simultaneous restraint & seclusion...help!

Published

Hi!

Wondering how this is handled--if a pt is in 4 pts and is screaming, is it ok to shut the door to the room they are restrained in (with staff monitoring of course)? I read that you cannot have restraint and seclusion occuring simultaneously, so I am confused about this.

Up Vote Up Vote ×
Specializes in Leadership, Psych, HomeCare, Amb. Care.

Where did you read this?

And why is the patient screaming?

A person in restraints requires continuous observation. Audio & visual equipment, or direct observation.

if you lock the door, and the patient would be unable to leave the room if they got out of restraints, then you would have restraints and seclusion simultaneously, and your orders would reflect this. This is according to an accreditation consultant that we used a few years.

Up Vote Up Vote ×
Specializes in Psych. Violence & Suicide prevention..

Restraints and seclusion can be accomplished with a closed door as long as staff can see the patient. Seems a closed door is indicated for a screamer, but I would consider medication management as well.

Up Vote Up Vote ×
Specializes in Psychiatry, Forensics, Addictions.

In your state, is a closed door considered seclusion? If that is an issue, just leave the door slightly ajar.

Up Vote Up Vote ×
Specializes in PMH.

A person in restraints is quite vulnerable. If the person in restraints is being remotely monitored (video monitor and intercom at nurses station) I would hope that the door to the room is locked for the patient's protection.

Up Vote Up Vote ×
Specializes in Psychiatry, Forensics, Addictions.

In my state, we aren't allowed to remotely monitor a restrained patient. They must be on a C/O.

Up Vote Up Vote ×
Specializes in Psychiatric / Forensic Nursing.

Seclusion is only defined if the person is physically prevented from leaving a space they would otherwise be able to leave.

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
A person in restraints is quite vulnerable. If the person in restraints is being remotely monitored (video monitor and intercom at nurses station) I would hope that the door to the room is locked for the patient's protection.

Yes, where I used to work, restraints required a locked door for the patient's own protection. We observed using monitors in the nursing station. Of course, that was many years ago before JCAHO changed the rules.

I still wouldn't leave a restrained patient unattended in an unlocked room.

Up Vote Up Vote ×
+ Join the Discussion