simultaneous restraint & seclusion...help!

Posted
by lillyt899 lillyt899 (New) New

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

Specializes in Leadership, Psych, HomeCare, Amb. Care. Has 30 years experience. 2,589 Posts

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.

Edited by MrChicagoRN

nurse lala, BSN, RN

Specializes in Psych. Violence & Suicide prevention.. Has 44 years experience. 110 Posts

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.

SarahMaria

SarahMaria, MSN, RN

Specializes in Psychiatry, Forensics, Addictions. Has 10 years experience. 300 Posts

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

MagnumRN

MagnumRN, BSN

Specializes in PMH. Has 30 years experience. 13 Posts

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.

SarahMaria

SarahMaria, MSN, RN

Specializes in Psychiatry, Forensics, Addictions. Has 10 years experience. 300 Posts

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

EKUGRAD

EKUGRAD, BSN, MSN, RN, CNS

Specializes in Psychiatric / Forensic Nursing. Has 47 years experience. 70 Posts

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

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 41 years experience. 4,295 Posts

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.