1 Alternatives to Restraints and Safe Use of Restraints Geriatric Aide Curriculum NC Division of Health Service Regulation Module 7

2 Alternatives to Restraints and Safe Use of Restraints Alternatives to Restraints and Safe Use of Restraints Objectives 1. Distinguish between myths and facts about physical restraints. 2. Define physical and chemical restraints. 3. Relate the use of restraints to federal and state laws. 4. State when restraints may be used.

3 Alternatives to Restraints and Safe Use of Restraints Alternatives to Restraints and Safe Use of Restraints Objectives 5. Discuss the role of the nurse aide and the family during care planning. 6. Describe the risks and side effects of using restraints. 7. Describe the benefits of being restraint free.

4 Alternatives to Restraints and Safe Use of Restraints Alternatives to Restraints and Safe Use of Restraints Objectives 8. Discuss alternatives to restraints. 9. Recognize different forms of restraints. 10. Demonstrate how to apply and monitor residents using selected physical restraints.

5 Alternatives to Restraints and Safe Use of Restraints Many long term care and other facilities are reducing and/or eliminating the use of physical and chemical restraints. Nurse aides play an important role in reducing and/or eliminating restraints.

6 Alternatives to Restraints and Safe Use of Restraints

7 A physical restraint is any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the resident cannot remove easily which restricts freedom of movement or normal access to one's body.

8 Alternatives to Restraints and Safe Use of Restraints The use of restraints is governed by federal and state law. Restraints require a written physician order.

9 Alternatives to Restraints and Safe Use of Restraints Restraints are to be used only when there is a medical need and only if the restraint is the last alternative to keep the resident and/or care team members safe.

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11 Benefits to Resident-Centered Care and Freedom From Restraints Examples: –Better quality of life –Dignity –Less depression –Increased motivation –Fewer skin tears –Less muscle loss –Lower care costs –Improved appetite –Improved hydration

12 Alternatives to Restraints and Safe Use of Restraints Know the resident –Know resident’s condition and capabilities –Ask family about resident’s past, likes and dislikes. –Share information with nurse or during care planning

13 Alternatives to Restraints and Safe Use of Restraints Successful use of restraint alternatives requires: –Total care team involvement –Care planning –Resident centered care –Shift in thinking by caregivers

14 Alternatives to Restraints and Safe Use of Restraints Care planning includes: –Physical, emotional, mental, social and spiritual assessment of whole person –Screening for fall risks and behavioral symptoms –Needs and desires of resident –Discussion of assessments/resident –How to adapt environment to resident

15 Alternatives to Restraints and Safe Use of Restraints People’s behaviors are an attempt to communicate. Base restraint alternative on reason for behavior.

16 Alternatives to Restraints and Safe Use of Restraints Use activities boxes for residents who wander or are agitated. Activities boxes can be purchased or assembled by the facility. The activities therapist can give some direction about items to put in boxes.

17 Safe Use of Restraints Restraints require a doctor’s order and must be used only to treat a medical condition. Never use restraints: –As a permanent means of control –As a form of punishment –For the convenience of the staff –As a substitute for activities or treatments

18 Safe Use of Restraints Review definition of physical restraint: A physical restraint is any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the resident cannot remove easily which restricts freedom of movement or normal access to one's body.

19 Safe Use of Restraints Nurse aides have the most influence to prevent incidents related to restraints by: –correctly applying devices, and –adequately monitoring residents when restrained.

20 Safe Use of Restraints Monitor residents by checking circulation every 15 minutes and removing the restraint every 2 hours for the meeting of basic needs and repositioning Restraints should be a temporary solution to a situation

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