremity restraints as well. So, on the order, if you get a verbal for seclusion and then they end up needing extremity restraints, do you need a whole new order and have to call the Dr again? Once our psychiatrists leave, we use the hospitalist to call for restraint orders. How do you handle this in terms of your orders? I have often seen locked seclusion patients requiring physical restraints when the seclusion does not manage them.
