simultaneous restraint & seclusion...help!

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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.

MrChicagoRN, RN

2,589 Posts

Specializes in Leadership, Psych, HomeCare, Amb. Care. Has 30 years experience.

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.

Specializes in Psych. Violence & Suicide prevention.. Has 45 years experience.

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.

Specializes in Psychiatry, Forensics, Addictions. Has 11 years experience.

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

MagnumRN, BSN

13 Posts

Specializes in PMH. Has 30 years experience.

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.

Specializes in Psychiatry, Forensics, Addictions. Has 11 years experience.

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

Specializes in Psychiatric / Forensic Nursing. Has 48 years experience.

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

TriciaJ, RN

4,295 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 42 years experience.
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.