Restraints and JCAHO standards

[fsaav]

I've searched JCAHO's website and unless I'm completely missing something I haven't been able to find information about restraints. I'm specifically looking for what documentation is required to meet JCAHO's standards for restraints.

Thanks for any help you can give me.

[cardiacmadeline, RN]

This is off the top of my head, I could be missing something, but this is what we must document when we use restraints. I am assuming these are JCAHO standards.

There must be an order for the restraints within the last 24 hours (it cannot be a prn order)

Must have CMS and ROM every 1-2 hours, also that toileting was offered (I can't remember if it is one or two, maybe someone else knows for sure?)

Attempted alternatives to restraints must be documented

Type of restraint and the reason for the restraint

We don't use restraints very much so this is all I can remember right now, but I have a feeling there may be more that needs to be documented. My brain just can't think of everything right now :)

[marineswife0809]

restraints are prohibited unless its an doctors order. full bed rails on both side ups can be considered a restraint also......this the info i know. hope it helps a little

[marineswife0809]

Go to http://www.ombuddy.org/InfoSheet/restraints.htm

[classicdame, MSN, EdD]

always a safety issue for patient - never a convenience issue for staff

[Boog'sCRRN246, RN]

Emergency restraints can be initiated w/o a MD order, but an order must be obtained within one hour of initiation. Orders must be reissued q4 hours for adults, q2 hours for children/adolescents, and q1 hour for children under 9yo. An in-person evaluation must be done by the MD within 4 hours of initiating restraints. I believe JCAHO allows restraints to be written into hospital policies when it is a matter of med-surg restraints (intubated patients, etc.) vs. behavioral restraints.

[kimmie518]

That frequency you just mentioned is for the mental health patient.

I can speak firmly to the medical side. Restraints have to be reissued every 24 hours- not 24.5 hours, 24, although they can be sooner. Emergancy restraints can be placed but the physican must complete a physical assessment within 1 hour. Every 2 hours, circulation checks, food/fluids and tolieting have to be offered, and reevaulated for d/c of restraint. I know in our facility we also have to complete q 2 hour vitals for restraints but I'm not sure if thats us or JCAHO.